Online child sexual exploitation and abuse: A community diagnosis using the social norms theory.

This study focused on the drivers of online child sexual exploitation and abuse (OCSEA) among Filipino children and youth, with emphasis on community norms. An ethnographic qualitative study was conducted in two communities in MetroManila that are considered "hotspots" for child sexual abuse. One hundred and forty-four (144) males and females from various age groups served as key informants. Political officials, Internet shop managers, professionals and police officers were also interviewed. Non-participant observations and mapping were used to provide context regarding OCSEA in the communities.The results revealed that OCSEA was committed online by heterosexual and same sex attracted men in their 40s-50s. The usual victims were girls aged 13-17 years, although boys were also noted. The victims came from poor families and were out-of-school. The various forms of online activities leading to OCSEA included sexual chatting, showing of child sex photos and live videos as well as sextortion. The online transactions were usually initiated by the peer group and some enablers. In general, online sexual activities were perceived as "normal" among young people, although regarded as "disgusting". Online sex activities had become a source of "easy money" for the child and family. They were perceived as not harmful because of anonymity and the absence of any actual physical contact. People in the community tolerate these online practices and do not report the incidence to authorities. The effects on children and youth were predominantly social and psychological, albeit perceived as economically beneficial. Some preventive and mitigating actions were recommended to curb the incidence of OCSEA in the communities.

Adverse childhood experiences (ACE) and health-risk behaviors among adults in a developing country setting.

OBJECTIVE: This study aimed to examine the association among adverse childhood experiences, health-risk behaviors, and chronic disease conditions in adult life. STUDY POPULATION: One thousand and sixty-eight (1,068) males and females aged 35 years and older, and residing in selected urban communities in Metro Manila participated in the cross-sectional survey. METHODS: A pretested local version of the Adverse Childhood Experiences Questionnaires developed by the Centers for Disease Control and Prevention, USA, was used. Data were collected through self-administration of the questionnaire. Prevalence and estimates of odds ratio were computed to obtain a measure of association among variables. Logistic regression analysis was employed to adjust for the potential confounding effects of age, sex, and socio-economic status. RESULTS: The results indicated that 75% of the respondents had at least 1 exposure to adverse childhood experiences. Nine percent had experienced 4 or more types of abuse and household dysfunctions. The most commonly reported types of negative childhood events were psychological/emotional abuse, physical neglect, and psychological neglect of basic needs. Majority of respondents claimed to have experienced living with an alcoholic or problem drinker and where there was domestic violence. Health-risk behavior consequences were mostly in the form of smoking, alcohol use, and risky sexual behavior. The general trend shows that there was a relatively strong graded relationship between number of adverse childhood experiences, health-risk behaviors, and poor health. CONCLUSION: This study provided evidence that child maltreatment is a public health problem even in poorer environments. Prevention and early intervention of child maltreatment were recommended to reduce the prevalence of health-risk behavior and morbidity in later life.

International variations in harsh child discipline.

BACKGROUND: Although the history of recognition of child abuse in Europe and North America extends over 40 years, recognition and data are lacking in other parts of the world. Cultural differences in child-rearing complicate cross-cultural studies of abuse. OBJECTIVE: To ascertain rates of harsh and less-harsh parenting behavior in population-based samples. METHODS: We used parallel surveys of parental discipline of children in samples of mothers in Brazil, Chile, Egypt, India, Philippines, and the United States. Data were collected between 1998 and 2003. The instrument used was a modification of the Parent-Child Conflict Tactics Scale, along with a study-developed survey of demographic characteristics and other parent and child variables. Women (N=14 239) from 19 communities in 6 countries were surveyed. We interviewed mothers aged 15 to 49 years (18-49 years in the United States) who had a child younger than 18 years in her home. Sample selection involved either random sampling or systematic sampling within randomly selected blocks or neighborhoods. RESULTS: Nearly all parents used nonviolent discipline and verbal or psychological punishment. Physical punishment was used in at least 55% of the families. Spanking rates (with open hand on buttocks) ranged from a low of 15% in an educated community in India to a high of 76% in a Philippine community. Similarly, there was a wide range in the rates of children who were hit with objects (9%-74% [median: 39%]) or beaten by their parents (0.1%-28.5%). Extremely harsh methods of physical punishment, such as burning or smothering, were rare in all countries. It is concerning that >or=20% of parents in 9 communities admitted shaking children younger than 2 years. CONCLUSIONS: Physical and verbal punishments of children are common in high-, middle-, and low-income communities around the world. The forms and rates of punishment vary among countries and among communities within countries. A median of 16% of children experienced harsh or potentially abusive physical discipline in the previous year.

Risk markers of severe psychological violence against women: a WorldSAFE multi-country study.

This study was an attempt to determine the prevalence and significant risk factors associated with severe psychological violence in 6 WorldSAFE sites. The respondents were 3975 women aged 15-49 years and residing in selected urban areas in Chile, Egypt, the Philippines and India. Using a standard instrument translated locally, psychological violence was measured using items indicating the following domains: verbal abuse, fear and separation. A woman who had experienced severe psychological violence had admitted that she had experienced any of the above-mentioned behaviors '3 or more times' in her lifetime (lifetime prevalence) or with her current partner during the past 12 months (current prevalence). The results showed a lifetime prevalence of severe psychological violence ranging from 10.5% of women in Egypt to about 50% in Chile and Trivandrum, India. Verbal abuse was most common among the different behavioral indicators. A woman's mental health status and partner alcohol use were found to be the common significant risk factors. Recommendations were made to facilitate efforts to address severe psychological violence in developing countries.

Coordination of international multicenter studies: governance and administrative structure.

A well-conducted multicenter study needs to assure standardization, uniformity of procedures, high data quality, and collaboration across sites. This manuscript describes the organization and dynamics of multicenter studies, focusing on governance and administrative structures among countries of diverse cultures. The organizational structure of a multicenter study is described, and a system for oversight and coordination, along with roles and responsibilities of participants in the multicenter study, are presented. The elements of a governance document are also reviewed, along with guidelines and policies for effective collaboration. The experience of an ongoing multi-country collaboration, the World Studies of Abuse in the Family Environment (WorldSAFE), illustrates the implementation of these guidelines. It is essential that multicenter studies have an objective coordinating center and that the investigators jointly develop a written governance document to enable collaboration and preserve collegiality among participating investigators.

Coordination of international multicenter studies: governance and administrative structure

A well-conducted multicenter study needs to assure standardization, uniformity of procedures, high data quality, and collaboration across sites. This manuscript describes the organization and dynamics of multicenter studies, focusing on governance and administrative structures among countries of diverse cultures. The organizational structure of a multicenter study is described, and a system for oversight and coordination, along with roles and responsibilities of participants in the multicenter study, are presented. The elements of a governance document are also reviewed, along with guidelines and policies for effective collaboration. The experience of an ongoing multi-country collaboration, the World Studies of Abuse in the Family Environment (WorldSAFE), illustrates the implementation of these guidelines. It is essential that multicenter studies have an objective coordinating center and that the investigators jointly develop a written governance document to enable collaboration and preserve collegiality among participating investigators