Patterns of adverse childhood experiences and depressive symptoms: self-esteem as a mediating mechanism.

PURPOSE: There is a growing interest in the co-occurring natures of adverse childhood experiences (ACEs) and unmeasured types of adversity. The current body of knowledge may also lack plausible mechanisms linking ACEs to mental health in young adulthood. This study aims to identify early adversity patterns using expanded ACEs items and investigate the pathway of ACEs and self-esteem to depressive symptoms in young adulthood. METHODS: Data were obtained from the National Longitudinal Study of Adolescent and Adult Health, including a nationally representative sample in the U.S. (N = 10,702). We identified the ACEs patterns and estimated the direct and indirect associations between ACEs and depressive symptoms through self-esteem, using a latent class analysis with a distal outcome. RESULTS: This study identified four distinct groups of ACEs that include Child Maltreatment, Household Dysfunction, Violence, and Low Adversity. The Child Maltreatment class showed a significantly higher risk of depressive symptoms compared to other ACEs groups. Self-esteem mediated the negative association of child maltreatment with depressive symptoms. The Violence class presented a significantly higher risk of depressive symptoms than Low Adversity, but no mediation of self-esteem was found. CONCLUSION: The study highlights the profound consequence of child abuse/neglect and identifies self-esteem as a plausible mediating mechanism. Researchers and practitioners should increase collaboration efforts to prevent early adversity exposures and detrimental effects on mental health.

Adverse childhood experiences (ACEs) on mental disorders in young adulthood: Latent classes and community violence exposure.

Adverse childhood experiences (ACEs) have significant impacts on mental health outcomes. There is a growing interest in expanding the scope of ACEs beyond household environments. To date, few studies examine multidimensional ACEs with community violence. This study aims to (1) identify underlying ACE classes including exposure to community violence, and (2) investigate the associations of ACE classes with mental disorders in adulthood: depression, anxiety, and Post-Traumatic Stress Disorder (PTSD). We employed Latent Class Analysis (LCA) and logistic regression analyses using the data from the National Longitudinal Study of Adolescent and Adult Health (Add Health). The LCA identified four heterogeneous ACE classes: (1) child maltreatment (17.47%), (2) household dysfunction (14.39%), (3) community violence (5.36%), and (4) low adversity (62.79%). Three logistic analyses showed that the "child maltreatment" class was more likely to report a depression (OR = 1.56, CI = 1.26-1.92), anxiety (OR = 1.31, CI = 1.06-1.62), and PTSD (OR = 1.97, CI = 1.35-2.87) in adulthood compared to the "low adversity" class. Also, the "community violence" class was more likely to have PTSD (OR = 2.15, CI = 1.14-4.06) in adulthood, compared to the "low adversity" class. However, the "household dysfunction" class was not significantly different in all three mental disorders from the "low adversity" class. Findings supported the differences in mental disorders in young adulthood by types of exposures to ACEs. The study highlights the importance of considering types of ACEs exposure for promoting mental health of young adults.

Race and the Criminal Justice System Response to Sexual Assault: A Systematic Review.

Prior research has consistently documented that the vast majority of sexual assault cases do not progress through the criminal justice system. However, there is less agreement in prior work on how race influences case progression, resulting in a literature frequently described as "inconsistent." This systematic review examines all prior research that has included race as an independent variable in predicting the criminal justice system response to sexual assault (N = 34) in an effort to provide insight into seemingly disparate findings. We assess each study for the degree to which race was a focal point of interest, if and what theory was used to inform the investigation of race, how samples were drawn, and how and whose race was measured. Results illustrate that findings in prior research are not inconsistent, but rather unite to tell a nuanced story of the role of race in the criminal justice system response to sexual assault. The review demonstrates how decisions made by researchers throughout the research process can have significant impacts on reported findings, and how such findings may be used to influence policy and practice.

A Pilot Randomized Trial of an Intervention to Enhance the Health-Promoting Effects of Older Adults' Activity Portfolios: The Engaged4Life Program.

The purpose of this study was to evaluate the feasibility and outcomes of the Engaged4Life program, an intervention to encourage inactive community-dwelling older adults to embed physical activity, cognitive activity, and social interaction into their everyday lives in contexts that are personally meaningful and natural for them. Fifteen participants were randomized to the intervention group (technology-assisted self-monitoring of daily activity via pedometers and daily tablet-based surveys; psychoeducation + goal-setting via a 3-hour workshop; and peer mentoring via phone 2×/week for 2.5 weeks) and 15 to the control (technology-assisted self-monitoring only). Recruitment was shown to be feasible and efficient, but not able to reach the target for men. Retention rate was 83% and participants manifested high adherence and engagement with the intervention. Though this pilot trial was not powered to demonstrate significant differences between groups, daily steps increased by 431 (11% increase) from baseline to Week 4 for the intervention (p < .05), but decreased by 458 for the control, for a net difference of 889 steps (p < .05). Findings were sustained at Week 8 (p < .01). In a future trial, difficulties in recruiting men, barriers due to the technology-intensive design, and the optimization of secondary outcome measures should be addressed.

