Adverse Childhood Experiences and Diabetes in Adulthood: Support for a Collaborative Approach to Primary Care

Prior studies have demonstrated an association between retrospective reports of experiencing trauma in childhood and the current incidence of type 2 diabetes in adulthood. Much less is known about this association among low-income minority patients in primary care settings. We replicated the adverse childhood experiences (ACEs) Centers for disease control and prevention (CDC) study with a low-income minority sample of primary care patients (N = 801) at a community-based healthcare center. We conducted a cross-sectional retrospective quantitative survey study to examine the association between participants’ reports of past childhood trauma and their current health care outcomes. Data were analyzed using binary logistic regression to evaluate the hypothesis that low income minority patients who reported more childhood trauma (abuse, neglect, household dysfunction, cumulative adverse childhood experiences [ACEs]) would more likely be diagnosed with type 2 diabetes. Results suggest that the number of ACEs in our sample were considerably higher than the original CDC ACEs study, as almost 50 % of patients surveyed at our clinic reported 4 or more ACEs, confirming that trauma is central in our urban primary care setting. The results of the cumulative ACEs score was in the expected direction and was significant, suggesting that participants who cumulatively reported experiencing more childhood trauma were more likely to be diagnosed with type 2 diabetes in adulthood. These findings have implications for family therapists, primary care providers, researchers, and policy makers to develop more collaborative approaches to primary care that better target the negative sequelae of ACEs.     

A Framework for Valuing Investments in a Nurturing Society: Opportunities for Prevention Research

Investing in strategies that aim to build a more nurturing society offers tremendous opportunities for the field of prevention science. Yet, scientists struggle to consistently take their research beyond effectiveness evaluations and actually value the impact of preventive strategies. Ultimately, it is clear that convincing policymakers to make meaningful investments in children and youth will require estimates of the fiscal impact of such strategies across public service systems. The framework offered here values such investments. First, we review current public spending on children and families. Then, we describe how to quantify and monetize the impact of preventive interventions. This includes a new measurement strategy for assessing multisystem service utilization and a price list for key service provision from public education, social services, criminal justice, health care and tax systems.     

Experiences and Perceived Effects of Rosary Praying: A Qualitative Study

Journal of Religion and Health - The aim of this study is to explore experiences and perceived effects of the Rosary on issues around health and well-being, as well as on spirituality and...     

Influence Opportunities and the Development of Argumentation Competencies in Childhood

Whether argumentation competencies are associated with the kind of influence opportunities children have in their lives is the focus of this study. The hypothesis is that when children have the opportunity to initiate and evaluate arguments, hear others make and examine arguments, and participate equally in resolving disputes, children are able to develop their argument skills. Four argumentation competencies associated with critical discussions of proposals are identified: creating consensus about problematic situations, advocating proposals, facilitating behavioral commitment, and integrating identities. Second, fourth, and sixth grade children completed tasks that assessed their influence opportunities and argument competencies. Children who perceived themselves to have many collaborative influence opportunities, that is, opportunities in which they could engage in mutual influence, had more highly developed argument competencies than children who did not have such opportunities. As predicted, this relationship occurred with the argument competencies of problem conception, proposal advocacy and facilitating commitment. Measures of non-collaborative influence opportunities were not associated with argument competencies. Together, the results suggest that discussions in which children are given the opportunity to influence and be influenced with arguments may provide the best context for children to develop their argument skills.     

Men and Menstruation: A Qualitative Exploration of Beliefs,Attitudes and Experiences

Our article presents the findings from a study exploring men’s attitudes towards and perceptions of menstruation. Using a social constructionist framework, we analyzed 48 Australian men’s written accounts in response to an anonymous online questionnaire which explored messages they received about menstruation growing up as well as their current attitudes towards, and experiences with, menstruation. Respondents were 18–69 years-old; most were Caucasian and in an intimate relationship, and they varied considerably in terms of educational attainment. Thematic analysis yielded four themes: (a) managing the stigma of menstruation, (b) talking menstruation today—open and closed communication, (c) menstruation is part of relationships, and (d) menstruation and social commentary. These findings shed light on how boys learn about menstruation and how men’s role in menstruation is constructed, emphasizing the educational, relational, and socio-political contexts in which these attitudes are created. Researchers, health care providers, and educators could use our findings to create more effective reproductive health education programs. Improving communication between parents and children may encourage a more balanced view towards menstruation, working towards reducing the stigma commonly experienced by girls and women.     

