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Sadler K, Rajabali F, Zheng A, Jain N, Pike I. Impact of a Parent Education Program Delivered by Nurses and Health Care Providers in Reducing Infant Physical Abuse Hospitalization Rates in British Columbia, Canada. Can J Nurs Res 2024; 56:109-116. [PMID: 38115698 DOI: 10.1177/08445621231222527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND The Period of PURPLE Crying Program® (PURPLE) is a universal parent education program that is delivered by nurses and health care providers to all parents/caregivers of newborns in British Columbia (B.C.). The aim of the program is to reduce the incidence of Traumatic Head Injury -Child Maltreatment (THI-CM), a form of child physical abuse. OBJECTIVE To determine if the PURPLE program had an impact on the rate of physical abuse hospitalizations for children less than or equal to 24 months of age in B.C. since implementation in 2009. METHODS The analysis measured physical abuse hospitalization rates for the period January 1, 1999 to December 31, 2019 and excluded any cases of confirmed Traumatic Head Injury-Child Maltreatment. Data were divided into pre-implementation period January, 1999 to December, 2008, and post-implementation period January, 2009 to December, 2019. Data were obtained from the Discharge Abstract Database and B.C. THI-CM Surveillance System to capture information on infant child abuse. Poisson regression and ANCOVA was applied to model the change in rates pre and post program implementation. RESULTS Physical abuse hospitalization rates decreased by 30% post-implementation period (95% CI: -14%, 57%, p = 0.1561). The decreasing linear trend in the post-implementation period was significantly different than the increasing linear trend in the pre-implementation period (F1,17 = 4.832, p = 0.042). CONCLUSIONS Nurses' role in engaging parents in conversations about PURPLE messages over multiple timepoints within a structured universal program model resulted in a decrease in physical abuse hospitalization rates since the implementation of PURPLE.
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Affiliation(s)
- Karen Sadler
- BC Injury Research and Prevention Unit, BC Children's Hospital, Vancouver, BC, Canada
| | - Fahra Rajabali
- BC Injury Research and Prevention Unit, BC Children's Hospital, Vancouver, BC, Canada
| | - Alex Zheng
- BC Injury Research and Prevention Unit, BC Children's Hospital, Vancouver, BC, Canada
| | - Nita Jain
- Child Protection Service Unit, BC Children's Hospital, Vancouver, BC, Canada
- Department of Pediatrics, University of British Columbia, BC Children's Hospital, Vancouver, BC, Canada
| | - Ian Pike
- BC Injury Research and Prevention Unit, BC Children's Hospital, Vancouver, BC, Canada
- Department of Pediatrics, University of British Columbia, BC Children's Hospital, Vancouver, BC, Canada
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Fabbri C, Rodrigues K, Leurent B, Allen E, Qiu M, Zuakulu M, Nombo D, Kaemingk M, De Filippo A, Torrats-Espinosa G, Shayo E, Barongo V, Greco G, Tol W, Devries KM. The EmpaTeach intervention for reducing physical violence from teachers to students in Nyarugusu Refugee Camp: A cluster-randomised controlled trial. PLoS Med 2021; 18:e1003808. [PMID: 34606500 PMCID: PMC8489723 DOI: 10.1371/journal.pmed.1003808] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 09/10/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND School-based violence prevention interventions offer enormous potential to reduce children's experience of violence perpetrated by teachers, but few have been rigorously evaluated globally and, to the best of our knowledge, none in humanitarian settings. We tested whether the EmpaTeach intervention could reduce physical violence from teachers to students in Nyarugusu Refugee Camp, Tanzania. METHODS AND FINDINGS We conducted a 2-arm cluster-randomised controlled trial with parallel assignment. A complete sample of all 27 primary and secondary schools in Nyarugusu Refugee Camp were approached and agreed to participate in the study. Eligible students and teachers participated in cross-sectional baseline, midline, and endline surveys in November/December 2018, May/June 2019, and January/February 2020, respectively. Fourteen schools were randomly assigned to receive a violence prevention intervention targeted at teachers implemented in January-March 2019; 13 formed a wait-list control group. The EmpaTeach intervention used empathy-building exercises and group work to equip teachers with self-regulation, alternative discipline techniques, and classroom management strategies. Allocation was not concealed due to the nature of the intervention. The primary outcome was students' self-reported experience of physical violence from teachers, assessed at midline using a modified version of the ISPCAN Child Abuse Screening Tool-Child Institutional. Secondary outcomes included student reports of emotional violence, depressive symptoms, and school attendance. Analyses were by intention to treat, using generalised estimating equations adjusted for stratification factors. No schools left the study. In total, 1,493 of the 1,866 (80%) randomly sampled students approached for participation took part in the baseline survey; at baseline 54.1% of students reported past-week physical violence from school staff. In total, 1,619 of 1,978 students (81.9%) took part in the midline survey, and 1,617 of 2,032 students (79.6%) participated at endline. Prevalence of past-week violence at midline was not statistically different in intervention (408 of 839 students, 48.6%) and control schools (412 of 777 students, 53.0%; risk ratio = 0.91, 95% CI 0.80 to 1.02, p = 0.106). No effect was detected on secondary outcomes. A camp-wide educational policy change during intervention implementation resulted in 14.7% of teachers in the intervention arm receiving a compressed version of the intervention, but exploratory analyses showed no difference in our primary outcome by school-level adherence to the intervention. Main study limitations included the small number of schools in the camp, which limited statistical power to detect small differences between intervention and control groups. We also did not assess the test-retest reliability of our outcome measures, and interviewers were unmasked to intervention allocation. CONCLUSIONS There was no evidence that the EmpaTeach intervention effectively reduced physical violence from teachers towards primary or secondary school students in Nyarugusu Refugee Camp. Further research is needed to develop and test interventions to prevent teacher violence in humanitarian settings. TRIAL REGISTRATION clinicaltrials.gov (NCT03745573).
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Affiliation(s)
- Camilla Fabbri
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Katherine Rodrigues
- International Rescue Committee, New York, New York, United States of America
| | - Baptiste Leurent
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Elizabeth Allen
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Mary Qiu
- Innovations for Poverty Action, Dar es Salaam, Tanzania
| | | | - Dennis Nombo
- International Rescue Committee, New York, New York, United States of America
| | - Michael Kaemingk
- Behavioral Insights Team, New York, New York, United States of America
| | | | | | - Elizabeth Shayo
- National Institute for Medical Research, Dar es Salaam, Tanzania
| | - Vivien Barongo
- National Institute for Medical Research, Dar es Salaam, Tanzania
| | - Giulia Greco
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Wietse Tol
- University of Copenhagen, Copenhagen, Denmark
| | - Karen M. Devries
- London School of Hygiene & Tropical Medicine, London, United Kingdom
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Affiliation(s)
- Etienne V Langlois
- Partnership for Maternal, Newborn & Child Health, WHO, 1211 Geneva 27, Switzerland.
| | - Teesta Dey
- Partnership for Maternal, Newborn & Child Health, WHO, 1211 Geneva 27, Switzerland; Department of Women's and Children's Health, University of Liverpool, Liverpool, UK
| | - Mehr Gul Shah
- Partnership for Maternal, Newborn & Child Health, WHO, 1211 Geneva 27, Switzerland
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Metzler J, Jonfa M, Savage K, Ager A. Educational, psychosocial, and protection outcomes of child- and youth-focused programming with Somali refugees in Dollo Ado, Ethiopia. Disasters 2021; 45:67-85. [PMID: 31322750 DOI: 10.1111/disa.12392] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Child- and youth-friendly spaces have become a common feature of emergency humanitarian provision. This study reports on the outcomes of child and youth learning centres (CYLCs) in Ethiopia's Buramino Camp established for those fleeing conflict in Somalia. Eighty-five youths completed baseline assessments shortly after arrival and follow-up assessments three to six months later. Caregivers of 106 younger children completed similar appraisals. 693 children attending the CYLCs completed pre- and post-educational assessments, which indicated major gains-significant at p<0.0001-in both literacy (younger children, t=9.06; youth, t=13.87) and numeracy (younger children, t=13.94; youths, t=17.10). Children's CYLC attendance increased reports of met needs among caregivers (t=2.53, p<0.05) and youths (t=2.57, p<0.05), and, among caregivers but not youths, significantly moderated protection concerns (t=2.39, p<0.05, and t=-1.90, p=0.06, respectively). There was general improvement in psychosocial well-being over time for all children; CYLC attendance predicted greater reductions in reported difficulties only among younger children (t=2.51, p<0.05).
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Affiliation(s)
- Janna Metzler
- Senior Research Officer, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, United States
| | - Mesfin Jonfa
- Education in Emergency Specialist, World Vision Ethiopia, Ethiopia
| | - Kevin Savage
- Humanitarian Research Director, World Vision International, Geneva, Switzerland
| | - Alastair Ager
- Professor of Population and Family Health, Columbia University, United States
- Now Director of the Institute for Global Health and Development, Queen Margaret University, United Kingdom
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Durrant JE, Stewart-Tufescu A, Afifi TO. Recognizing the child's right to protection from physical violence: An update on progress and a call to action. Child Abuse Negl 2020; 110:104297. [PMID: 31796214 DOI: 10.1016/j.chiabu.2019.104297] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 10/21/2019] [Accepted: 11/24/2019] [Indexed: 06/10/2023]
Abstract
For centuries, some level of physical violence against children has been normalized, prescribed and legally justified. It has long been argued that violence is not abusive if it is intended as punishment and does not injure the child physically. This proposition has heavily influenced our language, research methods and approaches to intervention with the effect of perpetuating the belief that some level of violence is justifiable and acceptable in children's lives. The United Nations (UN) Convention on the Rights of the Child precipitated a global recognition that the justification of punitive violence violates children's fundamental protection rights. Yet, in the research literature, terminology, methods and approaches often minimize acts of violence if they are intended as punishment. This article summarizes progress made over the past 30 years and issues a call for transformative change in our conceptualizations of punitive violence.
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Affiliation(s)
- Joan E Durrant
- Department of Community Health Sciences, University of Manitoba, Canada.
| | | | - Tracie O Afifi
- Departments of Community Health Sciences and Psychiatry, University of Manitoba, Canada
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Pitt K, Dheensa S, Feder G, Johnson E, Man MS, Roy J, Williamson E, Szilassy E. Sharing reports about domestic violence and abuse with general practitioners: a qualitative interview study. BMC Fam Pract 2020; 21:117. [PMID: 32576145 PMCID: PMC7313185 DOI: 10.1186/s12875-020-01171-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Accepted: 05/21/2020] [Indexed: 01/27/2023]
Abstract
BACKGROUND Domestic violence and abuse (DVA) is common and damaging to health. UK national guidance advocates a multi-agency response to DVA, and domestic homicide reviews consistently recommend improved information-sharing between agencies. Identification of patients experiencing DVA in general practice may come from external information shared with the practice, such as police incident reports and multi-agency risk assessment conference (MARAC) reports. The aim of this study was to explore the views of general practitioners (GPs) and the police about sharing reports about DVA with GPs. METHODS Qualitative semi-structured interviews were conducted with GPs, police staff and a partnership manager. Participants were located across England and Wales. Thematic analysis was undertaken. RESULTS Interviews were conducted with 23 GPs, six police staff and one former partnership manager. Experiences of information-sharing with GPs about DVA varied. Participants described the relevance and value of external reports to GPs to help address the health consequences of DVA and safeguard patients. They balanced competing priorities when managing this information in the electronic medical record, namely visibility to GPs versus the risk of unintended disclosure to patients. GPs also spoke of the judgements they made about exploring DVA with patients based on external reports, which varied between abusive and non-abusive adults and children. Some felt constrained by short general practice consultations. Some police and GPs reflected on a loss of control when information about DVA was shared between agencies, and the risk of unintended consequences. Both police and GPs highlighted the importance of clear information and a shared understanding about responsibility for action. CONCLUSION GPs regarded external reports about DVA as relevant to their role, but safely recording this information in the electronic medical record and using it to support patients required complex judgements. Both GPs and police staff emphasised the importance of clarity of information and responsibility for action when information was shared between agencies about patients affected by DVA.
