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Migeot J, Panesso C, Duran-Aniotz C, Ávila-Rincón C, Ochoa C, Huepe D, Santamaría-García H, Miranda JJ, Escobar MJ, Pina-Escudero S, Romero-Ortuno R, Lawlor B, Ibáñez A, Lipina S. Allostasis, health, and development in Latin America. Neurosci Biobehav Rev 2024; 162:105697. [PMID: 38710422 PMCID: PMC11162912 DOI: 10.1016/j.neubiorev.2024.105697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 03/05/2024] [Accepted: 04/28/2024] [Indexed: 05/08/2024]
Abstract
The lifespan is influenced by adverse childhood experiences that create predispositions to poor health outcomes. Here we propose an allostatic framework of childhood experiences and their impact on health across the lifespan, focusing on Latin American and Caribbean countries. This region is marked by significant social and health inequalities nested in environmental and social stressors, such as exposure to pollution, violence, and nutritional deficiencies, which critically influence current and later-life health outcomes. We review several manifestations across cognition, behavior, and the body, observed at the psychological (e.g., cognitive, socioemotional, and behavioral dysfunctions), brain (e.g., alteration of the development, structure, and function of the brain), and physiological levels (e.g., dysregulation of the body systems and damage to organs). To address the complexity of the interactions between environmental and health-related factors, we present an allostatic framework regarding the cumulative burden of environmental stressors on physiological systems (e.g., cardiovascular, metabolic, immune, and neuroendocrine) related to health across the life course. Lastly, we explore the relevance of this allostatic integrative approach in informing regional interventions and public policy recommendations. We also propose a research agenda, potentially providing detailed profiling and personalized care by assessing the social and environmental conditions. This framework could facilitate the delivery of evidence-based interventions and informed childhood-centered policy-making.
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Affiliation(s)
- Joaquín Migeot
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile; Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez, Santiago, Chile
| | - Carolina Panesso
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez, Santiago, Chile
| | - Claudia Duran-Aniotz
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile; Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez, Santiago, Chile
| | - Cristian Ávila-Rincón
- Pontificia Universidad Javeriana (PhD Program in Neuroscience) Bogotá, San Ignacio, Colombia
| | - Carolina Ochoa
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile
| | - David Huepe
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez, Santiago, Chile
| | - Hernando Santamaría-García
- Pontificia Universidad Javeriana (PhD Program in Neuroscience) Bogotá, San Ignacio, Colombia; Global Brain Health Institute, University of California San Francisco, San Francisco, CA, USA; Center of Memory and Cognition Intellectus, Hospital Universitario San Ignacio Bogotá, San Ignacio, Colombia
| | - J Jaime Miranda
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia; CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - María Josefina Escobar
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez, Santiago, Chile
| | - Stefanie Pina-Escudero
- Global Brain Health Institute, Memory and Aging Center, University of California, San Francisco, USA
| | - Roman Romero-Ortuno
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland; Discipline of Medical Gerontology, School of Medicine, Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland
| | - Brian Lawlor
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Agustín Ibáñez
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile; Global Brain Health Institute, University of California San Francisco, San Francisco, CA, USA; Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland; Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, Argentina.
| | - Sebastián Lipina
- Unidad de Neurobiología Aplicada (UNA, CEMIC-CONICET), Buenos Aires, Argentina.
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Fernández I, Juncal-Ruiz M, González-Menéndez AM, Paino M. Environmental and psychopathological predictors of clinical high-risk of psychosis in adolescence. J Clin Psychol 2024. [PMID: 38838109 DOI: 10.1002/jclp.23723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 05/14/2024] [Accepted: 05/15/2024] [Indexed: 06/07/2024]
Abstract
OBJECTIVES Clinical high-risk psychosis (CHRp) samples can be heterogeneous, consisting essentially of people with not only psychotic-like experiences but also nonspecific symptoms that may reflect common mental disorders such as depression, anxiety, or substance abuse pathologies. Few studies have attempted to analyze and understand psychosis risk in relation to both environmental (ER) and psychopathological risk (PsR) factors. This study aimed to determine the clinical risk of psychosis in adolescents. METHODS A representative sample of 1824 Spanish adolescents from the general population was evaluated using different scales to thoroughly examine the possible interaction of CHRp with various ER and PsR factors. Partial correlations were calculated to assess the relationships between the variables. A series of hierarchical linear regression models were then used to obtain a CHRp predictor model. RESULTS The CHRp predictor model indicated that PsR was the most significant determining factor, explaining 22% of the total associated variance of CHRp. However, the ER factor also emerged as a significant predictor of high-risk psychosis (accounting for 9% of the variance). CONCLUSIONS A predictive model for CHRp in adolescents was found, in which common psychological problems were presented as more determinant risk factors than ER disruptors. Furthermore, certain transdiagnostic processes, such as psychological inflexibility, may play a central role in the development of mental health problems, including psychosis. Specifying the mechanisms underlying the emergence of CHRp in adolescence is the key to optimizing the focus of preventive therapeutic interventions in these early stages.
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Affiliation(s)
| | - Maria Juncal-Ruiz
- Department of Psychiatry (Child and Adolescent Mental Health Unit), Sierrallana Hospital, IDIVAL, School of Medicine, University of Cantabria, Torrelavega, Spain
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3
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Cánepa ET, Berardino BG. Epigenetic mechanisms linking early-life adversities and mental health. Biochem J 2024; 481:615-642. [PMID: 38722301 DOI: 10.1042/bcj20230306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 04/22/2024] [Accepted: 04/24/2024] [Indexed: 05/15/2024]
Abstract
Early-life adversities, whether prenatal or postnatal exposure, have been linked to adverse mental health outcomes later in life increasing the risk of several psychiatric disorders. Research on its neurobiological consequences demonstrated an association between exposure to adversities and persistent alterations in the structure, function, and connectivity of the brain. Consistent evidence supports the idea that regulation of gene expression through epigenetic mechanisms are involved in embedding the impact of early-life experiences in the genome and mediate between social environments and later behavioral phenotypes. In addition, studies from rodent models and humans suggest that these experiences and the acquired risk factors can be transmitted through epigenetic mechanisms to offspring and the following generations potentially contributing to a cycle of disease or disease risk. However, one of the important aspects of epigenetic mechanisms, unlike genetic sequences that are fixed and unchangeable, is that although the epigenetic markings are long-lasting, they are nevertheless potentially reversible. In this review, we summarize our current understanding of the epigenetic mechanisms involved in the mental health consequences derived from early-life exposure to malnutrition, maltreatment and poverty, adversities with huge and pervasive impact on mental health. We also discuss the evidence about transgenerational epigenetic inheritance in mammals and experimental data suggesting that suitable social and pharmacological interventions could reverse adverse epigenetic modifications induced by early-life negative social experiences. In this regard, these studies must be accompanied by efforts to determine the causes that promote these adversities and that result in health inequity in the population.
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Affiliation(s)
- Eduardo T Cánepa
- Laboratorio de Neuroepigenética y Adversidades Tempranas, Departamento de Química Biológica, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires and IQUIBICEN, CONICET, Buenos Aires, Argentina
| | - Bruno G Berardino
- Laboratorio de Neuroepigenética y Adversidades Tempranas, Departamento de Química Biológica, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires and IQUIBICEN, CONICET, Buenos Aires, Argentina
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4
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Lanfranco RC, Dos Santos Sousa F, Wessel PM, Rivera-Rei Á, Bekinschtein TA, Lucero B, Canales-Johnson A, Huepe D. Slow-wave brain connectivity predicts executive functioning and group belonging in socially vulnerable individuals. Cortex 2024; 174:201-214. [PMID: 38569258 DOI: 10.1016/j.cortex.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 01/19/2024] [Accepted: 03/05/2024] [Indexed: 04/05/2024]
Abstract
Important efforts have been made to describe the neural and cognitive features of healthy and clinical populations. However, the neural and cognitive features of socially vulnerable individuals remain largely unexplored, despite their proneness to developing neurocognitive disorders. Socially vulnerable individuals can be characterised as socially deprived, having a low socioeconomic status, suffering from chronic social stress, and exhibiting poor social adaptation. While it is known that such individuals are likely to perform worse than their peers on executive function tasks, studies on healthy but socially vulnerable groups are lacking. In the current study, we explore whether neural power and connectivity signatures can characterise executive function performance in healthy but socially vulnerable individuals, shedding light on the impairing effects that chronic stress and social disadvantages have on cognition. We measured resting-state electroencephalography and executive functioning in 38 socially vulnerable participants and 38 matched control participants. Our findings indicate that while neural power was uninformative, lower delta and theta phase synchrony are associated with worse executive function performance in all participants, whereas delta phase synchrony is higher in the socially vulnerable group compared to the control group. Finally, we found that delta phase synchrony and years of schooling are the best predictors for belonging to the socially vulnerable group. Overall, these findings suggest that exposure to chronic stress due to socioeconomic factors and a lack of education are associated with changes in slow-wave neural connectivity and executive functioning.
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Affiliation(s)
- Renzo C Lanfranco
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden; Center for Research in Cognition & Neurosciences, Université libre de Bruxelles, Brussels, Belgium
| | | | - Pierre Musa Wessel
- Department of Criminology, University of Cambridge, Cambridge, United Kingdom
| | - Álvaro Rivera-Rei
- Center for Social and Cognitive Neuroscience (SCN), School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile
| | - Tristán A Bekinschtein
- Cambridge Consciousness and Cognition Lab, Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | - Boris Lucero
- The Neuropsychology and Cognitive Neurosciences Research Center, Faculty of Health Sciences, Universidad Católica del Maule, Talca, Chile
| | - Andrés Canales-Johnson
- Cambridge Consciousness and Cognition Lab, Department of Psychology, University of Cambridge, Cambridge, United Kingdom; The Neuropsychology and Cognitive Neurosciences Research Center, Faculty of Health Sciences, Universidad Católica del Maule, Talca, Chile.
| | - David Huepe
- Center for Social and Cognitive Neuroscience (SCN), School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile.
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DeJoseph ML, Ellwood-Lowe ME, Miller-Cotto D, Silverman D, Shannon KA, Reyes G, Rakesh D, Frankenhuis WE. The promise and pitfalls of a strength-based approach to child poverty and neurocognitive development: Implications for policy. Dev Cogn Neurosci 2024; 66:101375. [PMID: 38608359 PMCID: PMC11019102 DOI: 10.1016/j.dcn.2024.101375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 03/27/2024] [Accepted: 04/04/2024] [Indexed: 04/14/2024] Open
Abstract
There has been significant progress in understanding the effects of childhood poverty on neurocognitive development. This progress has captured the attention of policymakers and promoted progressive policy reform. However, the prevailing emphasis on the harms associated with childhood poverty may have inadvertently perpetuated a deficit-based narrative, focused on the presumed shortcomings of children and families in poverty. This focus can have unintended consequences for policy (e.g., overlooking strengths) as well as public discourse (e.g., focusing on individual rather than systemic factors). Here, we join scientists across disciplines in arguing for a more well-rounded, "strength-based" approach, which incorporates the positive and/or adaptive developmental responses to experiences of social disadvantage. Specifically, we first show the value of this approach in understanding normative brain development across diverse human environments. We then highlight its application to educational and social policy, explore pitfalls and ethical considerations, and offer practical solutions to conducting strength-based research responsibly. Our paper re-ignites old and recent calls for a strength-based paradigm shift, with a focus on its application to developmental cognitive neuroscience. We also offer a unique perspective from a new generation of early-career researchers engaged in this work, several of whom themselves have grown up in conditions of poverty. Ultimately, we argue that a balanced strength-based scientific approach will be essential to building more effective policies.
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Affiliation(s)
| | | | | | - David Silverman
- Department of Psychology, Northwestern University, United States
| | | | - Gabriel Reyes
- Graduate School of Education, Stanford University, United States
| | - Divyangana Rakesh
- Neuroimaging Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Willem E Frankenhuis
- Evolutionary and Population Biology, Institute for Biodiversity and Ecosystem Dynamics, University of Amsterdam, the Netherlands; Max Planck Institute for the Study of Crime, Security, and Law, Germany
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6
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Filakovska Bobakova D, Dankulincova Veselska Z. Early Childhood in Marginalized Roma Communities: Health Risks and Health Outcomes. Int J Public Health 2024; 69:1606784. [PMID: 38586473 PMCID: PMC10995347 DOI: 10.3389/ijph.2024.1606784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 03/12/2024] [Indexed: 04/09/2024] Open
Abstract
Objectives This study aims to compare selected early childhood health risks and health outcomes of children from marginalized Roma communities (MRCs) in Slovakia with those of the majority. Methods We obtained cross-sectional data from mother-child dyads from the majority (N = 109) and MRCs (N = 143) via questionnaires and from medical records. Socioeconomic status, health risks and health outcomes were compared using chi-square and Mann-Whitney U tests in SPSS. Results Mothers from MRCs reported significantly worse socioeconomic status. Air quality in the households in MRCs was significantly worse, affected by heating with stoves, burning fresh wood and indoor smoking. The diet composition of children from MRCs was characterized by shorter breastfeeding and unhealthy diet composition less fresh fruits and vegetables, more processed meat products, and sweet and salty snacks. Children from MRCs more often suffered from respiratory and diarrheal diseases, used antibiotics and were hospitalized. Conclusion The health and healthy development of children living in MRCs is endangered by various poverty-related factors. Persistent differences in exposures and health in early childhood should be a priority goal of the state's social and health policies.
