http://www.iowaaces360.org/uploads/1/0/9/2/10925571/relationship_of_childhood_abuse_and..._1998.pdf

Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study

The MMWR series of publications is published by the Office of Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention (CDC), U.S. Department of Health and Human Services, Atlanta, GA 30333.

/pdf/sexually-transmitted-diseases-treatment-guidelines-4zaqk3joit.pdf

Sexually transmitted diseases treatment guidelines.

Childhood maltreatment has been linked to a variety of changes in brain structure and function and stress–responsive neurobiological systems. Epidemiological studies have documented the impact of childhood maltreatment on health and emotional well–being. After a brief review of the neurobiology of childhood trauma, we use the Adverse Childhood Experiences (ACE) Study as an epidemiological “case example” of the convergence between epidemiologic and neurobiological evidence of the effects of childhood trauma. The ACE Study included 17,337 adult HMO members and assessed 8 adverse childhood experiences (ACEs) including abuse, witnessing domestic violence, and serious household dysfunction. We used the number of ACEs (ACE score) as a measure of cumulative childhood stress and hypothesized a "doseresponse" relationship of the ACE score to 18 selected outcomes and to the total number of these outcomes (comorbidity). Based upon logistic regression analysis, the risk of every outcome in the affective, somatic, substance abuse, memory, sexual,and aggressionrelated domains increased in a graded fashion as the ACE score increased (P <0.001). The mean number of comorbid outcomes tripled across the range of the ACE score. The graded relationship of the ACE score to 18 different outcomes in multiple domains theoretically parallels the cumulative exposure of the developing brain to the stress response with resulting impairment in multiple brain structures and functions.

https://traumasensitiveschools.org/wp-content/uploads/2013/06/Anda-Article-Enduring-Effects-of-Abuse.pdf

The enduring effects of abuse and related adverse experiences in childhood: A convergence of evidence from neurobiology and epidemiology

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(08)61706-7.pdf

Burden and consequences of child maltreatment in high-income countries

Summary Background A growing body of research identifies the harmful effects that adverse childhood experiences (ACEs; occurring during childhood or adolescence; eg, child maltreatment or exposure to domestic violence) have on health throughout life. Studies have quantified such effects for individual ACEs. However, ACEs frequently co-occur and no synthesis of findings from studies measuring the effect of multiple ACE types has been done. Methods In this systematic review and meta-analysis, we searched five electronic databases for cross-sectional, case-control, or cohort studies published up to May 6, 2016, reporting risks of health outcomes, consisting of substance use, sexual health, mental health, weight and physical exercise, violence, and physical health status and conditions, associated with multiple ACEs. We selected articles that presented risk estimates for individuals with at least four ACEs compared with those with none for outcomes with sufficient data for meta-analysis (at least four populations). Included studies also focused on adults aged at least 18 years with a sample size of at least 100. We excluded studies based on high-risk or clinical populations. We extracted data from published reports. We calculated pooled odds ratios (ORs) using a random-effects model. Findings Of 11 621 references identified by the search, 37 included studies provided risk estimates for 23 outcomes, with a total of 253 719 participants. Individuals with at least four ACEs were at increased risk of all health outcomes compared with individuals with no ACEs. Associations were weak or modest for physical inactivity, overweight or obesity, and diabetes (ORs of less than two); moderate for smoking, heavy alcohol use, poor self-rated health, cancer, heart disease, and respiratory disease (ORs of two to three), strong for sexual risk taking, mental ill health, and problematic alcohol use (ORs of more than three to six), and strongest for problematic drug use and interpersonal and self-directed violence (ORs of more than seven). We identified considerable heterogeneity ( I 2 of >75%) between estimates for almost half of the outcomes. Interpretation To have multiple ACEs is a major risk factor for many health conditions. The outcomes most strongly associated with multiple ACEs represent ACE risks for the next generation (eg, violence, mental illness, and substance use). To sustain improvements in public health requires a shift in focus to include prevention of ACEs, resilience building, and ACE-informed service provision. The Sustainable Development Goals provide a global platform to reduce ACEs and their life-course effect on health. Funding Public Health Wales.