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Affiliation(s)
- Katherine Pitt
- Bristol Medical School (Population Health Sciences), University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
| | - Sandi Dheensa
- Bristol Medical School (Population Health Sciences), University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Gene Feder
- Bristol Medical School (Population Health Sciences), University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Emma Johnson
- Bristol Medical School (Population Health Sciences), University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Mei-See Man
- Bristol Medical School (Population Health Sciences), University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Jessica Roy
- School for Policy Studies, University of Bristol, Bristol, UK
| | - Emma Williamson
- School for Policy Studies, University of Bristol, Bristol, UK
| | - Eszter Szilassy
- Bristol Medical School (Population Health Sciences), University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
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Emery CR, Eremina T, Arenas C, Kim J, Chan KL. When Bigger Is Better: Household Size, Abuse Injuries, Neglect, and Family Response in Novosibirsk, Russia. J Interpers Violence 2020; 35:1035-1051. [PMID: 29294655 DOI: 10.1177/0886260517692333] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Although previous research has demonstrated larger households to be at higher risk of physical abuse and neglect of children, we argue that unilateral conceptualization of larger households as a risk factor is inappropriate. Application of resource dilution theory must capture the possibility that larger families may have more members with both the agency and will to intervene against child maltreatment. We hypothesized a negative interaction between household size and protective informal social control by family members in predicting abuse injuries and neglect. A three-stage probability proportional to size cluster sample representative of Novosibirsk, Russia, was collected from 306 cohabiting couples. One parent in each household was interviewed. A focal child was selected using most recent birthday. When responses limited to families with minor children (below age 18) were selected, 172 families remained in the data. Physical abuse and neglect were measured using the Conflict Tactics Scales (CTS). Protective informal social control by family members was measured using the Informal Social Control of Child Maltreatment (ISC_CM) Scale. Models were tested using random effects regression and logistic regression. Nearly 7% of focal children were injured in the last year, 10% were neglected. Consistent with previous research, protective informal social control was associated with lower odds of injury and fewer instances of neglect. The significant negative interaction between household size and protective control is consistent with the idea that larger households may be protective when adult family members intervene against maltreatment to protect children. Replication and further investigation of protective ISC_CM in Western populations is much needed. Future research should not conceptualize or measure household size as a unilateral risk factor.
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Affiliation(s)
| | | | | | | | - Ko Ling Chan
- Yonsei University, Seoul, South Korea
- Hong Kong Polytechnic University, Kowloon, Hong Kong
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Mathews B, Pacella R, Dunne MP, Simunovic M, Marston C. Improving measurement of child abuse and neglect: A systematic review and analysis of national prevalence studies. PLoS One 2020; 15:e0227884. [PMID: 31990913 PMCID: PMC6986759 DOI: 10.1371/journal.pone.0227884] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 12/31/2019] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVES Child maltreatment through physical abuse, sexual abuse, emotional abuse, neglect, and exposure to domestic violence, causes substantial adverse health, educational and behavioural consequences through the lifespan. The generation of reliable data on the prevalence and characteristics of child maltreatment in nationwide populations is essential to plan and evaluate public health interventions to reduce maltreatment. Measurement of child maltreatment must overcome numerous methodological challenges. Little is known to date about the extent, nature and methodological quality of these national studies. This study aimed to systematically review the most comprehensive national studies of the prevalence of child maltreatment, and critically appraise their methodologies to help inform the design of future studies. METHODS Guided by PRISMA and following a published protocol, we searched 22 databases from inception to 31 May 2019 to identify nationwide studies of the prevalence of either all five or at least four forms of child maltreatment. We conducted a formal quality assessment and critical analysis of study design. RESULTS This review identified 30 national prevalence studies of all five or at least four forms of child maltreatment, in 22 countries. While sound approaches are available for different settings, methodologies varied widely in nature and robustness. Some instruments are more reliable and obtain more detailed and useful information about the characteristics of the maltreatment, including its nature, frequency, and the relationship between the child and the person who inflicted the maltreatment. Almost all studies had limitations, especially in the level of detail captured about maltreatment, and the adequacy of constructs of maltreatment types. CONCLUSIONS Countries must invest in rigorous national studies of the prevalence of child maltreatment. Studies should use a sound instrument containing appropriate maltreatment constructs, and obtain nuanced information about its nature.
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Affiliation(s)
- Ben Mathews
- Director, Childhood Adversity Research Program, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
- Adjunct Professor, Johns Hopkins University, Bloomberg School of Public Health, Baltimore MD, United States of America
| | - Rosana Pacella
- Institute for Lifecourse Development, University of Greenwich, Greenwich, London, United Kingdom
| | - Michael P. Dunne
- School of Public Health, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Marko Simunovic
- Institute for Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Cicely Marston
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Abstract
Prior research has found that pimps use both non-coercive and coercive management styles across and within market segments of the illicit sex trade. The current study is the first to examine the socialization processes underlying variation in the self-reported coerciveness of pimps. This study begins to fill a void in the almost non-existent research on pimps who are actively managing Internet-solicited sex workers, and adds to the sparse research on pimps' coerciveness. We extend Anderson's concepts of "street code" families, where respect is acquired through displaying physical violence and toughness, and "decent" families, where middle class values of avoiding unnecessary aggression and complying with the law prevail, to understand variation in the degree of coerciveness that pimps utilize toward sex workers. A purposive sample of 44 active pimps was obtained through referrals from selected pimps and through placing advertisements on Backpage, a website utilized by the illicit prostitution trade. Qualitative coding revealed a wide range of coercive control tactics such as supplying drugs, surveillance, and physical violence. Pimps who served as sex workers and those raised by parents who supported "the code of the street" reported use of a greater number of more severe coercive tactics. College-educated pimps, pimps operating business that charged fees of at least US$300, and those from "decent" families were more likely to use non-coercive management. These findings suggest that early prevention programs might address the "street code" mentality that contributes to coerciveness, and that "End Demand" policies need to recognize that many male pimps also have served as sex workers.
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Affiliation(s)
| | - Mary A Finn
- Michigan State University, East Lansing, USA
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Azene ZN, Yeshita HY, Mekonnen FA. Intimate partner violence and associated factors among pregnant women attending antenatal care service in Debre Markos town health facilities, Northwest Ethiopia. PLoS One 2019; 14:e0218722. [PMID: 31260469 PMCID: PMC6602189 DOI: 10.1371/journal.pone.0218722] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 06/07/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Intimate partner violence is a thoughtful public health concern and human rights violation towards pregnant women for it has a significant negative health effect on the life of both the mother and her fetus. However, there is a scanty of information about the extent of intimate partner violence during pregnancy in Ethiopia, particularly in the study area. Therefore, the current study was conducted to determine the prevalence of intimate partner violence among pregnant women attending antenatal care and identify associated factors that cause it. METHODS An institution based cross-sectional study was conducted on 409 pregnant women who were attending antenatal care service in Debre Markos town from March 17, 2018 -April 28, 2018. Systematic random sampling technique was used to select study participants. A pre-tested structured questionnaire was used to collect the data. Bivariable and Multivariable logistic regression models were done. Adjusted odds ratio with 95% confidence interval was used to identify factors associated with intimate partner violence during pregnancy. RESULTS The prevalence of intimate partner violence during current pregnancy was found to be 41.1% (95% confidence interval (CI): 36.0-46.0). Of this, the prevalence of psychological, physical, and sexual violence was 29.1%, 21%, 19.8% respectively. Lower educational status of partners (AOR = 3.26, 95%CI: 1.45-7.36), rural residency (AOR = 4.04, 95%CI: 1.17-13.93), frequent alcohol abuse by partner (AOR = 4.79, 95% CI: 2.08-11.04), early initiation of antenatal care (AOR = 0.44, 95% CI: 0.24-0.81), the age of women between 17-26 years (Adjusted odds ratio (AOR) = 0.21, 95%CI: 0.09-0.49),choice of partner by the women only (AOR = 3.26,95% CI:1.24-8.57) were statistically significant factors associated with intimate partner violence towards pregnant women. CONCLUSIONS In this study, the prevalence of intimate partner violence during pregnancy is found to be high. As a result, interventions that would address the above mentioned factors need to be implemented.
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Affiliation(s)
- Zelalem Nigussie Azene
- Reproductive Health, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- * E-mail:
| | - Hedija Yenus Yeshita
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Fantahun Ayenew Mekonnen
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Tonmyr L, Shields M, Asokumar A, Hovdestad W, Laurin J, Mukhi S, Burnside L. Can coders abstract child maltreatment variables from child welfare administrative data and case narratives for public health surveillance in Canada? Child Abuse Negl 2019; 92:77-84. [PMID: 30933833 DOI: 10.1016/j.chiabu.2019.03.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 03/17/2019] [Accepted: 03/21/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Public health surveillance is essential to inform programs that aim to eradicate child maltreatment (CM) and to provide services to children and families. However, collection of CM data imposes a burden on child welfare workers (CWWs). This study assesses the feasibility of hiring coders to abstract the required information from administrative records and case narratives. METHODS Based on a convenience sample of child welfare data from Manitoba, Canada, two coders abstracted information on 181 alleged CM cases. The coders completed a short web-based questionnaire for each case to identify which of five types of CM had been investigated, level of substantiation for each type, and risk of future CM. The CWWs responsible for each case completed the same questionnaire. Percentages of the occurrence of CM by the three sources were compared. The validity of the coders' classifications was assessed by calculating sensitivity, specificity, and positive and negative predictive values, against the CWWs' classifications as the "gold standard." Cohen's kappa was also calculated. RESULTS The coders' classifications of physical abuse, sexual abuse and neglect generally matched those of CWWs; for exposure to intimate partner violence, agreement was weak for one coder. Coding of emotional maltreatment and risk investigations could not be evaluated. CONCLUSION Results were promising. Abstraction was not time-consuming. Differences between coders and CWWs can be largely explained by the administrative data system, child welfare practice, and legislation. Further investigation is required to determine if additional training could improve coders' classifications of CM.
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Affiliation(s)
- Lil Tonmyr
- Public Health Agency of Canada, 785 Carling Ave, AL 6807B, Ottawa, ON, K1A 0K9, Canada.
| | - Margot Shields
- Public Health Agency of Canada, 785 Carling Ave, AL 6807B, Ottawa, ON, K1A 0K9, Canada
| | - Ajani Asokumar
- Department of Neuroscience, Carleton University, 1125 Colonel By Drive, Ottawa, ON, K1S 5B6, Canada
| | - Wendy Hovdestad
- Public Health Agency of Canada, 785 Carling Ave, AL 6807B, Ottawa, ON, K1A 0K9, Canada
| | - Jessica Laurin
- Public Health Agency of Canada, 785 Carling Ave, AL 6807B, Ottawa, ON, K1A 0K9, Canada
| | - Shamir Mukhi
- Canadian Network for Public Health Intelligence, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Linda Burnside
- Birch Wellness Centre, 34 Carlton St, Winnipeg, MB, R3C 1N9, Canada
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Woolf SM, Leventhal JM, Gaither JR, Hardikar P, Langhan ML, Bechtel K, Auerbach MA, Tiyyagura G. Oral injuries in children less than 24 months of age in a pediatric emergency department. Child Abuse Negl 2019; 89:70-77. [PMID: 30639971 DOI: 10.1016/j.chiabu.2019.01.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 12/18/2018] [Accepted: 01/03/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Oral injuries in young children may indicate physical abuse. The prevalence of oral injuries in young children presenting to the emergency department is unknown. These data would assist providers in making decisions about the need for further abuse evaluation. OBJECTIVE To determine the prevalence of oral injuries, associated chief complaints and characteristics, and frequency of abuse evaluations in children younger than 24 months presenting to a pediatric emergency department (PED). PARTICIPANTS AND SETTING Twelve pediatric emergency medicine physicians consecutively enrolled children younger than 24 months in a tertiary care PED. METHODS We performed a prospective observational study. Enrolled patients underwent a complete oral examination. Providers recorded patient demographics, type of chief complaint, oral injury details, developmental ability, and the presence of an abuse evaluation. RESULTS Oral injuries occurred in 36/1303 (2.8%, 95% CI 1.9-3.8%) and were more common in patients with traumatic (26/200, 13%) versus medical chief complaints (10/1,103, 0.9%) (p < .001). Of patients with oral injuries (36), 78% were mobile and 72% had traumatic chief complaints. Nine (25%) children with oral injuries were evaluated for abuse. Oral injuries in children 0-11 months old were more likely to be evaluated for abuse than children 12-24 months old (70.0% vs. 7.7%, p < .001). CONCLUSIONS The prevalence of oral injuries in children <24 months old presenting to a PED was low. Most occurred in mobile children and in children with traumatic chief complaints. Younger, non-mobile children with oral injuries had a higher likelihood of having an abuse evaluation.