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Affiliation(s)
- Daniela Filakovska Bobakova
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P. J. Safarik University, Kosice, Slovakia
- Olomouc University Social Health Institute, Palacky University in Olomouc, Olomouc, Czech Republic
| | - Zuzana Dankulincova Veselska
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P. J. Safarik University, Kosice, Slovakia
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Backhouse EV, Boardman JP, Wardlaw JM. Cerebral Small Vessel Disease: Early-Life Antecedents and Long-Term Implications for the Brain, Aging, Stroke, and Dementia. Hypertension 2024; 81:54-74. [PMID: 37732415 PMCID: PMC10734792 DOI: 10.1161/hypertensionaha.122.19940] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
Cerebral small vessel disease is common in older adults and increases the risk of stroke, cognitive impairment, and dementia. While often attributed to midlife vascular risk factors such as hypertension, factors from earlier in life may contribute to later small vessel disease risk. In this review, we summarize current evidence for early-life effects on small vessel disease, stroke and dementia focusing on prenatal nutrition, and cognitive ability, education, and socioeconomic status in childhood. We discuss possible reasons for these associations, including differences in brain resilience and reserve, access to cognitive, social, and economic resources, and health behaviors, and we consider the extent to which these associations are independent of vascular risk factors. Although early-life factors, particularly education, are major risk factors for Alzheimer disease, they are less established in small vessel disease or vascular cognitive impairment. We discuss current knowledge, gaps in knowledge, targets for future research, clinical practice, and policy change.
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Affiliation(s)
- Ellen V. Backhouse
- Centre for Clinical Brain Sciences (E.V.B., J.P.B., J.M.W.), University of Edinburgh, Scotland, United Kingdom
- MRC UK Dementia Research Institute (E.V.B., J.M.W.), University of Edinburgh, Scotland, United Kingdom
| | - James P. Boardman
- Centre for Clinical Brain Sciences (E.V.B., J.P.B., J.M.W.), University of Edinburgh, Scotland, United Kingdom
- MRC Centre for Reproductive Health (J.P.B.), University of Edinburgh, Scotland, United Kingdom
| | - Joanna M. Wardlaw
- Centre for Clinical Brain Sciences (E.V.B., J.P.B., J.M.W.), University of Edinburgh, Scotland, United Kingdom
- MRC UK Dementia Research Institute (E.V.B., J.M.W.), University of Edinburgh, Scotland, United Kingdom
- Edinburgh Imaging (J.M.W.), University of Edinburgh, Scotland, United Kingdom
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8
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Wijeakumar S, Forbes SH, Magnotta VA, Deoni S, Jackson K, Singh VP, Tiwari M, Kumar A, Spencer JP. Stunting in infancy is associated with atypical activation of working memory and attention networks. Nat Hum Behav 2023; 7:2199-2211. [PMID: 37884677 PMCID: PMC10730391 DOI: 10.1038/s41562-023-01725-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 09/13/2023] [Indexed: 10/28/2023]
Abstract
Stunting is associated with poor long-term cognitive, academic and economic outcomes, yet the mechanisms through which stunting impacts cognition in early development remain unknown. In a first-ever neuroimaging study conducted on infants from rural India, we demonstrate that stunting impacts a critical, early-developing cognitive system-visual working memory. Stunted infants showed poor visual working memory performance and were easily distractible. Poor performance was associated with reduced engagement of the left anterior intraparietal sulcus, a region involved in visual working memory maintenance and greater suppression in the right temporoparietal junction, a region involved in attentional shifting. When assessed one year later, stunted infants had lower problem-solving scores, while infants of normal height with greater left anterior intraparietal sulcus activation showed higher problem-solving scores. Finally, short-for-age infants with poor physical growth indices but good visual working memory performance showed more positive outcomes suggesting that intervention efforts should focus on improving working memory and reducing distractibility in infancy.
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Affiliation(s)
| | | | | | - Sean Deoni
- Maternal, Newborn and Child Health Discovery & Tools, Bill & Melinda Gates Foundation, Seattle, WA, USA
- Advanced Baby Imaging Lab, New England Pediatric Institute of Neurodevelopment, Rhode Island Hospital, Providence, RI, USA
| | - Kiara Jackson
- School of Psychology, University of East Anglia, Norwich, UK
| | | | | | | | - John P Spencer
- School of Psychology, University of East Anglia, Norwich, UK.
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Kim AW, Said Mohamed R, Norris SA, Naicker S, Richter LM, Kuzawa CW. Childhood adversity during the post-apartheid transition and COVID-19 stress independently predict adult PTSD risk in urban South Africa: A biocultural analysis of the stress sensitization hypothesis. AMERICAN JOURNAL OF BIOLOGICAL ANTHROPOLOGY 2023; 182:620-631. [PMID: 37283092 PMCID: PMC10700668 DOI: 10.1002/ajpa.24791] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 04/28/2023] [Accepted: 05/24/2023] [Indexed: 06/08/2023]
Abstract
OBJECTIVES The COVID-19 pandemic in South Africa introduced new societal adversities and mental health threats in a country where one in three individuals are expected to develop a psychiatric condition sometime in their life. Scientists have suggested that psychosocial stress and trauma during childhood may increase one's vulnerability to the mental health consequences of future stressors-a process known as stress sensitization. This prospective analysis assessed whether childhood adversity experienced among South African children across the first 18 years of life, coinciding with the post-apartheid transition, exacerbates the mental health impacts of psychosocial stress experienced during the 2019 coronavirus (COVID-19) pandemic (ca. 2020-2021). MATERIALS AND METHODS Data came from 88 adults who participated in a follow-up study of a longitudinal birth cohort study in Soweto, South Africa. Childhood adversity and COVID-19 psychosocial stress were assessed as primary predictors of adult PTSD risk, and an interaction term between childhood adversity and COVID-19 stress was calculated to evaluate the potential effect of stress sensitization. RESULTS Fifty-six percent of adults exhibited moderate-to-severe PTSD symptoms. Greater childhood adversity and higher COVID-19 psychosocial stress independently predicted worse post-traumatic stress disorder symptoms in adults. Adults who reported greater childhood adversity exhibited non-significantly worse PTSD symptoms from COVID-19 psychosocial stress. DISCUSSION These results highlight the deleterious mental health effects of both childhood trauma and COVID-19 psychosocial stress in our sample and emphasize the need for greater and more accessible mental health support as the pandemic progresses in South Africa.
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Affiliation(s)
- Andrew Wooyoung Kim
- Department of Anthropology, University of California, Berkeley, Berkeley, California, USA
- SAMRC Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Rihlat Said Mohamed
- SAMRC Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Shane A Norris
- SAMRC Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
- Global Health Research Institute, School of Human Development and Health, University of Southampton, Southampton, UK
| | - Sara Naicker
- SAMRC Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Linda M Richter
- SAMRC Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Christopher W Kuzawa
- Department of Anthropology, Northwestern University, Evanston, Illinois, USA
- Institute for Policy Research, Northwestern University, Evanston, Illinois, USA
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Kim AW, Rieder AD, Cooper-Vince CE, Kakuhikire B, Baguma C, Satinsky EN, Perkins JM, Kiconco A, Namara EB, Rasmussen JD, Ashaba S, Bangsberg DR, Tsai AC, Puffer ES. Maternal adverse childhood experiences, child mental health, and the mediating effect of maternal depression: A cross-sectional, population-based study in rural, southwestern Uganda. AMERICAN JOURNAL OF BIOLOGICAL ANTHROPOLOGY 2023; 182:19-31. [PMID: 37212482 PMCID: PMC10524293 DOI: 10.1002/ajpa.24758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 02/09/2023] [Accepted: 05/08/2023] [Indexed: 05/23/2023]
Abstract
OBJECTIVES This study aimed to examine the intergenerational effects of maternal adverse childhood experiences (ACEs) and child mental health outcomes in rural Uganda, as well as the potentially mediating role of maternal depression in this pathway. Additionally, we sought to test the extent to which maternal social group membership attenuated the mediating effect of maternal depression on child mental health. METHODS Data come from a population-based cohort of families living in the Nyakabare Parish, a rural district in southwestern Uganda. Between 2016 and 2018, mothers completed surveys about childhood adversity, depressive symptoms, social group membership, and their children's mental health. Survey data were analyzed using causal mediation and moderated-mediation analysis. RESULTS Among 218 mother-child pairs, 61 mothers (28%) and 47 children (22%) showed symptoms meeting cutoffs for clinically significant psychological distress. In multivariable linear regression models, maternal ACEs had a statistically significant association with severity of child conduct problems, peer problems, and total child difficulty scores. Maternal depression mediated the relationship between maternal ACEs and conduct problems, peer problems, and total difficulty, but this mediating effect was not moderated by maternal group membership. CONCLUSIONS Maternal depression may act as a potential mechanism linking maternal childhood adversity with poor child mental health in the next generation. Within a context of elevated rates of psychiatric morbidity, high prevalence of childhood adversity, and limited healthcare and economic infrastructures across Uganda, these results emphasize the prioritization of social services and mental health resources for rural Ugandan families.
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Affiliation(s)
- Andrew Wooyoung Kim
- Department of Anthropology, University of California, Berkeley, California, USA
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Amber D Rieder
- Duke Global Health Institute, Durham, North Carolina, USA
| | | | | | - Charles Baguma
- Mbarara University of Science and Technology, Mbarara, Uganda
| | - Emily N Satinsky
- Center for Global Health, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Psychology, University of Southern California, Los Angeles, California, USA
| | - Jessica M Perkins
- Peabody College, Vanderbilt University, Nashville, Tennessee, USA
- Vanderbilt Institute of Global Health, Nashville, Tennessee, USA
| | - Allen Kiconco
- Mbarara University of Science and Technology, Mbarara, Uganda
| | | | | | | | - David R Bangsberg
- Mbarara University of Science and Technology, Mbarara, Uganda
- Oregon Health and Science University - Portland State University School of Public Health, Portland, Oregon, USA
| | - Alexander C Tsai
- Mbarara University of Science and Technology, Mbarara, Uganda
- Center for Global Health, Massachusetts General Hospital, Boston, Massachusetts, USA
- Mongan Institute, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Eve S Puffer
- Duke Global Health Institute, Durham, North Carolina, USA
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11
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Lawton W, Araujo O, Kufaishi Y. Language Environment and Infants' Brain Structure. J Neurosci 2023; 43:5129-5131. [PMID: 37438100 PMCID: PMC10342219 DOI: 10.1523/jneurosci.0787-23.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 06/05/2023] [Accepted: 06/08/2023] [Indexed: 07/14/2023] Open
Affiliation(s)
- Will Lawton
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - Ozzy Araujo
- Undergraduate Life Sciences Program, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - Yousif Kufaishi
- Undergraduate Life Sciences Program, Queen's University, Kingston, Ontario K7L 3N6, Canada
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12
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Bhutta ZA, Bhavnani S, Betancourt TS, Tomlinson M, Patel V. Adverse childhood experiences and lifelong health. Nat Med 2023; 29:1639-1648. [PMID: 37464047 DOI: 10.1038/s41591-023-02426-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 05/30/2023] [Indexed: 07/20/2023]
Abstract
With the advent of the sustainable development goals, the field of global child health has shifted its focus from reducing mortality to improving health, nutrition and development outcomes - often measured as human capital. A growing knowledge of the biology of development and neuroscience has highlighted the importance of adverse environmental exposures, collectively termed adverse childhood experiences (ACEs) on health outcomes. ACEs are associated with short-term, medium-term and long-term negative consequences for health and development and their effects may be multiplicative, especially during critical periods of sensitivity and developmental plasticity. Some of these effects are compounded by emerging global threats such as climate change, conflict and population displacement. In this Review, we discuss the key mechanisms linking ACEs to health outcomes and consider promising strategies to prevent and mitigate their effects, highlighting evidence from programs in low-income and middle-income countries. Finally, we emphasize the need for early recognition of ACEs and delivery of packages of interventions spanning key sectors such as health, education, women's empowerment and social protection.
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Affiliation(s)
- Zulfiqar A Bhutta
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada.
- Institute for Global Health & Development, The Aga Khan University, South Central Asia, East Africa, United Kingdom, and Karachi, Pakistan.
| | | | | | - Mark Tomlinson
- Institute for Life Course Health Research, Stellenbosch University, Cape Town, South Africa
- School of Nursing and Midwifery, Queens University, Belfast, UK
| | - Vikram Patel
- Department of Global Health and Population, Harvard Chan School of Public Health, Boston, MA, USA
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
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13
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Grantham-McGregor SM, Walker SP. Early Childhood Interventions: Issues to Consider in Getting to Scale. Pediatrics 2023; 151:191221. [PMID: 37125888 DOI: 10.1542/peds.2023-060221p] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/17/2023] [Indexed: 05/02/2023] Open
Affiliation(s)
| | - Susan P Walker
- Caribbean Institute for Health Research, The University of the West Indies, Kingston, Jamaica
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Mrimi EC, Palmeirim MS, Minja EG, Long KZ, Keiser J. Correlation of Cytokines with Parasitic Infections, Undernutrition and Micronutrient Deficiency among Schoolchildren in Rural Tanzania: A Cross-Sectional Study. Nutrients 2023; 15:nu15081916. [PMID: 37111135 PMCID: PMC10145041 DOI: 10.3390/nu15081916] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/11/2023] [Accepted: 04/13/2023] [Indexed: 04/29/2023] Open
Abstract
Malnutrition and parasitic infections are often interconnected in a vicious cycle. Malnutrition can lead to changes in immune response, which may affect cytokine concentrations and potentially increase susceptibility to infections. In turn, parasitic infections can exacerbate malnutrition by impairing nutrient absorption. This cross-sectional study aimed to explore this interplay. Schoolchildren aged 6-12 years living in rural Tanzania (n = 120) provided blood, stool and urine samples to determine the relationship between cytokine concentrations (interleukin 4 (IL-4), interferon gamma (IFNγ) and interleukin 17A (IL-17A)), parasitic infections, undernutrition and micronutrient deficiency adjusting for sex, age, inflammatory markers, socioeconomic status and school categories. All schoolchildren had a normal blood cell count. The concentration of IL-4 was significantly higher in schoolchildren diagnosed with stunting, Schistosoma mansoni infection, a high C-reactive protein concentration, nausea, poor housing and increasing age. The concentration of IFNγ was associated with Plasmodium falciparum and Entamoeba histolytica/Entamoeba dispar/Entamoeba moshkovskii infections, vitamin A deficiency, attending the most remote schools and low socioeconomic status. Our study confirms a potential relationship between cytokine concentrations and parasitic infections, malnutrition and low socioeconomic status. A better understanding of long-term effects of parasitic infections and malnutrition on the immune function could help in designing tailored and effective interventions.
