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1.
Artículo en Inglés | MEDLINE | ID: mdl-33562467

RESUMEN

Introduction: Children are widely recognized as a vulnerable population during disasters and emergencies. The COVID-19 pandemic, like a natural disaster, brought uncertainties and instability to the economic development of the society and social distancing, which might lead to child maltreatment. This study aims to investigate whether job loss, income reduction and parenting affect child maltreatment. Methods: We conducted a cross-sectional online survey of 600 randomly sampled parents aged 18 years or older who had and lived with a child under 10 years old in Hong Kong between 29 May to 16 June 2020. Participants were recruited from a random list of mobile phone numbers of a panel of parents. Of 779 recruited target parents, 600 parents completed the survey successfully via a web-based system after obtaining their online consent for participating in the survey. Results: Income reduction was found significantly associated with severe (OR = 3.29, 95% CI = 1.06, 10.25) and very severe physical assaults (OR = 7.69, 95% CI = 2.24, 26.41) towards children. Job loss or large income reduction were also significantly associated with severe (OR= 3.68, 95% CI = 1.33, 10.19) and very severe physical assaults (OR = 4.05, 95% CI = 1.17, 14.08) towards children. However, income reduction (OR = 0.29, 95% CI = 0.15, 0.53) and job loss (OR = 0.47, 95% CI = 0.28, 0.76) were significantly associated with less psychological aggression. Exposure to intimate partner violence between parents is a very strong and significant factor associated with all types of child maltreatment. Having higher levels of difficulty in discussing COVID-19 with children was significantly associated with more corporal punishment (OR = 1.19, 95% CI = 1.05, 1.34), whereas having higher level of confidence in managing preventive COVID-19 behaviors with children was negatively associated with corporal punishment (OR = 0.87, 95% CI = 0.76, 0.99) and very severe physical assaults (OR = 0.74, 95% CI = 0.58, 0.93). Conclusions: Income instability such as income reduction and job loss amplified the risk of severe and very severe child physical assaults but protected children from psychological aggression. Also, confidence in teaching COVID-19 and managing preventive COVID-19 behaviors with children was significantly negatively associated with corporal punishment during pandemic.


Asunto(s)
Maltrato a los Niños/estadística & datos numéricos , Renta , Pandemias , Abuso Físico/estadística & datos numéricos , Niño , Estudios Transversales , Hong Kong/epidemiología , Humanos , Responsabilidad Parental , Castigo , Encuestas y Cuestionarios
2.
Prax Kinderpsychol Kinderpsychiatr ; 70(1): 64-83, 2021 Jan.
Artículo en Alemán | MEDLINE | ID: mdl-33459220

RESUMEN

Protection Against Violence and Abuse in Medical Institutions - Reasons, Prevalence and Implications for Practice Reported cases of (sexual) abuse in institutions as well as the results of surveys show that violence against children and adolescents, but also against adults, occurs also in medical institutions. There are still few studies on the frequency of these cases. However, the cases that have come to public attention show that medical institutions bear systemic risk factors for such assaults. On the other hand, medical institutions also play an important role in child protection, since many children and adolescents affected by maltreatment including sexual abuse come into contact with the medical system. It is necessary that medical institutions deal with this problem and develop respective institutional protection concepts. A protection concept is a system of measures that ensure better protection against assaults within an organisation. Important steps are analysis of risk factors, structural changes, the creation of plan of procedures and the development of an institutional attitude that assaults are not tolerated. Although the development of protection concepts takes time and resources, it has many advantages for institutions, such as an increased sense of security for professionals, because they know how to proceed in such situation. Now that the obligation to draw up protection concepts is anchored in the quality management guideline of the Federal Joint Committee (G-BA), all hospitals and practices must set out to develop appropriate concepts.


Asunto(s)
Maltrato a los Niños/prevención & control , Maltrato a los Niños/estadística & datos numéricos , Instituciones de Salud , Violencia/prevención & control , Violencia/estadística & datos numéricos , Adolescente , Adulto , Niño , Abuso Sexual Infantil/prevención & control , Abuso Sexual Infantil/estadística & datos numéricos , Femenino , Humanos , Masculino , Prevalencia , Factores de Riesgo
4.
J Surg Res ; 257: 232-238, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-32862050

RESUMEN

BACKGROUND: The purpose of this study was to identify the pattern of injuries that relates to abuse and neglect in children with burn injuries. METHODS: The Nationwide Readmissions Database for 2010-2014 was queried for all patients aged less than 18 y admitted with burn injuries. The primary outcome was child maltreatment identified at the index admission. The secondary outcome was readmission for maltreatment. A subgroup analysis was performed on patients without a diagnosis of maltreatment during the index admission. Multivariable logistic regression was performed for each outcome. RESULTS: There were 57,939 admissions identified and 1960 (3.4%) involved maltreatment at the index admission. Maltreatment was associated with total body surface area burned >20% (odds ratio (OR) 2.79, P < 0.001) and burn of the lower limbs (OR 1.37, P < 0.001). Readmission for maltreatment was found in 120 (0.2%), and the strongest risk factor was maltreatment identified at the index admission (OR 5.11, P < 0.001). After excluding the patients with maltreatment identified at the index admission, 96 (0.17%) children were found to have a readmission for maltreatment that may have been present on the index admission and subsequently missed. The strongest risk factor was burn of the eye or ocular adnexa (OR 3.79, P = 0.001). CONCLUSIONS: This study demonstrates that a portion of admissions for burn injuries in children could involve maltreatment that was undiagnosed. Identifying these at-risk individuals is critical to prevention efforts.


