Integration of services for victims of child sexual abuse at the university teaching hospital one-stop centre.

Objective. To improve care of sexually abused children by establishment of a "One Stop Centre" at the University Teaching Hospital. Methodology. Prior to opening of the One Stop Centre, a management team comprising of clinical departmental heads and a technical group of professionals (health workers, police, psychosocial counselors lawyers and media) were put in place. The team evaluated and identified gaps and weaknesses on the management of sexually abused children prevailing in Zambia. A manual was produced which would be used to train all professionals manning a One Stop Centre. A team of consultants from abroad were identified to offer need based training activities and a database was developed. Results. A multidisciplinary team comprising of health workers, police and psychosocial counselors now man the centre. The centre is assisted by lawyers as and when required. UTH is offering training to other areas of the country to establish similar services by using a Trainer of Trainers model. A comprehensive database has been established for Lusaka province. Conclusion. For establishment of a One Stop Centre, there needs to be a core group comprising of managers as well as a technical team committed to the management and protection of sexually abused children.

The role of European genetic admixture in the etiology of the insulin resistance syndrome in children: are the effects mediated by fat accumulation?

OBJECTIVES: To evaluate the contribution of European genetic admixture (EUADM) to insulin resistance syndrome (IRS) in a multiethnic sample of children age 7-12 years, and to explore whether body fat affects this relationship. STUDY DESIGN: Anthropometric measurements and blood pressure were assessed in 243 children. After an overnight fast, an intravenous glucose tolerance test was conducted, and measures of fasting insulin/glucose, lipids, insulin sensitivity (SI), and acute insulin response to glucose (AIRg) were obtained. The proportion of EUADM was determined by maximum likelihood estimation using 140 ancestry informative markers. Subjects were stratified into tertiles according to the proportion of EUADM for analyses. Subjects were categorized as lean or obese using body fat percentage cutpoints (25% in boys, 30% in girls). RESULTS: Among lean subjects (72%), the tertile representing the greatest proportion of EUADM was associated with higher SI (P<.001) and serum glucose (P<.05) and lower insulin (P<.05), AIRg (P<.001), high-density lipoprotein cholesterol (P=.05), and blood pressure (P<.05). However, among obese subjects, EUADM was associated only with SI (P<.05). CONCLUSIONS: Our results suggest that population differences in IRS likely have a genetic component, but that the influence of genetic background may be masked by obesity.