Objectives.This study attempts to develop a comprehensive set of comorbidity measures for use with large administrative inpatient datasets.Methods.The study involved clinical and empirical review of comorbidity measures, development of a framework that attempts to segregate comorbidities from other

https://czresearch.com/dropbox/Elixhauser_MedCare_1998v36p8.pdf

Comorbidity measures for use with administrative data.

The adolescent brain and age-related behavioral manifestations

This study followed a sample of 179 children from kindergarten through eighth grade to examine the extent to which kindergarten teachers' perceptions of their relationships with students predict a range of school outcomes. Kindergarten teachers rated children's behavior and the quality of the teacher-child relationship. Followup data from first through eighth grade were organized by epoch and included academic grades, standardized test scores, work-habit ratings, and discipline records. Relational Negativity in kindergarten, marked by conflict and dependency, was related to academic and behavioral outcomes through eighth grade, particularly for children with high levels of behavior problems in kindergarten and for boys generally. These associations remained significant after controlling for gender, ethnicity, cognitive ability, and behavior ratings. The results have implications for theories of the determinants of school success, the role of adult-child relationships in development, and a range of early intervention and prevention efforts.

/pdf/early-teacher-child-relationships-and-the-trajectory-of-433q8pxulv.pdf

Early Teacher–Child Relationships and the Trajectory of Children's School Outcomes through Eighth Grade

Risky families are characterized by conflict and aggression and by relationships that are cold, unsupportive, and neglectful. These family characteristics create vulnerabilities and/or interact with genetically based vulnerabilities in offspring that produce disruptions in psychosocial functioning (specifically emotion processing and social competence), disruptions in stress-responsive biological regulatory systems, including sympathetic-adrenomedullary and hypothalamic-pituitary-adrenocortical functioning, and poor health behaviors, especially substance abuse. This integrated biobehavioral profile leads to consequent accumulating risk for mental health disorders, major chronic diseases, and early mortality. We conclude that childhood family environments represent vital links for understanding mental and physical health across the life span.

/pdf/risky-families-family-social-environments-and-the-mental-and-2ydtsobufc.pdf

Risky Families: Family Social Environments and the Mental and Physical Health of Offspring

The authors propose a model of the prosocial classroom that highlights the importance of teachers’ social and emotional competence (SEC) and wellbeing in the development and maintenance of supportive teacher–student relationships, effective classroom management, and successful social and emotional learning program implementation. This model proposes that these factors contribute to creating a classroom climate that is more conducive to learning and that promotes positive developmental outcomes among students. Furthermore, this article reviews current research suggesting a relationship between SEC and teacher burnout and reviews intervention efforts to support teachers’ SEC through stress reduction and mindfulness programs. Finally, the authors propose a research agenda to address the potential efficacy of intervention strategies designed to promote teacher SEC and improved learning outcomes for students.

/pdf/the-prosocial-classroom-teacher-social-and-emotional-25zmo7aytk.pdf

The Prosocial Classroom: Teacher Social and Emotional Competence in Relation to Student and Classroom Outcomes:

Context. —The main threats to adolescents' health are the risk behaviors they choose. How their social context shapes their behaviors is poorly understood. Objective. —To identify risk and protective factors at the family, school, and individual levels as they relate to 4 domains of adolescent health and morbidity: emotional health, violence, substance use, and sexuality. Design. —Cross-sectional analysis of interview data from the National Longitudinal Study of Adolescent Health. Participants. —A total of 12118 adolescents in grades 7 through 12 drawn from an initial national school survey of 90118 adolescents from 80 high schools plus their feeder middle schools. Setting. —The interview was completed in the subject's home. Main Outcome Measures. —Eight areas were assessed: emotional distress; suicidal thoughts and behaviors; violence; use of 3 substances (cigarettes, alcohol, marijuana); and 2 types of sexual behaviors (age of sexual debut and pregnancy history). Independent variables included measures of family context, school context, and individual characteristics. Results. —Parent-family connectedness and perceived school connectedness were protective against every health risk behavior measure except history of pregnancy. Conversely, ease of access to guns at home was associated with suicidality (grades 9-12: P P P P P P P P P P P P P P P Conclusions. —Family and school contexts as well as individual characteristics are associated with health and risky behaviors in adolescents. The results should assist health and social service providers, educators, and others in taking the first steps to diminish risk factors and enhance protective factors for our young people.

/pdf/protecting-adolescents-from-harm-findings-from-the-national-427il6ghe1.pdf

Protecting adolescents from harm: Findings from the National Longitudinal Study on Adolescent Health.

Objective. In 1997, suicide was the third leading cause of death among 10- to 19-year-olds in the United States, with the greatest increases in suicide rates in the previous decade experienced by black and other minority youth. The purpose of this study was to identify risk and protective factors for suicide attempts among black, Hispanic, and white male and female adolescents. Methods. We used data from the National Longitudinal Study of Adolescent Health, conducted in 1995 and 1996. A nationally representative sample of 13 110 students in grades 7 through 12 completed 2 in-home interviews, an average of 11 months apart. We examined Time 1 factors at the individual, family, and community level that predicted or protected against Time 2 suicide attempts. Results. Perceived parent and family connectedness was protective against suicide attempts for black, Hispanic, and white girls and boys, with odds ratios ranging from 0.06 to 0.32. For girls, emotional well-being was also protective for all of the racial/ethnic groups studied, while a high grade point average was an additional protective factor for all of the boys. Cross-cutting risk factors included previous suicide attempt, violence victimization, violence perpetration, alcohol use, marijuana use, and school problems. Additionally, somatic symptoms, friend suicide attempt or completion, other illicit drug use, and a history of mental health treatment predicted suicide attempts among black, Hispanic, and white females. Weapon-carrying at school and same-sex romantic attraction were predictive for all groups of boys. Calculating the estimated probabilities of attempting suicide for adolescents with increasing numbers of risk and protective factors revealed that the presence of 3 protective factors reduced the risk of a suicide attempt by 70% to 85% for each of the gender and racial/ethnic groups, including those with and without identified risk factors. Conclusions. In these national samples of black, Hispanic, and white youth, unique and cross-cutting factors derived from a resiliency framework predicted or protected against attempting suicide. In addition to risk reduction, promotion of protective factors may offer an effective approach to primary as well as secondary prevention of adolescent suicidal behavior.

Adolescent Suicide Attempts: Risks and Protectors

Prevalence and risk and protective factors related to disordered eating behaviors among adolescents: relationship to gender and ethnicity

http://pdba.georgetown.edu/Security/citizensecurity/eeuu/documents/youthviolence.pdf

Marjorie Ireland

Papers

Protecting adolescents from harm: Findings from the National Longitudinal Study on Adolescent Health.

Adolescent Suicide Attempts: Risks and Protectors

Prevalence and risk and protective factors related to disordered eating behaviors among adolescents: relationship to gender and ethnicity

Youth violence perpetration: what protects? What predicts? Findings from the National Longitudinal Study of Adolescent Health.

Influences on adolescents’ decision to postpone onset of sexual intercourse: a survival analysis of virginity among youths aged 13 to 18 years