Adverse Childhood Experiences, Race, and Health Outcomes: Examining a Synergistic Relationship

Background: Adverse childhood experiences (ACEs) are potentially traumatic incidents occurring before age 18 years. Adverse childhood experiences include physical or mental abuse, financial stress, home or community violence, substance misuse, familial turmoil, and other factors. Adverse childhood experiences are associated with negative health outcomes in adulthood. Methods: Numerous research studies and systematic reviews were reviewed to assess the breadth and depth of racial and ethnic inclusivity in ACE research. Results: A wide range of ACEs have been investigated, and ample state-level data is publicly available. Early, fundamental ACE studies typically recruited White, educated, and insured participants; racial and ethnic diversity were often neglected. Conclusion: Adverse childhood experiences and race have been found exerting synergistic effects on adult health outcomes. Further evaluation of race is warranted to improve health outcomes. Scrutiny of racial and ethnic equity in health research is paramount for achieving health equity

Evaluating the e-Cigarette Epidemic in US Emergency Departments

Background: Electronic cigarettes (e-cigarettes) are often thought to be a healthier option to cigarette smoking. e-Cigarettes have been found to overheat and explode. e-Cigarette explosions have caused severe trauma and rendered patients in critical conditions. Inadvertent exposures to liquid nicotine products have caused systemic poisoning injuries. We sought to characterize e-cigarette injuries presenting to emergency departments (ED) in 2018.Methods: We analyzed one year of data from the US Consumer Product Safety Commission’s National Electronic Injury Surveillance System (NEISS). Patients presenting with injuries associated with e-cigarette products were manually identified for inclusion. We performed descriptive analyses on demographic factors, affected bodily regions, dispositions, locations of occurrence, and mechanisms of injury. By applying sample weights, nationally representative estimates were calculated.Results: A total of 361 667 injury cases were reported in NEISS (2018). We identified 50 e-cigarette injury cases, generating a national estimate of 1739 (95% CI [1333-2148]) patients presenting to US EDs with e-cigarette injuries in 2018. Approximately 1000 pediatric patients (age ≤17 years) and 700 adult patients (age ≥18 years) were included. The median age when presenting to the ED was 4 years (interquartile range [IQR], 1-25). Over 85% of injuries occurred at home. Ingestion (55.0%) was the most common mechanism of injury, followed by explosion (35.8%).Conclusion: Children and adults are susceptible to injury from e-cigarette products. Changes in manufacturing standards may prevent injuries from these products