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  • The use of one or more of psychotropic


    The use of one or more of psychotropic medications and hypnotics was associated with a higher risk of falls in the current study. Previous studies have also shown that these medications increase the risk of falls in the geriatric population.25, 26, 27, 28, 29, 30, 31 Clinicians should weigh the risks and benefits of adding or withdrawing these medications in hospitalized elderly patients, taking in consideration the increased risk of falls and its mortality, morbidity, and financial burden. The results of this study also showed female sex as a risk factor for falls in the geriatric population while they are admitted to the hospital. This correlates with previous studies assessing gender differences and unintentional falls in elderly populations.32, 33 This could be attributed to muscle weakness, higher prevalence of gtpase inhibitor and loss of lower body strength in females compared to males.
    Introduction Adverse childhood experiences (ACEs), such as maltreatment, exposure to violence, and parental incarceration, are stressful and potentially traumatic events during childhood (Felitti et al., 1998). ACEs are associated with a large number of health risk behaviors and mental and physical health outcomes (Larkin, Shields, & Anda, 2012); as well as greater use of emergency and mental and physical health services (Chartier, Walker, & Naimark, 2010; Herrenkohl et al., 2010; Yanos, Czaja, & Widom, 2010); and greater use of psychotropic medications (Anda et al., 2007; Björkenstam et al., 2013; Korkeila et al., 2010). If individuals with high levels of ACEs utilize more health care services but are less healthy, there may be a disconnect between what they need and how health care services are being marketed to them. These individuals may also be utilizing services in a sub-optimal manner, for example, to address health issues after they have turned into significant problems rather than relying on preventive strategies. ACEs are a significant risk factor in public health. ACEs have been estimated to account for 25–30% of all psychiatric disorders in adults in the U.S. (Green et al., 2010) and in 21 countries surveyed by the World Health Organization (Kessler et al., 2010). Exposure to two or more ACEs has been estimated to reduce lifespan by 7–15 years (Kiecolt-Glaser et al., 2011). Maltreatment, which only includes a few of the ACEs, doubles health care costs (Rovi, Chen, & Johnson, 2004). In their seminal study (Felitti et al., 1998) of the relationship of ACEs to “many of the leading causes of death in adults,” Felitti and colleagues examined health risk behaviors as one potential mediator of the relationship between ACEs and poor health outcomes, adding that there may be other mediators of this relationship, such as “attitudes and behaviors toward health and health care” (p. 251). Nevertheless, there has been little research on this hypothesis in the intervening two decades. Thus, identifying factors that can specifically enhance their likelihood of seeking and effectively utilizing health-related help, particularly before problems become more serious, can significantly improve the health of individuals with high levels of ACEs, leading to substantial savings for society in terms of both human and financial costs.
    Introduction Although there is ample research demonstrating the negative impacts of Adverse Childhood Experiences (ACEs) and of child maltreatment (e.g. Felitti et al., 1998; Wilson, Hansen, & Li, 2011) and there is evidence that youth in out of home placements report significantly higher ACE scores than the general population (Baglivio et al., 2014; Stambaugh et al., 2013), very few studies have empirically examined the effect of ACEs on the treatment process in general. Specifically, what are the effects of ACEs on engagement in treatment, particularly among residentially placed youth? Engagement in treatment is widely acknowledged as an important component of successful treatment (Cunningham, Duffee, Huang, Steinke, & Naccarato, 2009; Yatchmenoff, 2005), and understanding how a youth's history of trauma may affect his or her level of engagement in the treatment process might provide important implications for service providers.