Child and youth emotional trauma: An explanatory
model of adverse outcomes.
Not exact matches
We used multiple regression to estimate the differences in total cost between the settings for birth and to adjust for potential confounders, including maternal age, parity, ethnicity, understanding
of English, marital status, BMI, index
of multiple deprivation score, parity, and gestational age at birth, which could each be associated with planned place
of birth and with
adverse outcomes.12 For the generalised linear
model on costs, we selected a γ distribution and identity link function in preference to alternative distributional forms and link functions on the basis
of its low Akaike's information criterion (AIC) statistic.
While some meta - analyses
of home visiting programs suggest that many types
of home visiting programs can make a difference in reducing
adverse outcomes such as child maltreatment and childhood injuries, 14,15 meta - analyses can produce misleading results if there are insufficient numbers
of trials
of programs represented in the cross-classification
of home visiting target populations, program
models, and visitors» backgrounds.
This review suggests that women who received midwife - led continuity
models of care were less likely to experience intervention and more likely to be satisfied with their care with at least comparable
adverse outcomes for women or their infants than women who received other
models of care.
Overall, we did not find any increased likelihood for any
adverse outcome for women or their infants associated with having been randomised to a midwife - led continuity
model of care.
Bright Futures, the AAP health promotion initiative, provides resources for pediatricians to detect both ACEs and
adverse developmental
outcomes.36 Programs like Reach Out and Read, in which pediatricians distribute books and
model reading, simultaneously promote emergent literacy and parent — child relationships through shared reading.37, 38 However, ACEs can not be addressed in isolation and require collaborative efforts with partners in the education, home visitation, and other social service sectors in synergistic efforts to strengthen families.29 In this way, programs like Help Me Grow39 that create streamlined access to early childhood services for at - risk children can play a critical role in building an integrated system that connects families to needed resources to enhance the development
of vulnerable children.
Although additional efforts to refine an
adverse childhood experience checklist that predicts later health
outcomes has scientific merit, an argument can be made that enough is known about certain harmful childhood experiences22 that more testing
of parts
of this
model should be carried out through experiment rather than correlation.
Although no studies have yet examined whether maternal relationship quality during pregnancy is linked to the risk
of infectious disease in the offspring, there is growing evidence from animal
models that a link exists between prenatal maternal stress and a wide range
of adverse health
outcomes in the offspring, including immune dysfunction and infectious diseases [14,15].
The foregoing observations generally accord with «diathesis — stress»
models of gene × environment interaction (G × E), in which genetic vulnerabilities are thought to occasion negative
outcomes (e.g. psychopathology) mainly in individuals who are also disadvantaged by
adverse circumstance (Manuck, 2010; Manuck and McCaffery, 2010).