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Affiliation(s)
- Emmanuel C Mrimi
- Swiss Tropical and Public Health Institute, 4123 Allschwil, Switzerland
- University of Basel, 4001 Basel, Switzerland
- Ifakara Health Institute, Morogoro P.O. Box 53, Tanzania
| | - Marta S Palmeirim
- Swiss Tropical and Public Health Institute, 4123 Allschwil, Switzerland
- University of Basel, 4001 Basel, Switzerland
| | - Elihaika G Minja
- Swiss Tropical and Public Health Institute, 4123 Allschwil, Switzerland
- University of Basel, 4001 Basel, Switzerland
- Ifakara Health Institute, Morogoro P.O. Box 53, Tanzania
| | - Kurt Z Long
- Swiss Tropical and Public Health Institute, 4123 Allschwil, Switzerland
- University of Basel, 4001 Basel, Switzerland
| | - Jennifer Keiser
- Swiss Tropical and Public Health Institute, 4123 Allschwil, Switzerland
- University of Basel, 4001 Basel, Switzerland
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15
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Money Matters: Time for Prevention and Early Intervention to Address Family Economic Circumstances. JOURNAL OF PREVENTION (2022) 2023; 44:267-276. [PMID: 36913131 PMCID: PMC10009842 DOI: 10.1007/s10935-022-00717-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Accepted: 11/21/2022] [Indexed: 03/14/2023]
Abstract
Child poverty is associated with poorer physical and mental health, negative educational outcomes and adverse long-term social and psychological consequences, all of which impact on service demand and expenditure. Until now, however, prevention and early intervention practice has tended to focus on enhancing inter-parental relationships and parenting skills (e.g., via relationship skills education, home visiting, parenting programs, family therapy) or child language, social-emotional and life skills (e.g., early childhood education, school-based programs, youth mentoring). Programs often target low-income neighborhoods or families but rarely address poverty directly. While there is substantial evidence for the effectiveness of such interventions in improving child outcomes, null results are not uncommon and even positive effects are often small, short-term, and difficult to replicate. One avenue to enhance intervention effectiveness is to improve families' economic circumstances. There are several arguments for this refocusing. It is arguably unethical to focus on individual risk without acknowledging or seeking to address (where relevant) families' social and economic contexts, while the stigma and material constraints associated with poverty can make it harder for families to engage with psychosocial support. There is also evidence that increasing household income improves child outcomes. Although national policies to alleviate poverty are important, it is increasingly recognized that practice-based initiatives have a role to play (e.g., income maximization, devolved budgets, money management support). However, knowledge about their implementation and effectiveness is relatively thin. For instance, there is some evidence that co-located welfare rights advice in healthcare settings can improve recipients' financial circumstances and health, but it is mixed and of limited quality. Moreover, there is little rigorous research on whether and how such services affect mediators (parent-child interactions, parenting capacity) and/or child physical and psychosocial outcomes directly. We call for prevention and early intervention programs to attend more to families' economic circumstances, and for experimental studies to test their implementation, reach and effectiveness.
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16
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Atkinson L, Joshi D, Raina P, Griffith LE, MacMillan H, Gonzalez A. Social engagement and allostatic load mediate between adverse childhood experiences and multimorbidity in mid to late adulthood: the Canadian Longitudinal Study on Aging. Psychol Med 2023; 53:1437-1447. [PMID: 37010223 PMCID: PMC10009404 DOI: 10.1017/s0033291721003019] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 06/10/2021] [Accepted: 07/09/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are associated with multimorbidity in adulthood. This link may be mediated by psychosocial and biological factors, but evidence is lacking. The current study evaluates this mediation model. METHOD We analyzed data from the Canadian Longitudinal Study of Aging (N = 27 170 community participants). Participants were 45-85 years at recruitment, when allostatic load and social engagement data were collected, and 3 years older at follow-up, when ACEs and multimorbidity data were collected. Structural equation modeling was used to test for mediation in the overall sample, and in sex- and age-stratified subsamples, all analyses adjusted for concurrent lifestyle confounds. RESULTS In the overall sample, ACEs were associated with multimorbidity, directly, β = 0.12 (95% confidence interval 0.11-0.13) and indirectly. Regarding indirect associations, ACEs were related to social engagement, β = -0.14 (-0.16 to -0.12) and social engagement was related to multimorbidity, β = -0.10 (-0.12 to -0.08). ACEs were related to allostatic load, β = 0.04 (0.03-0.05) and allostatic load was related to multimorbidity, β = 0.16 (0.15-0.17). The model was significant for males and females and across age cohorts, with qualifications in the oldest stratum (age 75-85). CONCLUSIONS ACEs are related to multimorbidity, directly and via social engagement and allostatic load. This is the first study to show mediated pathways between early adversity and multimorbidity in adulthood. It provides a platform for understanding multimorbidity as a lifespan dynamic informing the co-occurrence of the varied disease processes represented in multimorbidity.
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Affiliation(s)
- Leslie Atkinson
- Department of Psychology, Ryerson University, Toronto, Canada
| | - Divya Joshi
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Parminder Raina
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Lauren E. Griffith
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Harriet MacMillan
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Andrea Gonzalez
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Canada
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17
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Strauß H, Venables P, Zentner M. Associations between early childhood poverty and cognitive functioning throughout childhood and adolescence: A 14-year prospective longitudinal analysis of the Mauritius Child Health Project. PLoS One 2023; 18:e0278618. [PMID: 36827363 PMCID: PMC9956590 DOI: 10.1371/journal.pone.0278618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 11/20/2022] [Indexed: 02/26/2023] Open
Abstract
Associations between childhood poverty and cognitive outcomes have been examined from multiple perspectives. However, most evidence is based on cross-sectional data or longitudinal data covering only segments of the developmental process. Moreover, previous longitudinal research has mostly relied on data from Western nations, limiting insights of poverty dynamics in low- and middle-income countries. Here, we use data from the Mauritius Child Health Project, a large-scale prospective longitudinal study conducted in a then low-income country, to examine long-term associations between poverty in early childhood and cognitive performance across childhood and adolescence. Poverty-related factors were assessed at age 3 years and comprised indicators of psychosocial adversity and malnutrition. Cognitive functioning was assessed at ages 3 and 11 years by using standardized intelligence measures and at age 17 years by means of a computerized test battery. Using multiple hierarchical regression models, we found that chronic malnutrition and parental characteristics showed similar-sized, independent associations with initial cognitive functioning at age 3 as well as at age 11 years. For age 17 years, however, associations with early childhood risk factors vanished and instead, cognitive functioning was predicted by performance on prior cognitive assessments. Sex was also found to be a powerful predictor of cognitive trajectories, with boys improving and girls worsening over time, regardless of the level of their initial exposure to risk. The current findings indicate that, to prevent cognitive impairment, interventions tackling poverty and malnutrition should focus on the infancy period and be designed in a gender-sensitive way.
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Affiliation(s)
- Hannah Strauß
- Personality, Emotion and Music Laboratory, Department of Psychology, University of Innsbruck, Innsbruck, Austria
- * E-mail:
| | - Peter Venables
- Department of Psychology, University of York, York, United Kingdom
| | - Marcel Zentner
- Personality, Emotion and Music Laboratory, Department of Psychology, University of Innsbruck, Innsbruck, Austria
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18
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Compton AB, Panlilio CC, Humphreys KL. What's the matter with ACEs? Recommendations for considering early adversity in educational contexts. CHILD ABUSE & NEGLECT 2023; 142:106073. [PMID: 36774310 DOI: 10.1016/j.chiabu.2023.106073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 01/18/2023] [Accepted: 01/28/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Currently, some trauma-informed education practices use "ACE scores," a number that represents the sum of endorsed items from a survey derived from the Adverse Childhood Experiences (ACEs) study in 1998. We caution that the survey provides limited information within education, and such scores have limited utility for designing and delivering individualized intervention to support students who have experienced adversity. OBJECTIVE We sought to illustrate why ACEs are not well-suited for use in trauma-informed education, provide definitions for adversity-related terms from which a broader and common understanding of adversity can stem, and provide recommendations for integration of adversity-informed approaches to the educational context. METHODS We compiled definitions of adversity-related constructs and made recommendations based on review of relevant research from the fields of psychology and education. RESULTS Rather than tailoring educational practices to specific children based on the "traumatic" events they experience, we recommend educators focus their efforts on building supportive classrooms geared toward supporting students with best practices drawn from the Science of Learning, and with the understanding that early adversity can influence heterogeneous trajectories in student development and behavior. In addition, further research on educational practices, including the use of a shared language for describing and defining adversity-related experiences, are the concrete steps needed to better support a goal of adversity-informed education.
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19
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Viglione C, Boynton-Jarrett R. The GROWBABY Research Network: A Framework for Advancing Health Equity Through Community Engaged Practice-Based Research. Matern Child Health J 2023; 27:210-217. [PMID: 36588142 PMCID: PMC9805911 DOI: 10.1007/s10995-022-03564-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 06/05/2022] [Accepted: 09/07/2022] [Indexed: 01/03/2023]
Abstract
PURPOSE Preventive health care, delivered through well child care visits, serves as a universal and primary entry point for promoting child wellbeing, yet children with lower socioeconomic status and children of color receive less consistent and lower quality preventive health care. Currently, limited research exists comparing models for delivering preventive care to children and their impact on longstanding racial/ethnic and socioeconomic inequities. DESCRIPTION Practice-based research networks can help to advance health equity by more rapidly studying and scaling innovative, local models of care to reduce racial/ethnic and socioeconomic inequities in primary care and preventive care utilization. This paper outlines a framework of community engagement that can be utilized by practice-based research networks to advance health equity and details the application of the framework using the GROWBABY Research Network (GROup Wellness Visits for BABies and FamilY Research Network). ASSESSMENT The GROWBABY Research Network launched in 2020, engaged clinical practices utilizing this unique model of group well childcare - CenteringParenting® - with the following goals: to promote collaboration among researchers, clinicians, patients, and community members; facilitate practice-based research; and increase the use of shared assessment measures and protocols. As a research collaborative, the GROWBABY Research Network connects clinical partners facing similar challenges and creates opportunities to draw upon the assets and strengths of the collective to identify solutions to the barriers to research participation. CONCLUSION Primary care, practice-based research networks like the GROWBABY Research Network that intentionally integrate community engagement principles and community-based participatory research methods can advance equitable health care systems and improve child wellbeing.
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Affiliation(s)
- Clare Viglione
- Division of General Pediatrics, Department of Pediatrics, Boston Medical Center, 801 Albany Street, 02119, Boston, MA, USA.
| | - Renée Boynton-Jarrett
- Division of General Pediatrics, Department of Pediatrics, Boston Medical Center, 801 Albany Street, 02119, Boston, MA, USA
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20
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Lee AR, Kingdon CC, Davie M, Hawcutt D, Sinha IP. Child poverty and health inequalities in the UK: a guide for paediatricians. Arch Dis Child 2023; 108:94-101. [PMID: 35680401 DOI: 10.1136/archdischild-2021-323671] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 05/12/2022] [Indexed: 01/24/2023]
Abstract
One in three children in the UK lives in relative poverty. There are clear and consistent links between child poverty and paediatric morbidity and mortality. In this review, we discuss drivers for family poverty in the UK, and how this leads to poor child health outcomes. We present a framework for healthcare professionals and institutions to consider interventions and strategies relating to socioeconomic health inequalities. We will focus on approaches to mitigate the effects of child poverty on children using our services at a local level and outline the importance of healthcare workers advocating for structural and high-level policy change to address the deep-rooted societal problems that cause child poverty.
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Affiliation(s)
- Alice R Lee
- Lab to Life Child Health Applied Data Centre, Department of Innovation, Alder Hey Children's NHS Foundation Trust, Liverpool, UK.,University of Liverpool, Liverpool, UK
| | | | - Max Davie
- Community Paediatrics, Mary Sheridan Centre, Evelina London Children's Hospital, London, UK
| | - Daniel Hawcutt
- National Institute for Health Research, Alder Hey Clinical Research Facility, Alder Hey Children's Hospital, Liverpool, UK.,Department of Women's and Children's Health, University of Liverpool, Liverpool, UK
| | - Ian P Sinha
- Lab to Life Child Health Applied Data Centre, Department of Innovation, Alder Hey Children's NHS Foundation Trust, Liverpool, UK .,University of Liverpool, Liverpool, UK
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21
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Kunin-Batson AS, Crain AL, Gunnar MR, Kelly AS, Kharbanda EO, Haapala J, Seburg EM, Sherwood NE, French SA. Household Income, Cortisol, and Obesity During Early Childhood: A Prospective Longitudinal Study. J Pediatr 2023; 252:76-82. [PMID: 36113639 DOI: 10.1016/j.jpeds.2022.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 09/02/2022] [Accepted: 09/09/2022] [Indexed: 10/14/2022]
Abstract
OBJECTIVE To prospectively evaluate the relationship between household income, children's cortisol, and body mass index (BMI) trajectories over a 3-year period in early childhood. STUDY DESIGN Household income, child hair cortisol levels, and BMI were measured at baseline, 12-, 24-, and 36-month follow-up visits in the Now Everybody Together for Amazing and Healthful Kids (NET-Works) Study (n = 534, children ages 2-4 years, and household income <$65 000/year at baseline). Relationships were examined between very low household income (<$25 000/year) at baseline, income status over time (remained <$25 000/year or had increasing income), cortisol accumulation from hair samples, and BMI percent of the 95th percentile (BMIp95) trajectories using adjusted linear growth curve modeling. Households with baseline income between $25 000 and $65 000/year were the reference group for all analyses. RESULTS Children from very low-income households at baseline had annual changes in BMIp95 that were higher (P < .001) than children from reference group households (0.40 vs -0.62 percentage units/year). Annual increases in BMIp95 were also greater among children from households that remained very low income (P < .01, .34 percentage units/year) and among those with increasing income (P = .01, .51 percentage units/year) compared with the reference group (-0.61 percentage units/year). Children from households that remained very low income had higher hair cortisol accumulations (0.22 pg/mg, P = .02) than reference group children, whereas hair cortisol concentrations of children from households with increasing income (0.03 pg/mg) did not differ significantly from the reference group. Cortisol was not related to BMIp95. CONCLUSIONS The economic circumstances of families may impact children's BMI trajectories and their developing stress systems, but these processes may be independent of one another.
