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Matjasko JL, Herbst JH, Estefan LF. Preventing Adverse Childhood Experiences: The Role of Etiological, Evaluation, and Implementation Research. Am J Prev Med 2022; 62:S6-S15. [PMID: 35597583 PMCID: PMC9215220 DOI: 10.1016/j.amepre.2021.10.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 09/24/2021] [Accepted: 10/06/2021] [Indexed: 11/11/2022]
Abstract
Research on adverse childhood experiences is a vital part of the data-to-action link and the development of evidence-based public health and violence prevention practice. Etiological research helps to elucidate the key risk and protective factors for adverse childhood experiences and outcome research examines the consequences of exposure to them. Evaluation research is critical to building the evidence base for strategies that are likely to have a significant impact on preventing and reducing adverse experiences during childhood. Implementation research efforts inform the movement and scale-up of evidence-based findings to public health practice. The Centers for Disease Control and Prevention's Division of Violence Prevention located in the National Center for Injury Prevention and Control is investing in a number of research initiatives that are designed to advance what is known about the causes and consequences of adverse childhood experiences (i.e., etiological research), the strategies that are effective at reducing and preventing them (i.e., evaluation research), and how to best adapt and scale effective strategies (i.e., implementation research). This article complements the other articles in this Special Supplement by briefly providing a review of reviews for each of these areas and highlighting recent research investments and strategic directions by the Centers for Disease Control and Prevention in the area of child abuse and neglect and adverse childhood experience prevention. Research investments are critical to advancing the evidence base on the prevention of adverse childhood experiences and to ensure safe, stable, and nurturing relationships and environments so that all children can live to their fullest potential.
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Affiliation(s)
- Jennifer L Matjasko
- Division of Violence Prevention, National Center for Injury Prevention and Control (NCIPC), U.S. Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Jeffrey H Herbst
- Division of Violence Prevention, National Center for Injury Prevention and Control (NCIPC), U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lianne Fuino Estefan
- Division of Violence Prevention, National Center for Injury Prevention and Control (NCIPC), U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
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Ahmed AA, Ramey SJ, Dean MK, Takita C, Schwartz D, Wilson LD, Vapiwala N, Thomas CR, Shanafelt TD, Deville C, Jagsi R, Holliday E. Socioeconomic Factors Associated With Burnout Among Oncology Trainees. JCO Oncol Pract 2020; 16:e415-e424. [DOI: 10.1200/jop.19.00703] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE: Burnout in the medical workforce leads to early retirement, absenteeism, career changes, financial losses for medical institutions, and adverse outcomes for patients. Recent literature has explored burnout in different specialties of medicine. This article examines burnout among medical oncology trainees and identifies factors associated with burnout and professional dissatisfaction, including socioeconomic factors. METHODS: US medical oncology programs were sent a survey that included the Maslach Burnout Index–Human Services Survey as well as demographic, socioeconomic, and program-specific questions tailored to medical oncology fellowship. Primary binary end points included burnout, satisfaction with being a physician, and satisfaction with being a medical oncologist. Binomial logistic models determined associations between various characteristics and end points. RESULTS: Overall, 261 US fellows completed the survey. Seventy percent of international medical graduates reported no educational debt, whereas only 36% of US graduates reported no educational debt. Eighty-two percent of survey respondents reported their mother had at least a bachelor’s degree, and 87% of respondents reported their father had at least a bachelor’s degree. At least 27% of respondents had symptoms of burnout. Factors inversely associated with burnout on multivariable analysis included having a mother who graduated college (odds ratio [OR], 0.27), reporting an adequate perceived balance between work and personal life (OR, 0.22), feeling that faculty care about educational success (OR, 0.16), and being in the final year of training (OR, 0.45). Having debt ≥ $150,000 (OR, 2.14) was directly associated with burnout. CONCLUSION: Symptoms of burnout are common among medical oncology fellows and are associated with educational debt and socioeconomic factors.
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Affiliation(s)
- Awad A. Ahmed
- Department of Radiation Oncology, University of Miami Miller School of Medicine/Sylvester Comprehensive Cancer Center and Jackson Memorial Hospital, Miami, FL
- MercyOne Waterloo Medical Center, Waterloo, IA
| | - Stephen J. Ramey
- Department of Radiation Oncology, Augusta University, Augusta, GA
| | - Mary K. Dean
- Department of Radiation Oncology, University of Miami Miller School of Medicine/Sylvester Comprehensive Cancer Center and Jackson Memorial Hospital, Miami, FL
- Southern Illinois Healthcare Cancer Institute, Carterville, IL
| | - Cristiane Takita
- Department of Radiation Oncology, University of Miami Miller School of Medicine/Sylvester Comprehensive Cancer Center and Jackson Memorial Hospital, Miami, FL
| | - David Schwartz
- Department of Radiation Oncology, University of Tennessee, Knoxville, TN
| | - Lynn D. Wilson
- Department of Dermatology and Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT
| | - Neha Vapiwala
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - Charles R. Thomas
- Department of Radiation Medicine, Oregon Health & Science University, Portland, OR
| | - Tait D. Shanafelt
- Department of Medicine, WellMD Center, Stanford School of Medicine, Stanford University, Palo Alto, CA
| | - Curtiland Deville
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, MD
| | - Reshma Jagsi
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI
| | - Emma Holliday
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
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Marquez E, Dodge Francis C, Gerstenberger S. Where I live: A qualitative analysis of renters living in poor housing. Health Place 2019; 58:102143. [PMID: 31174060 DOI: 10.1016/j.healthplace.2019.05.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 05/18/2019] [Accepted: 05/23/2019] [Indexed: 12/19/2022]
Abstract
This article examines the lived experiences of 17 renters residing in Clark County, Nevada. Using a phenomenological study design, we used semistructured interviews to investigate how renters navigate living in substandard housing. The qualitative analysis revealed four main themes: (a) housing serves as a mediator with one's sense of well-being and good health, (b) housing insecurity and displacement occur through various pathways, (c) housing quality can lead to a sense of powerlessness over where one lives, and (d) social networks are key in low-opportunity neighborhoods. The findings support numerous studies that connect housing quality and insecurity to health and well-being, but the findings also highlight the mediating factors to limited housing choices such as the landlord and tenant relationship. Studies of this nature are essential in identifying the various pathways by which housing inequities and disparities can occur, particularly among low-income communities.
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Affiliation(s)
- Erika Marquez
- Nevada Institute for Children's Research and Policy, University of Nevada, Las Vegas 4505 Maryland Parkway Box 453064 Las Vegas, NV, 89154-3030, USA.
| | - Carolee Dodge Francis
- Department of Environmental and Occupational Health, University of Nevada, Las Vegas 4505 Maryland Parkway Box 453064 Las Vegas, NV, 89154-3064, USA
| | - Shawn Gerstenberger
- Department of Environmental and Occupational Health, University of Nevada, Las Vegas 4505 Maryland Parkway Box 453064 Las Vegas, NV, 89154-3064, USA
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