Relapse Prevention Techniques in the Treatment of Childhood Anxiety Disorders: A Case Example

Research has shown that cognitive behavioral therapy (CBT) is an efficacious treatment for children and adolescents with anxiety disorders. CBT incorporates techniques such as cognitive restructuring and exposure, which foster symptom reduction. While these components promote sustained fear reduction, greater attention to relapse prevention (RP) may be warranted, particularly given the comorbidity associated with anxiety disorders. A case example demonstrates a comprehensive relapse prevention (RP) component. Specifically, parental involvement was emphasized as well as the creation of a bound book that consolidated skills and provided a concrete resource for potential future anxious episodes.     

Experiences of Patients in Cognitive Behavioural Group Therapy: A Qualitative Study of Eating Disorders

The aim of this study was to investigate whether there was a difference in skin conductance response between 2 groups of military personnel when exposed to emotionally neutral and charged stimuli. The 2 groups were a combat experience group (n?=?10) with prior experience of emotionally charged war situations and a comparison group (n?=?10) with no such experience. Results showed that the comparison group reacted more strongly to exposure to both charged and neutral pictures than did the combat experience group, regardless of exposure time. The results are discussed in terms of emotional numbing and differences in anxiety state between the 2 groups.     

Challenges in Disseminating Model Programs: A Qualitative Analysis of the Strengthening Washington DC Families Program

This article discusses the challenges faced when a popular model program, the Strengthening Families Program, which in the past has been implemented on a smaller scale in single organizations, moves to a larger, multiorganization endeavor. On the basis of 42 interviews conducted with program staff, the results highlight two main themes that address program and organizational characteristics. The themes relate to the cultural relevance of the program, the accessibility of program partners, the organization of program services, and the coordination of program activities. The article also offers a discussion of how to better prepare sites for program delivery. This discussion focuses explicitly on the need for good communication among program partners, extensive community outreach, and the ability to secure additional resources.     

Meditation Awareness Training (MAT) for Improved Psychological Well-being: A Qualitative Examination of Participant Experiences

Mindfulness-based interventions are reported as being efficacious treatments for a variety of psychological and somatic conditions. However, concerns have arisen relating to how mindfulness is operationalized in mindfulness-based interventions and whether its ‘spiritual essence’ and full potential treatment efficacy have remained intact. This qualitative study used interpretative phenomenological analysis to examine participant experiences regarding the acceptability and effectiveness of a newly designed secularized intervention called meditation awareness training (MAT) that follows a more traditional Buddhist approach to meditation. Participants (with issues of stress and low mood) reported experiencing improvements in psychological well-being due to receiving MAT. The wider implications are discussed.     

In the Wake of Don't Ask Don't Tell: Suicide Prevention and Outreach for LGB Service Members

It is estimated that lesbian, gay, and bisexual (LGB) individuals are three to five times more likely to attempt suicide than their heterosexual counterparts. Factors linked to increased LGB suicide risk are overt and covert discrimination, internalized oppression, nondisclosure of sexual orientation, and lack of adequate social support. As the U.S. military adjusts to the repeal of Don't Ask Don't Tell (DADT), it will be imperative to understand and support service people who are struggling with many of these same issues. This article explores factors linked to suicidality and provides education for professionals working with LGB service people. Emphasis is placed on strategies for the provision of support and suicide prevention for members of this population.     

Trajectory of Adolescent Obesity: Exploring the Impact of Prenatal to Childhood Experiences

This study examined longitudinal associations of prenatal exposures as well as childhood familial experiences with obesity status from ages 10 to 18. Hierarchical generalized linear modeling was applied to examine 5,156 adolescents from the child sample of the 1979 National Longitudinal Survey of Youth. Higher maternal weight, maternal smoking during pregnancy, lower maternal education, and lack of infant breastfeeding were contributors to elevated adolescent obesity risk in early adolescence. However, maternal age, high birth weight of child, and maternal annual income exhibited long-lasting impact on obesity risk over time throughout adolescence. Additionally, childhood familial experiences were significantly related to risk of adolescent obesity. Appropriate use of family rules in the home and parental engagement in children’s daily activities lowered adolescent obesity risk, but excessive television viewing heightened adolescent obesity risk. Implementation of consistent family rules and parental engagement may benefit adolescents at risk for obesity.     

