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2.
Hypertension ; 77(2): 308-318, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33390043

RESUMEN

The intent of this review is to critically consider the data that support the concept of programming and its implications. Birth weight and growth trajectories during childhood are associated with cardiometabolic disease in adult life. Both extremes, low and high birth weight coupled with postnatal growth increase the early presence of cardiometabolic risk factors and vascular imprinting, crucial elements of this framework. Data coming from epigenetics, proteomics, metabolomics, and microbiota added relevant information and contribute to better understanding of mechanisms as well as development of biomarkers helping to move forward to take actions. Research has reached a stage in which sufficiently robust data calls for new initiatives focused on early life. Prevention starting early in life is likely to have a very large impact on reducing disease incidence and its associated effects at the personal, economic, and social levels.


Asunto(s)
Enfermedades Cardiovasculares/etiología , Epigénesis Genética , Enfermedades Metabólicas/etiología , Adolescente , Adulto , Experiencias Adversas de la Infancia , Envejecimiento , Peso al Nacer , Enfermedades Cardiovasculares/embriología , Sistema Cardiovascular/crecimiento & desarrollo , Niño , Preescolar , Epigenómica/métodos , Femenino , Predicción , Edad Gestacional , Humanos , Lactante , Recién Nacido de Bajo Peso , Recién Nacido , Recien Nacido Prematuro , Masculino , Enfermedades Metabólicas/embriología , Metabolómica , Microbiota , Persona de Mediana Edad , Medicina de Precisión , Embarazo , Efectos Tardíos de la Exposición Prenatal , Proteómica , Factores de Riesgo
3.
Maturitas ; 143: 209-215, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33308631

RESUMEN

OBJECTIVE: To examine the association of adverse childhood experiences (ACEs) with overall menopausal symptom burden in midlife women. STUDY DESIGN: This was a cross-sectional study of women between the ages of 40 and 65 years who were seen for specialty consultation in the Menopause and Women's Sexual Health Clinic, Mayo Clinic, Rochester, MN between May 1, 2015 and December 31, 2016. MAIN OUTCOME MEASURES: Participants completed the ACE questionnaire to assess childhood abuse and neglect, the Menopause Rating Scale (MRS) to assess menopausal symptom burden, the Patient Health Questionnaire (PHQ-9) to assess depression, the Generalized Anxiety Disorder questionnaire (GAD-7) to assess anxiety, and provided information on current abuse (physical, sexual and verbal/emotional). RESULTS: Women meeting inclusion criteria (N = 1670) had a median age of 53.7 years (interquartile range: 49.1, 58.0). Of these women, 977 (58.5 %) reported any ACE and 288 (17.2 %) reported ≥4 ACEs. As menopausal symptoms increased in severity from the first to fourth quartile, the odds ratio of ACE 1-3 (vs. 0) increased from 1 to 2.50 (trend p < 0.01), and the odds ratio of ACE ≥ 4 (vs. 0) increased from 1 to 9.61 (trend p < 0.01), a pattern that was consistent across all menopausal symptom domains. The association between severe menopausal symptoms and higher childhood adversity (ACE score 1-3 or ≥4 vs. ACE = 0) remained significant after adjusting for age, partner status, education, employment, depression, anxiety, and hormone therapy use (OR 1.84 and 4.51, p < 0.01). CONCLUSION: In this large cross-sectional study, there was a significant association between childhood adversity and self-reported menopausal symptoms that persisted even after adjustment for multiple confounders. These associations highlight the importance of screening women with bothersome menopausal symptoms for childhood adversity, and of offering appropriate management and counseling for the adverse experiences, when indicated.


