Search

AimEarly life adversity leads to enduring effects on physical and mental health, school performance and other outcomes. We sought to identify potentially modifiable factors associated with socioeconomic adversity in early life.MethodsWe enrolled 1503 pregnant women aged 16-40 years, without pregnancy complications or pre-existing conditions from Shelby County, Tennessee. Social, familial and economic variables were analysed using principal components (PCs) analyses to generate the Socioeconomic Adversity Index (SAI). This was replicated using the National Survey of Children's Health (NSCH). Health and social outcomes were compared across the quintile groups defined by SAI values at the county, state and national levels.ResultsSignificant differences occurred across the SAI Quintile-1 to Quintile-5 groups in marital status, household structure, annual income, education and health insurance. Significantly worse health and social outcomes occurred in the lower versus higher SAI quintiles, including maternal depression, parental incarceration, child's birthweight and potential for child abuse. Maternal age and race also differed significantly across the SAI quintiles.ConclusionModifiable factors contributing to socioeconomic adversity in early life included marital status, household structure, annual income, education and health insurance. Those exposed to greater socioeconomic adversity as defined by SAI values had significantly worse maternal and child outcomes.

Many kindergarten teachers have encountered children who enter school lacking the ability to control their behavior, but they may not understand the social and biological processes behind these children's disruptive behavior. The author reviews research into early childhood brain development to explain how trauma and chronic stress can make it difficult for them to build the executive function skills needed in the classroom. By incorporating social-emotional learning, teachers in the early grades can help these children manage their emotional responses and succeed in school.

Previous research has documented that negative experiences in chemistry courses are a major factor that discourages many students from continuing in premedical studies. This adverse impact affects women and students from under-represented minority (URM) groups disproportionately. To determine if chemistry courses have a similar effect at a large public university, we surveyed 1,036 students from three entering cohorts at the University of California, Berkeley. We surveyed students at the beginning of their first year at the university and again at the end of their second year. All subjects had indicated an interest in premedical studies at the time they entered the university. We conducted follow-up interviews with a stratified sub-set of 63 survey respondents to explore the factors that affected their level of interest in premedical studies. Using a 10-point scale, we found that the strength of interest in premedical studies declined for all racial/ethnic groups. In the follow-up interviews, students identified chemistry courses as the principal factor contributing to their reported loss of interest. URM students especially often stated that chemistry courses caused them to abandon their hopes of becoming a physician. Consistent with reports over more than 50 years, it appears that undergraduate courses in chemistry have the effect of discouraging otherwise qualified students, as reflected in their admission to one of the most highly selective public universities in the US, from continuing in premedical studies, especially in the case of URM students. Reassessment of this role for chemistry courses may be overdue.

Recommendations for the treatment of tobacco and alcohol use disorders are plentiful. The literature is mixed, however, on the extent to which treatments for these disorders apply to people experiencing homelessness. We identified 12 community health centers from distinct counties across California that provide tobacco and alcohol use disorder treatments to people experiencing homelessness and conducted semi-structured interviews with each. We qualitatively analyzed transcripts using the NVivo 12 software. The following themes emerged: (1) the role of street outreach as the first step of service delivery, (2) the importance of patient choice and volition in the treatment decision-making process, (3) the need for explicit provider-patient trust-building, (4) acknowledging variability in access to and availability of resources at treatment sites, and (5) redefining successful outcomes. Findings have implications for dissemination and implementation research in tobacco and alcohol use disorders among people experiencing homelessness, both in California and broader North American settings. [ABSTRACT FROM AUTHOR]

Minorities are significantly underrepresented in the U.S. physician workforce. Female minorities wishing to become doctors face additional gender barriers, since women who enter college with the desire of becoming physicians are more likely than men to exit programs of undergraduate studies ("premed studies") that lead to medical school. To explore the factors that may cause minority women to lose interest in a medical career, in-depth one-to-one interviews were conducted during the first quarter of freshman year with minority women who had said prior to matriculating that they were interested in pursuing a career in medicine. Interviews with seven Latinas were analyzed to develop grounded theory to identify potential causes of attrition from premedical studies within this underrepresented group. Findings point to the importance of linking such students into premedical-student support systems at the beginning of their freshman year to retain them in the premedical pipeline and argue that the mechanisms that push students out of the "premed pipeline" operate at the institutional level to passively, rather than actively, discourage premedical students' career ambitions. (Contains 1 table and 5 notes.)

Previous research has documented that negative experiences in chemistry courses are a major factor that discourages many students from continuing in premedical studies. This adverse impact affects women and students from under-represented minority (URM) groups disproportionately. To determine if chemistry courses have a similar effect at a large public university, we surveyed 1,036 students from three entering cohorts at the University of California, Berkeley. We surveyed students at the beginning of their first year at the university and again at the end of their second year. All subjects had indicated an interest in premedical studies at the time they entered the university. We conducted follow-up interviews with a stratified sub-set of 63 survey respondents to explore the factors that affected their level of interest in premedical studies. Using a 10-point scale, we found that the strength of interest in premedical studies declined for all racial/ethnic groups. In the follow-up interviews, students identified chemistry courses as the principal factor contributing to their reported loss of interest. URM students especially often stated that chemistry courses caused them to abandon their hopes of becoming a physician. Consistent with reports over more than 50 years, it appears that undergraduate courses in chemistry have the effect of discouraging otherwise qualified students, as reflected in their admission to one of the most highly selective public universities in the US, from continuing in premedical studies, especially in the case of URM students. Reassessment of this role for chemistry courses may be overdue.

A community food security movement has begun to address problems of hunger and food insecurity by utilizing a community-based approach. Although various models have been implemented, little empirical research has assessed how power operates within community-based food security initiatives. The purpose of this research was to determine how power influenced participation in decision-making, agenda setting, and the shaping of perceived needs within a community-based food security planning process, with particular reference to disenfranchised stakeholders. Power influenced participation in decision-making, agenda setting, and the shaping of perceived needs through managing 1) problem framing, 2) trust, 3) knowledge, and 4) consent. To overcome these mechanisms of power, practitioners need to address individual-, community-, and institutional-level barriers to participation in community-based food security planning processes. Practitioners and researchers can work with disenfranchised groups to determine which agents have the power to create desired changes by utilizing theory-based methods and strategies that focus on changing external determinants at multiple levels. (Contains 1 figure and 4 tables.)

Describes one working group's attempts to develop and utilize assessment tools for measuring and changing organizational support for employee health. Originally designed as part of a heart health related intervention, the system has evolved into a managed care evaluation and major chronic disease inventory. Findings indicate the potential of working at the organizational level and applying ecological models to worksite health promotion. (SM)