Understanding Health Risks for Adolescents in Protective Custody

Children in child welfare protective custody (e.g., foster care) are known to have increased health concerns compared to children not in protective custody. The poor health documented for children in protective custody persists well into adulthood; young adults who emancipate from protective custody report poorer health, lower quality of life, and increased health risk behaviors compared to young adults in the general population. This includes increased mental health concerns, substance use, sexually transmitted infections, unintended pregnancy, and HIV diagnosis. Identifying youth in protective custody with mental health concerns, chronic medical conditions, and increased health risk behaviors while they remain in custody would provide the opportunity to target prevention and intervention efforts to curtail poor health outcomes while youth are still connected to health and social services. This study leveraged linked electronic health records and child welfare administrative records for 351 youth ages 15 and older to identify young people in custody who were experiencing mental health conditions, chronic medical conditions, and health risk behaviors (e.g., substance use, sexual risk). Results indicate that 41.6% of youth have a mental health diagnosis, with depression and behavior disorders most common. Additionally, 41.3% of youth experience chronic medical conditions, primarily allergies, obesity, and vision and hearing concerns. Finally, 39.6% of youth use substances and 37.0% engage in risky sexual behaviors. Predictors of health risks were examined. Those findings indicate that women, those with longer lengths of stay and more times in custody, and those in independent living and conjugate care settings are at greatest risk for mental health conditions, chronic medical conditions, and health risk behaviors. Results suggest a need to ensure that youth remain connected to health and mental health safety nets, with particular attention needed for adolescents in care for longer and/or those placed in non-family style settings. Understanding who is at risk is critical for developing interventions and policies to target youth who are most vulnerable for increased health concerns that can be implemented while they are in custody and are available to receive services

Adolescents Occupational and Educational Goals: A Test of Reciprocal Relations

During adolescence, young people’s future aspirations and expectations begin to crystallize, especially in the domains of education and occupation. Much of the research in this area has emphasized development within a particular domain (e.g., education) and relations between aspirations and expectations across domains remain largely unexplored, resulting in a lack of information on how goals develop in tandem and affect each other. It is also unclear whether these developmental processes differ by gender and socioeconomic status. We tested reciprocal effects between occupational and educational goals using a longitudinal sample of 636 adolescents (52% boys). Results from dynamic systems models indicated change in occupational and educational goals across high school. For all youth, occupational aspirations predicted change in occupational expectations. Educational expectations predicted change in occupational aspirations for youth in high but not low parent education groups, and occupational expectations predicted change in educational expectations for girls but not boys

Who Speaks for Me?: Addressing Variability in Informed Consent Practices for Minimal Risk Research Involving Foster Youth

Background: Youth in protective custody (i.e., foster care) are at higher risk for poorer physical and mental health outcomes compared with those who are not. These differences may be due in part to the lack of research on the population to create evidence-based recommendations for health care delivery. A potential contributor to this lack of research is difficulties in obtaining informed consent for empirical studies in this population. The objective of this study was to describe the approaches to obtaining informed consent in minimal risk studies of foster youth and provide recommendations for future requirements. Methods: We conducted a systematic review of the literature to characterize the informed consent approaches in published minimal risk research involving youth in foster care. We searched PubMed, CINAHL, PsychINFO, Embase, ERIC, Scopus, and EBMR. Inclusion criteria were: studies conducted in the United States, included current foster youth, minimal risk, peer reviewed, and published in English. Full text was reviewed, and individuals required to consent and assent were extracted. Results: Forty-nine publications from 33 studies were identified. Studies required 0 to 3 individuals to consent. Individuals required to give consent included case workers (16, 48%), foster caregivers (12, 36%), biological parents (7, 21%), judges (5, 15%), and guardian ad litems (2, 6%). Twenty-nine (88%) studies required the youth’s assent. The studies used 14 different combinations of individuals. One (3%) study utilized a waiver of consent. Conclusions: There is no consistent approach for obtaining informed consent for foster youth to participate in minimal risk research. Consent should ideally involve individuals with legal authority and knowledge of the individual youth’s interests and should not be burdensome. Consensus regarding consent requirements may facilitate research involving foster youth