Asunto(s)
Experiencias Adversas de la Infancia , Envejecimiento , Menopausia , Adulto , Anciano , Envejecimiento/fisiología , Envejecimiento/psicología , Ansiedad/epidemiología , Niño , Maltrato a los Niños , Estudios Transversales , Depresión/epidemiología , Femenino , Humanos , Menopausia/fisiología , Menopausia/psicología , Persona de Mediana Edad , Sexualidad
6.
Artículo en Inglés | MEDLINE | ID: mdl-33334020

RESUMEN

The etiology of "dual harm" (the co-occurrence of self-harm and externalized violence in the same individual) is under-researched. Risk factors have mostly been investigated for each behavior separately. We aimed to examine adversities experienced between birth and age 15 years among adolescents and young adults with histories of self-harm and violent criminality, with a specific focus on dual harm. Three nested case-control studies were delineated using national interlinked Danish registers; 58,409 cases in total aged 15-35 were identified: 28,956 with a history of violent criminality (but not self-harm), 25,826 with a history of self-harm (but not violent criminality), and 3987 with dual-harm history. Each case was matched by date of birth and gender to 20 controls who had not engaged in either behavior. We estimated exposure prevalence for cases versus controls for each of the three behavior groups, and incidence rate ratios (IRRs). Experiencing five or more childhood adversities was more prevalent among individuals with dual-harm history (19.3%; 95% CI 18.0, 20.8%) versus self-harm (10.9%; 10.5, 11.3%) and violence (11.4%; 11.0%, 11.8%) histories. The highest IRRs for dual harm were linked with parental unemployment (5.15; 95% CI 4.71, 5.64), parental hospitalization following self-harm (4.91; 4.40, 5.48) or assault (5.90; 5.07, 6.86), and parental violent criminality (6.11; 5.57, 6.70). Growing up in environments that are characterized by poverty, violence, and substance misuse, and experiencing multiple adversities in childhood, appear to be especially strongly linked with elevated dual-harm risk. These novel findings indicate potential etiologic pathways to dual harm.


Asunto(s)
Experiencias Adversas de la Infancia , Conducta Autodestructiva , Adolescente , Adulto , Estudios de Casos y Controles , Humanos , Factores de Riesgo , Conducta Autodestructiva/epidemiología , Violencia , Adulto Joven
7.
PLoS One ; 15(12): e0243083, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33373377

RESUMEN

Several studies have shown that child maltreatment is associated with both positive and negative effects on the recognition of facial emotions. Research has provided little evidence of a relation between maltreatment during childhood and young adults' ability to recognize facial displays of emotion in children, an essential skill for a sensitive parental response. In this study, we examined the consequences of different forms of maltreatment experienced in childhood on emotion recognition during parenthood. Participants included sixty-three mothers of children aged 2 to 5 years. Retrospective self-reports of childhood maltreatment were assessed using the short form of the Childhood Trauma Questionnaire (CTQ). Emotion recognition was measured using a morphed facial emotion identification task of all six basic emotions (anger, disgust, fear, happiness, sadness, and surprise). A Path Analysis via Structural Equation Model revealed that a history of physical abuse is related to a decreased ability to recognize both fear and sadness in children, whereas emotional abuse and sexual abuse are related to a decreased ability to recognize anger in children. In addition, emotional neglect is associated with an increased ability to recognize anger, whereas physical neglect is associated with less accuracy in recognizing happiness in children's facial emotional expressions. These findings have important clinical implications and expand current understanding of the consequences of childhood maltreatment on parents' ability to detect children's needs.


Asunto(s)
Experiencias Adversas de la Infancia/psicología , Reconocimiento Facial , Madres/psicología , Adulto , Preescolar , Emociones , Femenino , Humanos , Masculino , Reconocimiento en Psicología , Estudios Retrospectivos , Autoinforme , Adulto Joven
8.
Artículo en Inglés | MEDLINE | ID: mdl-33379385

RESUMEN

We investigated if adverse childhood experiences (ACEs) and ACE sub-types were associated with increased odds of planning to have children and adolescent pregnancy. The Gulf Resilience on Women's Health (GROWH) is a diverse cohort of reproductive-age women living in southeastern Louisiana during the 2010 Deepwater Horizon oil spill. In our sample of 1482 women, we used multinomial logistic regression to model odds ratios of wanting future children and assessed effect measure modification by educational attainment. We also estimated odds ratios of adolescent pregnancy with binomial logistic regression. Exposure to ACEs increased odds of wanting future children across all ACE sub-types. Among women with lower educational attainment, three or more ACEs (overall, childhood, and adolescence) had over two times the odds of wanting future children. History of ACE and the various sub-types, except for emotional abuse, were associated with increased risk of adolescent pregnancy. ACEs may be linked to adolescent pregnancy and reproductive plans, and variations by educational status highlighted social discrepancies and importance of social context in evaluation and intervention.