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Affiliation(s)
- Alicia S Kunin-Batson
- Department of Pediatrics and Center for Pediatric Obesity Medicine, University of Minnesota Medical School, Minneapolis, MN.
| | | | - Megan R Gunnar
- Institute for Child Development, University of Minnesota, Minneapolis, MN
| | - Aaron S Kelly
- Department of Pediatrics and Center for Pediatric Obesity Medicine, University of Minnesota Medical School, Minneapolis, MN
| | | | | | | | - Nancy E Sherwood
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Simone A French
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
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22
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Gontijo ML, Moreira JM, Silva TR, Alves CRL. Impact of adverse childhood experiences (ACE) on the development of 18-months-old children. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022. [DOI: 10.1016/j.jadr.2022.100401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
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23
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Childhood Trauma and Epigenetics: State of the Science and Future. Curr Environ Health Rep 2022; 9:661-672. [PMID: 36242743 DOI: 10.1007/s40572-022-00381-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2022] [Indexed: 01/31/2023]
Abstract
PURPOSE OF REVIEW There is a great deal of interest regarding the biological embedding of childhood trauma and social exposures through epigenetic mechanisms, including DNA methylation (DNAm), but a comprehensive understanding has been hindered by issues of limited reproducibility between studies. This review presents a summary of the literature on childhood trauma and DNAm, highlights issues in the field, and proposes some potential solutions. RECENT FINDINGS Investigations of the associations between DNAm and childhood trauma are commonly performed using candidate gene approaches, specifically involving genes related to neurological and stress pathways. Childhood trauma is defined in a wide range of ways in several societal contexts. However, although variations in DNAm are frequently found in stress-related genes, unsupervised epigenome-wide association studies (EWAS) have shown limited reproducibility both between studies and in relating these changes to exposures. The reproducibility of childhood trauma DNAm studies, and the field of social epigenetics in general, may be improved by increasing sample sizes, standardizing variables, making use of effect size thresholds, collecting longitudinal and intervention samples, appropriately accounting for known confounding factors, and applying causal analysis wherever possible, such as "two-step epigenetic Mendelian randomization."
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Botdorf M, Dunstan J, Sorcher L, Dougherty LR, Riggins T. Socioeconomic disadvantage and episodic memory ability in the ABCD sample: Contributions of hippocampal subregion and subfield volumes. Dev Cogn Neurosci 2022; 57:101138. [PMID: 35907312 PMCID: PMC9335384 DOI: 10.1016/j.dcn.2022.101138] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 04/22/2022] [Accepted: 07/15/2022] [Indexed: 01/06/2023] Open
Abstract
Socioeconomic disadvantage is associated with volumetric differences in stress-sensitive neural structures, including the hippocampus, and deficits in episodic memory. Rodent studies provide evidence that memory deficits arise via stress-related structural differences in hippocampal subdivisions; however, human studies have only provided limited evidence to support this notion. We used a sample of 10,695 9-13-year-old participants from two timepoints of the Adolescent Brain and Cognitive Development (ABCD) Study to assess whether socioeconomic disadvantage relates to episodic memory performance through hippocampal volumes. We explored associations among socioeconomic disadvantage, measured via the Area Deprivation Index (ADI), concurrent subregion (anterior, posterior) and subfield volumes (CA1, CA3, CA4/DG, subiculum), and episodic memory, assessed via the NIH Toolbox Picture Sequence Memory Test at baseline and 2-year follow-up (Time 2). Results showed that higher baseline ADI related to smaller concurrent anterior, CA1, CA4/DG, and subiculum volumes and poorer Time 2 memory performance controlling for baseline memory. Moreover, anterior, CA1, and subiculum volumes mediated the longitudinal association between the ADI and memory. Results suggest that greater socioeconomic disadvantage relates to smaller hippocampal subregion and subfield volumes and less age-related improvement in memory. These findings shed light on the neural mechanisms linking socioeconomic disadvantage and cognitive ability in childhood.
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Affiliation(s)
- Morgan Botdorf
- University of Maryland, College Park, Department of Psychology, United States; University of Pennsylvania, Department of Psychology, United States.
| | - Jade Dunstan
- University of Maryland, College Park, Department of Psychology, United States
| | - Leah Sorcher
- University of Maryland, College Park, Department of Psychology, United States
| | - Lea R Dougherty
- University of Maryland, College Park, Department of Psychology, United States
| | - Tracy Riggins
- University of Maryland, College Park, Department of Psychology, United States
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25
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Cain KS, Meyer SC, Cummer E, Patel KK, Casacchia NJ, Montez K, Palakshappa D, Brown CL. Association of Food Insecurity with Mental Health Outcomes in Parents and Children. Acad Pediatr 2022; 22:1105-1114. [PMID: 35577282 PMCID: PMC10153634 DOI: 10.1016/j.acap.2022.04.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 04/07/2022] [Accepted: 04/30/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND Food insecurity affects 13.7 million US households and is linked to poor mental health. Families shield children from food insecurity by sacrificing their nutritional needs, suggesting parents and children experience food insecurity differentially. OBJECTIVE To identify the associations of food insecurity and mental health outcomes in parents and children DATA SOURCES: PubMed, Embase, Web of Science, and PsycInfo STUDY ELIGIBILITY CRITERIA: We included original research published in English from January 1990 to June 2020 that examined associations between food insecurity and mental health in children or parents/guardians in the United States. STUDY APPRAISAL AND SYNTHESIS METHODS Two reviewers screened studies for inclusion. Data extraction was completed by one reviewer and checked by a second. Bias and confounding were assessed using the Agency for Healthcare Research and Quality RTI Item Bank. Studies were synthesized qualitatively, grouped by mental health outcome, and patterns were assessed. Meta-analyses were not performed due to high variability between studies. RESULTS We included 108 studies, assessing 250,553 parents and 203,822 children in total. Most studies showed a significant association between food insecurity and parental depression, anxiety, and stress, and between food insecurity and child depression, externalizing/internalizing behaviors, and hyperactivity. LIMITATIONS Most studies were cross-sectional and many were medium- or high-risk for bias or confounding. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS Food insecurity is significantly associated with various mental health outcomes in both parents and children. The rising prevalence of food insecurity and mental health problems make it imperative that effective public health and policy interventions address both problems.
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Affiliation(s)
- Kathryn S Cain
- Department of Pediatrics (KS Cain, SC Meyer, E Cummer, KK Patel, K Montez, D Palakshappa, and CL Brown), Wake Forest School of Medicine, Winston-Salem, NC
| | - Stephanie C Meyer
- Department of Pediatrics (KS Cain, SC Meyer, E Cummer, KK Patel, K Montez, D Palakshappa, and CL Brown), Wake Forest School of Medicine, Winston-Salem, NC
| | - Elaina Cummer
- Department of Pediatrics (KS Cain, SC Meyer, E Cummer, KK Patel, K Montez, D Palakshappa, and CL Brown), Wake Forest School of Medicine, Winston-Salem, NC
| | - Kishan K Patel
- Department of Pediatrics (KS Cain, SC Meyer, E Cummer, KK Patel, K Montez, D Palakshappa, and CL Brown), Wake Forest School of Medicine, Winston-Salem, NC
| | - Nicholas J Casacchia
- Clinical and Translational Science Institute (NJ Casacchia), Wake Forest University, Winston-Salem, NC
| | - Kimberly Montez
- Department of Pediatrics (KS Cain, SC Meyer, E Cummer, KK Patel, K Montez, D Palakshappa, and CL Brown), Wake Forest School of Medicine, Winston-Salem, NC
| | - Deepak Palakshappa
- Department of Pediatrics (KS Cain, SC Meyer, E Cummer, KK Patel, K Montez, D Palakshappa, and CL Brown), Wake Forest School of Medicine, Winston-Salem, NC; Department of Internal Medicine (D Palakshappa), Wake Forest School of Medicine, Winston-Salem, NC; Department of Epidemiology and Prevention (D Palakshappa, CL Brown), Wake Forest School of Medicine, Winston-Salem, NC
| | - Callie L Brown
- Department of Pediatrics (KS Cain, SC Meyer, E Cummer, KK Patel, K Montez, D Palakshappa, and CL Brown), Wake Forest School of Medicine, Winston-Salem, NC; Department of Epidemiology and Prevention (D Palakshappa, CL Brown), Wake Forest School of Medicine, Winston-Salem, NC.
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Bendezú JJ, Handley ED, Manly JT, Toth SL, Cicchetti D. Psychobiological foundations of coping and emotion regulation: Links to maltreatment and depression in a racially diverse, economically disadvantaged sample of adolescent girls. Psychoneuroendocrinology 2022; 143:105826. [PMID: 35700563 PMCID: PMC9357119 DOI: 10.1016/j.psyneuen.2022.105826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 06/02/2022] [Accepted: 06/03/2022] [Indexed: 11/22/2022]
Abstract
Adolescent risk for depression and passive or active suicidal ideation (PASI) involves disturbance across multiple systems (e.g., arousal regulatory, affective valence, neurocognitive). Exposure to maltreatment while growing up as a child or teenager may potentiate this risk by noxiously impacting these systems. However, research exploring how coordinated disturbance across these systems (i.e., profiles) might be uniquely linked to depressogenic function, and how past maltreatment contributes to such disturbance, is lacking. Utilizing a racially diverse, economically disadvantaged sample of adolescent girls, this person-centered study identified psychobiological profiles and linked them to maltreatment histories, as well as current depressive symptoms and PASI. Girls (N = 237, Mage=13.98, SD=0.85) who were non-depressed/non-maltreated (15.1%), depressed/non-maltreated (40.5%), or depressed/maltreated (44.4%) provided morning saliva samples, completed questionnaires, a clinical interview, and a neurocognitive battery. Latent profile analysis of girls' morning cortisol:C-reactive protein ratio, positive and negative affect levels, and attentional set-shifting ability revealed four profiles. Relative to Normative (66.6%), girls exhibiting a Pro-inflammatory Affective Disturbance (13.1%), Severe Affective Disturbance (10.1%), or Hypercortisol Affective Neurocognitive Disturbance (n = 24, 10.1%) profile reported exposure to a greater number of maltreatment subtypes while growing up. Girls exhibiting these dysregulated profiles were also more likely (relative to Normative) to report current depressive symptoms (all three profiles) and PASI (only Pro-inflammatory Affective Disturbance and Hypercortisol Affective Neurocognitive Disturbance). Of note, girls' cognitive reappraisal utilization moderated profile membership-depression linkages (depressive symptoms, but not PASI). A synthesis of the findings is presented alongside implications for person-centered tailoring of intervention efforts.
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Affiliation(s)
- Jason José Bendezú
- The Institute of Child Development, University of Minnesota, USA; Department of Psychology, University of Minnesota, USA.
| | | | - Jody T Manly
- Mt. Hope Family Center, University of Rochester, USA
| | - Sheree L Toth
- Mt. Hope Family Center, University of Rochester, USA
| | - Dante Cicchetti
- The Institute of Child Development, University of Minnesota, USA
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Mukherjee D, Bhopal S, Bhavnani S, Sharma KK, Roy R, Divan G, Mandal S, Soremekun S, Kirkwood B, Patel V. The effect of cumulative early life adversities, and their differential mediation through hair cortisol levels, on childhood growth and cognition: Three-year follow-up of a birth cohort in rural India. Wellcome Open Res 2022; 7:74. [PMID: 35592545 PMCID: PMC9096148 DOI: 10.12688/wellcomeopenres.17712.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2022] [Indexed: 11/09/2023] Open
Abstract
Background: Early adversities negatively impact children's growth and development, putatively mediated by chronic physiological stress resulting from these adverse experiences. We aimed to estimate the associations between prospectively measured cumulative early adversities with growth and cognition outcomes in rural Indian preschool children and to explore if hair cortisol concentration (HCC), a measure of chronic physiological stress, mediated the above association. Methods: Participants were recruited from the SPRING cRCT in rural Haryana, India. Adversities experienced through pregnancy and the first year of life were measured in 1304 children at 12-months. HCC was measured at 12-months in 845 of them. Outcome measures were height-for-age-z-score (HAZ), weight-for-age-z-score (WAZ) and cognition, measured in 1124 children followed up at 3-years. Cognition was measured using a validated tablet-based gamified tool named DEEP. Results: Cumulative adversities at 12-months were inversely associated with all outcomes measures at 3-years. Each unit increase in adversity score led to a decrease of 0·08 units [95% confidence interval (CI):-0·11,-0·06] in DEEP-z-score; 0·12 units [-0·14,-0·09] in HAZ and 0·11 units [-0·13,-0·09] in WAZ. 12-month HCC was inversely associated with DEEP-z-score (-0·09 [-0·16,-0·01]) and HAZ (-0·12 [-0·20,-0·04]), but the association with WAZ was not significant (p = 0·142). HCC marginally mediated the association between cumulative adversities and HAZ (proportion mediated = 0·06, p = 0·014). No evidence of mediation was found for the cognition outcome. Conclusions: Cumulative early adversities and HCC measured at 12-months have persistent negative effects on child growth and cognition at 3-years. The association between adversities and these two child outcomes were differentially mediated by HCC, with no evidence of mediation observed for the cognitive outcome. Future studies should focus on other stress biomarkers, and alternate pathways such as the immune, inflammation and cellular ageing pathways, to unpack key mechanisms underlying the established relationship between early adversities and poor child outcomes.