The Role of Emotional Reactivity, Self-regulation, and Puberty in Adolescents\u27 Prosocial Behaviors

This study was designed to examine the roles of emotional reactivity, self-regulation, and pubertal timing in prosocial behaviors during adolescence. Participants were 850 sixth graders (50% female, Mean age = 11.03, SD = .17) who were followed up at age 15. In hierarchical regression models, measures of emotional reactivity, self-regulation, pubertal timing and their interactions were used to predict (concurrently and over time) adolescents’ prosocial behaviors in the home and with peers. Overall, the findings provide evidence for pubertal and temperament based predictors of prosocial behaviors expressed in different contexts. Self-regulation was positively related to both forms of prosocial behavior, concurrently and longitudinally. Emotional reactivity showed moderately consistent effects, showing negative concurrent relations to prosocial behavior with peers and negative longitudinal relations (four years later) to prosocial behavior at home. Some curvilinear effects of temperament on prosocial behaviors were also found. Effects of pubertal timing were found to interact with gender, such that boys who were early maturers showed the highest levels of prosocial behavior at home concurrently. Discussion focuses on the role of temperament-based mechanisms in the expression of prosocial behaviors in different contexts in adolescence

The Role of Information Sharing to Improve Case Management in Child Welfare

Congress enacted the Adoption and Safe Families Act to improve outcomes concerning the permanency, safety, and wellbeing of children in the care of child welfare agencies. However, achieving its goals for the more than 700,000 children who spend time in the custody of child protective services (CPS) every year in the United States is made more difficult by their poorer health compared to the general population.1 Common health concerns among children in CPS custody include developmental delay (e.g., intellectual delay or disability, gross or fine motor delay, speech delay), infections diseases, mental and behavioral health concerns, and medical concerns. Higher levels of healthcare compared to other children who live in poverty are often required.2 While health concerns may have been identified before children entered CPS custody, connections to healthcare providers and services are disrupted when children are removed from their families of origin and placed in out-of-home care. Efforts to collect a child’s complete medical history upon entering care may be difficult, and incomplete histories negatively impact health and disease management. Moreover, disruptions in healthcare can continue even after children enter CPS custody and out-of-home care—for example, when children change placements or caseworkers—leading to additional challenges managing children’s health needs and increasing healthcare use.

EVALUATION OF RELATIONSHIPS BETWEEN REPORTED RESILIENCE AND SOLDIER OUTCOMES, Report #2: Positive Performance Outcomes in Officers (Promotions, Selections, & Professions)

This technical report presents an analysis of reported resilience and psychological health among the U.S. Army’s Officer Corps. The focus of the current report is on linking resilience and psychological health (hereafter referred to as R/PH) to objective outcomes associated with high job performance. Specifically, this report examines the statistical relationships between officer R/PH - as measured by the Army’s Global Assessment Tool (GAT) - and promotions to Brigadier General, early (below zone) Field Grade Officer promotions, selections for command / key billet assignments, and officers who serve in career fields that require terminal professional degrees (e.g., medical doctors, dentists, lawyers, etc). Results show that officers who have been promoted to Brigadier General are more emotionally and socially fit than their peers who have not received a promotion to Brigadier General. These officers are more engaged with their work, have higher levels of organizational trust and friendship, report lower levels of loneliness, are more optimistic, and report higher levels of positive affect and lower levels of negative affect. Each of these findings is in line with our expectations regarding R/PH and job performance, and the findings comport with a substantial body of work in the academic literature. Additionally, analysis of R/PH for officers promoted early resulted in findings similar to above. In particular, those who have been promoted below zone report higher levels of work engagement, friendship, organizational trust, optimism, and coping abilities. In short, these officers score higher on the GAT dimensions of Emotional and Social Fitness than their peers who were not promoted early (“due course” officers). Similar results were found for officers selected for command for key billet assignments. They are also more emotionally and socially fit than their peers who were not selected for command (more engaged with their work, have higher levels of organizational trust and friendship, are less lonely, are more optimistic, and report higher levels of positive affect and lower levels of negative affect). There are no practical differences in R/PH between officers serving in career fields that require terminal professional degrees and other officers serving in “line” career fields (rank-matched analysis, Captain - Colonel). In light of academic literature on the subject, this finding is somewhat surprising as it suggests that advanced professional education / training alone may not influence (or be influenced by) R/PH. When taken together, the findings above strongly suggest there is a relationship between reported resilience and psychological health and outcomes associated with high job performance, but we are currently unable to determine causality. Stated differently, we do not know if the reported R/PH contributed to the performance outcomes, or if the high job performance outcomes contributed to the reported R/PH. Further data collection and analysis over the next 12-24 months will broaden our understanding of the relationships