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Affiliation(s)
- Seth M Woolf
- Department of Pediatrics, Section of Emergency Medicine, Yale University School of Medicine, 100 York Street, Suite 1F, New Haven, Connecticut, 06511, USA.
| | - John M Leventhal
- Department of Pediatrics, Section of General Pediatrics, Yale University School of Medicine, Dana Clinic Building Basement, 789 Howard Avenue, New Haven, Connecticut, 06519, USA.
| | - Julie R Gaither
- Department of Pediatrics, Section of General Pediatrics, Yale University School of Medicine, Dana Clinic Building Basement, 789 Howard Avenue, New Haven, Connecticut, 06519, USA.
| | - Priyanka Hardikar
- Department of Pediatrics, Section of Emergency Medicine, Yale University School of Medicine, 100 York Street, Suite 1F, New Haven, Connecticut, 06511, USA.
| | - Melissa L Langhan
- Department of Pediatrics, Section of Emergency Medicine, Yale University School of Medicine, 100 York Street, Suite 1F, New Haven, Connecticut, 06511, USA.
| | - Kirsten Bechtel
- Department of Pediatrics, Section of Emergency Medicine, Yale University School of Medicine, 100 York Street, Suite 1F, New Haven, Connecticut, 06511, USA.
| | - Marc A Auerbach
- Department of Pediatrics, Section of Emergency Medicine, Yale University School of Medicine, 100 York Street, Suite 1F, New Haven, Connecticut, 06511, USA.
| | - Gunjan Tiyyagura
- Department of Pediatrics, Section of Emergency Medicine, Yale University School of Medicine, 100 York Street, Suite 1F, New Haven, Connecticut, 06511, USA.
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Bright MA, Lynne SD, Masyn KE, Waldman MR, Graber J, Alexander R. Association of Friday School Report Card Release With Saturday Incidence Rates of Agency-Verified Physical Child Abuse. JAMA Pediatr 2019; 173:176-182. [PMID: 30556830 PMCID: PMC6439612 DOI: 10.1001/jamapediatrics.2018.4346] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 09/07/2018] [Indexed: 11/14/2022]
Abstract
Importance Corporal punishment is a leading risk factor for physical abuse. Strong anecdotal evidence from physicians and other professionals working in child protection suggest that punishment-initiated physical abuse for school-aged children increases after release of report cards. However, no empirical examination of this association has occurred. Objective To examine the temporal association between school report card release and incidence rates (IRs) of physical abuse. Design, Setting, and Participants This retrospective study reviewed calls to a state child abuse hotline and school report card release dates across a single academic year in Florida. Data were collected in a 265-day window from September 8, 2015, to May 30, 2016, in the 64 of 67 Florida counties with report card release dates available (16 960 days). Participants included all children aged 5 to 11 years for whom calls were made. A total of 1943 verified cases of physical abuse were reported in the study period in the 64 counties. Data were analyzed from October 2017 through May 2018. Exposures School report cards release across a single academic year, measured daily by county. Main Outcomes and Measures Daily counts of calls to a child abuse hotline that later resulted in agency-verified incidents of child physical abuse across a single academic year by county. Results During the academic year, 167 906 calls came in to the child abuse hotline for children aged 5 to 11 years; 17.8% (n = 29 887) of these calls were suspected incidents of physical abuse, and 2017 (6.7%) of these suspected incidents were later verified as cases of physical abuse before excluding the 3 counties with no release dates available. Among the 1943 cases included in the analysis (58.9% males [n = 1145]; mean [SD] age, 7.69 [1.92] years), calls resulting in verified reports of child physical abuse occurred at a higher rate on Saturdays after a Friday report card release compared with Saturdays that do not follow a Friday report card release (IR ratio, 3.75; 95% CI, 1.21-11.63; P = .02). No significant association of report card release with IRs was found for any other days of the week. Conclusion and Relevance This association of school report card release and physical abuse appears to illustrate a unique systems-based opportunity for prevention.
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Affiliation(s)
- Melissa A. Bright
- Anita Zucker Center for Excellence in Early Childhood Studies, University of Florida, Gainesville
| | - Sarah D. Lynne
- Department of Family, Youth, and Community Sciences, University of Florida, Gainesville
| | - Katherine E. Masyn
- Population Health Sciences, School of Public Health, Georgia State University, Atlanta
| | - Marcus R. Waldman
- Quantitative Policy Analysis in Education, Harvard University, Cambridge, Massachusetts
| | - Julia Graber
- Department of Psychology, University of Florida, Gainesville
| | - Randell Alexander
- Division of Child Protection and Forensic Pediatrics, Department of Pediatrics, University of Florida, Jacksonville
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Duran S, Eraslan ST. Violence against women: Affecting factors and coping methods for women. J PAK MED ASSOC 2019; 69:53-57. [PMID: 30623912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To determine women's exposure to domestic violence, it's affecting factors and coping methods. METHODS The descriptive, cross-sectional study was conducted from September to December 2017 and comprised married women living in Kesan, a district in the Turkish province of Edirne. A self-generated questionnaire was used to gather sociodemographic data and women's exposure to domestic violence. SPSS 16 was used to analyse data. RESULTS Of the 586 subjects, 321(55%) were aged up to 40 years, while 265(45%) were aged 41 years or more. Domestic violence was reported by 156(26.6%) women. Beating ranked first among physical violence behavior reported by 83(14.2%) subjects. Name-calling and yelling ranked first among verbal violence behaviour reported by 118(20.1%). Keeping women at a certain distance rankedfirst among emotional violence behaviour, reported by 95(16.2%). Not purchasing the fundamental needs of the home ranked first among the economic violence behaviour, reported by 38(6.5%). Finally, 14(2.4%) reported being physically forced to engage in a sexual act, which ranked first among sexual violence behaviour. From among the women abused, 114(66.7%) women said violence occurred because of the instant anger of their partners, and 69(44.2%)said they did not apply to any officialinstitution for help. CONCLUSIONS Women preferred to remain silent about domestic violence. There is a need to introduce urgent prevention programmes to end domestic violence.
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Affiliation(s)
- Songul Duran
- Nursing Department, Kesan Hakki Yoruk School of Health, Trakya University, Turkey
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15
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Lee E, Kirkland K, Miranda-Julian C, Greene R. Reducing maltreatment recurrence through home visitation: A promising intervention for child welfare involved families. Child Abuse Negl 2018; 86:55-66. [PMID: 30268057 DOI: 10.1016/j.chiabu.2018.09.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 08/31/2018] [Accepted: 09/11/2018] [Indexed: 05/28/2023]
Abstract
Maltreatment of children is a key predictor of a range of problematic health and developmental outcomes. Not only are affected children at high risk for recurrence of maltreatment, but effective interventions with known long term impact are few and limited. While home visiting is one of the most tested secondary prevention models for improving parenting, its primary focus on young primiparous mothers underemphasizes one of the most important risk groups: child welfare involved multiparous mothers. This study's focus is a randomized controlled trial of Healthy Families New York that included a subgroup of mothers (n = 104) who had at least one substantiated child protective services (CPS) report before enrolling in the program. By the child's seventh birthday, mothers in the home visited group were as half as likely as mothers in the control group to be confirmed subjects for physical abuse or neglect (AOR = .46, p = .08). The number of substantiated reports for mothers in the control group was twice as high as for those in the home visited group (1.59 vs. 79 p = .02, ES = .44). Group differences were only observed after the child's third birthday, suggesting the possible effect of surveillance in early years. Post-hoc analyses indicate that home visited mothers had fewer subsequent births that may have contributed to less parenting stress and improved life course development for mothers. In light of our findings, we suggest considering and further testing home visiting programs as a tertiary prevention strategy for child welfare-involved mothers.
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Affiliation(s)
- Eunju Lee
- School of Social Welfare, University at Albany, United States.
| | - Kristen Kirkland
- Bureau of Research, Evaluation and Performance Analytics, New York State Office of Children and Family Services, United States
| | - Claudia Miranda-Julian
- Bureau of Research, Evaluation and Performance Analytics, New York State Office of Children and Family Services, United States
| | - Rose Greene
- Center for Human Services Research, University at Albany, United States
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Hébert ST, Hélie S, Esposito T. Temporary placements: A crisis-management strategy for physically abused children? Child Abuse Negl 2018; 86:314-323. [PMID: 30245082 DOI: 10.1016/j.chiabu.2018.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 08/30/2018] [Accepted: 09/12/2018] [Indexed: 06/08/2023]
Abstract
A large majority of children who are placed outside the family home experience temporary placements (between 1 to 60 days) at some point in time. Yet, information on the use of temporary placements remains fragmentary, with only occasional indirect references. This scant information does, however, suggests a particular link between physical abuse and temporary placements. The objective of the present study is to describe the context in which temporary placements are used by children's services in Quebec (Canada) while analyzing the associative link between temporary placements and physical abuse as the reason for the placement. Our study is based on a population cohort of 10,181 children placed in Quebec who have been followed for four years. Propensity-weighted multinomial regression analysis was used to assess the relative importance of the various individual pre-placement factors that may be associated with physical abuse. Results show that children investigated for physical abuse alone are 6.335 times more likely to have temporary placement trajectories compared to children investigated for other reasons. Cases that involved physical abuse combined with other reasons, were between 33.4% and 41% more likely to involve trajectories with temporary placements, than cases that were investigated for reasons other than physical abuse. Sex, age, and history of services have been used as covariates. In conclusion, the use of temporary placements is discussed with regards to the mandate of child-protection services and of certain etiological profiles of physical abuse.
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Affiliation(s)
- Sophie T Hébert
- Institut universitaire Jeunes en difficulté, Integrated University Health and Social Services Centre of Centre-sud-de-l'ile-de Montréal, 1001 Maisonneuve est, Montréal, QC, H2L 4P9, Canada.
| | - Sonia Hélie
- Institut universitaire Jeunes en difficulté, Integrated University Health and Social Services Centre of Centre-sud-de-l'ile-de Montréal, 1001 Maisonneuve est, Montréal, QC, H2L 4P9, Canada.
| | - Tonino Esposito
- School of Social Work, University of Montreal, 3150, Jean-Brillant, Montreal, QC, H3C 3J7, Canada.
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Olson LM, Campbell KA, Cook L, Keenan HT. Social history: A qualitative analysis of child abuse pediatricians' consultation notes. Child Abuse Negl 2018; 86:267-277. [PMID: 30388710 PMCID: PMC6342195 DOI: 10.1016/j.chiabu.2018.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 09/25/2018] [Accepted: 10/03/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Child abuse pediatricians (CAPs) are often consulted for injuries when child physical abuse is suspected or when the etiology of a serious injury is unclear. CAPs carefully evaluate the reported mechanism of the child's injury and the medical findings in the context of the child's family and social setting to identify possible risk and protective factors for child abuse and the need for social services. It is unknown what population risk indicators along with other social cues CAPs record in the social history of the consultation notes when assessing families who are being evaluated for child physical abuse. PARTICIPANTS AND SETTING Thirty-two CAPs representing 28 US child abuse programs. METHODS Participants submitted 730 completed cases of inpatient medical consultation notes for three injury types: traumatic brain injury, long bone fracture, and skull fracture in hospitalized children 4 years of age and younger. We defined a priori 12 social cues using known population risk indicators (e.g., single mother) and identified de novo 13 negative (e.g., legal engagement) and ten positive social cues (e.g., competent parenting). Using content analysis, we systematically coded the social history for the social cues. RESULTS We coded 3,543 cues resulting in a median of 7 coded cues per case. One quarter of the cues were population indicators while half of the cues were negative and one quarter positive. CONCLUSIONS CAPs choose a wide variety of information, not always related to known population risk indicators, to include in their social histories.