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Affiliation(s)
- Debarati Mukherjee
- Life course Epidemiology, Indian Institute of Public Health-Bengaluru, Public Health Foundation of India, Bengaluru, Karnataka, 560023, India
| | - Sunil Bhopal
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK
- Maternal & Child Health Intervention Research Group, Department of Population Health, Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Supriya Bhavnani
- Child Development Group, Sangath, 451 Bhatkar Waddo, Succor, Bardez, Goa, 403501, India
| | - Kamal Kant Sharma
- Child Development Group, Sangath, 451 Bhatkar Waddo, Succor, Bardez, Goa, 403501, India
| | - Reetabrata Roy
- Maternal & Child Health Intervention Research Group, Department of Population Health, Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
- Child Development Group, Sangath, 451 Bhatkar Waddo, Succor, Bardez, Goa, 403501, India
| | - Gauri Divan
- Child Development Group, Sangath, 451 Bhatkar Waddo, Succor, Bardez, Goa, 403501, India
| | - Siddhartha Mandal
- Center for Chronic Disease Control, C-1/52, 2ND FL, Safdarjung Development Area, New Delhi, 110016, India
| | - Seyi Soremekun
- Department of Infection Biology, Faculty of Infectious and Tropical Disease, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Betty Kirkwood
- Maternal & Child Health Intervention Research Group, Department of Population Health, Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Vikram Patel
- Child Development Group, Sangath, 451 Bhatkar Waddo, Succor, Bardez, Goa, 403501, India
- Department of Global Health & Social Medicine, Harvard Medical School, 41 Huntington Ave, Boston, MA, 02115, USA
- Department of Global Health and Population, Harvard T H Chan School of Public Health, 655 Huntington Ave, Boston, MA, 02115, USA
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Mukherjee D, Bhopal S, Bhavnani S, Sharma KK, Roy R, Divan G, Mandal S, Soremekun S, Kirkwood B, Patel V. The effect of cumulative early life adversities, and their differential mediation through hair cortisol levels, on childhood growth and cognition: Three-year follow-up of a birth cohort in rural India. Wellcome Open Res 2022; 7:74. [PMID: 35592545 PMCID: PMC9096148 DOI: 10.12688/wellcomeopenres.17712.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Early adversities negatively impact children’s growth and development, putatively mediated by chronic physiological stress resulting from these adverse experiences. We aimed to estimate the associations between prospectively measured cumulative early adversities with growth and cognition outcomes in rural Indian preschool children and to explore if hair cortisol concentration (HCC), a measure of chronic physiological stress, mediated the above association. Methods: Participants were recruited from the SPRING cRCT in rural Haryana, India. Adversities experienced through pregnancy and the first year of life were measured in 1304 children at 12-months. HCC was measured at 12-months in 845 of them. Outcome measures were height-for-age-z-score (HAZ), weight-for-age-z-score (WAZ) and cognition, measured in 1124 children followed up at 3-years. Cognition was measured using a validated tablet-based gamified tool named DEEP. Results: Cumulative adversities at 12-months were inversely associated with all outcomes measures at 3-years. Each unit increase in adversity score led to a decrease of 0·08 units [95% confidence interval (CI):-0·11,-0·06] in DEEP-z-score; 0·12 units [-0·14,-0·09] in HAZ and 0·11 units [-0·13,-0·09] in WAZ. 12-month HCC was inversely associated with DEEP-z-score (-0·09 [-0·16,-0·01]) and HAZ (-0·12 [-0·20,-0·04]), but the association with WAZ was not significant (p = 0·142). HCC marginally mediated the association between cumulative adversities and HAZ (proportion mediated = 0·06, p = 0·014). No evidence of mediation was found for the cognition outcome. Conclusions: Cumulative early adversities and HCC measured at 12-months have persistent negative effects on child growth and cognition at 3-years. The association between adversities and these two child outcomes were differentially mediated by HCC, with no evidence of mediation observed for the cognitive outcome. Future studies should focus on other stress biomarkers, and alternate pathways such as the immune, inflammation and cellular ageing pathways, to unpack key mechanisms underlying the established relationship between early adversities and poor child outcomes.
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Affiliation(s)
- Debarati Mukherjee
- Life course Epidemiology, Indian Institute of Public Health-Bengaluru, Public Health Foundation of India, Bengaluru, Karnataka, 560023, India
| | - Sunil Bhopal
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK
- Maternal & Child Health Intervention Research Group, Department of Population Health, Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Supriya Bhavnani
- Child Development Group, Sangath, 451 Bhatkar Waddo, Succor, Bardez, Goa, 403501, India
| | - Kamal Kant Sharma
- Child Development Group, Sangath, 451 Bhatkar Waddo, Succor, Bardez, Goa, 403501, India
| | - Reetabrata Roy
- Maternal & Child Health Intervention Research Group, Department of Population Health, Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
- Child Development Group, Sangath, 451 Bhatkar Waddo, Succor, Bardez, Goa, 403501, India
| | - Gauri Divan
- Child Development Group, Sangath, 451 Bhatkar Waddo, Succor, Bardez, Goa, 403501, India
| | - Siddhartha Mandal
- Center for Chronic Disease Control, C-1/52, 2ND FL, Safdarjung Development Area, New Delhi, 110016, India
| | - Seyi Soremekun
- Department of Infection Biology, Faculty of Infectious and Tropical Disease, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Betty Kirkwood
- Maternal & Child Health Intervention Research Group, Department of Population Health, Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Vikram Patel
- Child Development Group, Sangath, 451 Bhatkar Waddo, Succor, Bardez, Goa, 403501, India
- Department of Global Health & Social Medicine, Harvard Medical School, 41 Huntington Ave, Boston, MA, 02115, USA
- Department of Global Health and Population, Harvard T H Chan School of Public Health, 655 Huntington Ave, Boston, MA, 02115, USA
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Bayly BL, Cooper BR, Rhoades KA. Head Start’s impact on long-term School Success: assessing variation across latent classes of Family RiskPlease remove blank page at last in PDF. CHILD & YOUTH CARE FORUM 2022. [DOI: 10.1007/s10566-022-09702-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Cumulative Effects of Poverty on Children's Social-Emotional Development: Absolute Poverty and Relative Poverty. Community Ment Health J 2022; 58:930-943. [PMID: 34750684 DOI: 10.1007/s10597-021-00901-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 10/02/2021] [Indexed: 10/19/2022]
Abstract
This study examines the cumulative effects of poverty on children's socio-emotional outcomes from ages 5 to 12, using U.S. National Longitudinal Survey of Youth data (N = 6941). Two definitions of poverty were used: absolute poverty as defined by the federal poverty threshold, and relative poverty defined as income less than 50 percent of median household income. (1) Does cumulative poverty, measured in absolute and relative terms, have any impact on children's socio-emotional outcomes? (2) Does this association increase/decrease as children become older? Relative poverty had a stronger adverse effect on children's social-emotional development than absolute poverty, and the adverse effect of relative poverty was bigger when children were older. Child and maternal characteristics affected children's socio-emotional development. The income threshold for absolute poverty is lower than that for relative poverty; using a relative poverty threshold might better identify individuals with limited resources that are at risk of having adverse socio-emotional outcomes.
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Kapustka LA. What makes radiation protection so challenging? Int J Radiat Biol 2022; 98:1008-1011. [DOI: 10.1080/09553002.2020.1793026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Ford KJ, Kobayashi LC, Leist AK. Childhood Socioeconomic Disadvantage and Pathways to Memory Performance in Mid to Late Adulthood: What Matters Most? J Gerontol B Psychol Sci Soc Sci 2022; 77:1478-1489. [PMID: 35583218 PMCID: PMC9371451 DOI: 10.1093/geronb/gbac075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Childhood socioeconomic disadvantage is consistently associated with lower cognitive function in later life. This study aims to distinguish the contribution of specific aspects of childhood socioeconomic disadvantage for memory performance in mid-to-late adulthood, with consideration for direct and indirect effects through education and occupation. METHODS Data were from adults aged 50-80 years who completed the life history module in the 2006/07 wave of the English Longitudinal Study of Ageing (n=4,553). The outcome, memory score, was based on word recall tests (range: 0-20 points). We used the g-formula to estimate direct and indirect effects of a composite variable for childhood socioeconomic disadvantage, and its four individual components: lower-skilled occupation of the primary breadwinner, having few books in the home, overcrowding in the home, and lack of water and heating facilities in the home. RESULTS Few books were the most consequential component of childhood socioeconomic disadvantage for later life memory (total effect: ⎼0.82 points for few books; 95% CI: ⎼1.04, ⎼0.60), with roughly half being a direct effect. The total effect of a breadwinner in lower-skilled occupations was smaller but not significantly different from few books (⎼0.67 points; 95% CI: ⎼0.88, ⎼0.46), while it was significantly smaller with overcrowding (⎼0.31 points; 95% CI: ⎼0.56, ⎼0.06). The latter two total effects were mostly mediated by education and occupation. DISCUSSION A literate environment in the childhood home may have lasting direct effects on memory function in mid-to-later life, while parental occupation and overcrowding appear to influence memory primarily through educational and occupational pathways.
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Affiliation(s)
- Katherine J Ford
- Institute for Research on Socio-Economic Inequality (IRSEI), University of Luxembourg, 11 Porte des Sciences, L-4366 Esch-sur-Alzette, Luxembourg
| | - Lindsay C Kobayashi
- Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, Michigan 48109, USA
| | - Anja K Leist
- Institute for Research on Socio-Economic Inequality (IRSEI), University of Luxembourg, 11 Porte des Sciences, L-4366 Esch-sur-Alzette, Luxembourg
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von Stumm S, Cave SN, Wakeling P. Persistent association between family socioeconomic status and primary school performance in Britain over 95 years. NPJ SCIENCE OF LEARNING 2022; 7:4. [PMID: 35443764 PMCID: PMC9021311 DOI: 10.1038/s41539-022-00120-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 01/24/2022] [Indexed: 06/07/2023]
Abstract
In Britain and elsewhere, the influence of family socioeconomic status (SES) on education is already evident in primary school, and it persists and increases throughout the school years, with children from impoverished families earning lower grades and obtaining fewer educational qualifications than children from more privileged backgrounds. Reducing the effect of family background on children's education is a pivotal aim of educators, policymakers, and researchers, but the success of their efforts is poorly evidenced to date. Here, we show for the first time that over 95 years in Britain the association between family SES and children's primary school performance has remained stable. Across 16 British population cohorts born between 1921 and 2011 (N = 91,935), we confirmed previous findings of a correlation between family SES and children's school performance of 0.28 [95% Confidence Interval 0.22-0.34], after adjusting for cohort-specific confounders. Contrary to the popular assumption that family background inequality has increased over time, we observed only minimal differences in the association between family SES and school performance across British cohorts. We argue that education policies must prioritize equity in learning outcomes over equality in learning opportunities, if they seek to disrupt the perpetuation of social and economic inequality across generations. We speculate that the influence of family SES on children's education will only noticeably weaken if primary education settings become better equipped to meet and remediate the children's differential learning needs.
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Affiliation(s)
- Sophie von Stumm
- Department of Education, University of York, YO10 5DD, Heslington, York, UK.
| | - Sophie Nicole Cave
- Department of Education, University of York, YO10 5DD, Heslington, York, UK
| | - Paul Wakeling
- Department of Education, University of York, YO10 5DD, Heslington, York, UK
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Triplett RL, Lean RE, Parikh A, Miller JP, Alexopoulos D, Kaplan S, Meyer D, Adamson C, Smyser TA, Rogers CE, Barch DM, Warner B, Luby JL, Smyser CD. Association of Prenatal Exposure to Early-Life Adversity With Neonatal Brain Volumes at Birth. JAMA Netw Open 2022; 5:e227045. [PMID: 35412624 PMCID: PMC9006107 DOI: 10.1001/jamanetworkopen.2022.7045] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 02/24/2022] [Indexed: 12/21/2022] Open
Abstract
Importance Exposure to early-life adversity alters the structural development of key brain regions underlying neurodevelopmental impairments. The association between prenatal exposure to adversity and brain structure at birth remains poorly understood. Objective To examine whether prenatal exposure to maternal social disadvantage and psychosocial stress is associated with neonatal global and regional brain volumes and cortical folding. Design, Setting, and Participants This prospective, longitudinal cohort study included 399 mother-infant dyads of sociodemographically diverse mothers recruited in the first or early second trimester of pregnancy and their infants, who underwent brain magnetic resonance imaging in the first weeks of life. Mothers were recruited from local obstetric clinics in St Louis, Missouri from September 1, 2017, to February 28, 2020. Exposures Maternal social disadvantage and psychosocial stress in pregnancy. Main Outcomes and Measures Confirmatory factor analyses were used to create latent constructs of maternal social disadvantage (income-to-needs ratio, Area Deprivation Index, Healthy Eating Index, educational level, and insurance status) and psychosocial stress (Perceived Stress Scale, Edinburgh Postnatal Depression Scale, Everyday Discrimination Scale, and Stress and Adversity Inventory). Neonatal cortical and subcortical gray matter, white matter, cerebellum, hippocampus, and amygdala volumes were generated using semiautomated, age-specific, segmentation pipelines. Results A total of 280 mothers (mean [SD] age, 29.1 [5.3] years; 170 [60.7%] Black or African American, 100 [35.7%] White, and 10 [3.6%] other race or ethnicity) and their healthy, term-born infants (149 [53.2%] male; mean [SD] infant gestational age, 38.6 [1.0] weeks) were included in the analysis. After covariate adjustment and multiple comparisons correction, greater social disadvantage was associated with reduced cortical gray matter (unstandardized β = -2.0; 95% CI, -3.5 to -0.5; P = .01), subcortical gray matter (unstandardized β = -0.4; 95% CI, -0.7 to -0.2; P = .003), and white matter (unstandardized β = -5.5; 95% CI, -7.8 to -3.3; P < .001) volumes and cortical folding (unstandardized β = -0.03; 95% CI, -0.04 to -0.01; P < .001). Psychosocial stress showed no association with brain metrics. Although social disadvantage accounted for an additional 2.3% of the variance of the left hippocampus (unstandardized β = -0.03; 95% CI, -0.05 to -0.01), 2.3% of the right hippocampus (unstandardized β = -0.03; 95% CI, -0.05 to -0.01), 3.1% of the left amygdala (unstandardized β = -0.02; 95% CI, -0.03 to -0.01), and 2.9% of the right amygdala (unstandardized β = -0.02; 95% CI, -0.03 to -0.01), no regional effects were found after accounting for total brain volume. Conclusions and Relevance In this baseline assessment of an ongoing cohort study, prenatal social disadvantage was associated with global reductions in brain volumes and cortical folding at birth. No regional specificity for the hippocampus or amygdala was detected. Results highlight that associations between poverty and brain development begin in utero and are evident early in life. These findings emphasize that preventive interventions that support fetal brain development should address parental socioeconomic hardships.