Asunto(s)
Quemaduras/etiología , Maltrato a los Niños/diagnóstico , Niño Hospitalizado/estadística & datos numéricos , Diagnóstico Erróneo/estadística & datos numéricos , Adolescente , Quemaduras/terapia , Niño , Maltrato a los Niños/prevención & control , Maltrato a los Niños/estadística & datos numéricos , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Readmisión del Paciente/estadística & datos numéricos , Factores de Riesgo , Estados Unidos
5.
Rev Paul Pediatr ; 39: e2020267, 2020.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-33146295

RESUMEN

OBJECTIVE: Social isolation is currently identified as the best way to prevent the infection by the new coronavirus. However, for some social groups, such as children and adolescents, this measure carries a contradiction: the home, which should be the safest place for them, is also a frequent environment of a sad aggravation: domestic violence. This study aims to evaluate the notifications of interpersonal/self-inflicted violence available in the Information System for Notifiable Diseases in the State of Santa Catarina (southern Brazil), for the juvenile age group, before and during the new coronavirus pandemics. METHODS: Cross-sectional, descriptive study of violence against children and adolescents (from 0 to 19 years) notified by health professionals by completing and entering the occurrence in the Information System for Notifiable Diseases of the State of Santa Catarina in 11 weeks in which the social isolation measure was instituted as mandatory, comparing with the same period before this measure. RESULTS: During the study period, 136 municipalities in Santa Catarina made 1,851 notifications. There was a decrease of 55.3% of them in the isolation period, and the difficulties encountered in seeking protection and assistance institutions were listed. CONCLUSIONS: The society needs to be aware of possible cases of violence in the children and adolescent population. It is important to provide accessible, effective, and safe ways for complaints and notifications, as well as a quick response to the cases, aiming at protecting victims and minimizing damages to prevent the perpetuation of the violence.


Asunto(s)
Maltrato a los Niños , Bienestar del Niño , Infecciones por Coronavirus/epidemiología , Violencia Doméstica , Neumonía Viral/epidemiología , Adolescente , Salud del Adolescente/tendencias , Betacoronavirus , Brasil/epidemiología , Niño , Maltrato a los Niños/prevención & control , Maltrato a los Niños/estadística & datos numéricos , Salud del Niño/tendencias , Estudios Transversales , Recolección de Datos/métodos , Recolección de Datos/estadística & datos numéricos , Violencia Doméstica/prevención & control , Violencia Doméstica/tendencias , Femenino , Humanos , Masculino , Evaluación de Necesidades , Pandemias
8.
PLoS One ; 15(10): e0239820, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33002039

RESUMEN

BACKGROUND: Childhood maltreatment affects social functioning in the general adult population. However, how child abuse affects functional disability in adulthood remains unknown. Thus, we investigated the correlation between child abuse, depressive symptoms, cognitive complaints, and functional disability in adult community volunteers. METHODS: Participants (N = 556) completed the Child Abuse and Trauma Scale, Patient Health Questionnaire-9, Cognitive Complaints in Bipolar Disorder Rating Assessment, and Sheehan Disability Scale. Multiple regression analyses and structural equation modeling were performed to evaluate scale correlations. RESULTS: Structural equation modeling showed that the direct effect of childhood maltreatment on depressive symptoms, the indirect effect of childhood maltreatment on cognitive function via depressive symptoms, and the indirect effects of childhood maltreatment on functional disability via depressive symptoms and via cognitive function were all significant. The direct effects of childhood maltreatment on cognitive function and functional disability were not significant. There was no significant association between variables. LIMITATIONS: Cross-sectional designs cannot identify causal relationships between parameters. Participants were adult volunteers from the community; therefore, results may not be generalizable to individuals with psychiatric disorders. Sociodemographic variability was a limitation because we used self-reported childhood maltreatment. CONCLUSIONS: Childhood maltreatment indirectly affects functional disability via depressive symptoms and via cognitive function through depressive symptoms. We suggest that depressive symptoms and cognitive function play crucial roles in the influence of childhood maltreatment on functional disability in adult community volunteers.