Asunto(s)
Experiencias Adversas de la Infancia , Embarazo en Adolescencia , Salud de la Mujer , Adolescente , Adulto , Niño , Estudios de Cohortes , Escolaridad , Femenino , Humanos , Louisiana , Embarazo , Adulto Joven
9.
Artículo en Inglés | MEDLINE | ID: mdl-33374531

RESUMEN

Alteration in cortisol response to acute social stressors has been hypothesized to mediate childhood adversities (CA) and increased morbidity in adulthood. However, the evidence supporting an association between CA and cortisol response to social stressors is inconclusive. The present review addressed this issue by reviewing the literature on CA and cortisol response to acute social stressors, with a focus on studies with adolescents or adults, using the Childhood Trauma Questionnaire (CTQ) to assess CA, and examining salivary cortisol response to the Trier Social Stress Test (TSST). Systematic searches of relevant articles in PsycINFO, PubMed, Web of Science and ScienceDirect in February and March 2020 identified 12 articles including 1196 participants with mean ages ranging from 15.3 to 52.3 yrs. across studies. CTQ scores were significantly associated with cortisol response in 2 studies. In addition, the physical abuse and emotional neglect subscales were associated with cortisol response respectively in 2 separate studies. The lack of association between CA and cortisol response calls for more longitudinal studies, and the use of formal records of maltreatment or informant reports in future research to complement information collected by retrospective measures. In addition, increased attention to biological mechanisms other than that associated with the regulation of cortisol in explaining the connection between CA and psychiatry morbidity is warranted.


Asunto(s)
Experiencias Adversas de la Infancia , Hidrocortisona/análisis , Pruebas Psicológicas , Estrés Psicológico , Adolescente , Adulto , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Saliva/química , Encuestas y Cuestionarios , Adulto Joven
11.
JAMA ; 324(17): 1788-1789, 2020 11 03.
Artículo en Inglés | MEDLINE | ID: mdl-33141203
15.
Pediatrics ; 146(4)2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32938778

RESUMEN

BACKGROUND: Involvement with Child Protective Services (CPS) provides an opportunity to recognize those children at risk for ongoing adverse childhood experiences (ACEs). The relationship between ACEs and child health among CPS-involved children and the role of primary care providers (PCPs) in moderating this relationship is unknown. METHODS: We conducted a convergent mixed-methods study of caregivers of children age 2 to 12 years with a CPS finding of physical abuse, modeling the association between cumulative ACEs and child health-related quality of life (HRQoL) using the PedsQL4.0, a validated 23-item survey of multidimensional health, with and without the moderator of a patient-centered medical home. Interviews elicited descriptions of a child's experience with ACEs, the impact of ACEs on child health, and the role of a PCP in this context. RESULTS: One hundred seventy-eight surveyed caregivers reported a mean of 5.5 (±3.3) ACE exposures per child. In a fully adjusted model, each ACE resulted in a 1.3-point (95% confidence interval: 0.7-2.0) reduction in HRQoL, a clinically important difference in HRQoL associated with ACE exposures. This association was explained by reduced psychosocial HRQoL and was not moderated by a patient-centered medical home. Twenty-seven interviewed caregivers described the influence of ACEs on a child's health. Many felt that a trusted PCP could support a child's well-being after such experiences. CONCLUSIONS: Children with CPS involvement have ACE exposures that are associated with reduced HRQoL. Although PCPs are often unaware of CPS involvement or other ACEs, many caregivers welcome the support of a child's PCP in improving child well-being after adversity.