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Affiliation(s)
- Regina L. Triplett
- Department of Neurology, Washington University in St Louis, St Louis, Missouri
| | - Rachel E. Lean
- Department of Psychiatry, Washington University in St Louis, St Louis, Missouri
| | - Amisha Parikh
- School of Medicine, Washington University in St Louis, St Louis, Missouri
| | - J. Philip Miller
- Department of Biostatistics, Washington University in St Louis, St Louis, Missouri
| | | | - Sydney Kaplan
- Department of Neurology, Washington University in St Louis, St Louis, Missouri
| | - Dominique Meyer
- Department of Neurology, Washington University in St Louis, St Louis, Missouri
| | - Christopher Adamson
- Developmental Imaging, Murdoch Children’s Institute, Melbourne, Australia
- Electrical and Electronic Engineering, University of Melbourne, Melbourne, Australia
| | - Tara A. Smyser
- Department of Psychiatry, Washington University in St Louis, St Louis, Missouri
| | - Cynthia E. Rogers
- Department of Psychiatry, Washington University in St Louis, St Louis, Missouri
- Department of Pediatrics, Washington University in St Louis, St Louis, Missouri
| | - Deanna M. Barch
- Department of Psychiatry, Washington University in St Louis, St Louis, Missouri
- Department of Psychological and Brain Sciences, Washington University in St Louis, St Louis, Missouri
- Department of Radiology, Washington University in St Louis, St Louis, Missouri
| | - Barbara Warner
- Department of Pediatrics, Washington University in St Louis, St Louis, Missouri
| | - Joan L. Luby
- Department of Psychiatry, Washington University in St Louis, St Louis, Missouri
| | - Christopher D. Smyser
- Department of Neurology, Washington University in St Louis, St Louis, Missouri
- Department of Pediatrics, Washington University in St Louis, St Louis, Missouri
- Department of Radiology, Washington University in St Louis, St Louis, Missouri
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Chiang S, Bai S. Internalizing symptoms among Taiwanese adolescents in poverty: Longitudinal influences of neighborhood, family, and school. J Adolesc 2022; 94:390-400. [PMID: 35390190 PMCID: PMC9009220 DOI: 10.1002/jad.12030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 12/01/2020] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Identifying specific contextual factors that contribute to the development of internalizing symptoms in adolescents in poverty is critical for prevention. This study examined the longitudinal effects of neighborhood disadvantage, family cohesion, and teacher-student relationship on adolescent internalizing symptoms from economically disadvantaged families. METHODS Participants were 1404 Taiwanese adolescents (49% female) in the nationally representative Taiwan database of children and youth in poverty. Youth were enrolled in the seventh, eighth, or ninth grades (Time 1; Mage = 14.85, SD = 0.95) and completed biennial follow-up assessments 2 (Time 2; Mage = 16.47, SD = 0.74) and 4 years after baseline (Time 3; Mage = 18.21, SD = 0.70). Latent growth models examined longitudinal associations between contextual factors and internalizing symptoms over time. RESULTS Adolescents reported declines in neighborhood disadvantage and teacher-student relationship but increases in family cohesion over the 4 years. At baseline, greater neighborhood disadvantage was associated with higher levels of internalizing symptoms, whereas higher family cohesion was associated with lower levels of internalizing symptoms. Over time, an increase in family cohesion was associated with a decrease in internalizing symptoms. CONCLUSION This study provides empirical support that family cohesion plays a critical role in shaping the development of adolescent internalizing symptoms despite poverty. There was an increase in family cohesion from early to late adolescence among Taiwanese adolescents in poverty and such change was correlated with decreases in youth internalizing symptoms. Family cohesion may be a key target of prevention programs aiming to reduce internalizing symptoms for youth in poverty.
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Affiliation(s)
- Shou‐Chun Chiang
- Department of Human Development and Family Studies The Pennsylvania State University University Park Pennsylvania USA
| | - Sunhye Bai
- Department of Human Development and Family Studies The Pennsylvania State University University Park Pennsylvania USA
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Bach AM, Xie W, Piazzoli L, Jensen SKG, Afreen S, Haque R, Petri WA, Nelson CA. Systemic inflammation during the first year of life is associated with brain functional connectivity and future cognitive outcomes. Dev Cogn Neurosci 2022; 53:101041. [PMID: 34973509 PMCID: PMC8728426 DOI: 10.1016/j.dcn.2021.101041] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 10/09/2021] [Accepted: 11/27/2021] [Indexed: 01/01/2023] Open
Abstract
The first years of life are a sensitive period of rapid neural and immune system development vulnerable to the impact of adverse experiences. Several studies support inflammation as a consequence of various adversities and an exposure negatively associated with developmental outcomes. The mechanism by which systemic inflammation may affect brain development and later cognitive outcomes remains unclear. In this longitudinal cohort study, we examine the associations between recurrent systemic inflammation, defined as C-reactive protein elevation on ≥ 2 of 4 measurements across the first year of life, electroencephalography (EEG) functional connectivity (FC) at 36 months, and composite cognitive outcomes at 3, 4, and 5 years among 122 children living in a limited-resource setting in Dhaka, Bangladesh. Recurrent systemic inflammation during the first year of life is significantly negatively associated with cognitive outcomes at 3, 4, and 5 years, after accounting for stunting and family care indicators (a measure of stimulation in the home environment). Recurrent systemic inflammation is significantly positively associated with parietal-occipital FC in the Beta band at 36 months, which in turn is significantly negatively associated with composite cognitive scores at 3 and 4 years. However, FC does not mediate the relationship between recurrent systemic inflammation and cognitive outcomes.
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Affiliation(s)
- Ashley M Bach
- Labs of Cognitive Neuroscience, Division of Developmental Medicine, Boston Children's Hospital, USA; Harvard T.H. Chan School of Public Health, USA
| | - Wanze Xie
- School of Psychological and Cognitive Sciences, Peking University, China; PKU-IDG/McGovern Institute for Brain Research, Peking University, China; Beijing Key Laboratory of Behavior and Mental Health, Peking University, China
| | - Laura Piazzoli
- Labs of Cognitive Neuroscience, Division of Developmental Medicine, Boston Children's Hospital, USA; Harvard Medical School, USA
| | | | - Sajia Afreen
- International Centre for Diarrhoeal Disease Research, Bangladesh
| | - Rashidul Haque
- International Centre for Diarrhoeal Disease Research, Bangladesh
| | - William A Petri
- Division of Infectious Diseases, University of Virginia School of Medicine, USA
| | - Charles A Nelson
- Labs of Cognitive Neuroscience, Division of Developmental Medicine, Boston Children's Hospital, USA; Harvard Medical School, USA; Harvard Graduate School of Education, USA.
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Alexandra Dunn J, Medhin G, Dewey M, Alem A, Worku B, Paksarian D, Newton CR, Tomlinson M, Prince M, Hanlon C. Common perinatal mental disorders and post‐infancy child development in rural Ethiopia: a population‐based cohort study. Trop Med Int Health 2022; 27:251-261. [PMID: 35080279 PMCID: PMC9305759 DOI: 10.1111/tmi.13725] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Objective To investigate whether maternal common mental disorders (CMD) in the postnatal period are prospectively associated with child development at 2.5 and 3.5 years in a rural low‐income African setting. Methods This study was nested within the C‐MaMiE (Child outcomes in relation to Maternal Mental health in Ethiopia) population‐based cohort in Butajira, Ethiopia, and conducted from 2005 to 2006. The sample comprised of 496 women who had recently given birth to living, singleton babies with recorded birth weight measurements, who were 15 to 44 years of age, and residing in six rural sub‐districts. Postnatal CMD measurements were ascertained 2 months after delivery. Language, cognitive, and motor development were obtained from the child 2.5 and 3.5 years after birth using a locally adapted version of the Bayley Scales of Infant Development (3rd Ed). Maternal CMD symptoms were measured using a locally validated WHO Self‐Reporting Questionnaire. A linear mixed‐effects regression model was used to analyze the relationship between postnatal CMD and child development. Results After adjusting for confounders, there was no evidence for an association between postnatal CMD and overall child development or the cognitive sub‐domain in the preschool period. There was no evidence of effect modification by levels of social support, socioeconomic status, stunting, or sex of the child. Conclusions Previous studies from predominantly urban and peri‐urban settings in middle‐income countries have established a relationship between maternal CMD and child development, which contrasts with the findings from this study. The risk and protective factors for child development may differ in areas characterized by high social adversity and food insecurity. More studies are needed to investigate maternal CMD’s impact on child development in low‐resource and rural areas.
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Affiliation(s)
- Julia Alexandra Dunn
- King’s College London Centre for Global Mental Health Health Service and Population Research Department Institute of Psychiatry, Psychology and Neuroscience London UK
- National Institute of Mental Health Genetic Epidemiology Research Branch Intramural Research Program Bethesda USA
| | - Girmay Medhin
- Aklilu‐Lemma Institute of Pathobiology Addis Ababa University Addis Ababa Ethiopia
| | - Michael Dewey
- King’s College London Centre for Global Mental Health Health Service and Population Research Department Institute of Psychiatry, Psychology and Neuroscience London UK
| | - Atalay Alem
- Addis Ababa University Department of Psychiatry WHO Collaborating Centre for Mental Health Research and Capacity‐Building School of Medicine College of Health Sciences Addis Ababa Ethiopia
| | - Bogale Worku
- Department of Paediatrics and Community Health Addis Ababa University Addis Ababa Ethiopia
| | - Diana Paksarian
- National Institute of Mental Health Genetic Epidemiology Research Branch Intramural Research Program Bethesda USA
| | | | - Mark Tomlinson
- Institute for Life Course Health Research Department of Global Health Stellenbosch University Cape Town South Africa
- School of Nursing and Midwifery Queens University Belfast UK
| | - Martin Prince
- King’s College London King’s Global Health Institute London UK
| | - Charlotte Hanlon
- King’s College London Centre for Global Mental Health Health Service and Population Research Department Institute of Psychiatry, Psychology and Neuroscience London UK
- Addis Ababa University Department of Psychiatry WHO Collaborating Centre for Mental Health Research and Capacity‐Building School of Medicine College of Health Sciences Addis Ababa Ethiopia
- Addis Ababa University Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT‐Africa) College of Health Sciences Addis Ababa Ethiopia
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Kohl PL, Gyimah EA, Diaz J, Kuhlmann FM, Dulience SJL, Embaye F, Brown DS, Guo S, Luby JL, Nicholas JL, Turner J, Chapnick M, Pierre JM, Boncy J, St Fleur R, Black MM, Iannotti LL. Grandi Byen-supporting child growth and development through integrated, responsive parenting, nutrition and hygiene: study protocol for a randomized controlled trial. BMC Pediatr 2022; 22:54. [PMID: 35062907 PMCID: PMC8780724 DOI: 10.1186/s12887-021-03089-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 12/22/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Poor child growth and development outcomes stem from complex relationships encompassing biological, behavioral, social, and environmental conditions. However, there is a dearth of research on integrated approaches targeting these interwoven factors. The Grandi Byen study seeks to fill this research gap through a three-arm longitudinal randomized controlled trial which will evaluate the impact of an integrated nutrition, responsive parenting, and WASH (water, sanitation and hygiene) intervention on holistic child growth and development. METHODS We will recruit 600 mother-infant dyads living in Cap-Haitien, Haiti and randomize them equally into one of the following groups: 1) standard well-baby care; 2) nutritional intervention (one egg per day for 6 months); and 3) multicomponent Grandi Byen intervention (responsive parenting, nutrition, WASH + one egg per day for 6 months). Primary outcomes include child growth as well as cognitive, language, motor, and social-emotional development. The study also assesses other indicators of child health (bone maturation, brain growth, diarrheal morbidity and allergies, dietary intake, nutrient biomarkers) along with responsive parenting as mediating factors influencing the primary outcomes. An economic evaluation will assess the feasibility of large-scale implementation of the interventions. DISCUSSION This study builds on research highlighting the importance of responsive parenting interventions on overall child health, as well as evidence demonstrating that providing an egg daily to infants during the complementary feeding period can prevent stunted growth. The multicomponent Grandi Byen intervention may provide evidence of synergistic or mediating effects of an egg intervention with instruction on psychoeducational parenting and WASH on child growth and development. Grandi Byen presents key innovations with implications for the well-being of children living in poverty globally. TRIAL REGISTRATION NCT04785352 . Registered March 5, 2021 at https://clinicaltrials.gov/.
