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Item Adverse Childhood Experiences (ACEs) and Their Impact on Substance Misuse & Overall Health(The Center for Health Policy, 2018-03-01) Balio, Casey; Greene, Marion S.Adverse childhood experiences (ACEs) encompass a wide variety of distressing events, including emotional, physical, or sexual abuse; witnessing maternal domestic violence; or living with a household member who has a substance use disorder, is mentally ill or suicidal, or is currently or was ever incarcerated during the first 18 years of a child’s life. According to most recent estimates, nearly half of Indiana’s youth have experienced at least one ACE in their life. ACEs are linked to many risk behaviors, including substance use, which can adversely affect health outcomes.Item Associations between Urinary, Dietary, and Water Fluoride Concentrations among Children in Mexico and Canada(MDPI, 2020-11-08) Green, Rivka; Till, Christine; Cantoral, Alejandra; Lanphear, Bruce; Martinez-Mier, E. Angeles; Ayotte, Pierre; Wright, Robert O.; Tellez-Rojo, Martha M.; Malin, Ashley J.; Cariology, Operative Dentistry and Dental Public Health, School of DentistryFluoride, which may be toxic to the developing brain, is added to salt in Mexico and drinking water in Canada to prevent dental caries. We compared childhood urinary fluoride (CUF) concentrations in Mexico City and Canada to characterize patterns of fluoride exposure in these two populations. We also examined associations of CUF with dietary and water fluoride levels in Mexico City and Canada respectively. We included 561 children (ages 4–6; mean age 4.8 years) from the Programming Research in Obesity, Growth, Environment, and Social Stress (PROGRESS) cohort in Mexico City, and 645 children (ages 2–6; mean age 3.7 years) from the Maternal–Infant Research on Environmental Chemicals (MIREC) cohort in Canada. We applied Spearman correlations, T-tests, ANOVA or covariate-adjusted linear regression to examine associations of CUF (mg/L; adjusted for specific gravity) with demographics and dietary or water fluoride concentrations. We used Welch equivalence testing to compare means across cohorts. Mean (SD) CUF was equivalent (t = 4.26, p < 0.001) in PROGRESS: 0.74 (0.42) and fluoridated Canadian communities: 0.66 (0.47), but lower in non-fluoridated Canadian communities: 0.42 (0.31) (t = −6.37, p < 0.001). Water fluoride concentrations were significantly associated with CUF after covariate adjustment for age and sex in MIREC (B = 0.44, 95% CI: 0.30, 0.59, p < 0.001). In contrast, daily food and beverage fluoride intake was not associated with CUF in PROGRESS (p = 0.82). We found that CUF levels are comparable among children in Mexico City and fluoridated Canadian communities, despite distinct sources of exposure. Community water fluoridation is a major source of fluoride exposure for Canadian children.Item Child labor: a critical discourse analysis(2016-03-23) Karikari, Isaac; Khaja, Khadija; Adamek, Margaret E.; Reza, Hasan; Seybold, PeterChild labor is a complex global phenomenon. Though poverty is widely accepted as the primary cause of child labor, there are many dimensions of the phenomenon that still remain to be explored. Very little attention has been given to the policies that drive efforts to address child labor and how they are framed. Of particular interest is how we determine who is a child, and the notions of childhood underpinning these policies. Less attention has been given to the relationships and power dynamics underlying the policy-making process that surrounds this discourse. A qualitative method, namely, critical discourse analysis (CDA) was used to examine the discursive construction of children and childhood in child labor discourse. Underlying power dynamics through the analysis of diverse child labor-related policies at the global (ILO), regional (OAU/AU), sub-regional (ECOWAS), global/sub-regional (Harkin-Engel Protocol), and local (Ghana) levels was explored. Findings revealed that homogenized and hegemonic trends are visible in child labor discourse. While the ILO's discourse on child labor was either reproduced or referenced in the other policies, there was generally a homogenized definition of children based on Western social constructions and views of children. Child labor policies were not fully cognizant or sensitive to local constructions and conceptions of how we define children and what we determine are appropriate roles at various ages. In particular reference to Ghana, the Government of Ghana's child labor policies did not reflect the sociological and cultural realities of the nation. Findings of the study also suggest that for some organizations and countries, especially in the Global South, political and economic considerations influenced whose voices were included in child labor policy creation. Critical discourse implications for social work education, policy analysis, practice and research are discussed.Item Dragging Wyatt Earp(Swallow Press / Ohio University Press, 2013-03) Rebein, RobertItem Parents of healthy children assign lower quality of life measure to scenarios labeled as cancer than to identical scenarios not labeled as cancer(BMC, 2019-02-21) McElderry, Brenna M.; Mueller, Emily L.; Garcia, Abigail; Carroll, Aaron E.; Bennett, William E., Jr.; Medicine, School of MedicineBACKGROUND: While it is commonly understood that a cancer diagnosis evokes feelings of fear, the effect of labeling a child's illness as "cancer" remains unstudied. We hypothesized that lower health utility scores would be assigned to disease states labeled as cancer compared to identical disease states without the mention of cancer. METHODS: In this randomized study, caregivers of healthy children were asked to assign health utility values to different scenarios written as improving, stable, or worsening. Participants from general pediatric clinics at Eskenazi Health were randomly assigned to either the scenarios labeled as "cancer" or "a serious illness". Participants then rated the scenarios using the Standard Gamble, with laddering of health utilities between 0 (a painless death) and 1 (perfect health). We also gathered subject demographics and assessed the subject's numeracy. RESULTS: We approached 319 subjects and 167 completed the study. Overall median health utilities of "cancer" scenarios were lower than "serious illness" scenarios (0.61 vs. 0.72, p = 0.018). Multivariate regression (with an outcome of having a utility above the 75th percentile) showed no significant effects by race, ethnicity, numeracy, or income level. "Cancer" scenarios remained significantly lower after adjustment for confounders using logistic regression, but only for the more serious scenarios (OR 0.92, p = 0.048). CONCLUSIONS: On average, caregivers with healthy children were shown to take more risk with their treatment options and view their child as having a worse quality of life when they knew the disease was cancer. Awareness of this bias is important when discussing treatments with families, particularly when a risk of cancer is present.Item Transgenerational latent early-life associated regulation unites environment and genetics across generations(Future Science Group, 2016-03) Lahiri, Debomoy K.; Maloney, Bryan; Bayon, Baindu L.; Chopra, Nipun; White, Fletcher A.; Greig, Nigel H.; Nurnberger, John I.; Department of Psychiatry, IU School of MedicineThe origin of idiopathic diseases is still poorly understood. The latent early-life associated regulation (LEARn) model unites environmental exposures and gene expression while providing a mechanistic underpinning for later-occurring disorders. We propose that this process can occur across generations via transgenerational LEARn (tLEARn). In tLEARn, each person is a 'unit' accumulating preclinical or subclinical 'hits' as in the original LEARn model. These changes can then be epigenomically passed along to offspring. Transgenerational accumulation of 'hits' determines a sporadic disease state. Few significant transgenerational hits would accompany conception or gestation of most people, but these may suffice to 'prime' someone to respond to later-life hits. Hits need not produce symptoms or microphenotypes to have a transgenerational effect. Testing tLEARn requires longitudinal approaches. A recently proposed longitudinal epigenome/envirome-wide association study would unite genetic sequence, epigenomic markers, environmental exposures, patient personal history taken at multiple time points and family history.