Asunto(s)
Experiencias Adversas de la Infancia/estadística & datos numéricos , Cuidadores/psicología , Maltrato a los Niños/psicología , Salud del Niño , Servicios de Protección Infantil , Calidad de Vida/psicología , Adulto , Cuidadores/estadística & datos numéricos , Niño , Preescolar , Intervalos de Confianza , Femenino , Humanos , Masculino , Atención Dirigida al Paciente , Investigación Cualitativa , Tamaño de la Muestra
16.
PLoS One ; 15(9): e0238320, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32911529

RESUMEN

AIM: In view of the current context of poverty and socio-economic inequalities and the high and rising burdens of HIV infection and non-communicable diseases in South Africa, this study aims to describe the distribution of adverse life events (ALEs) by age and gender, and examine the socio-demographic characteristics, psychosocial coping mechanisms, risky lifestyle behaviours and family burden of HIV-related ill-health associated with ALEs in 25-74-year-old black residents of Cape Town. MATERIALS AND METHODS: In a random cross-sectional sample, 12 ALEs, tobacco and alcohol use, sense of coherence (SOC), locus of control (LOC) and impact of HIV in the family were determined by administered questionnaires. Data analyses included descriptive statistics adjusted for the realised sample. Multivariable linear regression models assessed the independent associations of increasing number of ALEs. RESULTS: Among 1099 participants, mean lifetime score of ALE categories examined was 6.1 ±2.1 (range 0-12) with men reporting significantly higher number of events compared with women (p<0.001). The most frequent ALE was the death of a loved one (88.5%) followed by a major financial crisis (81.2%) with no trend across gender or age group. In the multivariable linear regression model, increasing ALEs were significantly associated with male gender, unemployment, having spent >50% of life in urban areas, >7 years of education, problematic alcohol use and poorer psychosocial coping mechanisms defined by low SOC and LOC. All four variables pertaining to HIV-related burden of ill-health in the family were significantly associated with increasing ALEs. CONCLUSIONS: Considering that lower SOC and LOC and problem drinking were significantly linked to ALEs, policymakers need to formulate strategies that improve coping mechanisms and promote problem-solving behaviours, target the high burden of alcohol misuse and address unemployment.


Asunto(s)
Adaptación Psicológica , Experiencias Adversas de la Infancia/estadística & datos numéricos , Consumo de Bebidas Alcohólicas/epidemiología , Infecciones por VIH/complicaciones , Acontecimientos que Cambian la Vida , Fumar Tabaco/epidemiología , Población Urbana/estadística & datos numéricos , Adulto , Grupo de Ascendencia Continental Africana , Anciano , Estudios Transversales , Femenino , VIH/aislamiento & purificación , Infecciones por VIH/psicología , Infecciones por VIH/virología , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Sudáfrica/epidemiología
17.
BMC Public Health ; 20(1): 1327, 2020 Sep 10.
Artículo en Inglés | MEDLINE | ID: mdl-32907569

RESUMEN

BACKGROUND: Adversity experienced during childhood manifests deleteriously across the lifespan. This study provides updated frequency estimates of ACEs using the most comprehensive and geographically diverse sample to date. METHODS: ACEs data were collected via BRFSS (Behavioral Risk Factor Surveillance System). Data from a total of 211,376 adults across 34 states were analyzed. The ACEs survey is comprised of 8 domains: physical/emotional/sexual abuse, household mental illness, household substance use, household domestic violence, incarcerated household member, and parental separation/divorce. Frequencies were calculated for each domain and summed to derive mean ACE scores. Findings were weighted and stratified by demographic variables. Group differences were assessed by post-estimation F-tests. RESULTS: Most individuals experienced at least one ACE (57.8%) with 21.5% experiencing 3+ ACEs. F-tests showed females had significantly higher ACEs than males (1.64 to 1.46). Multiracial individuals had a significantly higher ACEs (2.39) than all other races/ethnicities, while White individuals had significantly lower mean ACE scores (1.53) than Black (1.66) or Hispanic (1.63) individuals. The 25-to-34 age group had a significantly higher mean ACE score than any other group (1.98). Generally, those with higher income/educational attainment had lower mean ACE scores than those with lower income/educational attainment. Sexual minority individuals had higher ACEs than straight individuals, with significantly higher ACEs in bisexual individuals (3.01). CONCLUSION: Findings highlight that childhood adversity is common across sociodemographic, yet higher in certain categories. Identifying at-risk populations for higher ACEs is essential to improving the health outcomes and attainment across the lifespan.