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Affiliation(s)
- Lenora M Olson
- Department of Pediatrics, Division of Critical Care, University of Utah School of Medicine, Salt Lake City, UT, USA.
| | - Kristine A Campbell
- Department of Pediatrics, Division of Child Protection and Family Health, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Lawrence Cook
- Department of Pediatrics, Division of Critical Care, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Heather T Keenan
- Department of Pediatrics, Division of Critical Care, University of Utah School of Medicine, Salt Lake City, UT, USA
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18
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Chew YR, Cheng MH, Goh MC, Shen L, Wong PC, Ganapathy S. Five-Year Review of Patients Presenting with Non-Accidental Injury to a Children's Emergency Unit in Singapore. Ann Acad Med Singap 2018; 47:413-419. [PMID: 30460968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
INTRODUCTION There is an increasing trend of physical child abuse cases reported in Singapore. Children presenting to the Emergency Department with injuries require a high index of suspicion for clinicians to distinguish those that are abusive in nature. MATERIALS AND METHODS A retrospective study of children with diagnosis of NAI presenting to KK Women's and Children's Hospital (KKH) from June 2011 to May 2016 was conducted. RESULTS There were 1917 cases reported from 1730 subjects, of which: 8.8% of subjects had repeat visits; 55.2% of cases were male; and mean age was 7.69 years. Racial demographics were: Chinese 45.5%, Malay 33.4%, Indian 15.4% and Others 5.9%. The most frequent injuries sustained were head and neck (50.8%), limbs (32.2%), and chest (5.7%). Of the type of injuries, 55% had contusions, 21% had cane marks, 16% had lacerations, 4.4% had burn marks and 1% sustained fractures. Males were more likely to be caned (P <0.001); 54.9% of cases were admitted and 38.9% were discharged. Cases that presented without a parent (P <0.001), were known to Child Protective Service (P <0.001), or had a history of parental substance abuse (P = 0.038), mental illness in caregiver (P = 0.021), or domestic violence (P <0.001) were more likely to require admission. CONCLUSION Analysing these factors provide a better understanding of the presentation of NAI cases, including 'red flags' and vulnerable groups who should have better protection.
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Affiliation(s)
- Yi Rong Chew
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
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Yeşilçiçek Çalik K. Attitudes of Turkish Academics Regarding Violence Against Women in the Name of Honor. J Interpers Violence 2018; 33:3232-3254. [PMID: 29294983 DOI: 10.1177/0886260517739288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Honor is an important concept that has a vital value in Turkey and affects many women's lives and even causes death. It is of utmost importance to know and scientifically demonstrate the value judgments of the academics that lead and pioneer the society in our country where honor culture is adopted. Therefore, in Turkey, where thousands of women are exposed to violence every year, 877 academics participated in this descriptive study to determine the attitudes of academics toward violence against women in the name of honor. The data were collected using "The Scale for Attitudes Towards Violence Against Women in the Name of Honor (SAVWNH)" in the form of electronic questionnaires through email addresses of the academics working at different faculties of the university in the official website of the university in September 1 to October 1, 2015. In our study, academics' "attitudes towards violence against women in the name of honor" were found low. That is, academics had negative attitudes toward the verbal or physical violence against women in the name of honor and opposed to the punishment of women for this reason. Nevertheless, the attitudes of those who were males; those who were not professors, associate professors, and assistant professors; those who were single; those who had lived in the district/village for a long time; those who had arranged marriages; those who used any kind of violence; and those who considered violence as a solution were found somewhat more conventional. These results showed that, for some academics, the traditional beliefs of the Turkish patriarchal society continued to be valid although they were included in university academic cultures. In fact, it is revealed here that social values, traditions, and customs are very effective and important on the formation of personality in socialization process.
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20
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Chandraratne NK, Fernando AD, Gunawardena N. Cultural adaptation, translation and validation of the ISPCAN Child Abuse Screening Tool - Retrospective Version (ICAST-R) for young adults in Sri Lanka. Child Abuse Negl 2018; 84:11-22. [PMID: 30036689 DOI: 10.1016/j.chiabu.2018.07.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 06/13/2018] [Accepted: 07/06/2018] [Indexed: 06/08/2023]
Abstract
The aim of the present study was to adapt and validate the ISPCAN child abuse screening tool-retrospective version (ICAST-R) in Sri Lanka with a view to investigating the experiences of physical, sexual and emotional abuse during childhood. The adaptation was performed using qualitative research methods with young adults, parents, teachers, and a multidisciplinary group of experts. The translation to Sinhala (the local Sri Lankan dialect) was carried out by a nominal group technique. A multidisciplinary team of experts assessed the Sinhala ICAST-R (SICAST-R) for its content validity. Moreover, acceptability, reliability and construct validity were determined by conducting a validation study among 200 schooling young adults. The principal component analysis (PCA) technique was used to assess the construct validity. Response rates for each item were taken as evidence of acceptability. The internal consistency was assessed by Cronbach's alpha, and test-retest reliability after two weeks was assessed using Cohen's kappa coefficient. The adaptation of ICAST-R included the introduction of an objective manner by which to measure severity of abuse and the inclusion of a set of questions regarding help-seeking behavior following physical and emotional abusive experiences. The SICAST-R showed adequate content validity and high acceptability, with response rates ranging from 90.3% to 99.5%. The minimum Cohen's kappa coefficient was 0.76, indicating good test-retest reliability. The internal consistency (Cronbach's alpha) for the total tool was 0.708, with the three constructs being 0.398, 0.844 and 0.637 for physical, sexual and emotional abuse, respectively. The PCA demonstrated good reproducibility for sexual and emotional abuse with the hypothesized structure. Overall, the SICAST-R showed adequate validity for the assessment of experiences of physical, sexual and emotional abuse during childhood among Sri Lankan young adults.
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Affiliation(s)
- Nadeeka K Chandraratne
- Ministry of Health, Nutrition & Indigenous Medicine, Suwasiripaya, No 38, Rev. Baddegama Wimalawansa Thero Mawatha, Colombo 10, Sri Lanka.
| | - Asvini D Fernando
- Department of Pediatrics, Faculty of Medicine, University of Kelaniya, Sri Lanka.
| | - Nalika Gunawardena
- Dept. of Community Medicine, Faculty of Medicine, University of Colombo, Sri Lanka.
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Self-Brown S, Osborne MC, Boyd C, DeVeausse Brown N, Rostad W, Patterson A, Baker E, Thomas A, McAdam EM, Jackson M, Glasheen TL, Lai B. The impact of SafeCare® Dads to Kids program on father maltreatment risk and involvement: Outcomes and lessons learned from an efficacy trial. Child Abuse Negl 2018; 83:31-41. [PMID: 30016743 DOI: 10.1016/j.chiabu.2018.06.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 06/21/2018] [Accepted: 06/28/2018] [Indexed: 05/28/2023]
Abstract
Child Maltreatment (CM) is a public health problem, and experts recommend parent training programs as a prevention method. Few programs target fathers, even though male caregivers are involved as perpetrators in approximately 45% of substantiated CM cases. This study examines the efficacy of an adapted version of SafeCare (Dad2K) with marginalized fathers. Participants include a convenience sample of fathers with children ages 2-5 years. Fathers (n=99) were randomized to an 1) intervention group (SafeCare Dad2K) or to a 2) comparison group (receiving parenting information in the mail). Quantitative data were collected at baseline, post-intervention (7-weeks post-baseline), and 3-months post-intervention. Qualitative data (semi-structured interviews) were collected from 11 intervention father completers following the second quantitative data collection timepoint. Multi-level modeling results indicated no statistically significant time-by-treatment findings for father involvement (b=0.03, 95% confidence interval [CI]: -0.03, 0.08, p=0.38), total corporal punishment (b=-0.03, 95% CI: -0.47, 0.41, p=0.89), or neglect (b=-0.13, 95% CI: -1.93, 1.68, p=0.89). Qualitative findings indicated that Dad2K completers exhibited positive knowledge and behavioral change related to parenting. Study limitations, lessons learned from this formative work, and recommendations for future research are discussed.
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Affiliation(s)
| | | | - Clinton Boyd
- School of Public Health, Georgia State University, United States
| | | | - Whitney Rostad
- School of Public Health, Georgia State University, United States
| | | | - Evander Baker
- School of Public Health, Georgia State University, United States
| | - Akilah Thomas
- School of Public Health, Georgia State University, United States
| | | | - Matt Jackson
- School of Public Health, Georgia State University, United States
| | | | - Betty Lai
- School of Public Health, Georgia State University, United States
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Nkuba M, Hermenau K, Goessmann K, Hecker T. Reducing violence by teachers using the preventative intervention Interaction Competencies with Children for Teachers (ICC-T): A cluster randomized controlled trial at public secondary schools in Tanzania. PLoS One 2018; 13:e0201362. [PMID: 30110358 PMCID: PMC6093611 DOI: 10.1371/journal.pone.0201362] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 07/13/2018] [Indexed: 11/23/2022] Open
Abstract
The high global prevalence of school violence underlines the need for prevention. However, there are few scientifically evaluated intervention approaches that aim at preventing violence by teachers. We evaluated the feasibility and efficacy of the preventative intervention Interaction Competencies with Children for Teachers (ICC-T). In a cluster randomized controlled trial we assessed attitudes towards and use of violence by teachers (self-reported and reported by students) at eight schools in four regions in Tanzania. Two regions were randomly assigned as intervention regions. Data were assessed in the months before and three months after intervention. In total, 158 teachers (58% females; age: 32.08 years, SD = 5.65) and 486 students (54% females; age: 15.61 years, SD = 0.89) participated in this study. The feasibility was very good: Participants' acceptance was high and they reported a good integration of the core elements in their working routine. The significantly stronger decrease in the use of emotional and physical violence reported both by teachers and students as well as the stronger decrease in positive attitudes of teachers towards physical and emotional violence in the intervention schools at follow-up provide initial evidence of the efficacy. However, further evidence for the sustainability of its effect is needed.
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Affiliation(s)
- Mabula Nkuba
- Department of Psychology, University of Konstanz, Konstanz, Germany
- Department of Educational Psychology and Curriculum Studies, Dar es Salaam University College of Education, Dar es salaam, Tanzania
| | - Katharin Hermenau
- Department of Psychology, University of Konstanz, Konstanz, Germany
- Vivo International, Konstanz, Germany
| | | | - Tobias Hecker
- Vivo International, Konstanz, Germany
- Department of Psychology, University of Bielefeld, Bielefeld, Germany
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Ssenyonga J, Hermenau K, Nkuba M, Hecker T. Reducing violence against children by implementing the preventative intervention Interaction Competencies with Children for Teachers (ICC-T): study protocol for a cluster randomized controlled trial in Southwestern Uganda. Trials 2018; 19:435. [PMID: 30103776 PMCID: PMC6090607 DOI: 10.1186/s13063-018-2827-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 07/28/2018] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND An adolescent's school is often the second most important place for his development and education after the home. However, reports highlight the recurrence of the use of violent discipline in schools. There are few school-based interventions that aim at reducing violence at school that have been implemented and evaluated in sub-Saharan Africa. To reduce violent disciplinary measures used at school, we aim to implement and evaluate the feasibility and efficacy of the preventative intervention Interaction Competencies with Children for Teachers (ICC-T). METHODS/DESIGN The study will be conducted in six randomly selected districts of the Ankole region in southwestern Uganda. We shall randomly select two mixed-day secondary schools from each district that fulfill our inclusion criteria. Schools will be randomly assigned to the intervention condition, where ICC-T will be implemented, and control schools (no intervention). Sixty students between the ages of 12 and 17 years and at least 15 teachers per school will be included in the trial. We aim to collect pre-assessment data directly before the intervention (t1) and 3 months after the intervention (t2) in both intervention and control schools. Using self-administered questionnaires, we will measure students' exposure to violence using the Conflict Tactics Scale (CTS), their psychological well-being using the Strengths and Difficulties Questionnaire (SDQ), and teachers' positive attitudes towards violent disciplining and teachers' use of violent disciplinary methods (CTS). The implementation feasibility of ICC-T in the cultural context of southwestern Uganda will be assessed with purpose-built measures that follow the guidelines for feasibility studies assessing the demand, applicability, acceptability, and integration of core elements in the daily work. DISCUSSION The proposed study will allow us to test the feasibility and efficacy of a preventative intervention seeking to reduce violent disciplinary measures in school settings using a scientifically rigorous design. The proposed study provides the opportunity to contribute to the attainment of goal number 16.2 of the United Nations' Sustainable Development Agenda 2015-2030, which aspires to end all forms of violence against children. TRIAL REGISTRATION ClinicalTrials.gov, NCT03051854 . Registered on 14 February 2017.