https://uwe-repository.worktribe.com/preview/883491/PIIS2468266717301184.pdf

The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis

Although street youth are at increased risk of lifetime pregnancy involvement (LPI), or ever becoming or getting someone pregnant, no reports to date describe the epidemiology of LPI among systematically sampled street youth from multiple cities outside of North America The purpose of our assessment was to describe the prevalence of and risk factors associated with LPI among street youth from three Ukrainian cities We used modified time–location sampling to conduct a cross-sectional assessment in Odesa, Kyiv, and Donetsk that included citywide mapping of 91 public venue locations frequented by street youth, random selection of 74 sites, and interviewing all eligible and consenting street youth aged 15–24 years found at sampled sites (n = 929) Characteristics of youth and prevalence of LPI overall and by demographic, social, sexual, and substance use risk factors, were estimated separately for males and females Adjusted odds ratios (AORs) were calculated with multivariable logistic regression and effect modification by gender was examined Most (966%) eligible youth consented to participate LPI was reported for 417% of females (93/223) and 235% of males (166/706) For females, LPI was significantly elevated and highest (>70%) among those initiating sexual activity at ≤12 years and for those reporting lifetime anal sex and exchanging sex for goods For males, LPI was significantly elevated and highest (>40%) among those who reported lifetime anal sex and history of a sexually transmitted infection Overall, risk factors associated with LPI were similar for females and males Among the total sample (females and males combined), significant independent risk factors with AORs ≥25 included female gender, being aged 20–24 years, having five to six total adverse childhood experiences, initiating sex at age ≤12 or 13–14 years, lifetime anal sex, most recent sex act unprotected, and lifetime exchange of sex for goods Among street youth with LPI (n = 259), the most recent LPI event was reported to be unintended by 633% and to have ended in abortion by 432% In conclusion, our assessment documented high rates of LPI among Ukrainian street youth who, given the potential for negative outcomes and the challenges of raising a child on the streets, are in need of community-based pregnancy prevention programs and services Promising preventive strategies are discussed, which are likely applicable to other urban populations of street-based youth as well

/pdf/multi-city-assessment-of-lifetime-pregnancy-involvement-2rep3v56e6.pdf

Multi-City Assessment of Lifetime Pregnancy Involvement among Street Youth, Ukraine

OBJECTIVE: We evaluated the relationship between delayed care of symptomatic pelvic inflammatory disease and impaired fertility. STUDY DESIGN: We used data from a cohort of women with clinically recognized pelvic inflammatory disease. Case patients were women with either ectopic pregnancy or infertility ( n = 76); controls were women with intrauterine pregnancies ( n = 367). RESULTS: Women who delayed seeking care for pelvic inflammatory disease were three times more likely to experience infertility or ectopic pregnancy than women who sought care promptly after adjustment for age, organism, year of diagnosis, and history of recent gynecologic events (95% confidence interval=1.27, 6.11). This association was strongest for women with chlamydia; 17.8% (18/101) of those who delayed seeking care had impaired fertility, whereas 0.0% (0/13) of those who sought care promptly suffered known sequelae. CONCLUSIONS: Women with pelvic inflammatory disease who delay seeking care are at increased risk for infertility and ectopic pregnancy. Furthermore, our data suggest that prompt evaluation and treatment of chlamydia) pelvic inflammatory disease can prevent these sequelae.

Delayed Care of Pelvic Inflammatory Disease as a Risk Factor for Impaired Fertility

History and features of the Wisconsin Chlamydia trachomatis control program.

Objective: The objective of this study was to assess the relationship between body mass index (BMI) and epithelial ovarian cancer survival among young women. Methods: We conducted a cohort analysis of 425 women aged 20–54 years with incident epithelial ovarian cancer enrolled during 1980–1982 in Cancer and Steroid Hormone (CASH), a population-based, case-control study. Participants' vital status was ascertained though linkage with the Surveillance, Epidemiology and End Results (SEER) program. Using Cox proportional hazards models, we estimated adjusted hazard ratios (HR) and 95% confidence intervals (CI) for the association between survival and usual adult BMI, BMI at age 18, and weight change from age 18 to adult. Results: During a follow-up of up to 17 years, 215 women died. Compared to women with an adult BMI in the lowest quartile (<20.7), women in the second (20.8–22.5), third (22.6–24.9), and fourth (≥25.0) quartiles were not at increased risk for death (HR 1.2, 95% CI 0.8-1.8; HR 1.1, 95% ...

Susan D. Hillis

Papers

Multi-City Assessment of Lifetime Pregnancy Involvement among Street Youth, Ukraine

Delayed Care of Pelvic Inflammatory Disease as a Risk Factor for Impaired Fertility

History and features of the Wisconsin Chlamydia trachomatis control program.

The effect of body mass index and weight change on epithelial ovarian cancer survival in younger women: a long-term follow-up study.

Reproductive Tract Infections