Medical research on "adverse childhood experiences" (ACEs) reveals a compelling relationship between the extent of childhood adversity, adult health risk behaviors, and principal causes of death in the United States. This article provides a selective review of the ACE Study and related social science research to describe how effective social work practice that prevents ACEs and mobilizes resilience and recovery from childhood adversity could support the achievement of national health policy goals. This article applies a biopsychosocial perspective, with an emphasis on mind-body coping processes to demonstrate that social work responses to adverse childhood experiences may contribute to improvement in overall health. Consistent with this framework, the article sets forth prevention and intervention response strategies with individuals, families, communities, and the larger society. Economic research on human capital development is reviewed that suggests significant cost savings may result from effective implementation of these strategies.
This introduction to the themed issue overviews of the Adverse Childhood Experiences (ACE) Study and discusses prevention and intervention with ACE and their consequences in communities. A commentary by Dr. Robert Anda, an ACE Study Co-Principal Investigator, is incorporated within this introduction. Implications of articles within the issue are addressed, and next steps are explored.
BackgroundThe etiology of pre-eclampsia (PE) is not yet fully understood, though current literature indicates an upregulation of inflammatory mediators produced by the placenta as a potential causal mechanism. Vitamin D is known to have anti-inflammatory properties and there is evidence of an inverse relationship between dietary calcium intake and the incidence of PE. Evidence of the role of vitamin D status and supplementation in the etiology and prevention of PE is reviewed in this article along with identification of research gaps to inform future studies.MethodsWe conducted a structured literature search using MEDLINE electronic databases to identify published studies until February 2015. These sources were retrieved, collected, indexed, and assessed for availability of pregnancy-related data on PE and vitamin D.ResultsSeveral case-control studies and cross-sectional studies have shown an association between vitamin D status and PE, although evidence has been inconsistent. Clinical trials to date have been unable to show an independent effect of vitamin D supplementation in preventing PE.ConclusionsThe included clinical trials do not show an independent effect of vitamin D supplementation in preventing PE; however, issues with dose, timing, and duration of supplementation have not been completely addressed.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-017-1408-3) contains supplementary material, which is available to authorized users.
Despite increasing evidence in the public health field about the prevalence of adverse childhood experiences (ACEs) in the general population, little is known about the prevalence of ACEs among social service providers. Trauma backgrounds may influence both worker susceptibility to vicarious traumatization as well as clinical decision making. Similarly, individuals with trauma backgrounds are vulnerable to re-enactment of their history. With pressure on social service agencies to demonstrate successful client outcomes, it is critical that agencies explore factors that influence high-quality care. This exploratory study is the first investigation of ACE prevalence among workers in an agency that provides residential treatment, day treatment, and schooling for children with histories of trauma. Study results suggest a high prevalence of ACEs among these workers.
Recognizing that spiritual needs often emerge in health care settings, the Joint Commission requires spiritual assessments in numerous organizations frequented by older adults. Given that many gerontological practitioners have received little training in identifying spiritual needs, a qualitative meta-synthesis (N = 9 studies) was conducted to identify and describe older adults' perceptions of their spiritual needs in health care settings. Five interrelated categories emerged: (a) spiritual practices; (b) relationship with God; (c) hope, meaning, and purpose; (d) interpersonal connection; and (e) professional staff interactions. The implications of the findings are discussed as they inform the spiritual assessment process.
this study examines categories of adverse childhood experiences (aCes) and service use backgrounds among a convenience sample of people experiencing homelessness (N = 224), using logistic regression analysis (n = 174) and descriptive and comparative analyses. eighty-seven percent reported at least 1 of 10 aCes prior to age 18. over half (53.2%) reported 4 or more aCes. approximately half reported parental loss, emotional neglect, living with a substance abuser, and emotional abuse. aCes were significantly correlated with one another. among those who used prior services, aCes predicted interpersonal prevention, clinical, and criminal justice services for emotional or substance abuse problems. most indicated services were helpful. this study provides data for policy and program leaders to ensure at-risk families and communities have access to responsive services.
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