Browsing by Subject "Adverse Childhood Experiences"
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Item Investigating the Complex Relationship Between Adverse Childhood Experiences and Oral Health-Related Quality of Life(2017-05) Kabani, Faizan A.; Lykens, Kristine A.Dental caries is one of the most common chronic disease in children and continues to be a significant global public health concern. Evidence indicates that chronic diseases, and adverse childhood experiences (ACEs), have destructive impacts on overall quality of life, health outcomes, and health care expenditures. The ACE investigation identified cumulative dose-response relationships between ACEs and development of diverse health and social consequences later in life. Research is scarce on investigating causal pathways to facilitate contextualized public health interventions addressing this seismic threat. Data was utilized from the 2011-2012 National Survey of Children's Health, inclusive of ages 1-17 for dentate status. The dependent variables identified untreated oral health care needs and preventive dental utilization. The key independent variable, ACEs, included exposure to parental death, parental divorce, parental incarceration, mental health illnesses, domestic violence, neighborhood violence, and racial discrimination. Exogenous variables included age, sex, race/ethnicity, number of children in household, socioeconomic status proxies, health insurance status, and presence of special health care needs. Path analysis, a special subcomponent of structural equation modeling was utilized to explore direct, indirect, and mediating causal pathways. The data, when adjusted for complex survey design, proportionately represents children in the United States. The results of the adjusted logistic regressions revealed ACEs demonstrating varying magnitudes of significance across diverse racial and ethnic profiles. Exposures to parental divorce and parental death particularly exhibited critical magnitudes of influence. Adjusted path analyses demonstrated alternative family structures contributing a mediating role between ACEs and oral health-related quality of life (OHRQoL). In keeping with the Pareto Principle, exposure to certain ACEs, namely parental divorce and parental death, potentially introduces more profound social and health-related consequences later in life. Moreover, invocation of Occam's razor, can assist in theorizing that exposure to alternative family structures (i.e. via parental divorce and/or parental death) initiate a concatenated deteriorating domino effect sequela of secondary ACEs. Therefore, contextualized interventions should prioritize psychotherapeutic child, marriage, and family counseling services improving the home, as an enabling environment, to potentially minimize detriments of ACEs on OHRQoL.Item The Impact of Travel Stressors on the Pathogenesis of Autoimmunity in Female Lupus Mice(2022-05) Dinh, Viet Q.; Mathis, Keisa W.; Ma, Rong; Cunningham, J. Thomas; Basha, RiyazPreliminary studies found that an established model of systemic lupus erythematosus, the female NZBWF1 mouse, developed heightened disease severity later in life when shipped to UNTHSC during summer due to travel stressors. We hypothesized that this was partly due to early life stress that the mice experienced, and that eliminating these stressors will attenuate disease severity. We measured biomarkers of disease severity in NZBWF1 mice that were shipped as adults and compared with mice that were shipped in early life along with mice that were not shipped at all. We found that long-term biomarkers were higher in adult travel mice compared to early life travel mice, that these biomarkers were higher in summer mice compared to winter mice, and that non-travelling mice had the highest levels. Our findings indicate that adulthood stress exacerbates disease progression in NZBWF1 mice, and that seasonal factors impacted lupus pathogenesis in these adult mice.