Asunto(s)
Experiencias Adversas de la Infancia/estadística & datos numéricos , Divorcio , Composición Familiar , Trastornos Mentales , Prisiones , Trastornos Relacionados con Sustancias , Violencia , Adolescente , Adulto , Afroamericanos , Anciano , Sistema de Vigilancia de Factor de Riesgo Conductual , Niño , Preescolar , Grupos Étnicos , Femenino , Hispanoamericanos , Humanos , Masculino , Persona de Mediana Edad , Padres , Factores de Riesgo , Factores Socioeconómicos , Adulto Joven
18.
PLoS One ; 15(9): e0239940, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32991598

RESUMEN

BACKGROUND: Exposure to adverse childhood experiences (ACEs) is associated with many childhood diseases and poor health outcomes in adulthood. However, the association with childhood obesity is inconsistent. We investigated the association between reported cumulative ACE score and body mass index (BMI) in a large sample of patients at a single institution. METHODS: This cross-sectional study included children aged 2-20 years that were screened in a general pediatrics clinic for ACEs utilizing the Center for Youth Wellness ACEs questionnaire between July 2017 and July 2018. Overall ACE score was categorized as 'no exposure' (score = 0), 'low exposure' (score = 1), and 'high exposure' (score≥ 2). BMI was categorized as overweight/obese (BMI percentile ≥ 85) or non-obese (BMI percentile < 85). The association between ACEs score and obesity was determined using univariate and multivariable logistic regression. RESULTS: Of the 948 patients included in the study, 30% (n = 314) were overweight/obese and 53% (n = 504) had no ACE exposure, 19% (n = 179) had low ACE exposure, and 28% (n = 265) had high ACE exposure. High ACE exposure was associated with increased odds of obesity (OR = 1.47, 95%CI = 1.07-2.03, p = 0.026). However, after adjusting for age, race/ethnicity, insurance type, and birth weight, the association attenuated and was null (OR = 1.01, 95%CI = 0.70-1.46, p = 0.97). CONCLUSION: The study findings may suggest an association between ACE and childhood obesity. However, the association attenuated after adjusting for age, race/ethnicity, insurance type, and birth weight. Larger prospective studies are warranted to better understand the association.


Asunto(s)
Experiencias Adversas de la Infancia/estadística & datos numéricos , Obesidad Pediátrica/epidemiología , Adolescente , Niño , Preescolar , Femenino , Humanos , Masculino , Obesidad Pediátrica/psicología , Factores Socioeconómicos , Adulto Joven
19.
Pediatr. aten. prim ; 22(87): 273-281, jul.-sept. 2020. ilus, tab, graf
Artículo en Español | IBECS | ID: ibc-194299

RESUMEN

INTRODUCCIÓN: los niños muestran sentimientos y vivencias que no saben o no se atreven a expresar y que se pueden conocer a través de sus dibujos e imaginación. La Asociación Española de Pediatría de Atención Primaria (AEPap) se ha propuesto conocer cómo han vivido los niños el confinamiento. MATERIAL Y MÉTODOS: se ha organizado un concurso en la página web Familia y Salud. Sujetos: niños o niñas de todo el territorio nacional con edades comprendidas entre los 3 y 16 años. Trabajos: dibujos, cuentos y vídeos breves. RESULTADOS: hemos recibido 53 trabajos procedentes de diferentes comunidades autónomas y entregado cinco premios. Los elementos que más se repiten son: el coronavirus, figuras de niños dentro de las casas, el arco iris entre las nubes y los sanitarios. El aburrimiento, la tristeza de no poder ver a abuelos y amigos, la confianza en los sanitarios, la valoración positiva del cambio de vida en la familia, la mejora en la contaminación ambiental y el mensaje positivo de que todo va a salir bien son algunos de los temas expresados. CONCLUSIONES: los resultados obtenidos en el presente estudio denotan optimismo en general, y permiten concluir que los dibujos, los relatos y los vídeos son herramientas útiles para analizar la percepción de esta población ante situaciones de riesgo. Además, destaca el interés de los pediatras de Atención Primaria por conocer cómo han vivido los niños el confinamiento a causa de la infección por coronavirus y crear la inquietud de que el dibujo infantil debe ser estudiado de manera rigurosa


