Child Maltreatment and the Child Welfare System as Environmental Factors in the International Classification of Functioning

The WHO defines child maltreatment as any form of neglect, exploitation, and physical, emotional, or sexual abuse, committed against children under the age of 18. Youth involved in the child welfare system report more maltreatment experiences and environmental turbulence (e.g., number of moves, caseworkers), placing them at greater risk for poorer physical and mental health. The International Classification of Functioning, Disability, and Health (ICF) provides a framework to describe health conditions and severity of disabilities for an individual and/or group in the context of environmental factors. The Maltreatment and Adolescent Pathways (MAP) study is a longitudinal study, assessing self-reports on variables (e.g., child maltreatment history, trauma symptoms, dating violence, and substance use) of youth in an urban child protection service system. This study focuses on 11 of the 24 MAP publications that pertain to health and functioning, which can be considered applicable to the ICF framework, following established linking rules. The purpose of this study is to analyze these MAP sub-studies, with maltreatment and involvement in the child welfare system as environmental factors that impact the functioning of child welfare-involved youth. Findings indicate significant relationships across environmental factors (i.e., child maltreatment histories, child welfare system involvement), health conditions (i.e., trauma symptomatology, psychological distress, intellectual disabilities), and functioning problems (i.e., substance use, adolescent dating violence, sexual risk-taking, coping motives, sleep problems). The interrelated nature of these factors in the MAP sub-studies suggests the value of the ICF model to a holistic health view of use to practitioners supporting system-involved youth, clarifying unattended environmental factors in guiding service provision for foster care and/or maltreated youth.

The Autism Phenome Project: Toward Identifying Clinically Meaningful Subgroups of Autism

One of the most universally accepted facts about autism is that it is heterogenous. Individuals diagnosed with autism spectrum disorder have a wide range of behavioral presentations and a variety of co-occurring medical and mental health conditions. The identification of more homogenous subgroups is likely to lead to a better understanding of etiologies as well as more targeted interventions and treatments. In 2006, we initiated the UC Davis MIND Institute Autism Phenome Project (APP) with the overarching goal of identifying clinically meaningful subtypes of autism. This ongoing longitudinal multidisciplinary study now includes over 400 children and involves comprehensive medical, behavioral, and neuroimaging assessments from early childhood through adolescence (2–19 years of age). We have employed several strategies to identify sub-populations within autistic individuals: subgrouping by neural, biological, behavioral or clinical characteristics as well as by developmental trajectories. In this Mini Review, we summarize findings to date from the APP cohort and describe progress made toward identifying meaningful subgroups of autism.

The impact of concealable chronic health conditions on college students’ academic outcomes: A two-wave study

College students ( N = 125) with concealable chronic health conditions (CCHCs) completed online surveys at the beginning and end of the semester assessing stigma experiences and academic outcomes. Correlations showed stigma, alienation, and lack of campus fit were associated with greater illness-related academic interference ( ps < 0.001), negative academic self-comparison ( ps < 0.001), academic anxiety ( ps < 0.001), academic dissatisfaction ( ps < 0.001), and lower expected grades (except alienation; ps < 0.001–0.03) over time. Hierarchical multiple regressions identified a lack of campus fit as an important predictor across academic outcomes ( ps < 0.001–0.019). Students with CCHCs face health- and stigma-related challenges that can interfere with academic performance.

Exercise, Diet and Sleeping as Regenerative Medicine Adjuvants: Obesity and Ageing as Illustrations

Regenerative medicine uses the biological and medical knowledge on how the cells and tissue regenerate and evolve in order to develop novel therapies. Health conditions such as ageing, obesity and cancer lead to an impaired regeneration ability. Exercise, diet choices and sleeping pattern have significant impacts on regeneration biology via diverse pathways including reducing the inflammatory and oxidative components. Thus, exercise, diet and sleeping management can be optimized towards therapeutic applications in regenerative medicine. It could allow to prevent degeneration, optimize the biological regeneration and also provide adjuvants for regenerative medicine.

Emergency department utilization for substance use disorders and mental health conditions during COVID-19

Background As the emergency department (ED) has evolved into the de-facto site of care for a variety of substance use disorder (SUD) presentations, trends in ED utilization are an essential public health surveillance tool. Changes in ED visit patterns during the COVID-19 pandemic may reflect changes in access to outpatient treatment, changes in SUD incidence, or the unintended effects of public policy to mitigate COVID-19. We use a national emergency medicine registry to describe and characterize trends in ED visitation for SUDs since 2019. Methods We included all ED visits identified in a national emergency medicine clinical quality registry, which included 174 sites across 33 states with data from January 2019 through June 2021. We defined SUD using ED visit diagnosis codes including: opioid overdose and opioid use disorder (OUD), alcohol use disorders (AUD), and other SUD. To characterize changes in ED utilization, we plotted the 3-week moving average ratio of visit counts in 2020 and 2021 as compared to visit counts in 2019. Findings While overall ED visits declined in the early pandemic period and had not returned to 2019 baseline by June 2021, ED visit counts for SUD demonstrated smaller declines in March and April of 2020, so that the proportion of overall ED visits that were for SUD increased. Furthermore, in the second half of 2020, ED visits for SUD returned to baseline, and increased above baseline for OUD ever since May 2020. Conclusions We observe distinct patterns in ED visitation for SUDs over the course of the COVID-19 pandemic, particularly for OUD for which ED visitation barely declined and now exceeds previous baselines. These trends likely demonstrate the essential role of hospital-based EDs in providing 24/7/365 care for people with SUDs and mental health conditions. Allocation of resources must be directed towards the ED as a de-facto safety net for populations in crisis.

