Maternal adverse childhood experiences,child mental health,and the mediating effect of maternal depression: A cross-sectional,population-based study in rural,southwestern Uganda

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.     

国家公园遴选标准的国际经验及对我国的启示

建立以国家公园为主体的自然保护地体系,是我国生态文明思想的重大举措。国家公园作为国际普遍认可的自然保护手段,受到世界各国的欢迎。美国、加拿大、德国、南非、日本等国的国家公园建设较早、发展较好,通过分析其国家公园建设经验得出：（1）国家公园是以自然保护为首要目标,并为公众提供享受大自然的场所;（2）其评价对象与标准主要包括,自然景观/自然遗迹、生态系统、生物多样性/重要栖息地、面积/范围、自然区域/自然环境、文化景观等;（3）根据资源条件和目标定位的差异,国外国家公园的选建模式主要有基于生态区划的国家公园建设模式、基于社区共建的国家公园建设模式和基于资源主导的国家公园建设模式。在国际经验研究和分析的基础上,结合我国自然资源状况及国家公园建设需求,提出我国国家公园发展建议：（1）明确国家公园的功能定位和发展目标;（2）制定国家公园评价准则和方法,建立以国家代表性、完整性、原真性为主,包括生态区位重要性、历史文化价值等因素的国家公园评价指标体系;（3）划定面向国家公园规划布局的生态地理分区,在区域内建立国家公园,并与生态系统优先区、生物多样性保护关键区,或代表性自然景观格局相协调。     

Stress exposure in specific growth periods associates with children's weight,height, and body mass index

Objectives

We investigate associations between children exposure to stressful events, considering: (1) the period in which the event took place, (2) the type of event, and (3) the cumulative effect of the events on children's weight, height and body mass index (BMI).

Methods

A total of 8429 Portuguese children (3349 exposed to at least one stressful event during their lifetime; 50.2% males; mean age = 7.21 ± 1.85 years) were included in the analysis. The occurrence of stressful (i.e., adverse) events was reported in a parental questionnaire; children's weight and height were objectively measured.

Results

When the stress event took place in the first 2 years of life, compared with during pregnancy or after the 2 years, children were shorter; but the association was weak and only significant for boys. After adjustment for child's birthweight, gestational age, breastfeeding duration, number of siblings, and father's education, the experience of 3+ stressful events (vs. 1 or 2) was associated with higher weight and height in boys. No interaction effect was found between stress and BMI.

Discussion

We found some evidence of associations between exposure to stressful events and physical growth of boys. We highlight the complex relationship between exposure to stressful experiences and children's physical growth, particularly the different effects of specific characteristics of the stress event and the sex differences.

     

REFLECTIVE EQUILIBRIUM AND EMPIRICAL DATA: THIRD PERSON MORAL EXPERIENCES IN EMPIRICAL MEDICAL ETHICS

In ethics, the use of empirical data has become more and more popular, leading to a distinct form of applied ethics, namely empirical ethics. This ‘empirical turn’ is especially visible in bioethics. There are various ways of combining empirical research and ethical reflection. In this paper we discuss the use of empirical data in a special form of Reflective Equilibrium (RE), namely the Network Model with Third Person Moral Experiences. In this model, the empirical data consist of the moral experiences of people in a practice. Although inclusion of these moral experiences in this specific model of RE can be well defended, their use in the application of the model still raises important questions. What precisely are moral experiences? How to determine relevance of experiences, in other words: should there be a selection of the moral experiences that are eventually used in the RE? How much weight should the empirical data have in the RE? And the key question: can the use of RE by empirical ethicists really produce answers to practical moral questions? In this paper we start to answer the above questions by giving examples taken from our research project on understanding the norm of informed consent in the field of pediatric oncology. We especially emphasize that incorporation of empirical data in a network model can reduce the risk of self‐justification and bias and can increase the credibility of the RE reached.     

生活中的绿色与环境教育课题

了解环境并对我们熟悉的环境产生兴趣，对于察知环境问题并采取恰当的行动非常重要。本文涉及作者以往参与的几个研究实例，介绍关于身边自然环境和农作物的知识、认知、经验。在对花草游憩活动的调查中表明，人们使用植物进行的活动逐渐减少。对于外来植物的调查显示，许多人无法识别外来植物。在一项父母对于蔬菜的态度和经验的调查中表明，能够自发栽种蔬菜的人并不多，而父母对蔬菜的经验和意识可能会影响他们的孩子。基于上述结果得出，自然体验活动需要成年人提供适当的支持，并且有必要在家庭和社区中增加成年人的参与机会。     

Abnormal behaviors in nursery-reared squirrel monkeys (Saimiri sciureus)

Seventeen squirrel monkeys (Saimiri sciureus), 11 nursery-reared and six mother-reared, were monitored to clarify the type and degree of deviant behaviors that result from rearing this species in the nursery. Two observation periods were used: the first when the subjects averaged 6.7 months of age, the second when they averaged 15.5 months. Thirteen activities involving variations of nonnutritive orality, stereotypic posturing, and agitated behaviors were seen in the nursery-reared subjects, but never in the mother-reared subjects. No consistent gender, subspecies, or age differences were evident. Squirrel monkeys, like chimpanzees and some Old World monkeys, do develop atypical self-directed behaviors when deprived of normal stimulation during early development.     

The association between adverse childhood experiences and epigenetic age acceleration in the Canadian longitudinal study on aging (CLSA)

Research examining the association between exposure to a wide range of adverse childhood experiences (ACEs) and accelerated biological aging in older adults is limited. The purpose of this study was to examine the association of ACEs, both as a cumulative score and individual forms of adversity, with epigenetic age acceleration assessed using the DNA methylation (DNAm) GrimAge and DNAm PhenoAge epigenetic clocks in middle and older-aged adults. This cross-sectional study analyzed baseline and first follow-up data on 1445 participants aged 45–85 years from the Canadian Longitudinal Study on Aging (CLSA) who provided blood samples for DNAm analysis. ACEs were assessed using a validated self-reported questionnaire. Epigenetic age acceleration was estimated by regressing each epigenetic clock estimate on chronological age. Cumulative ACEs score was associated with higher DNAm GrimAge acceleration (β: 0.07; 95% CI: 0.02, 0.11) after adjusting for covariates. Childhood exposure to parental separation or divorce (β: 0.06; 95% CI: 0.00, 0.11) and emotional abuse (β: 0.06; 95% CI: 0.00, 0.12) were associated with higher DNAm GrimAge acceleration after adjusting for other adversities and covariates. There was no statistical association between ACEs and DNAm PhenoAge acceleration. Early life adversity may become biologically embedded and lead to premature biological aging, in relation to DNAm GrimAge, which estimates risk of mortality. Strategies that increase awareness of ACEs and promote healthy child development are needed to prevent ACEs.