A high-resolution map of human evolutionary constraint using 29 mammals.

The comparison of related genomes has emerged as a powerful lens for genome interpretation. Here we report the sequencing and comparative analysis of 29 eutherian genomes. We confirm that at least 5.5% of the human genome has undergone purifying selection, and locate constrained elements covering ∼4.2% of the genome. We use evolutionary signatures and comparisons with experimental data sets to suggest candidate functions for ∼60% of constrained bases. These elements reveal a small number of new coding exons, candidate stop codon readthrough events and over 10,000 regions of overlapping synonymous constraint within protein-coding exons. We find 220 candidate RNA structural families, and nearly a million elements overlapping potential promoter, enhancer and insulator regions. We report specific amino acid residues that have undergone positive selection, 280,000 non-coding elements exapted from mobile elements and more than 1,000 primate- and human-accelerated elements. Overlap with disease-associated variants indicates that our findings will be relevant for studies of human biology, health and disease

Genome sequence of an Australian kangaroo, Macropus eugenii, provides insight into the evolution of mammalian reproduction and development.

BACKGROUND: We present the genome sequence of the tammar wallaby, Macropus eugenii, which is a member of the kangaroo family and the first representative of the iconic hopping mammals that symbolize Australia to be sequenced. The tammar has many unusual biological characteristics, including the longest period of embryonic diapause of any mammal, extremely synchronized seasonal breeding and prolonged and sophisticated lactation within a well-defined pouch. Like other marsupials, it gives birth to highly altricial young, and has a small number of very large chromosomes, making it a valuable model for genomics, reproduction and development. RESULTS: The genome has been sequenced to 2 × coverage using Sanger sequencing, enhanced with additional next generation sequencing and the integration of extensive physical and linkage maps to build the genome assembly. We also sequenced the tammar transcriptome across many tissues and developmental time points. Our analyses of these data shed light on mammalian reproduction, development and genome evolution: there is innovation in reproductive and lactational genes, rapid evolution of germ cell genes, and incomplete, locus-specific X inactivation. We also observe novel retrotransposons and a highly rearranged major histocompatibility complex, with many class I genes located outside the complex. Novel microRNAs in the tammar HOX clusters uncover new potential mammalian HOX regulatory elements. CONCLUSIONS: Analyses of these resources enhance our understanding of marsupial gene evolution, identify marsupial-specific conserved non-coding elements and critical genes across a range of biological systems, including reproduction, development and immunity, and provide new insight into marsupial and mammalian biology and genome evolution

Paternal exposure to benzo(a)pyrene induces genome-wide mutations in mouse offspring

Understanding the effects of environmental exposures on germline mutation rates has been a decades-long pursuit in genetics. We used next-generation sequencing and comparative genomic hybridization arrays to investigate genome-wide mutations in the offspring of male mice exposed to benzo(a)pyrene (BaP), a common environmental pollutant. We demonstrate that offspring developing from sperm exposed during the mitotic or post-mitotic phases of spermatogenesis have significantly more de novo single nucleotide variants (1.8-fold; P < 0.01) than controls. Both phases of spermatogenesis are susceptible to the induction of heritable mutations, although mutations arising from post-fertilization events are more common after post-mitotic exposure. In addition, the mutation spectra in sperm and offspring of BaP-exposed males are consistent. Finally, we report a significant increase in transmitted copy number duplications (P = 0.001) in BaP-exposed sires. Our study demonstrates that germ cell mutagen exposures induce genome-wide mutations in the offspring that may be associated with adverse health outcomes