Pre-Colombian Mesoamerica Childhoods

Research on pre-Columbian childhood refers to all those studies that consider the different evidence and expressions of children in Mesoamerica, prior to the Spanish invasion in the 16th century. Archaeology, understandably by its very focus, has been one of the most prolific disciplines that has approached this subject of study. Currently, archaeological research focuses on highlighting the different social experiences of the past (or multi-vocality) of social identities, such as gender and childhood, and its relationship with material culture. In addition, archaeologists recognize a modern stereotype that considers children as passive or dependent beings and therefore biases childhood research in the past. Consequently, it is necessary to critically evaluate the cultural specificity of past childhood since each culture has its own way of considering that stage of the life cycle. Another problem, in the archaeological study of childhood, is to consider that children are not socially important individuals. It has been said that their activities are not significant for the economy or the social realm of communities and societies of the past. From archaeology, there exists a general perception that children are virtually unrecognizable from the archaeological record because their behavior leaves few material traces, apart from child burials. It has been since feminist critiques within the discipline that the study of childhood became of vital importance in archaeology to understand the process of gender acquisition through enculturation. This process refers to the way children learn about their gender identity through the material world that surrounds them and the various rituals that prepare them to become persons. Thus, the intent of recent studies on childhood has been to call upon archaeologists to consider children as social actors capable of making meaningful decisions on their own behalf and that they make substantial contributions to their families and their communities. In this sense, studies on pre-Hispanic Mesoamerican cultures have focused at the most basic sense on identifying the presence of children in the archaeological record or ethnohistoric sources. Its aim has been to document the different social ages that make up childhood, the ritual importance of Mesoamerican children, funerary practices, and health conditions marked in children’s bones as well as the different material and identity expressions of childhood through art and its associated material culture.

Saracura-Mirá, a Proposed Brazilian Amazonian Adaptogen from Ampelozizyphus amazonicus

The Amazon Forest is known all over the world for its diversity and exuberance, and for sheltering several indigenous groups and other traditional communities. There, as well as in several other countries, in traditional medical systems, weakness, fatigue and debility are seen as limiting health conditions where medicinal plants are often used in a non-specific way to improve body functions. This review brings together literature data on Ampelozizyphus amazonicus, commonly known in Brazil as “saracura-mirá” and/or “cerveja de índio”, as an Amazonian adaptogen, including some contributions from the authors based on their ethnographic and laboratory experiences. Topics such as botany, chemistry, ethnopharmacological and pharmacological aspects that support the adaptogen character of this plant, as well as cultivation, market status and supply chain aspects are discussed, and the gaps to establish “saracura-mirá” as an ingredient for the pharmaceutical purposes identified. The revised data presented good scientific evidence supporting the use of this Amazonian plant as a new adaptogen. Literature data also reveal that a detailed survey on natural populations of this plant is needed, as well as agronomical studies that could furnish A. amazonicus bark as a raw material. Another important issue is the lack of developed quality control methods to assure its quality assessment.

Overlooked and unaddressed: A narrative review of mental health consequences of child marriages

Child Marriage (before the age of 18) affects over 12 million young women globally, annually. Despite acknowledgement of the negative impacts of the practice on reproductive health, mental health consequences are largely overlooked. Given the ability for poor mental health to intensify other health and social challenges, understanding the mental health consequences linked to child marriage is vital. Our study is the first to examine how mental health is approached in current literature on child marriage. Our conceptual framework was informed by a rapid assessment of key issues in the field. Systematic searches of papers published between 2000–2020 were completed on four electronic databases with no language restrictions. Our protocol was registered on Prospero (CRD42019139685). Articles were assessed using PRISMA guidelines, and their quality assessed using the Joanna Briggs Institute Critical Appraisal Tools. Of the 4,457 records identified, 21 papers meeting inclusion criteria were analysed using narrative synthesis. The final sample included 5 qualitative, 1 mixed-methods and 15 quantitative studies (14 cross-sectional and 1 longitudinal study) reporting on data from 12 countries, largely in the global south. Intimate partner violence, poverty, challenges in childbirth and isolation were identified as social factors linked to emotional distress by those married as children. Depression was the most reported mental disorder. Anxiety, phobias, psychological distress, substance misuse, negative well-being and anti-social personality disorder were reported less frequently. Findings highlight that while significant emotional distress and specific mental health conditions are linked to child marriage, gaps in our understanding remain. Future studies are needed to; clarify directionality in these relationships; understand the mental health needs of young men, LGBTQI communities and those in humanitarian settings. Given the well documented cyclical relationship between social determinants and mental health conditions, we outline a series of community-oriented interventions which blend psychological, social and structural support to promote mental health and wellbeing in the contexts of child marriage.