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Affiliation(s)
- Joseph Ssenyonga
- Department of Psychology, University of Konstanz, 78567 Konstanz, Germany
| | - Katharin Hermenau
- Department of Psychology, University of Konstanz, 78567 Konstanz, Germany
- vivo international, 78340 Konstanz, Germany
| | - Mabula Nkuba
- Department of Psychology, University of Konstanz, 78567 Konstanz, Germany
- Department of Educational Psychology and Curriculum Studies, Dar es Salaam University College of Education, 2329 Dar es salaam, Tanzania
| | - Tobias Hecker
- vivo international, 78340 Konstanz, Germany
- Department of Psychology, Bielefeld University, Postbox 100131, 33501 Bielefeld, Germany
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Cowley LE, Maguire S, Farewell DM, Quinn-Scoggins HD, Flynn MO, Kemp AM. Factors influencing child protection professionals' decision-making and multidisciplinary collaboration in suspected abusive head trauma cases: A qualitative study. Child Abuse Negl 2018; 82:178-191. [PMID: 29913434 DOI: 10.1016/j.chiabu.2018.06.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 06/07/2018] [Accepted: 06/11/2018] [Indexed: 06/08/2023]
Abstract
Clinicians face unique challenges when assessing suspected child abuse cases. The majority of the literature exploring diagnostic decision-making in this field is anecdotal or survey-based and there is a lack of studies exploring decision-making around suspected abusive head trauma (AHT). We aimed to determine factors influencing decision-making and multidisciplinary collaboration in suspected AHT cases, amongst 56 child protection professionals. Semi-structured interviews were conducted with clinicians (25), child protection social workers (10), legal practitioners (9, including 4 judges), police officers (8), and pathologists (4), purposively sampled across southwest United Kingdom. Interviews were recorded, transcribed and imported into NVivo for thematic analysis (38% double-coded). We identified six themes influencing decision-making: 'professional', 'medical', 'circumstantial', 'family', 'psychological' and 'legal' factors. Participants diagnose AHT based on clinical features, the history, and the social history, after excluding potential differential diagnoses. Participants find these cases emotionally challenging but are aware of potential biases in their evaluations and strive to overcome these. Barriers to decision-making include lack of experience, uncertainty, the impact on the family, the pressure of making the correct diagnosis, and disagreements between professionals. Legal barriers include alternative theories of causation proposed in court. Facilitators include support from colleagues and knowledge of the evidence-base. Participants' experiences with multidisciplinary collaboration are generally positive, however child protection social workers and police officers are heavily reliant on clinicians to guide their decision-making, suggesting the need for training on the medical aspects of physical abuse for these professionals and multidisciplinary training that provides knowledge about the roles of each agency.
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Affiliation(s)
- Laura E Cowley
- Division of Population Medicine, School of Medicine, Cardiff University, Wales, United Kingdom.
| | - Sabine Maguire
- Division of Population Medicine, School of Medicine, Cardiff University, Wales, United Kingdom.
| | - Daniel M Farewell
- Division of Population Medicine, School of Medicine, Cardiff University, Wales, United Kingdom.
| | | | - Matthew O Flynn
- Division of Population Medicine, School of Medicine, Cardiff University, Wales, United Kingdom.
| | - Alison M Kemp
- Division of Population Medicine, School of Medicine, Cardiff University, Wales, United Kingdom.
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Barto B, Bartlett JD, Von Ende A, Bodian R, Noroña CR, Griffin J, Fraser JG, Kinniburgh K, Spinazzola J, Montagna C, Todd M. The impact of a statewide trauma-informed child welfare initiative on children's permanency and maltreatment outcomes. Child Abuse Negl 2018; 81:149-160. [PMID: 29739000 DOI: 10.1016/j.chiabu.2018.04.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 04/12/2018] [Accepted: 04/27/2018] [Indexed: 05/16/2023]
Abstract
This article presents findings of a state-wide trauma informed child-welfare initiative with the goal of improving well-being, permanency and maltreatment outcomes for traumatized children. The Massachuetts Child Trauma Project (MCTP), funded by the Administration of Children and Families, Children's Bureau was a multi-year project implementing trauma-informed care into child welfare service delivery. The project's implementation design included training and consultation for mental health providers in three evidence-based treatments and training of the child-welfare workforce in trauma-informed case work practice. The learning was integrated between child-welfare and mental health with Trauma Informed Leadership Teams which included leaders from both systems and the greater community. These teams developed incremental steps toward trauma-informed system improvement. This study evaluated whether MCTP was associated with reductions in child abuse and neglect, improvements in placement stability, and higher rates of permanency during the first year of implementation. Children in the intervention group had fewer total substantiated reports of maltreatment, including less physical abuse and neglect than the comparison group by the end of the intervention year. However, children in the intervention group had more maltreatment reports (substantiated or not) and total out-of-home placements than did their counterparts in the comparison group. Assignment to MCTP, however, was not associated with an increase in kinship care or adoption. Overall, the results are promising in reinforcing the importance of mobilizing communities toward improvements in child-welfare service delivery.
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Affiliation(s)
- Beth Barto
- LUK, Inc., 545 Westminster St., Fitchburg, MA, 01420, United States.
| | | | - Adam Von Ende
- Brazelton Touchpoints Center, Division of Developmental Medicine, Boston Children's Hospital, 1295 Boylston St., Suite 320, Boston, MA, 02215, United States
| | - Ruth Bodian
- Massachusetts Department of Children & Families, 600 Washington St., Boston, MA, 02111, United States
| | - Carmen Rosa Noroña
- Child Witness to Violence Project, Boston Medical Center, One Boston Medical Center Pl, Boston, MA, 02118, United States
| | - Jessica Griffin
- University of Massachusetts Medical School, 55 N Lake Ave., Worcester, MA, 01655, United States
| | | | - Kristine Kinniburgh
- Trauma Center at Justice Resource Institute, 1269 Beacon St., Brookline, MA, 02446, United States
| | - Joseph Spinazzola
- The Foundation Trust, P.O. Box 760995, Melrose, MA, 02176, United States
| | - Crystaltina Montagna
- University of Massachusetts Medical School, 55 N Lake Ave., Worcester, MA, 01655, United States
| | - Marybeth Todd
- Child Trends, 56 Robbins St., Acton, MA, 01720, United States
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Hubel GS, Rostad WL, Self-Brown S, Moreland AD. Service needs of adolescent parents in child welfare: Is an evidence-based, structured, in-home behavioral parent training protocol effective? Child Abuse Negl 2018; 79:203-212. [PMID: 29482107 PMCID: PMC6168945 DOI: 10.1016/j.chiabu.2018.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 01/08/2018] [Accepted: 02/07/2018] [Indexed: 06/08/2023]
Abstract
SafeCare is an evidence-based behavioral parent training intervention that has been successfully implemented in multiple state child welfare systems. A statewide implementation in Oklahoma established the effectiveness of SafeCare with a diverse group of parents, which included adolescent parents under 21 years of age, a particularly at-risk group. The current study examined whether SafeCare is also effective for this subsample of 294 adolescent parents with regard to child welfare recidivism, depression and child abuse potential, and attainment of service goals. Post-treatment adolescent parent ratings of program engagement and satisfaction were also examined. Among the subsample of adolescent parents, the SafeCare intervention did not result in significantly improved outcomes in terms of preventing recidivism or reduction in risk factors associated with child abuse and neglect as compared to child welfare services as usual. Further, no significant differences in program engagement and satisfaction between SafeCare and services as usual were detected. These findings shed light on the potential differences in program effectiveness between adolescent and adult parents, and the need for future research to rigorously evaluate the effectiveness of behavioral parenting programs with adolescent parents.
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Affiliation(s)
- Grace S Hubel
- College of Charleston, Department of Psychology, Charleston, SC, United States.
| | - Whitney L Rostad
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, United States
| | - Shannon Self-Brown
- Georgia State University, School of Public Health, Atlanta, GA, United States
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27
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Miller-Perrin C, Perrin R. Changing attitudes about spanking among conservative Christians using interventions that focus on empirical research evidence and progressive biblical interpretations. Child Abuse Negl 2017; 71:69-79. [PMID: 28442195 DOI: 10.1016/j.chiabu.2017.03.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 03/22/2017] [Accepted: 03/23/2017] [Indexed: 06/07/2023]
Abstract
This study examined how interventions that include either empirical research evidence about spanking, progressive biblical interpretations, or both, affect attitudes and intentions about spanking. A sample of 129 college students (70% female; 30% male; Mage=19) attending a private, Christian university was randomly assigned to one of three intervention conditions: (1) Research Only, (2) Religion Only, or (3) Research and Religion. Four weeks prior to the intervention sessions, students completed a Demographic Form, the Religious Fundamentalism Scale, and the Attitudes Toward Spanking (ATS) scale. Following the intervention, students completed the ATS scale a second time. A two-way ANOVA indicated a significant main effect for the intervention condition and an interaction effect between intervention condition and religious fundamentalism, indicating that positive spanking attitudes declined most significantly in the Research and Religion intervention condition (F(2, 123)=4.05, p=.02, hp2=.06) with the greatest change in attitudes among the Religious Fundamentalism Group in that condition (F(2, 123)=4.50, p=.01, hp2=.07). A second two-way ANOVA indicated a significant main effect for Conservative Protestant Affiliation (F(2, 123)=4.39, p=.04, hp2=.03) indicating that positive spanking attitudes declined most significantly for participants identifying with a conservative religious affiliation. Overall, the findings suggest that, especially among Conservative Protestants, interventions that focus on both empirical research and progressive biblical interpretations of scripture can reduce positive attitudes toward, and intentions to use, spanking. This study has implications for decreasing spanking use among Conservative Christians and for the development of training programs to reduce parents' use of spanking.
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Vlahovicova K, Melendez-Torres GJ, Leijten P, Knerr W, Gardner F. Parenting Programs for the Prevention of Child Physical Abuse Recurrence: A Systematic Review and Meta-Analysis. Clin Child Fam Psychol Rev 2017; 20:351-365. [PMID: 28378136 PMCID: PMC5527061 DOI: 10.1007/s10567-017-0232-7] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Child physical abuse is an issue of global concern. Conservative estimates set global prevalence of this type of maltreatment at 25%, its consequences and cost to society escalating with increasing frequency and severity of episodes. Syntheses of the evidence on parenting programs for reducing rates of physical abuse recidivism have, to date, not been able to establish effectiveness. Paucity of data and inconsistent inclusion criteria in past reviews made meta-analysis often impossible or uninformative. The current systematic review updates prior reviews and overcomes some of the methodological issues they encountered by pooling trial-level data from a well-defined scope of trials of parenting interventions aimed at preventing the re-abuse of children by parents with substantiated or suspected physical abuse history. Randomized controlled trials and rigorous non-randomized designs were sought via nine online databases, two trial registries, several clearinghouses and contact with experts. A total of fourteen studies of variable quality were included in this review, four of which had outcomes that enabled meta-analysis. Overall, this review presents evidence supporting the effectiveness of parenting behavioral programs based on social learning theory for reducing hard markers of child physical abuse recidivism. Meta-analysis found that the absolute risk reduction in risk of recidivism was 11 percentage points less for maltreating parents who undergo parenting programs (RD = -0.11, 95% CI [-0.22, -0.004], p = 0.043, I 2 = 28.9%). However, the pooled effect size was not statistically significant when calculated as a risk ratio (0.76, 95% CI [0.54, 1.07], I 2 = 38.4%). Policy makers and practitioners should be made aware that this intervention method is backed by promising evidence featuring modest yet significant reductions in hard markers of child physical abuse, even though the methodological robustness of these findings should be further explored in future research.