Framing Childhood Obesity: How Individualizing the Problem Affects Public Support for Prevention

Political actors recognize the power of framing problems using personalized examples and causal stories to shape public opinion. Yet little is known about how these frames interact. This research presents the results of three studies designed to investigate the effect of “individualizing” the problem of childhood obesity, in combination with information about causes of obesity, on public support for obesity prevention policies (Studies 1 and 2) and to examine how frequently the news media rely on individual depictions of obese children to portray the problem in actual news coverage (Study 3). Results from two experiments consistently demonstrated that, regardless of how the cause of childhood obesity was framed, when a news report identified an individual obese child, participants were less likely to support prevention policies than when the report described the problem in more general terms. A content analysis indicated that news articles relatively infrequently frame the problem using individualized depictions of a specific child. When specific overweight or obese children were mentioned, news coverage emphasized internal (behavioral and genetic) causes rather than factors external to the child such as neighborhood, economic, or food‐industry factors. Findings underscore the importance of considering attitudes toward a policy's target population when assessing how individual depictions of a policy problem influence public sentiment.     

Religious Experiences in Childhood and Adolescence: A Viewpoint of Religious Development Between the Ages of 7 and 20

This study clarified religious experiences of Finnish children and adolescents from two points of view: experiences of God's closeness and guidance. It was part of a larger study that covered other aspects of religiousness aside from religious experiences. Three different substudies were included: the original study, longitudinal study, and replicate study. Altogether, nearly 3,000 Finnish children and adolescents ages 7 to 20 took part in these substudies. This part of the overall study concentrated on three questions: (a) To what extent do children and adolescents of different ages have religious experiences; (b) to what external or internal contexts are their personal religious experiences related; and (c) how do these experiences relate to their other religiousness and to their gender, personality, school, and home backgrounds? The empirical bases of the study were mainly the responses of subjects to direct questions and their own reports of their experiences.     

Religion and Spirituality in the Meaning–Making and Coping Experiences of African American Women: A Qualitative Analysis

This qualitative study examines the ways in which African American women use religion/spirituality to cope and to construct meaning in times of adversity. Content analysis of the narratives of a sample of African American women respondents ( n = 23) revealed a set of eight nonoverlapping themes that explicate religiosity/spirituality's role in meaning–making and coping. Findings suggest that religion/spirituality help women to (1) interrogate and accept reality, (2) gain the insight and courage needed to engage in spiritual surrender, (3) confront and transcend limitations, (4) identify and grapple with existential questions and life lessons, (5) recognize purpose and destiny, (6) define character and act within subjectively meaningful moral principles, (7) achieve growth, and (8) trust in the viability of transcendent sources of knowledge and communication. Narrative examples are used to elucidate each theme. Findings point to the importance of relationships and intimacy in the meaning–making enterprise. Implications for theory and practice are discussed.     

Spiritual Experiences of War Veterans Who Suffer from Combat-Related Post-Traumatic Stress Disorder: A Qualitative Study

Recognition of the spiritual experiences of patients with post-traumatic stress disorder may be helpful in their rehabilitation. Accordingly, the present study has been carried out to determine the spiritual experiences of Iranian Muslim warriors who suffer from the previously mentioned disorder. In this qualitative study, 22 patients were selected using an objective-based sampling method and underwent an individual, semi-structured thorough interview. The data were analyzed using content analysis. The spiritual experiences of the participants were divided into two main categories as follows: (1) religious attitude consisting of three sub-categories known as “religious beliefs,” “religious sentiments,” and “religious behaviors” and (2) a national sensibility that includes the two sub-categories of “patriotism” and “proud” of being injured for my homeland. The analysis of the participants’ spiritual experiences showed that their specific religious orientation and feelings of nationalism assisted with their improved ability to cope with the consequences of their disorder. Therefore, it is recommended that caregivers use patients’ spiritual values to help them cope more efficiently.