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Affiliation(s)
- Patricia L Kohl
- Brown School, Washington University in St. Louis, 1 Brookings Dr., Campus Box 1196, St. Louis, MO, 63130, USA
| | - Emmanuel A Gyimah
- Brown School, Washington University in St. Louis, 1 Brookings Dr., Campus Box 1196, St. Louis, MO, 63130, USA.
| | - Jenna Diaz
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Washington University School of Medicine in St. Louis, 660 S. Euclid Ave., St. Louis, MO, 63110, USA
| | - F Matthew Kuhlmann
- Division of Infectious Diseases, Washington University School of Medicine in St. Louis, 660 S. Euclid Ave., St. Louis, MO, 63110, USA
| | - Sherlie Jean-Louis Dulience
- Brown School, Washington University in St. Louis, 1 Brookings Dr., Campus Box 1196, St. Louis, MO, 63130, USA
| | - Fithi Embaye
- Brown School, Washington University in St. Louis, 1 Brookings Dr., Campus Box 1196, St. Louis, MO, 63130, USA
| | - Derek S Brown
- Brown School, Washington University in St. Louis, 1 Brookings Dr., Campus Box 1196, St. Louis, MO, 63130, USA
| | - Shenyang Guo
- Brown School, Washington University in St. Louis, 1 Brookings Dr., Campus Box 1196, St. Louis, MO, 63130, USA
| | - Joan L Luby
- Department of Psychiatry, Washington University School of Medicine in St. Louis, 660 S. Euclid Ave., St. Louis, MO, 63110, USA
| | - Jennifer L Nicholas
- Department of Radiology, School of Medicine, Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH, 44106, USA
| | - Jay Turner
- McKelvey School of Engineering, Washington University in St. Louis, 1 Brookings Dr., St. Louis, MO, 63130, USA
| | - Melissa Chapnick
- Brown School, Washington University in St. Louis, 1 Brookings Dr., Campus Box 1196, St. Louis, MO, 63130, USA
| | - Joseline Marhone Pierre
- Unité de Coordination du Programme National d'Alimentation et de Nutrition, Ministère de la Santé Publique et de la Population, 1, Angle Avenue Maïs Gaté et, Rue Jacques Roumain, Port-au-Prince, Haiti
| | - Jacques Boncy
- Laboratoire National de Santé Publique, Ministère de la Santé Publique et de la Population, 1, Angle Avenue Maïs Gaté et, Rue Jacques Roumain, Port-au-Prince, Haiti
| | | | - Maureen M Black
- Department of Pediatrics, University of Maryland School of Medicine, 655 W. Baltimore Street, Baltimore, MD, 21201, USA
| | - Lora L Iannotti
- Brown School, Washington University in St. Louis, 1 Brookings Dr., Campus Box 1196, St. Louis, MO, 63130, USA
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Leone M, Kuja-Halkola R, Leval A, D'Onofrio BM, Larsson H, Lichtenstein P, Bergen SE. Association of severe childhood infections with depression and intentional self-harm in adolescents and young adults. Brain Behav Immun 2022; 99:247-255. [PMID: 34655731 DOI: 10.1016/j.bbi.2021.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/16/2021] [Accepted: 10/11/2021] [Indexed: 02/08/2023] Open
Abstract
Early-life infections have been linked with subsequent depression and self-harm. Examination of specific groups of infections and the role of familial factors may elucidate this observed relationship. We addressed these considerations in our investigations of the association of severe childhood infections with the risks of depression and self-harm in adolescence and early-adulthood. This population-based cohort study included all individuals born in Sweden between 1982 and 1996, with follow-up through 2013 (N = 1,506,070). Severe childhood infections were identified using inpatient and outpatient diagnoses from birth through age 12. Any infection as well as specific groups of infections were investigated. We examined diagnoses of depression and self-harm within inpatient and outpatient care and death by self-harm between ages 13 and 31. Cox proportional hazards regression models were used to estimate absolute risks, hazard ratios (HRs), and 95% CIs. When adjusting for sex and birth year, individuals exposed to any childhood infection demonstrated increased absolute risk differences for both outcomes (2.42% [95% CI, 0.41-4.43%] of being diagnosed with depression up until age 31, and 0.73% [-2.05% to 3.51%] of self-harm up until age 31) and increased relative risks (HR, 1.22 [1.20-1.24] for depression and HR, 1.29 [1.25-1.32] for self-harm). When controlling for unmeasured factors shared between family members by comparing discordant siblings, no strong association persisted. Our findings show that childhood infections may not be involved in the etiology of later depression and self-harm, and highlight the importance of identifying these genetic and environmental familial risk factors, which may serve as targets for interventions.
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Affiliation(s)
- Marica Leone
- Janssen Pharmaceutical Companies of Johnson and Johnson, Solna, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
| | - Ralf Kuja-Halkola
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
| | - Amy Leval
- Janssen Pharmaceutical Companies of Johnson and Johnson, Solna, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
| | - Brian M D'Onofrio
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden; Department of Psychological and Brain Sciences, Indiana University, Bloomington, United States
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden; School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
| | - Sarah E Bergen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden.
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Pfeiffer JR, van Rooij SJH, Mekawi Y, Fani N, Jovanovic T, Michopoulos V, Smith AK, Stevens JS, Uddin M. Blood-derived deoxyribonucleic acid methylation clusters associate with adverse social exposures and endophenotypes of stress-related psychiatric illness in a trauma-exposed cohort of women. Front Psychiatry 2022; 13:892302. [PMID: 36405926 PMCID: PMC9668877 DOI: 10.3389/fpsyt.2022.892302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 09/21/2022] [Indexed: 11/06/2022] Open
Abstract
Adverse social exposures (ASEs) such as low income, low educational attainment, and childhood/adult trauma exposure are associated with variability in brain region measurements of gray matter volume (GMV), surface area (SA), and cortical thickness (CT). These CNS morphometries are associated with stress-related psychiatric illnesses and represent endophenotypes of stress-related psychiatric illness development. Epigenetic mechanisms, such as 5-methyl-cytosine (5mC), may contribute to the biological embedding of the environment but are understudied and not well understood. How 5mC relates to CNS endophenotypes of psychiatric illness is also unclear. In 97 female, African American, trauma-exposed participants from the Grady Trauma Project, we examined the associations of childhood trauma burden (CTQ), adult trauma burden, low income, and low education with blood-derived 5mC clusters and variability in brain region measurements in the amygdala, hippocampus, and frontal cortex subregions. To elucidate whether peripheral 5mC indexes central nervous system (CNS) endophenotypes of psychiatric illness, we tested whether 73 brain/blood correlated 5mC clusters, defined by networks of correlated 5mC probes measured on Illumina's HumanMethylation Epic Beadchip, mediated the relationship between ASEs and brain measurements. CTQ was negatively associated with rostral middle frontal gyrus (RMFG) SA (β =-0.231, p = 0.041). Low income and low education were also associated with SA or CT in a number of brain regions. Seven 5mC clusters were associated with CTQ (pmin = 0.002), two with low education (pmin = 0.010), and three with low income (pmin = 0.007). Two clusters fully mediated the relation between CTQ and RMFG SA, accounting for 47 and 35% of variability, respectively. These clusters were enriched for probes falling in DNA regulatory regions, as well as signal transduction and immune signaling gene ontology functions. Methylome-network analyses showed enrichment of macrophage migration (p = 9 × 10-8), T cell receptor complex (p = 6 × 10-6), and chemokine-mediated signaling (p = 7 × 10-4) pathway enrichment in association with CTQ. Our results support prior work highlighting brain region variability associated with ASEs, while informing a peripheral inflammation-based epigenetic mechanism of biological embedding of such exposures. These findings could also serve to potentiate increased investigation of understudied populations at elevated risk for stress-related psychiatric illness development.
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Affiliation(s)
- John R Pfeiffer
- Department of Psychology, University of Illinois at Urbana-Champaign, Urbana, IL, United States.,Carl R. Woese Institute for Genomic Biology, Urbana, IL, United States
| | - Sanne J H van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Yara Mekawi
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY, United States
| | - Negar Fani
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, United States
| | - Vasiliki Michopoulos
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Alicia K Smith
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States.,Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, United States
| | - Jennifer S Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Monica Uddin
- Genomics Program, College of Public Health, University of South Florida, Tampa, FL, United States
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Impacts of a perinatal exposure to manganese coupled with maternal stress in rats: Maternal somatic measures and the postnatal growth and development of rat offspring. Neurotoxicol Teratol 2021; 90:107061. [PMID: 34971732 DOI: 10.1016/j.ntt.2021.107061] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 12/13/2021] [Accepted: 12/23/2021] [Indexed: 12/18/2022]
Abstract
Psychological stress experienced by the mother during pregnancy has been associated with emotional and cognitive disorders in children such as depression and anxiety. Socioeconomically disadvantaged populations are vulnerable to adverse life experiences and can also be disproportionally exposed to environmental contaminants. To better understand the neurodevelopmental impacts of an environmental toxicant coupled with elevated psychological stress, we exposed pregnant rats to a series of perinatal stressors. Manganese (Mn), a neurotoxicant at excessive concentrations was delivered through drinking water (0, 2, or 4 mg/mL) from gestational day (GD) 7 to postnatal day (PND) 22. A variable stress paradigm was applied to half of the animals from GD13 to PND9. Measurements of somatic development and behavior were examined in the offspring at different developmental stages. No evidence of overt maternal toxicity was observed although the 4 mg/mL Mn-exposed dams gained less body weight during gestation compared to the other dams. Stress also reduced gestational maternal weight gain. Daily fluid consumption normalized for body weight was decreased in the Mn-exposed dams in a dose-dependent manner but was not altered by the stress paradigm. Maternal stress and/or Mn exposure did not affect litter size or viability, but pup weight was significantly reduced in the 4 mg/mL Mn-exposed groups on PNDs 9 through 34 when compared to the other offspring groups. The efficacy of the manipulations to increase maternal stress levels was determined using serum corticosterone as a biomarker. The baseline concentration was established prior to treatment (GD7) and levels were low and similar in all treatment groups. Corticosterone levels were elevated in the perinatal-stress groups compared to the no-stress groups, regardless of Mn exposure, on subsequent time points (GD16, PND9), but were only significantly different on GD16. An analysis of tissue concentrations revealed Mn was elevated similarly in the brain and blood of offspring at PND2 and at PND22 in a significant dose-dependent pattern. Dams also showed a dose-dependent increase in Mn concentrations in the brain and blood; the addition of stress increased the Mn concentrations in the maternal blood but not the brain. Perinatal stress did not alter the effects of Mn on the maternal or offspring somatic endpoints described here.
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Yong HEJ, Chan SY, Chakraborty A, Rajaraman G, Ricardo S, Benharouga M, Alfaidy N, Staud F, Murthi P. Significance of the placental barrier in antenatal viral infections. Biochim Biophys Acta Mol Basis Dis 2021; 1867:166244. [PMID: 34411716 DOI: 10.1016/j.bbadis.2021.166244] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 07/23/2021] [Accepted: 08/06/2021] [Indexed: 01/30/2023]
Abstract
The placenta provides a significant physical and physiological barrier to prevent fetal infection during pregnancy. Nevertheless, it is at times breached by pathogens and leads to vertical transmission of infection from mother to fetus. This review will focus specifically on the Zika flavivirus, the HIV retrovirus and the emerging SARS-CoV2 coronavirus, which have affected pregnant women and their offspring in recent epidemics. In particular, we will address how viral infections affect the immune response at the maternal-fetal interface and how the placental barrier is physically breached and discuss the consequences of infection on various aspects of placental function to support fetal growth and development. Improved understanding of how the placenta responds to viral infections will lay the foundation for developing therapeutics to these and emergent viruses, to minimise the harms of infection to the offspring.
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Affiliation(s)
- Hannah E J Yong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
| | - Shiao-Yng Chan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore; Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Amlan Chakraborty
- Department of Pharmacology, Monash Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia
| | | | - Sharon Ricardo
- Department of Pharmacology, Monash Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia
| | - Mohamed Benharouga
- Unité 1292, Institut National de la Santé et de la Recherche Médicale, Grenoble, France; Department of Biology, University of Grenoble Alpes, Grenoble, France; Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA), Biosciences and Biotechnology Institute of Grenoble, Grenoble, France
| | - Nadia Alfaidy
- Unité 1292, Institut National de la Santé et de la Recherche Médicale, Grenoble, France; Department of Biology, University of Grenoble Alpes, Grenoble, France; Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA), Biosciences and Biotechnology Institute of Grenoble, Grenoble, France
| | - Frantisek Staud
- Department of Pharmacology and Toxicology, Faculty of Pharmacy in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Padma Murthi
- Department of Pharmacology, Monash Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia; Department of Medicine, School of Clinical Sciences, Monash University, Victoria, Australia; Department of Obstetrics and Gynaecology, University of Melbourne, Victoria, Australia.
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Turesky TK, Shama T, Kakon SH, Haque R, Islam N, Someshwar A, Gagoski B, Petri WA, Nelson CA, Gaab N. Brain morphometry and diminished physical growth in Bangladeshi children growing up in extreme poverty: A longitudinal study. Dev Cogn Neurosci 2021; 52:101029. [PMID: 34801857 PMCID: PMC8605388 DOI: 10.1016/j.dcn.2021.101029] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 09/14/2021] [Accepted: 10/24/2021] [Indexed: 11/25/2022] Open
Abstract
Diminished physical growth is a common marker of malnutrition and it affects approximately 200 million children worldwide. Despite its importance and prevalence, it is not clear whether diminished growth relates to brain development and general cognitive ability. Further, diminished growth is more common in areas of extreme poverty, raising the possibility that it may mediate previously shown links between socioeconomic status (SES) and brain structure. To address these gaps, 79 children growing up in an extremely poor, urban area of Bangladesh underwent MRI at age six years. Structural brain images were submitted to Mindboggle software, a Docker-compliant and high-reproducibility tool for tissue segmentation and regional estimations of volume, surface area, cortical thickness, sulcal depth, and mean curvature. Diminished growth predicted brain morphometry and mediated the link between SES and brain morphometry most consistently for subcortical and white matter subcortical volumes. Meanwhile, brain volume in left pallidum and right ventral diencephalon mediated the relationship between diminished growth and full-scale IQ. These findings offer malnutrition as one possible pathway through which SES affects brain development and general cognitive ability in areas of extreme poverty.