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Affiliation(s)
| | | | - Patty Leijten
- University of Oxford, Oxford, UK
- UvA University of Amsterdam, Amsterdam, Netherlands
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Abstract
Despite numerous studies identifying a broad range of harms associated with the use of spanking and other types of physical punishment, debate continues about its use as a form of discipline. In this commentary, we recommend four strategies to move the field forward and beyond the spanking debate including: 1) use of methodological approaches that allow for stronger causal inference; 2) consideration of human rights issues; 3) a focus on understanding the causes of spanking and reasons for its decline in certain countries; and 4) more emphasis on evidence-based approaches to changing social norms to reject spanking as a form of discipline. Physical punishment needs to be recognized as an important public health problem.
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Affiliation(s)
- Harriet L MacMillan
- Departments of Psychiatry & Behavioural Neurosciences, and of Pediatrics, McMaster University, Offord Centre for Child Studies, McMaster Innovation Park, Suite 201A, 1280 Main Street West Hamilton, Ontario, L8S 4K1, Canada.
| | - Christopher R Mikton
- Department of Health and Social Sciences, University of the West of England Bristol, Frenchay Campus, Coldharbour Lane, Bristol, BS16 1QY, United Kingdom.
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Gershoff ET, Lee SJ, Durrant JE. Promising intervention strategies to reduce parents' use of physical punishment. Child Abuse Negl 2017; 71:9-23. [PMID: 28162793 PMCID: PMC5540797 DOI: 10.1016/j.chiabu.2017.01.017] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 01/16/2017] [Accepted: 01/22/2017] [Indexed: 05/12/2023]
Abstract
The strong and ever-growing evidence base demonstrating that physical punishment places children at risk for a range of negative outcomes, coupled with global recognition of children's inherent rights to protection and dignity, has led to the emergence of programs specifically designed to prevent physical punishment by parents. This paper describes promising programs and strategies designed for each of three levels of intervention - indicated, selective, and universal - and summarizes the existing evidence base of each. Areas for further program development and evaluation are identified.
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Affiliation(s)
- Elizabeth T Gershoff
- Department of Human Development and Family Sciences, University of Texas at Austin, 108 E. Dean Keeton St., Stop A2702, Austin, TX, 78712, USA.
| | - Shawna J Lee
- School of Social Work, University of Michigan, 1080 South University Ave., Ann Arbor, MI, 48109, USA.
| | - Joan E Durrant
- Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Science, University of Manitoba, 35 Chancellor's Circle, Fort Garry Campus, University of Manitoba, Winnipeg, Manitoba, R3T 2N2, Canada.
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Durrant JE, Fallon B, Lefebvre R, Allan K. Defining reasonable force: Does it advance child protection? Child Abuse Negl 2017; 71:32-43. [PMID: 28258758 DOI: 10.1016/j.chiabu.2017.02.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 01/22/2017] [Accepted: 02/11/2017] [Indexed: 06/06/2023]
Abstract
Fifty-two countries have abolished all physical punishment of children, yet Canada has retained its criminal defense to 'reasonable' corrective force. In 2004, Canada's Supreme Court attempted to set limits on punitive acts that can be considered reasonable under the law. In the present study, we examined the validity of these limits. If the court's limits provide adequate protection to children, most substantiated child maltreatment cases should exceed those limits. We operationalized each limit and applied it to a provincially representative sample of substantiated child physical maltreatment cases. We found that the majority of substantiated physical abuse cases fell within each of the court's limits. In more than one in four substantiated physical abuse cases, not even one of the court's limits was exceeded. The best predictor of whether a report was substantiated was whether spanking was typical in the child's home. The findings suggest that abolition of physical punishment would provide greater protection to children than attempts to set limits on its use.
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Fréchette S, Romano E. How do parents label their physical disciplinary practices? A focus on the definition of corporal punishment. Child Abuse Negl 2017; 71:92-103. [PMID: 28209377 DOI: 10.1016/j.chiabu.2017.02.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 01/30/2017] [Accepted: 02/01/2017] [Indexed: 06/06/2023]
Abstract
The lack of consensus about the definition of corporal punishment (CP) contributes to the varying research findings and fuels the debate surrounding its use. Related to the problem of definitional variability is also the possibility that some parents may not be aware that their physical disciplinary strategies (PDS) are forms of CP. As a first step to move beyond the debate and to tailor educational efforts to change cultural norms and parents' behaviors, the objective of the current study was to clarify what parents self-label as CP. Using a sample of 338 Canadian parents, the study assessed the relationship between endorsement of CP and self-reports of specific PDS ranging in level of severity. Predictors (i.e., cultural norms, attitudes toward and childhood experiences of CP) of this relationship were investigated. Results revealed that general questions on CP may best reflect parental use of milder forms of PDS, such as spanking (Φ=0.62; r=-0.65) and slapping on the hand, arm, or leg (r=-0.47). Results also suggested that some parents (19.8%) do not endorse CP but use mild PDS. To move beyond the debate and to reach parents at risk of underreporting their use of CP, educational messages need to be tailored to specific and mild forms of PDS rather than to broad concepts such as CP. Moreover, factors such as attitudes toward corporal punishment (p ˂0.001) can help identify those parents who use PDS but who do not endorse CP.
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Affiliation(s)
| | - Elisa Romano
- School of Psychology, University of Ottawa, Ontario, Canada
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33
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Santini PM, Williams LCA. A randomized controlled trial of an intervention program to Brazilian mothers who use corporal punishment. Child Abuse Negl 2017; 71:80-91. [PMID: 28506540 DOI: 10.1016/j.chiabu.2017.04.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 04/22/2017] [Accepted: 04/23/2017] [Indexed: 05/28/2023]
Abstract
This study evaluated a positive parenting program to Brazilian mothers who used corporal punishment with their children. The intervention was conducted in four agencies serving vulnerable children, and at a home replica laboratory at the University. Mothers who admitted using corporal punishment were randomly assigned between experimental (n=20) and control group (n=20). The program consisted of 12 individual sessions using one unit from Projeto Parceria (Partnership Project), with specific guidelines and materials on positive parenting, followed by observational sessions of mother-child interaction with live coaching and a video feedback session in the lab. The study used an equivalent group experimental design with pre/post-test and follow-up, in randomized controlled trials. Measures involved: Initial Interview; Strengths and Difficulties Questionnaire (SDQ) - parent and child versions; Beck Depression Inventory (BDI); observational sessions with a protocol; and a Program Evaluation by participants. Analysis of mixed models for repeated measures revealed significant positive effects on the BDI and SDQ total scores, as well as less Conduct problems and Hyperactivity in SDQ measures from the experimental group mothers, comparing pre with post-test. Observational data also indicated significant improvement in positive interaction from the experimental group mothers at post-test, in comparison with controls. No significant results were found, however, in children's observational measures. Limitations of the study involved using a restricted sample, among others. Implications for future research are suggested.
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Affiliation(s)
- Paolla Magioni Santini
- Universidade Federal de São Carlos (Federal University of São Carlos), Department of Psychology, Laprev (The Laboratory for Violence Analysis & Prevention), Rodovia Washington Luís, Km 235 - SP-310, CEP 13565-905, São Carlos, SP, Brazil.
| | - Lucia C A Williams
- Universidade Federal de São Carlos (Federal University of São Carlos), Department of Psychology, Laprev (The Laboratory for Violence Analysis & Prevention), Rodovia Washington Luís, Km 235 - SP-310, CEP 13565-905, São Carlos, SP, Brazil.
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Taylor CA, Fleckman JM, Lee SJ. Attitudes, beliefs, and perceived norms about corporal punishment and related training needs among members of the "American Professional Society on the Abuse of Children". Child Abuse Negl 2017; 71:56-68. [PMID: 28457581 DOI: 10.1016/j.chiabu.2017.04.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 03/29/2017] [Accepted: 04/10/2017] [Indexed: 06/07/2023]
Abstract
Hitting children for disciplinary purposes (i.e., spanking or corporal punishment [CP]) is a strong risk factor for child physical abuse and is highly prevalent in the U.S. Yet, little is currently known about the relevant attitudes, beliefs, or training needs of key professionals who often advise parents regarding child discipline strategies. A survey of the American Professional Society on the Abuse of Children (APSAC) membership, comprised of mental health professionals, physicians, child welfare professionals, and other professionals in the child maltreatment field, was conducted to assess attitudes, beliefs, perceived norms, training needs, and motivations to change norms regarding CP (N=571, response rate=51%). Most respondents agreed that spanking is a bad disciplinary technique (82%), is harmful for children (74%), and leads to negative outcomes (M=3.0, SD=0.6) more frequently than positive outcomes (M=2.1, SD=0.6; t=20.8; p<0.0001) for children. Professionals reported perceiving that their colleagues' level of endorsement of CP (M=2.4, SD=1.0) was higher than their own (M=1.9, SD=1.0; t(568)=-10.7, p<0.0001) though still below the midpoint. Professionals reported high levels of preparedness to effectively advise parents on non-physical child discipline strategies, but reported perceiving lower levels of preparedness amongst their colleagues. They reported highly valuing giving such advice to parents and being very motivated to participate in activities designed to change social norms regarding CP. Most APSAC members are poised to change these norms and, in doing so, to help reduce rates of child physical abuse in the U.S.
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Affiliation(s)
- Catherine A Taylor
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, United States.
| | - Julia M Fleckman
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, United States
| | - Shawna J Lee
- University of Michigan, School of Social Work, United States
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Lansford JE, Cappa C, Putnick DL, Bornstein MH, Deater-Deckard K, Bradley RH. Change over time in parents' beliefs about and reported use of corporal punishment in eight countries with and without legal bans. Child Abuse Negl 2017; 71:44-55. [PMID: 28277271 PMCID: PMC5407940 DOI: 10.1016/j.chiabu.2016.10.016] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 09/30/2016] [Accepted: 10/16/2016] [Indexed: 05/05/2023]
Abstract
Stopping violence against children is prioritized in goal 16 of the Sustainable Development Goals adopted by the United Nations General Assembly in 2015. All forms of child corporal punishment have been outlawed in 50 countries as of October 2016. Using data from 56,371 caregivers in eight countries that participated in UNICEF's Multiple Indicator Cluster Survey, we examined change from Time 1 (2005-6) to Time 2 (2008-13) in national rates of corporal punishment of 2- to 14-year-old children and in caregivers' beliefs regarding the necessity of using corporal punishment. One of the participating countries outlawed corporal punishment prior to Time 1 (Ukraine), one outlawed corporal punishment between Times 1 and 2 (Togo), two outlawed corporal punishment after Time 2 (Albania and Macedonia), and four have not outlawed corporal punishment as of 2016 (Central African Republic, Kazakhstan, Montenegro, and Sierra Leone). Rates of reported use of corporal punishment and belief in its necessity decreased over time in three countries; rates of reported use of severe corporal punishment decreased in four countries. Continuing use of corporal punishment and belief in the necessity of its use in some countries despite legal bans suggest that campaigns to promote awareness of legal bans and to educate parents regarding alternate forms of discipline are worthy of international attention and effort along with legal bans themselves.
