Commercial sexual exploitation of children has emerged as a critical issue within child welfare, but little is currently known about this population or effective treatment approaches to address their unique needs. Children in foster care and runaways are reported to be vulnerable to exploitation because they frequently have unmet needs for family relationships, and they have had inadequate supervision and histories of trauma of which traffickers take advantage. The current article presents data on the demographic characteristics, trauma history, mental and behavioral health needs, physical health needs, and strengths collected on a sample of 87 commercially sexually exploited youth. These youth were served in a specialized treatment program in Miami-Dade County, Florida, for exploited youth involved with the child welfare system. Findings revealed that the youth in this study have high rates of previous sexual abuse (86% of the youth) and other traumatic experiences prior to their exploitation. Youth also exhibited considerable mental and behavioral health needs. Given that few programs emphasize the unique needs of children who have been sexually exploited, recommendations are offered for providing a continuum of specialized housing and treatment services to meet the needs of sexually exploited youth, based on the authors' experiences working with this population.
Behavioral management services should be considered for inclusion in covered plans. Further research addressing the mechanisms of effect and specific populations, particularly at the school level, will assist in bolstering the evidence base for this important category of clinical intervention.
Aim
SEARCH has recently reported that both prevalence and incidence of youth onset type 2 diabetes (YT2D) increased among most US race/ethnic groups in the early 2000s. This study reports on the incidence (2002‐2013) and prevalence (2001, 2009) of YT2D in the Navajo Nation among youth age < 20 years from 2001 to 2013.
Methods
SEARCH sought to identify prevalent YT2D cases in 2001 (N = 75) and 2009 (N = 70) and all incident YT2D cases in three periods: 2002 to 2005 (N = 53), 2006 to 2009 (N = 68), and 2010 2013 (N = 90) in Navajo Nation. Denominators were based on the active Indian Health Service user population for eligible health care facilities. Prevalence (per 100 000) and period‐specific incidence rates (per 100 000 person‐years) were computed for youth aged 10 to 19 years. Changes in prevalence were tested with a two‐sided skew‐corrected inverted score test, while changes in incidence were tested with Poisson regression.
Results
YT2D prevalence was high but stable in 2001 and 2009, overall [146.6 (116.8, 184.0) vs 141.5 (112.0, 178.8), P = .65) and in all subgroups. In contrast, incidence rates increased particularly between the second and third periods overall and in most subgroups by age and by sex.
Conclusions
These data confirm the high burden of YT2D among Navajo youth and suggest an increasing risk in more recent years. However, recent improvements in obesity reduction in this population demonstrate optimism for potential reductions in YT2D in Navajo Nation.
Cardiometabolic diseases and disorders continue to be the most significant and leading causes of morbidity and mortality in the United States, as well as globally. Among the cardiometabolic disorders, cardiovascular diseases (CVDs) have the greatest prevalence; other cardiometabolic disorders closely related to CVDs such as diabetes mellitus and Metabolic Syndrome (MetS) continue to contribute to the public health burden as well. Common risks for cardiometabolic disorders include biological (i.e. genetic predisposition, race, age, gender), demographic (socioeconomic status), dietary (dietary intake), behavioral (e.g., physical activity) and environmental (e.g., obesogenic, atherogenic, carcinogenic environments) characteristics. Paradoxically, dietary risk is both the most modifiable and least modifiable risk for certain diseases, as other modifiable and non-modifiable characteristics act in synergy to influence dietary intake. Although many inconclusive and conflicting research findings exist, the benefits of consuming a high quality diet are consistently valued and the role of diet in safeguarding cardiometabolic health cannot be underestimated. Diets rich in whole grains, non-starchy vegetables, and fruits, moderate in processed foods and refined grains, and consequently lower omega-6 to omega-3 fatty acid ratios appear to offer the greatest potential benefit. This mini review briefly summarizes the implications of diet and nutritional intake to cardiometabolic health.
State agencies play a critical role in addressing the mental health needs of children and youth. Significant changes underway throughout the nation at the federal and state levels have led to questions about the role of state children's mental health (CMH) agencies and the effects of these changes on children's services. The purpose of this study was to examine the current status of state offices for CMH with regard to structure and responsibilities and to identify what state CMH directors express as opportunities and challenges for CMH at the state level. CMH directors or their representatives from 46 states, 1 US territory, and D.C. completed an online survey developed to address the specific aims of this study. Findings highlight the importance of a strong state structure to support CMH and opportunities for reform and system change, particularly related to the Affordable Care Act and expansion of Systems of Care.
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