Objective The goal of this study was to investigate the adverse childhood experiences (ACEs) in youth in a low-income, urban community. Study design Data from a retrospective chart review of 701 subjects from the Bayview Child Health Center in San Francisco are presented. Medical chart documentation of ACEs as defined in previous studies were coded and each ACE criterion endorsed by a traumatic event received a score of 1 (range = 0 to 9). This study reports on the prevalence of various ACE categories in this population, as well as the association between ACE score and two pediatric problems: learning/behavior problems and body mass index (BMI) ≥ 85% (i.e., overweight or obese). Results The majority of subjects (67.2%, N = 471) had experienced 1 or more categories of adverse childhood experiences (ACE ≥ 1) and 12.0% (N = 84) had experienced 4 or more ACEs (ACE ≥ 4). Increased ACE scores correlated with increased risk of learning/behavior problems and obesity. Conclusions There was a significant prevalence of endorsed ACE categories in this urban population. Exposure to 4 or greater ACE categories was associated with increased risk for learning/behavior problems, as well as obesity. Practice implications Results from this study demonstrate the need both for screening of ACEs among youth in urban areas and for developing effective primary prevention and intervention models.

This study examined the stability of post traumatic stress disorder (PTSD) symptoms in a predominantly ethnic minority sample of youth exposed to Hurricane Katrina. Youth (n = 191 grades 4th thru 8th) were screened for exposure to traumatic experiences and PTSD symptoms at 24 months (Time 1) and then again at 30 months (Time 2) post-disaster. PTSD symptoms did not significantly decline over time and were higher than rates reported at earlier time points for more ethnically diverse samples. Younger age, female sex, and continued disrepair to the child's home predicted stable elevated PTSD symptoms. Findings are consistent with predictions from contextual theories of disaster exposure and with epidemiological data from adult samples suggesting that the incidence of PTSD post Katrina is showing an atypical pattern of remittance. Theoretical, applied, and policy implications are discussed.

Background: The American Academy of Orthopaedic Surgeons has adopted the strategic goal of evolving its culture and governance to become more strategic, innovative, and diverse. Given the charge to increase diversity, a focus on assessing and increasing diversity at the faculty level may help this cause. However, an analysis of gender and racial diversity among orthopaedic faculty has not been performed. The purpose of this study was to evaluate faculty appointments for underrepresented minority (URM) and female orthopaedic surgeons. We also aim to draw comparisons between orthopaedic surgery and other specialties. Methods: Data on gender, race, and faculty rank (clinical instructor, assistant professor, associate professor, and professor) of academic faculty for 18 specialties from 1997 to 2017 were obtained from the Association of American Medical Colleges (AAMC) Faculty Roster. Assistant professors were designated as junior faculty, whereas associate professor and professor were considered senior faculty. URMs were defined using the AAMC definition—groups having lower representation than in the general population. Regression analysis was used to evaluate and compare the change over time and to compare the change across different specialties. Results: Over the 20-year study period, the number of female faculty increased (8.8% pts) but represents a lower proportion than other specialties (13.9% pts) (p = 0.029). Female orthopaedic senior faculty grew slower (7.3% pts) than other specialties (14.7% pts) (p < 0.001). There was no difference in the growth of URM faculty positions (2.0% pts) compared with all other specialties (2.4% pts) (p = 0.165). The proportion of orthopaedic URM senior faculty increased less (0.5% pts) than other specialties (2.5% pts) (p < 0.001), whereas more orthopaedic URM junior faculty were added than other specialties (2.2% pts) (p = 0.012). Conclusions: Although orthopaedic surgery has increased the representation of female and URM faculty members, it continues to lag behind other specialties. In addition, fewer female and URM orthopaedic faculty members obtained senior faculty status than other specialties. To address the differences seen in faculty diversity, a concerted effort should be made to recruit and promote more diverse faculty, given similar qualifications and capabilities. Level of Evidence: Prognostic Level IV .

Despite an abundance of evidence linking maltreatment and violence-related trauma exposure to externalizing problems in youth, there is surprisingly little evidence to support a direct link between disaster exposure and youth aggressive behavior. This study tested the theory that there is primarily an indirect association between disaster exposure and aggression via posttraumatic stress disorder (PTSD) symptoms. The current study also examined the association between aggression and academic achievement. A sample of 191 4th- to 8th-grade minority youth who experienced Hurricane Katrina were assessed for aggressive behavior using the Peer Conflict Scale (PCS), disaster exposure, PTSD symptoms, and academic achievement. Structural equation modeling of the set of associations was consistent with the theory suggesting that there is an indirect link between disaster exposure and aggression through PTSD symptoms. Aggression was negatively associated with academic achievement, and modeling indicated that the set of associations was age and gender invariant. Findings advance the theoretical understanding of the linkage between aggression and disaster exposure. Findings also support the utility of the PCS in disaster research and the link between PCS scores and academic achievement.

In youths, watching T.V. coverage of a disaster is associated with traumatic-stress symptoms. However, the role of predisaster symptoms in this link has not been addressed. In this study, urban-school youths who had experienced both Hurricanes Katrina and Gustav (N = 141; grades 4-8) were assessed 12 months and 6 months before Gustav and then 1 month after Gustav. The amount of T.V. viewing was associated with post-Gustav stress symptoms, controlling for pre-Gustav symptoms. However, pre-Gustav stress symptoms interacted with T.V. viewing in predicting post-Gustav symptoms such that for youths with higher preexisting symptoms, there was a stronger association between T.V. viewing and level of post-Gustav symptoms. The results advance the literature on the role of media coverage in stress reactions by showing that preexisting symptoms can be an important component of identifying which children are likely to be most negatively affected by TV coverage.