Adverse Childhood Experiences identification from clinical notes with ontologies and NLP

Adverse Childhood Experiences (ACEs) are defined as a collection of highly stressful, and potentially traumatic, events or circumstances that occur throughout childhood and/or adolescence. They have been shown to be associated with increased risks of mental health diseases or other abnormal behaviours in later lives. However, the identification of ACEs from free-text Electronic Health Records (EHRs) with Natural Language Processing (NLP) is challenging because (a) there is no NLP ready ACE ontologies; (b) there are limited cases available for machine learning, necessitating the data annotation from clinical experts. We are currently developing a tool that would use NLP techniques to assist us in surfacing ACEs from clinical notes. This will enable us further research in identifying evidence of the relationship between ACEs and the subsequent developments of mental illness (e.g., addictions) in large-scale and longitudinal free-text EHRs, which has previously not been possible

A Phenomenological Study of Adult Patients with Auto-Immune Disease and Their Exposure to Adverse Childhood Experiences

This qualitative phenomenological study explored and described the shared experiences of individuals impacted by an autoimmune disease and their exposure to adverse childhood experiences. The theory guiding this study was Vygotsky’s social constructivist theory, utilizing Kaiser Permanente’s Adverse Childhood Experience study as a guide to create awareness amongst physicians and mental health professionals, leading them to a more holistic approach when treating patients affected by an autoimmune disease. This was a qualitative study using Husserl’s transcendental phenomenology (TPh). The data collection methods used in the study included questionnaires, individual interviews, and document analysis. These forms of data were analyzed through member-checking, triangulation of data, and peer debriefing

Big Ideas in a Micro Village: Evaluating the Potential Efficacy of a Young Person’s supported Housing Concept

Young people at risk of homelessness can often struggle to find suitable accommodation that adequately meets their needs. It is this lack of appropriate supported housing provision that has prompted the Wallich homelessness charity to start developing an innovative housing project for young people called the Carmarthenshire Wellbeing, Therapeutic and Social Hub (CWTSH). Thus, this study aimed to evaluate the potential efficacy of the CWTSH in order to gain a deeper understanding of its possible benefits, challenges and criticisms.This study employed a predominantly qualitative methodology and sits within an interpretivist paradigm. The literature review focused on indirect literature that was central to the CWTSH concept, such as the context of youth homelessness; policy and legislation; existing homelessness housing models; intentional community discourse; psychologically informed environments; adverse childhood experiences, and collaboration. Participants were sampled through the Wallich using both a convenience and purposive approach, whilst data was collected via ethnographic research with Wallich management, group participation with young people and their staff, and a young people’s survey. Data was then analysed using thematic analysis. As the CWTSH has not yet been physically developed, this study was unable to produce any solid inferences. However, it was successful in gaining a deeper understanding of the CWTSH’s potential efficacy, providing a firm basis for future research, and generating multiple hypothesises. Thus, several hypothetical findings emerged from the data which related to the co-production process, the CWTSH’s potential to meet young people’s needs, and potential risks and challenges. It is therefore an overall finding of this research that there are several risks attached to the CWTSH concept, with the potential for isolation being significant. However, if the Wallich can successfully manage the risks identified in this study, the CWTSH has the potential to effectively meet multiple needs, thus improving the lives and prospects of young people with housing and support needs

Autistic Authors\u27 Narratives of Trauma and Resilience: A Qualitative Analysis

This qualitative dissertation investigates current research gaps regarding autistic individuals’ experience of trauma and resilience in the face of adversity. Specifically, it conceptualizes trauma and resilience through a neurodiverse lens, through identifying themes in memoirs written by five autistic authors related to trauma, potentially traumatic events, resiliency, and posttraumatic growth. Through Interpretive Phenomenological Analysis, I identified individual, interpersonal, and societal factors impacting the memoirists experiences of trauma, through the identification of 11 superordinate themes. Prominent themes at the individual level included self-acceptance and emotion regulation promoting resilience. At the contextual level, sensory processing and uncertainty coincided with experiences of trauma. At the interpersonal level, many memoirists describe interpersonal traumas, including mutual misunderstanding between themselves and others. Finally, at the societal level, themes across the memoirs point to the importance of mental health professional training and awareness regarding autism and expanding our understanding of traumatic experiences. Thus, I propose a sociocultural approach for conceptualizing how autism and trauma intersect. Based on this approach, I advocate for systemic-level changes, community, contextual, and individual interventions to support the resiliency of autistic individuals