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Affiliation(s)
| | | | - Diane L Putnick
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6705 Rockledge Drive, Rockville, MD 20817, USA
| | - Marc H Bornstein
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6705 Rockledge Drive, Rockville, MD 20817, USA
| | | | - Robert H Bradley
- Arizona State University, 951 S. Cady Mall, Tempe, AZ 85287, USA
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Abstract
As foundational work in preparation for a sustainable, multi-center network devoted to child abuse medical research, we recently used a combination of survey and modified Delphi methodologies to determine research priorities for future multi-center studies. Avoiding missed diagnoses, and improving selected/indicated prevention were the topics rated most highly in terms of research priority. Several constructive commentaries in this issue identify the key challenges which must be overcome to ensure a successful network. Indeed, as with the clinical work of child abuse pediatrics, a scientific network will also require constant collaboration within and outside the community of child abuse pediatricians, the wider medical community, and even non-medical professions.
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Affiliation(s)
- Daniel M Lindberg
- The Kempe Center for the Prevention & Treatment of Child Abuse & Neglect, University of Colorado School of Medicine, 12401 E. 17th Ave. Mailstop B-215, Aurora, CO 80045, United States.
| | - Philip V Scribano
- Safe Place: Center for Child Protection and Health, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, United States.
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Li Z, Yan CM, Shi L, Mu HT, Li X, Li AQ, Zhao CS, Sun T, Gao L, Fan LH, Mu Y. Workplace violence against medical staff of Chinese children's hospitals: A cross-sectional study. PLoS One 2017; 12:e0179373. [PMID: 28609441 PMCID: PMC5469493 DOI: 10.1371/journal.pone.0179373] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 05/30/2017] [Indexed: 11/19/2022] Open
Abstract
Background In China, medical staff of children’s hospitals are commonly exposed to violence. However, few studies on medical violence are conducted in the settings of children’s hospitals. The aim of this study is to assess the incidence, magnitude, consequences, and potential risk factors of workplace violence (WPV) against medical staff of children’s hospitals. Methods A retrospective cross-sectional design was used. A self-administered questionnaire was utilized to collect data on 12 children’s hospitals. The questionnaires were distributed to a stratified proportional random sample of 2,400 medical staff; 1,932 valid questionnaires were collected. A chi-square test and multiple logistic regression analysis were conducted. Results A total of 68.6% of respondents had experienced at least one WPV incident involving non-physical and/or physical violence in the past year. The perpetrators were mainly family members of patients (94.9%). Most of the WPV occurred during the day shift (70.7%) and in wards (41.8%). Males were 1.979 times (95% CI, 1.378 to 2.841) more likely than females to experience physical violence. Emergency departments were more exposed to physical violence than other departments. Oncology was 2.733 times (95% CI, 1.126 to 6.633) more exposed to non-physical violence than the emergency department. As a result of WPV, victims felt aggrieved and angry, work enthusiasm declined, and work efficiency was reduced. However, only 5.6% of the victims received psychological counseling. Conclusion Medical staff are at high risk of violence in China’s children’s hospitals. Hospital administrators and related departments should pay attention to the consequences of these incidents. There is a need for preventive measures to protect medical staff and provide a safer workplace environment. Our results can provide reference information for intervention strategies and safety measures.
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Affiliation(s)
- Zhe Li
- Department of Health Management, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, People’s Republic of China
| | - Chun-mei Yan
- Department of Customer Service, Beijing Children’s Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Lei Shi
- Department of Health Management, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, People’s Republic of China
| | - Hui-tong Mu
- Department of Health Management, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, People’s Republic of China
| | - Xin Li
- Department of Health Management, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, People’s Republic of China
| | - An-qi Li
- Department of Health Management, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, People’s Republic of China
| | - Cheng-song Zhao
- Hospital Administration Office, Beijing Children’s Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Tao Sun
- Department of Health Management, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, People’s Republic of China
| | - Lei Gao
- Department of Health Management, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, People’s Republic of China
| | - Li-hua Fan
- Department of Health Management, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, People’s Republic of China
- * E-mail: (LF); (YM)
| | - Yi Mu
- Hospital Administration Office, Beijing Children’s Hospital, Capital Medical University, Beijing, People’s Republic of China
- * E-mail: (LF); (YM)
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Richards TN, Tillyer MS, Wright EM. Intimate partner violence and the overlap of perpetration and victimization: Considering the influence of physical, sexual, and emotional abuse in childhood. Child Abuse Negl 2017; 67:240-248. [PMID: 28282597 DOI: 10.1016/j.chiabu.2017.02.037] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 12/13/2016] [Accepted: 02/27/2017] [Indexed: 05/05/2023]
Abstract
Using data from Wave 4 of the National Longitudinal Study of Adolescent to Adult Health, this study examined the independent relationship of childhood maltreatment type (emotional, sexual, physical) on IPV victimization and perpetration; then mutually exclusive categories of IPV involvement (victimization, perpetration, and victimization/perpetration) were investigated. IPV victimization and perpetration were assessed using items from the revised Conflict Tactics Scales. A series of binary regression models and multinomial regression models were estimated. Models were stratified across gender. Results uncovered significant relationships between child physical abuse and IPV victimization as well as IPV perpetration for males and females, but this effect was reduced when emotional maltreatment was added to the model. When IPV victimization/perpetration was considered, maltreatment effects changed. For males, physical maltreatment remained significantly related to victimization only and physical, sexual, and emotional maltreatment were related to victimization/perpetration. For females, physical maltreatment remained significantly related to IPV victimization only and emotional maltreatment was related to perpetration only and to victimization/perpetration. Screening and intervention for maltreatment, including emotional maltreatment, among children as well as adults with IPV histories may be important to preventing first IPV experiences and stemming current involvement.
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Abstract
OBJECTIVE The aim of this study was to examine nurses' knowledge of the state of New Jersey (NJ) Violence Prevention in Health Care Facilities Act, workplace violence training, and experience with workplace violence. METHODS In 2013, 309 (22.5% response rate) nurses returned a mailed survey. Univariate and multivariate analyses were conducted. RESULTS Ninety percent of respondents were female. When the perpetrator was a patient or a family member, the respondents experienced verbal abuse the most (57.8%), followed by threats (52.3%), and physical assault (38.3%). Respondents who had heard of the regulation (89.6%) received a higher proportion of training than those who had not heard of the regulation (57.9%) (P < 0.0001). CONCLUSIONS Nurses who received at least 80% of the required training components were more likely to feel more secure at work, suggesting that training is an important tool to address workplace violence.
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Affiliation(s)
- Marilyn Lou Ridenour
- National Institute for Occupational Safety and Health (NIOSH), Division of Safety Research, Morgantown, West Virginia (Ms Ridenour, Mr Hendricks, Dr Hartley); and Old Dominion University, College of Health Sciences, School of Community and Environmental Health, Norfolk, Virginia (Dr Blando)
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Bailly RM, DeFazio DM. Justice or Injustice: a History and Critique of the New York State Justice Center for the Protection of People with Special Needs. Albany Law Rev 2017; 80:1181-1225. [PMID: 30990589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The creation of the New York State Justice Center for the Protection of People with Special Needs ("Justice Center") was announced with great fanfare in 2013. Its goal is laudable: strengthening and standardizing "the safety net for vulnerable persons, adults and children alike, who are receiving care from New York's human service agencies and programs." Its jurisdiction is broad: covering residential and non-residential programs and provider agencies that come within the purview of six state oversight agencies, namely, the Office of Mental Health, the Office for People with Developmental Disabilities, the Office of Alcohol and Substance Abuse Services, the Office of Children and Family Services, the Department of Health, and the State Education Department. Its powers are comprehensive: investigating allegations of abuse, neglect, and significant incidents, and disciplining individuals and agencies pursuant to administrative authority. In addition, it can prosecute crimes of neglect and abuse pursuant to criminal prosecutorial authority. Given that over 270,000 vulnerable children and adults live in residential facilities overseen by the state and that numerous other individuals receive services from "day programs operated, licensed[,] or certified by the state[,]" the creation of the Justice Center is consistent with New York's history of oversight of vulnerable individuals. The state has overseen various state and municipal programs and private organizations that have addressed the needs of vulnerable individuals practically since New York's first poorhouse opened in 1736. The development of that oversight has been a series of responses to perceived deficiencies of an existing system, and the creation of the Justice Center is, much in the same way, a response to a 2011 study commissioned by the Governor to examine the treatment and care of vulnerable adults. The Justice Center’s jurisdiction reflects a departure, however, from traditional oversight. State administrative and regulatory review has been carried out by specialized state agencies established during the late nineteenth and twentieth centuries to address specific categories of individuals receiving care and treatment according to their needs. Residential and day treatment programs, as well as their custodians and employees, have been disciplined for abuse and neglect in accordance with state regulations created by these agencies. Criminal prosecutions have also been referred to county district attorneys. The Justice Center unites all specialized agencies, all vulnerable individuals with diverse needs, and all custodians and employees trained to meet those needs under one additional layer of uniform rules and regulations, with potential administrative discipline, civil liability, and criminal prosecution also under the same umbrella. This article explores the history of state oversight in New York and the departure represented by the Justice Center. This article first traces the early history of oversight. It then discusses the role of the Commission on Quality of Care for the Mentally Disabled, an antecedent organization similar to the Justice Center. Next, it examines the Justice Center itself. Last, this article concludes with some reflections on the Center.
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Lee A, Berry MD. Long-Term Care: Facility Quality and Safety. Issue Brief Health Policy Track Serv 2016; 2016:1-36. [PMID: 28252275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Eldeeb N, Halileh S, Alyafei KA, Ghandour R, Dargham S, Giacaman R, Kamal M, Imseeh S, Korayem M, Nasr S, Mahfoud Z, Abu-Rmeileh N, Mahmoud MH, Tawfik H, Lynch MA, Mian M. Child discipline in Qatar and Palestine: A comparative study of ICAST-R. Child Abuse Negl 2016; 61:63-72. [PMID: 27760709 DOI: 10.1016/j.chiabu.2016.10.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 10/05/2016] [Accepted: 10/06/2016] [Indexed: 05/29/2023]
Abstract
To compare the nature and determinants of child discipline in Qatar and Palestine among young adults through retrospective survey to develop legislation, policies and interventions for effective prevention of child maltreatment, and educational materials to promote positive discipline among parents and caregivers. Cross-sectional random household surveys were conducted in each country (Qataris N=697, Palestinians N=2064) using ISPCAN Child Abuse Screening Tool-Retrospective (ICAST-R) for young adults (18-24 years), to investigate child discipline methods into the maltreatment range. Qatari young adults were more educated (p<0.001) and had more full-time employment (p=0.004) than Palestinian young adults. Qatar reported lower physical and emotional abuse compared to their counterparts in Palestine, e.g. Hit/Punch, Kick (p<0.001) and Insult/Criticize, Threaten to be hurt/killed (p<0.001). Qatari participants found any harsh discipline they received in childhood was not reasonable and not justified compared to Palestinian participants. The more advantaged Qatari population was less likely to experience disciplinary methods that experts developing the ICAST-R defined as abuse compared to Palestinians where the higher incidence of child abuse could be attributed to lower economic advantage, lower level of education and greater exposure to violence. Suggestions are made for future studies in Qatar and Palestine to develop survey methodology with a more culturally appropriate level of intrusion, such as indirect yet meaningful child maltreatment questions.