Ixeris dentata (Thunb. Ex Thunb.) Nakai Extract Inhibits Proliferation and Induces Apoptosis in Breast Cancer Cells through Akt/NF-κB Pathways.

Ixeris dentata (Thunb. Ex Thunb.) Nakai (ID) exhibits various physiological activities, and its related plant derived-products are expected to represent promising cancer therapeutic agents. However, the anticancer effects of ID extract on breast cancer cells classified as estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) are still unknown. In this study, we investigated the anti-cancer effects and analyzed the molecular mechanism of ID extract in T47D, MCF-7 (ER-, PR-positive, HER2-negative), SK-BR-3(ER-, PR-negative, HER2-positive), and MDA-MB-231 (Triple-negative) through in vitro studies. Additionally, we examined its anti-tumor effects through in vivo studies. Our findings indicated that ID extract-induced apoptosis was mediated via various survival pathways on four breast cancer cells by identifying the factors including Bcl-2 family, phospho-Akt and phospho-nuclear factor-κB (NF-κB). Based on in vitro findings that induced apoptosis via Akt-NF-κB signaling, we investigated the effects of ID extract on mice bearing MDA-MB-231 cells. The results showed that ID extract significantly decreased MDA-MB-231 tumor volume and weight via inducing apoptosis by suppressing phospho-Akt. Overall, these results indicate that ID extract induces apoptosis through the Akt-NFκB signaling pathway in MDA-MB-231 breast cancer cells and tumors, and it may serve as a therapeutic agent for triple-negative human breast cancer.

Anticancer Effect of Fucoidan on DU-145 Prostate Cancer Cells through Inhibition of PI3K/Akt and MAPK Pathway Expression.

In this study, we showed that PI3K/Akt signaling mediates fucoidan's anticancer effects on prostate cancer cells, including suppression of proliferation. Fucoidan significantly decreased viability of DU-145 cancer cells in a concentration-dependent manner as shown by MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] assay. The drug also significantly increased chromatin condensation, which indicates apoptosis, in a concentration-dependent manner as shown by DAPI (4',6-diamidino-2-phenylindole) staining. Fucoidan increased expression of Bax, cleaved poly-ADP ribose polymerase and cleaved caspase-9, and decreased of the Bcl-2, p-Akt, p-PI3K, p-P38, and p-ERK in a concentration-dependent manner. In vivo, fucoidan (at 5 and 10 mg/kg) significantly decreased tumor volume, and increased apoptosis as assessed by the TUNEL (terminal deoxynucleotidyl transferase dUTP nick end labeling) assay, confirming the tumor inhibitory effect. The drug also increased expression of p-Akt and p-ERK as shown by immunohistochemistry staining. Therefore, fucoidan may be a promising cancer preventive medicine due to its growth inhibitory effects and induction of apoptosis in human prostate cancer cells.

The Influence of Adverse Childhood Experiences on Suicidal Behaviors in South Korea: The Mediating Effects of Depressive Symptoms and Latent Class Analysis.

This study examines the relationship between patterns of adverse childhood experiences (ACEs) and suicidal behaviors. It investigates the role of depressive symptoms as an underlying mechanism between patterns of ACEs and suicidal behaviors in South Korea. Data came from the 2012 Korean General Social Survey (KGSS), a nationally representative sample in South Korea (N = 1,048). The dependent variables included two suicidal behaviors: suicidal thoughts and a suicide plan or attempt. The independent variable was the patterns of ACEs identified using ten binary indicators of childhood adversity. The mediating variable of depressive symptoms was measured using the Korean version of the Patient Health Questionnaire-9 (PHQ-9). Covariates were also included to control for socio-demographic characteristics: age, gender, education, and household income. This study conducted a latent class analysis (LCA) to classify different patterns of ACEs and then employed path analysis to examine mediating effects of depressive symptoms in the relationship between ACEs and suicidal behavior. Among the results, three latent classes of ACEs were identified-child maltreatment, child maltreatment and family dysfunction, and low ACEs. The child maltreatment and child maltreatment and family dysfunction classes were more likely to have suicidal thoughts and to plan or attempt suicide compared to the low ACEs class. Path analysis also showed significant indirect pathways from ACEs exposure to suicidal behaviors through depressive symptoms. This evidence corroborates previous research that shows family dysfunction and child maltreatment as detrimental factors leading to depressive symptoms and suicidal behaviors. Practitioners and policy-makers should therefore consider childhood life experiences when assessing suicidal behaviors in health prevention and intervention strategies.