Emerging Victims in Contemporary Drugs Policing

Recent shifts in UK policy have seen certain populations, who were predominantly viewed as offenders due to their involvement in drug offences, increasingly recognized as victims of exploitation. Drawing on qualitative data from three studies, this article interrogates how this trend is playing out within contemporary drugs policing, focussing on officers’ responses to people affected by: drug addiction, child criminal exploitation and ‘cuckooing’. It examines the tensions that arise as these three categories of emergent drug victims conflict with officers’ normative expectations of victimhood, perceptions of their role as police and existing operational strategies. It also reveals officers’ attempts to (re)gain ontological security by policing the boundaries of victimhood and re-focussing on new categories of offender

Exploring the Meaning of Doctoral Completion for African American Females Who Have Attended a Predominantly White Institution

As evidenced by the average doctoral student turnover rate, pursuing a doctorate degree may be exceedingly difficult. African American women (AAW) in particular, tend to face unique challenges in higher education due to their gender and racial identities, yet because of their perceived success in comparison to their Black male counterparts, their doctoral experiences at predominantly White institutions (PWIs) frequently go overlooked. Furthermore, considering the impact that trauma can have on higher education success, it is crucial to better understand the intricate nature of the doctoral experiences of AAW to determine how to further facilitate their success. To add to the existing literature, the present qualitative phenomenological study sought to amplify the doctoral experiences of eight AAW and how they describe the meaning of graduating with a doctoral degree from a PWI. The personal narratives of these Black women were collected via semi-structured interviews and summarized utilizing Interpretative Phenomenological Analysis, guided by the conceptual frameworks of Black Feminist Thought (Collins, 1989) and Critical Race Theory (Delgado & Stefancic, 2001). Study implications, limitations and suggested future directions are also discussed

Latina\u27s experiences of shared parenting in the context of intimate partner violence: a phenomenological study

This dissertation presented a hermeneutic phenomenological study conducted with 12 Latina mothers who were survivors of intimate partner violence (IPV) considering or in a process of shared parenting with their former abusive partner. The purpose of this study was to explore the essence of shared parenting experiences among participants in the IPV context and examine how attachment style, adverse childhood experiences, and cultural values impacted their shared parenting decisions and processes. The study was guided by the theoretical frameworks of symbolic interactionism, intersectional feminism, and attachment. Findings indicated adverse childhood experiences and cultural values affected participants’ shared parenting decisions and processes, with all but one participant reporting they desired shared parenting for the sake of their children. Participants were fully aware of risks associated with shared parenting including psychological abuse, physical violence, and coercive control. Participants reported riskmanagement strategies, the most prevalent of which included involving a third party, often family or a trusted friend, using supervised visitation, and meeting the\ perpetrator in a public place. Given the role of attachment style in relation to shared parenting was unclear, future research should investigate the impact of attachment style and shared parenting. Additionally, assessing adverse childhood experiences and cultural values will be beneficial when combined with interview data. Due to the prevalence of IPV, culturally sensitive and trauma-informed interventions must focus on individual skills training for survivors, group therapy to help process IPV experiences and instill hope, and relational therapy with family members and loved ones to strengthen problem-solving skills and promote recovery. Furthermore, in the context of the COVID-19 global pandemic, many women reside with perpetrators due to lack of resources, so secure online platforms must be constructed to provide support and ensure women and children’s safety. Recommendations were provided for improving how the legal and judicial system recognize and respond to coercive control as a punishable form of abuse. Moreover, to improve competence among mental health practitioners working with IPV survivors, graduate programs for mental health practitioners must include general knowledge and intervention on IPV. Intervention through the educational system and the church system is also recommended. Keywords: intimate partner violence, Latinx, shared parenting, adverse childhood experiences, attachment styles, intersectional feminis