INTRODUCTION: children have feelings and experiences that they cannot or will not express and that may manifest through their drawings and imagination. The Asociación Española de Pediatría de Atención Primaria (Spanish Association of Primary Care Pediatrics, AEPap) wanted to explore how children have experienced the confinement. MATERIAL AND METHODS: we organized a contest through the Family and Health website. The study population consisted of children residing anywhere in Spain aged 3 to 16 years. The works submitted were drawings, micro stories or micro videos. RESULTS: we received 53 works from children in different autonomous communities and gave 5 awards. The elements featured most frequently were the coronavirus, figures of children indoors, a rainbow in the clouds and health care professionals. Some of the subjects expressed in the works were boredom, missing grandparents and friends, trust in health care professionals, a positive perception of the change in life in the family, the improvement in environmental pollution and a positive view that everything will turn out well. CONCLUSIONS: the results obtained in this study suggest a generalized optimism and allow us to conclude that drawings, stories and videos are a useful tool to analyze the perception of this population in risk situations. We also ought to highlight the interest of primary care paediatricians in how children have experienced the confinement imposed due to the coronavirus pandemic and raise awareness that children's drawings should be carefully studied


Asunto(s)
Humanos , Masculino , Femenino , Preescolar , Niño , Adolescente , Cuarentena/psicología , Infecciones por Coronavirus/psicología , Terapia Narrativa/métodos , Trastornos de la Conducta Infantil/psicología , Pinturas/psicología , Experiencias Adversas de la Infancia , Factores de Riesgo , Atención Primaria de Salud/organización & administración
20.
Pediatrics ; 146(3)2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32747472

RESUMEN

BACKGROUND AND OBJECTIVES: Little is known about the 2% of US children being raised by their grandparents. We sought to characterize and compare grandparent- and parent-headed households with respect to adverse childhood experiences (ACEs), child temperament, attention-deficit/hyperactivity disorder (ADHD), and caregiver aggravation and coping. METHODS: Using a combined data set of children ages 3 to 17 from the 2016, 2017, and 2018 National Survey of Children's Health, we applied survey regression procedures, adjusted for sociodemographic confounders, to compare grandparent- and parent-headed households on composite and single-item outcome measures of ACEs; ADHD; preschool inattention and restlessness; child temperament; and caregiver aggravation, coping, support, and interactions with children. RESULTS: Among 80 646 households (2407 grandparent-headed, 78 239 parent-headed), children in grandparent-headed households experienced more ACEs (ß = 1.22, 95% confidence interval [CI]: 1.07 to 1.38). Preschool-aged and school-aged children in grandparent-headed households were more likely to have ADHD (adjusted odds ratio = 4.29, 95% CI: 2.22 to 8.28; adjusted odds ratio = 1.72, 95% CI: 1.34 to 2.20). School-aged children in these households had poorer temperament (ßadj = .25, 95% CI: -0.63 to 1.14), and their caregivers experienced greater aggravation (ßadj = .29, 95% CI: 0.08 to 0.49). However, these differences were not detected after excluding children with ADHD from the sample. No differences were noted between grandparent- and parent-headed households for caregiver coping, emotional support, or interactions with children. CONCLUSIONS: Despite caring for children with greater developmental problems and poorer temperaments, grandparent caregivers seem to cope with parenting about as well as parents.


Asunto(s)
Experiencias Adversas de la Infancia/estadística & datos numéricos , Salud de la Familia , Abuelos/psicología , Responsabilidad Parental/psicología , Padres/psicología , Adaptación Psicológica , Adolescente , Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Niño , Preescolar , Intervalos de Confianza , Estudios Transversales , Escolaridad , Femenino , Abuelos/educación , Estado de Salud , Humanos , Masculino , Oportunidad Relativa , Evaluación de Resultado en la Atención de Salud , Relaciones Padres-Hijo , Padres/educación , Agitación Psicomotora/epidemiología , Familia de Padres Solteros/psicología , Familia de Padres Solteros/estadística & datos numéricos , Apoyo Social , Temperamento
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