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Woodhead M. Australian medical leaders call for urgent action on reports of abuse of immigrant detainees. BMJ 2016; 354:i4454. [PMID: 27519710 DOI: 10.1136/bmj.i4454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Ratcliffe HL, Sando D, Mwanyika-Sando M, Chalamilla G, Langer A, McDonald KP. Applying a participatory approach to the promotion of a culture of respect during childbirth. Reprod Health 2016; 13:80. [PMID: 27424514 PMCID: PMC4948103 DOI: 10.1186/s12978-016-0186-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 05/19/2016] [Indexed: 11/10/2022] Open
Abstract
Disrespect and abuse (D&A) during facility-based childbirth is a topic of growing concern and attention globally. Several recent studies have sought to quantify the prevalence of D&A, however little evidence exists about effective interventions to mitigate disrespect and abuse, and promote respectful maternity care. In an accompanying article, we describe the process of selecting, implementing, and evaluating a package of interventions designed to prevent and reduce disrespect and abuse in a large urban hospital in Tanzania. Though that study was not powered to detect a definitive impact on reducing D&A, the results showed important changes in intermediate outcomes associated with this goal. In this commentary, we describe the factors that enabled this effect, especially the participatory approach we adopted to engage key stakeholders throughout the planning and implementation of the program. Based on our experience and findings, we conclude that a visible, sustained, and participatory intervention process; committed facility leadership; management support; and staff engagement throughout the project contributed to a marked change in the culture of the hospital to one that values and promotes respectful maternity care. For these changes to translate into dignified care during childbirth for all women in a sustainable fashion, institutional commitment to providing the necessary resources and staff will be needed.
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Affiliation(s)
- Hannah L Ratcliffe
- Women and Health Initiative, Department of Global Health and Population, Harvard T.H Chan School of Public Health, Boston, MA, USA.
- Ariadne Labs at Brigham and Women's Hospital and the Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - David Sando
- Women and Health Initiative, Department of Global Health and Population, Harvard T.H Chan School of Public Health, Boston, MA, USA
- Management and Development for Health, Dar es Salaam, Tanzania
| | | | - Guerino Chalamilla
- Management and Development for Health, Dar es Salaam, Tanzania
- Africa Academy for Public Health, Dar es Salaam, Tanzania
| | - Ana Langer
- Women and Health Initiative, Department of Global Health and Population, Harvard T.H Chan School of Public Health, Boston, MA, USA
| | - Kathleen P McDonald
- Women and Health Initiative, Department of Global Health and Population, Harvard T.H Chan School of Public Health, Boston, MA, USA
- Boston University School of Public Health, Boston, MA, USA
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Affiliation(s)
- S D Shanti
- A T Still University of Health Sciences, 8535 East Still Circle, Mesa, AZ 85206, USA
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46
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Berglund A, Heimer G. [Having been exposed to violence increases the risk of health problems later in life]. Lakartidningen 2016; 113:DYMD. [PMID: 27299328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Violence is a common problem in society worldwide, and recent research has shown links to various signs of ill-health among victims. In a Swedish population based study, 46 per cent of women and 38 per cent of men had, at some point, been subjected to severe sexual, physical or emotional violence. The respondents were also asked about their present health. The study showed a significant over-representation of respondents subjected to serious violence in all ill-health indicators (PTSD, depression, psychosomatic symptoms, self-harm behaviour, risky alcohol intake, low self-rated physical health and heart attacks in the older age group). Several other Swedish studies have addressed abuse and future health. In a study among young people attending youth clinics the last year prevalence of sexual, physical and emotional violence was high, as expected. Young women were to a higher extent than young men exposed to sexual (14 and 4 per cent, respectively) and emotional violence (33 and 18 per cent respectively) and young men more to physical violence than young women (27 and 18 per cent respectively). Those who had been exposed to more than two types of violence were significantly more likely to resort to self-harm behaviour and suicide ideation and rated their psychological wellbeing lower than others. In one study the violence victimization and self-reported physical and mental ill-health among young women belonging to a sexual minority and heterosexual young women was assessed. Being subjected to two or more types of violence was significantly more frequent among the minority women compared to heterosexual women. However all victimized women had significantly higher risk for ill-health in all outcomes (PTSD, sleeping difficulties, and recurrent bowel problems). The impact of being subjected to more than one type of violence has been shown to be even more strongly linked to mental ill-health also in adult patients. Hence, research supports that violence victimisation is associated with various symptoms and conditions for which people seek medical care. Therefore questions about violence victimization should routinely be included in the medical history.
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Affiliation(s)
- Anna Berglund
- Nationellt centrum för kvinnofrid, Uppsala universitet - Uppsala, Sweden National centre for knowledge on men's violence against women, Upsala University - Uppsala, Sweden
| | - Gun Heimer
- Nationellt centrum för kvinnofrid, Uppsala universitet - Uppsala, Sweden Nationellt centrum för kvinnofrid, Uppsala universitet - Uppsala, Sweden
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Wijma B, Zbikowski A, Brüggemann AJ. Silence, shame and abuse in health care: theoretical development on basis of an intervention project among staff. BMC Med Educ 2016; 16:75. [PMID: 26922381 PMCID: PMC4769844 DOI: 10.1186/s12909-016-0595-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 02/13/2016] [Indexed: 05/26/2023]
Abstract
As health care exists to alleviate patients' suffering it is unacceptable that it inflicts unnecessary suffering on patients. We therefore have developed and evaluated a drama pedagogical model for staff interventions using Forum Play, focusing on staff's experiences of failed encounters where they have perceived that the patient felt abused. In the current paper we present how our preliminary theoretical framework of intervening against abuse in health care developed and was revised during this intervention. During and after the intervention, five important lessons were learned and incorporated in our present theoretical framework. First, a Forum Play intervention may break the silence culture that surrounds abuse in health care. Second, organizing staff training in groups was essential and transformed abuse from being an individual problem inflicting shame into a collective responsibility. Third, initial theoretical concepts "moral resources" and "the vicious violence triangle" proved valuable and became useful pedagogical tools during the intervention. Four, the intervention can be understood as having strengthened staff's moral resources. Five, regret appeared to be an underexplored resource in medical training and clinical work.The occurrence of abuse in health care is a complex phenomenon and the research area is in need of theoretical understanding. We hope this paper can inspire others to further develop theories and interventions in order to counteract abuse in health care.
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Affiliation(s)
- Barbro Wijma
- />Gender and Medicine, Department of Clinical and Experimental Medicine, Faculty of Medicine and Health Sciences, Linköping University, 581 83 Linköping, Sweden
| | - Anke Zbikowski
- />Gender and Medicine, Department of Clinical and Experimental Medicine, Faculty of Medicine and Health Sciences, Linköping University, 581 83 Linköping, Sweden
- />Department of Obstetrics and Gynaecology, Ryhov County Hospital, Jönköping, Sweden
| | - A. Jelmer Brüggemann
- />Gender and Medicine, Department of Clinical and Experimental Medicine, Faculty of Medicine and Health Sciences, Linköping University, 581 83 Linköping, Sweden
- />Current address: Department of Thematic Studies - Technology and Social Change, Faculty of Arts and Sciences, Linköping University, 581 83 Linköping, Sweden
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Orlando MS, Rothman RE, Woodfield A, Gauvey-Kern M, Peterson S, Miller T, Hill PM, Gaydos CA, Hsieh YH. Public Health Information Delivery in the Emergency Department: Analysis of a Kiosk-Based Program. J Emerg Med 2016; 50:223-7. [PMID: 26403985 PMCID: PMC4728010 DOI: 10.1016/j.jemermed.2015.06.075] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2015] [Revised: 06/11/2015] [Accepted: 06/25/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Because more than one-third of the U.S. population visits an emergency department (ED) any given year, public health interventions in the ED can have major population-level impacts. OBJECTIVES We determined ED patients' interest in receiving information via kiosk on common, chronic conditions for which education and preventive screening could offer public health benefit and to assess what topical information patients are interested in receiving. METHODS This is a secondary analysis of survey data from an ED pilot program December 2011 to April 2012. Main outcome measures were patients' interests in receiving information on health topics via kiosk module. RESULTS More than half of the 4351 patients indicated interest in receiving information on at least one health topic, including high blood pressure (30%), depression (21%), diabetes (18%), sexually transmitted diseases (11%), drug abuse (6%), and physical abuse (3%). African-American patients were more likely to be interested in receiving information on high blood pressure (odds ratio [OR] 2.7, 95% confidence interval [95% CI] 2.2-3.2]), depression (OR 1.3, 95% CI 1.1-1.6), diabetes/sugar (OR 2.2, 95% CI 1.8-2.8), drug abuse (OR 1.4, 95% CI 1.0-1.9), and sexually transmitted diseases (OR 2.6, 95% CI 1.9-3.7). Participants >55 years of age were more likely to desire information on high blood pressure and diabetes (age 55-64 years: OR 4.0, 95% CI 3.1-5.1; age >64 years: OR 4.4, 95% CI 3.2-6.2). Patients who were interested in receiving public health information were more likely to be older, African American, and male (p < 0.05). CONCLUSIONS Interest in obtaining kiosk-delivered education on hypertension predominated. Kiosks are versatile tools that could be used in ED settings to provide health education services.
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Affiliation(s)
- Megan S Orlando
- Department of Emergency Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Richard E Rothman
- Department of Emergency Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland; Division of Infectious Diseases, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Alonzo Woodfield
- Department of Emergency Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Megan Gauvey-Kern
- Department of Emergency Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Stephen Peterson
- Department of Emergency Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Tammi Miller
- Department of Emergency Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Peter M Hill
- Department of Emergency Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Charlotte A Gaydos
- Department of Emergency Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland; Division of Infectious Diseases, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Yu-Hsiang Hsieh
- Department of Emergency Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland
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Nishinaka H, Nakane J, Nagata T, Imai A, Kuroki N, Sakikawa N, Omori M, Kuroda O, Hirabayashi N, Igarashi Y, Hashimoto K. Neuropsychological Impairment and Its Association with Violence Risk in Japanese Forensic Psychiatric Patients: A Case-Control Study. PLoS One 2016; 11:e0148354. [PMID: 26824701 PMCID: PMC4732612 DOI: 10.1371/journal.pone.0148354] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 01/15/2016] [Indexed: 12/16/2022] Open
Abstract
Background In Japan, the legislation directing treatment of offenders with psychiatric disorders was enacted in 2005. Neuropsychological impairment is highly related to functional outcomes in patients with psychiatric disorders, and several studies have suggested an association between neuropsychological impairment and violent behaviors. However, there have been no studies of neuropsychological impairment in forensic patients covered by the Japanese legislation. This study is designed to examine the neuropsychological characteristics of forensic patients in comparison to healthy controls and to assess the relationship between neuropsychological impairment and violence risk. Methods Seventy-one forensic patients with psychiatric disorders and 54 healthy controls (matched by age, gender, and education) were enrolled. The CogState Battery (CSB) consisting of eight cognitive domains, the Iowa Gambling Task (IGT) to test emotion-based decision making, and psychological measures of violence risk including psychopathy were used. Results Forensic patients exhibited poorer performances on all CSB subtests and the IGT than controls. For each group, partial correlational analyses indicated that poor IGT performance was related to psychopathy, especially antisocial behavior. In forensic patients, the CSB composite score was associated with risk factors for future violent behavior, including stress and noncompliance with remediation attempts. Conclusion Forensic patients with psychiatric disorders exhibit a wide range of neuropsychological impairments, and these findings suggest that neuropsychological impairment may increase the risk of violent behavior. Therefore, the treatment of neuropsychological impairment in forensic patients with psychiatric disorders is necessary to improve functional outcomes as well as to prevent violence.
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Affiliation(s)
- Hirofumi Nishinaka
- Division of Clinical Neuroscience, Center for Forensic Mental Health, Chiba University, Chiba, Japan
| | - Jun Nakane
- National Hospital Organization Shimofusa Psychiatric Medical Center, Chiba, Japan
| | - Takako Nagata
- Department of Psychiatry, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Atsushi Imai
- Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan
| | - Noriomi Kuroki
- Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan
| | - Noriko Sakikawa
- Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan
| | - Mayu Omori
- Department of Psychiatry, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Osamu Kuroda
- Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan
| | - Naotsugu Hirabayashi
- Department of Psychiatry, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Yoshito Igarashi
- Division of Law and Psychiatry, Center for Forensic Mental Health, Chiba University, Chiba, Japan
| | - Kenji Hashimoto
- Division of Clinical Neuroscience, Center for Forensic Mental Health, Chiba University, Chiba, Japan
- * E-mail:
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50
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Parish C. No more excuses on institutional care. Nurs Stand 2015; 30:3. [PMID: 26530546 DOI: 10.7748/ns.30.10.3.s1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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