Prior incarceration and barriers to receipt of services among entrants to alternative to incarceration programs: a gender-based disparity.

The high levels of health and psychosocial needs among correctional populations strongly shape the well-being of the urban communities from which a large number of criminal justice-involved individuals come or to which they return. The benefits of providing services to correction-involved individuals and linking them to providers such as with alternative to incarceration (ATI) programs may be limited if they encounter difficulties accessing such services. This study identified the types of barriers that have prevented entrants into ATI programs from receiving health and psychosocial services. We then tested the association between number of prior incarcerations and number of barriers by gender. From a random sample of adults (N = 322; 83 women and 239 men) entering ATI programs in New York City, data were collected via structured interviews that elicited self-reported sociodemographics, substance use, prior incarcerations, and barriers that had actually prevented a participant from visiting or returning to a service provider. Participants reported an average of 3.0 barriers that have prevented them from receiving health and psychosocial services. The most prevalent barriers predominantly concerned service providers' inability to accommodate constraints on participants' time availability or flexibility, transportation, and money. Compared to women, men had a significantly different association that was in the adverse direction--i.e., more prior incarcerations was associated with more barriers--between prior incarcerations and encountering service barriers. Findings indicate that ATI program entrants experience many barriers that have prevented them from receiving health and/or psychosocial services. Furthermore, men with more extensive incarceration histories particularly are disadvantaged. ATI programs can improve the public health of urban communities if such programs are prepared and resourced to facilitate the receipt of services among program participants, especially men who have more extensive incarceration histories.

From Arksey and O'Malley and Beyond: Customizations to enhance a team-based, mixed approach to scoping review methodology.

This article presents a method of conducting a scoping review that synthesizes recommendations from previous literature while contributing additional customizations to enhance a team-based, mixed method approach. A form of knowledge synthesis, scoping reviews aim to describe the breadth of an existent knowledge base and inform future research, practice, and policy. Scoping review methodology has continued to evolve since the inception of the Arksey and O'Malley Framework in 2005. After examining recommendations from the body of literature on scoping review methodology and scoping reviews about scoping reviews, we found that teamwork and mixed method approaches were rarely addressed. Following the Arksey and O'Malley Framework, we discuss current recommendations within the literature, rationale for our customizations to enhance the method, and present an application of these customizations as illustrated in our companion article, "Outcomes and outputs affiliated with children's advocacy centers in the United States: A scoping review."In sum, our enhancements to the Arksey and O'Malley Framework:•Explicitly integrate qualitative and quantitative assessment of the literature following best practices in mixed methods research, and,•Integrate a team-based approach throughout all stages of the scoping review process.

Outcomes and outputs affiliated with Children's Advocacy Centers in the United States: A scoping review.

BACKGROUND: The Children's Advocacy Center (CAC) model is the predominant multidisciplinary model that responds to child sexual abuse (CSA) in the United States (US). While the CAC model has made important contributions in case coordination and referrals for specialty services, little is known about child- or family-oriented outcomes. OBJECTIVE: Explore the trends and gaps involving outcome and output measures affiliated with CACs in the US. PARTICIPANTS & SETTING: A scoping review of the literature was conducted on English language articles published between 1985-2019 that involved CACs and children less than 18 years of age. METHODS: An electronic database search using the terms "Children's Advocacy Center(s)," "Child Advocacy Center(s)," and "CAC(s)" identified titles and abstracts. Data from articles selected for full text review were evaluated by a multidisciplinary team using a mixed methods approach. RESULTS: Measures of CAC impact frequently focus on service and programmatic outputs with person-centered outcomes left often reported. The most prevalent output measures related to case prosecution and forensic interviews. Person-centered outcomes most commonly emphasized child mental health and caregiver satisfaction. The majority of articles were limited by weak or unspecified study designs. CONCLUSION: The current literature on CACs suggests that while they are successful in coordinating services and facilitating referrals, little is known about how engagement with CACs impacts short- and long-term outcomes for children and families. Further research beyond cross sectional or quasi-experimental designs is necessary to better understand how variability in CAC structure, function, and resources can be optimized to meet the needs of the diverse communities that they serve. This is especially salient given the national dissemination of the CAC model. Without such additional studies, knowledge will remain limited regarding the enduring impacts of CACs on the lives of those impacted by CSA.