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Affiliation(s)
- Ted K Turesky
- Laboratories of Cognitive Neuroscience, Division of Developmental Medicine, Department of Medicine, Boston Children's Hospital, Boston, MA, United States; Harvard Graduate School of Education, Cambridge, MA, United States; Harvard Medical School, Boston, MA, United States.
| | - Talat Shama
- The International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | - Rashidul Haque
- The International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Nazrul Islam
- National Institute of Neuroscience and Hospital, Dhaka, Bangladesh
| | - Amala Someshwar
- Laboratories of Cognitive Neuroscience, Division of Developmental Medicine, Department of Medicine, Boston Children's Hospital, Boston, MA, United States
| | - Borjan Gagoski
- Harvard Graduate School of Education, Cambridge, MA, United States; Fetal-Neonatal Neuroimaging and Development Science Center, Boston Children's Hospital, Boston, MA, United States
| | - William A Petri
- Division of Infectious Diseases and International Health, Department of Medicine, School of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Charles A Nelson
- Laboratories of Cognitive Neuroscience, Division of Developmental Medicine, Department of Medicine, Boston Children's Hospital, Boston, MA, United States; Harvard Graduate School of Education, Cambridge, MA, United States; Harvard Medical School, Boston, MA, United States
| | - Nadine Gaab
- Laboratories of Cognitive Neuroscience, Division of Developmental Medicine, Department of Medicine, Boston Children's Hospital, Boston, MA, United States; Harvard Graduate School of Education, Cambridge, MA, United States; Harvard Medical School, Boston, MA, United States
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Conflict-Related Brain Activity after Individualized Cognitive Training in Preschoolers from Poor Homes. JOURNAL OF COGNITIVE ENHANCEMENT 2021. [DOI: 10.1007/s41465-021-00223-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Hughes K, Olufajo OA, White K, Roby DH, Fryer CS, Wright JL, Sehgal NJ. The influence of socioeconomic status on outcomes of lower extremity arterial reconstruction. J Vasc Surg 2021; 75:168-176. [PMID: 34506895 DOI: 10.1016/j.jvs.2021.08.071] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Accepted: 08/13/2021] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Although it has been shown that patient socioeconomic status (SES) is associated with the surgical treatments chosen for severe peripheral arterial disease (PAD), the association between SES and outcomes of arterial reconstruction have not been well-studied. The objective of this study was to determine if SES is associated with outcomes following lower extremity arterial reconstruction. METHODS Patients 40 years and older who had surgical revascularization for severe lower extremity PAD were identified in the Nationwide Readmissions Database, 2010 to 2014. Measures of SES including median household income (MHI) quartiles of patients' residential ZIP codes were extracted. Factors associated with repeat revascularization, subsequent major amputations, hospital mortality, and 30-day all-cause readmission were evaluated using multivariable regression analyses. RESULTS Of the 131,529 patients identified, the majority (61%) were male, and the average age was 69 years. On unadjusted analyses, subsequent amputations were higher among patients in the lowest MHI quartile compared with patients in the highest MHI quartile (13% vs 10%; overall P < .001). On multivariable analyses, compared with patients in the lowest quartile, those in the highest quartile had lower amputation (adjusted odds ratio [aOR], 0.70; 95% confidence interval (CI), 0.63-0.77; overall P < .001) and readmission (aOR, 0.91; 95% CI, 0.84-0.99; overall P = .028) rates. However, subsequent revascularization (aOR, 1.04; 95% CI, 0.94-1.15) and mortality (aOR, 1.01; 95% CI, 0.79-1.28) rates were not different across the groups. CONCLUSIONS Lower SES is associated with disproportionally worse outcomes following lower extremity arterial reconstruction for severe PAD. These data suggest that improving outcomes of lower extremity arterial reconstruction may involve addressing socioeconomic disparities.
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Affiliation(s)
- Kakra Hughes
- Department of Health Policy and Management, University of Maryland School of Public Health, College Park, Md; Department of Surgery, Howard University College of Medicine, Washington, DC.
| | - Olubode A Olufajo
- Department of Surgery, Howard University College of Medicine, Washington, DC
| | - Kellee White
- Department of Health Policy and Management, University of Maryland School of Public Health, College Park, Md
| | - Dylan H Roby
- Department of Health Policy and Management, University of Maryland School of Public Health, College Park, Md
| | - Craig S Fryer
- Department of Behavioral and Community Health, University of Maryland School of Public Health, College Park, Md
| | - Joseph L Wright
- Department of Health Policy and Management, University of Maryland School of Public Health, College Park, Md; Executive Suite, University of Maryland Capital Region Health, Cheverly, Md
| | - Neil J Sehgal
- Department of Health Policy and Management, University of Maryland School of Public Health, College Park, Md
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Society to cell: How child poverty gets “Under the Skin” to influence child development and lifelong health. DEVELOPMENTAL REVIEW 2021. [DOI: 10.1016/j.dr.2021.100983] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Bates RA, Ford JL, Jiang H, Pickler R, Justice LM, Dynia JM, Ssekayombya P. Sociodemographics and chronic stress in mother-toddler dyads living in poverty. Dev Psychobiol 2021; 63:e22179. [PMID: 34423424 DOI: 10.1002/dev.22179] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 07/24/2021] [Accepted: 08/01/2021] [Indexed: 11/08/2022]
Abstract
Experiencing chronic stress early in life is associated with later health disparities, and poverty may be a significant stressor for both mothers and children. With a sample of primarily Black and White mothers (N = 75) and toddlers (N = 71) living in poverty in the United States, we examined the direct relations between sociodemographic conditions of poverty and chronic physiological stress. Mothers completed questionnaires on sociodemographics, including mother/toddler race, mother's education, father's education, poverty level, economic hardship, marital status, unemployment status, and toddler sex. Physiological chronic stress was measured by assaying the cortisol content of 4 cm samples of hair cut from the posterior vertex of mothers and toddlers (20-24 months of age) to represent 4 months of stress. Mothers' and toddlers' chronic stress was significantly, moderately, and positively associated. Toddlers had a trending relationship of moderately higher chronic stress if they were Black compared to not Black. Mothers had significantly, moderately higher chronic stress if they were Black or had a Black toddler (compared to not Black), not married (compared to married), or were working (compared to not working). The findings suggest that these mothers, simultaneously navigating poverty and parenting a toddler, need resources to reduce chronic stress.
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Affiliation(s)
- Randi A Bates
- College of Nursing, University of Cincinnati, Cincinnati, Ohio, USA.,Crane Center for Early Childhood Research and Policy, The Ohio State University, Columbus, Ohio, USA
| | - Jodi L Ford
- College of Nursing, The Ohio State University, Columbus, Ohio, USA
| | - Hui Jiang
- Crane Center for Early Childhood Research and Policy, The Ohio State University, Columbus, Ohio, USA
| | - Rita Pickler
- College of Nursing, The Ohio State University, Columbus, Ohio, USA
| | - Laura M Justice
- Crane Center for Early Childhood Research and Policy, The Ohio State University, Columbus, Ohio, USA
| | - Jaclyn M Dynia
- Crane Center for Early Childhood Research and Policy, The Ohio State University, Columbus, Ohio, USA
| | - Prosper Ssekayombya
- Crane Center for Early Childhood Research and Policy, The Ohio State University, Columbus, Ohio, USA.,College of Nursing, The Ohio State University, Columbus, Ohio, USA
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48
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Lathrop B. When Healthcare Isn't Enough: A Christian Response to Social Determinants of Health. J Christ Nurs 2021; 38:16-23. [PMID: 33284212 DOI: 10.1097/cnj.0000000000000784] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Education, employment, housing, neighborhood safety, and traumatic life experiences influence people's health, and poor health as a result of inequities in these areas cannot be remedied by medical care alone. Although social determinants of health threaten the attainment of a healthy life for people across North America, nurses are positioned to be leaders in a movement toward health equity. Nurses can follow the example of Jesus in loving their neighbors as themselves by addressing the social needs of patients, championing health system change, educating their communities, and advocating for Health in All Policies.
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Affiliation(s)
- Breanna Lathrop
- Breanna Lathrop, DNP, MPH, RN, FNP-BC , is a family nurse practitioner and the Chief Operating Officer at the Good Samaritan Health Center in Atlanta, GA. She is the coauthor of How Neighborhood Make Us Sick: Restoring Health and Wellness to Our Communities (IV Press)
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49
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Fatori D, Fonseca Zuccolo P, Shephard E, Brentani H, Matijasevich A, Archanjo Ferraro A, Aparecida Fracolli L, Chiesa AM, Leckman J, Constantino Miguel E, V Polanczyk G. A randomized controlled trial testing the efficacy of a Nurse Home Visiting Program for Pregnant Adolescents. Sci Rep 2021; 11:14432. [PMID: 34257407 PMCID: PMC8277870 DOI: 10.1038/s41598-021-93938-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 06/28/2021] [Indexed: 02/06/2023] Open
Abstract
To test the efficacy of a nurse home visiting program (HVP) on child development, maternal and environmental outcomes in the first years of life. We conducted a randomized controlled trial to test the efficacy of Primeiros Laços, a nurse HVP for adolescent mothers living in a poor urban area of São Paulo, Brazil. Eighty adolescent mothers were included and randomized to receive either Primeiros Laços (intervention group, n = 40) or healthcare as usual (control group, n = 40). Primeiros Laços is a home visiting intervention delivered by trained nurses that starts during the first 16 weeks of pregnancy and continues to the child's age of 24 months. Participants were assessed by blind interviewers at 8-16 weeks of pregnancy (baseline), 30 weeks of pregnancy, and 3, 6, 12, and 24 months of child's age. We assessed oscillatory power in the mid-range alpha frequency via electroencephalography when the children were aged 6 months. Child development was measured by the Bayley Scales of Infant Development Third Edition (BSID-III). Weight and length were measured by trained professionals and anthropometric indexes were calculated. The home environment and maternal interaction with the child was measured by the Home Observation and Measurement of the Environment. Generalized estimating equation models were used to examine intervention effects on the trajectories of outcomes. Standardized effect sizes (Cohen's d) were calculated using marginal means from endpoint assessments of all outcomes. The trial was registered at clinicaltrial.gov: NCT02807818. Our analyses showed significant positive effects of the intervention on child expressive language development (coefficient = 0.89, 95% CI [0.18, 1.61], p = 0.014), maternal emotional/verbal responsivity (coefficient = 0.97, 95% CI [0.37, 1.58], p = 0.002), and opportunities for variety in daily stimulation (coefficient = 0.37, 95% CI [0.09, 0.66], p = 0.009). Standardized effect sizes of the intervention were small to moderate. Primeiros Laços is a promising intervention to promote child development and to improve the home environment of low-income adolescent mothers. However, considering the limitations of our study, future studies should be conducted to assess Primeiros Laços potential to benefit this population.Clinical Trial Registration: The study was registered at clinicaltrial.gov (Registration date: 21/06/2016 and Registration number: NCT02807818).
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Affiliation(s)
- Daniel Fatori
- Departamento de Psiquiatria, Faculdade de Medicina FMUSP, Universidade de São Paulo, R Dr Ovídio Pires de Campos, 785, São Paulo, SP, CEP 05403-903, Brazil.
| | - Pedro Fonseca Zuccolo
- Departamento de Psiquiatria, Faculdade de Medicina FMUSP, Universidade de São Paulo, R Dr Ovídio Pires de Campos, 785, São Paulo, SP, CEP 05403-903, Brazil
| | - Elizabeth Shephard
- Departamento de Psiquiatria, Faculdade de Medicina FMUSP, Universidade de São Paulo, R Dr Ovídio Pires de Campos, 785, São Paulo, SP, CEP 05403-903, Brazil
| | - Helena Brentani
- Departamento de Psiquiatria, Faculdade de Medicina FMUSP, Universidade de São Paulo, R Dr Ovídio Pires de Campos, 785, São Paulo, SP, CEP 05403-903, Brazil
| | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Alexandre Archanjo Ferraro
- Departamento de Pediatria, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Lislaine Aparecida Fracolli
- Departamento de Enfermagem Em Saúde Coletiva da Escola de Enfermagem, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Anna Maria Chiesa
- Departamento de Enfermagem Em Saúde Coletiva da Escola de Enfermagem, Universidade de São Paulo, São Paulo, SP, Brazil
| | - James Leckman
- Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA
| | - Euripedes Constantino Miguel
- Departamento de Psiquiatria, Faculdade de Medicina FMUSP, Universidade de São Paulo, R Dr Ovídio Pires de Campos, 785, São Paulo, SP, CEP 05403-903, Brazil
| | - Guilherme V Polanczyk
- Departamento de Psiquiatria, Faculdade de Medicina FMUSP, Universidade de São Paulo, R Dr Ovídio Pires de Campos, 785, São Paulo, SP, CEP 05403-903, Brazil.
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50
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Cerveny L, Murthi P, Staud F. HIV in pregnancy: Mother-to-child transmission, pharmacotherapy, and toxicity. Biochim Biophys Acta Mol Basis Dis 2021; 1867:166206. [PMID: 34197912 DOI: 10.1016/j.bbadis.2021.166206] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 05/18/2021] [Accepted: 06/11/2021] [Indexed: 12/15/2022]
Abstract
An estimated 1.3 million pregnant women were living with HIV in 2018. HIV infection is associated with adverse pregnancy outcomes and all HIV-positive pregnant women, regardless of their clinical stage, should receive a combination of antiretroviral drugs to suppress maternal viral load and prevent vertical fetal infection. Although antiretroviral treatment in pregnant women has undoubtedly minimized mother-to-child transmission of HIV, several uncertainties remain. For example, while pregnancy is accompanied by changes in pharmacokinetic parameters, relevant data from clinical studies are lacking. Similarly, long-term adverse effects of exposure to antiretrovirals on fetuses have not been studied in detail. Here, we review current knowledge on HIV effects on the placenta and developing fetus, recommended antiretroviral regimens, and pharmacokinetic considerations with particular focus on placental transport. We also discuss recent advances in antiretroviral research and potential effects of antiretroviral treatment on placental/fetal development and programming.
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Affiliation(s)
- Lukas Cerveny
- Department of Pharmacology and Toxicology, Faculty of Pharmacy in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Padma Murthi
- Department of Medicine, School of Clinical Sciences, and Department of Pharmacology, Monash Biomedicine Discovery Institute Monash University, Clayton, Victoria, Australia; Hudson Institute of Medical Research, The Ritchie Centre, Clayton, Victoria, Australia; Department of Obstetrics and Gynaecology, The University of Melbourne, Parkville, Victoria, Australia
| | - Frantisek Staud
- Department of Pharmacology and Toxicology, Faculty of Pharmacy in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic.
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