Asunto(s)
Maltrato a los Niños/estadística & datos numéricos , Depresión/epidemiología , Adolescente , Adulto , Niño , Maltrato a los Niños/psicología , Cognición , Depresión/etiología , Femenino , Humanos , Masculino , Persona de Mediana Edad
10.
Niger J Clin Pract ; 23(10): 1356-1367, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-33047691

RESUMEN

Background: Neglectful feeding and physical activity (PA) practices by parents are associated with development of adulthood obesity. The Arab world has reported an alarming increase of adulthood obesity and childhood neglect by parents, yet have not studied the association between the two variables. Aims: The objectives of this study were to evaluate two parental negligence parameters (feeding style and social activity) associated with adulthood obesity and to identify the level of parental negligence on a customized parent neglect scale. Methods: In total 450 adult subjects 18-30 were screened for body mass index (BMI) values. 240 subjects fulfilling the criteria for the study were divided into two groups normal weight (N Gp) (n = 150) and overweight/obese (Ov/Ob Gp) (n = 90) groups. A questionnaire was formulated through a dual moderator focus group discussion, which was then tested in a prepilot and a pilot study (qualitative) to determine its validity (content and criterion) and reliability (repeated measurement) before distributing to the parents of both groups. Physical activity and screen time were also recorded for the subjects and their parents. Chi square test for association/difference between two categorical variables and Pearsons correlation coefficient for BMI correlation were employed. Results: Parenting parameters like maternal age, consanguineous marriage, breastfeeding duration, formula food introduction, and maternal smoking were significantly different between studied groups. Higher physical inactivity was observed among parents (father/mother 53%) and subjects (80%). The higher amount of screen time (73% ≥ 60-100 h/week) was found in the Ov/Ob Gp that significantly differed with the other group. Maternal BMI was positively related to the subjects BMI. Parents of obese subjects were found negligent in feeding style and very negligent for social activity on a parent neglect scale as compared to the parents of the normal weight subjects. Conclusion: Parents are responsible for developing healthy eating habits and competitive social behavior among their children. Parents need to practice the same to influence changes in their children during their early childhood, as well as when their children grow into adults. Negligent parenting in the studied parameters were found to increase the risk of developing adulthood obesity and should be considered as a potential marker for adult obesity.


Asunto(s)
Maltrato a los Niños/estadística & datos numéricos , Ejercicio Físico , Responsabilidad Parental/psicología , Padres/psicología , Conducta Social , Adolescente , Adulto , Índice de Masa Corporal , Lactancia Materna , Niño , Maltrato a los Niños/etnología , Preescolar , Dieta Saludable , Conducta Alimentaria , Femenino , Humanos , Masculino , Madres/psicología , Obesidad/epidemiología , Sobrepeso/epidemiología , Encuestas y Cuestionarios , Adulto Joven
11.
BMJ Open ; 10(9): e042867, 2020 09 29.
Artículo en Inglés | MEDLINE | ID: mdl-32994262

RESUMEN

OBJECTIVES: To determine any change in referral patterns and outcomes in children (0-18) referred for child protection medical examination (CPME) during the COVID-19 pandemic compared with previous years. DESIGN: Retrospective observational study, analysing routinely collected clinical data from CPME reports in a rapid response to the pandemic lockdown. SETTING: Birmingham Community Healthcare NHS Trust, which provides all routine CPME for Birmingham, England, population 1.1 million including 288 000 children. PARTICIPANTS: Children aged under 18 years attending CPME during an 18-week period from late February to late June during the years 2018-2020. MAIN OUTCOME MEASURES: Numbers of referrals, source of disclosure and outcomes from CPME. RESULTS: There were 78 CPME referrals in 2018, 75 in 2019 and 47 in 2020, this was a 39.7% (95% CI 12.4% to 59.0%) reduction in referrals from 2018 to 2020, and a 37.3% (95% CI 8.6% to 57.4%) reduction from 2019 to 2020. There were fewer CPME referrals initiated by school staff in 2020, 12 (26%) compared with 36 (47%) and 38 (52%) in 2018 and 2019, respectively. In all years 75.9% of children were known to social care prior to CPME, and 94% of CPME concluded that there were significant safeguarding concerns. CONCLUSIONS: School closure due to COVID-19 may have harmed children as child abuse has remained hidden. There needs to be either mandatory attendance at schools in future or viable alternatives found. There may be a significant increase in safeguarding referrals when schools fully reopen as children disclose the abuse they have experienced at home.


Asunto(s)
Maltrato a los Niños , Servicios de Protección Infantil , Bienestar del Niño , Control de Enfermedades Transmisibles , Infecciones por Coronavirus , Pandemias , Neumonía Viral , Servicios de Salud Escolar/estadística & datos numéricos , Betacoronavirus , Niño , Maltrato a los Niños/prevención & control , Maltrato a los Niños/psicología , Maltrato a los Niños/estadística & datos numéricos , Servicios de Protección Infantil/métodos , Servicios de Protección Infantil/estadística & datos numéricos , Bienestar del Niño/estadística & datos numéricos , Bienestar del Niño/tendencias , Control de Enfermedades Transmisibles/métodos , Control de Enfermedades Transmisibles/estadística & datos numéricos , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/psicología , Femenino , Humanos , Masculino , Pandemias/prevención & control , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Neumonía Viral/psicología , Población , Aislamiento Social , Servicio Social/métodos , Servicio Social/estadística & datos numéricos , Reino Unido/epidemiología
12.
Pediatrics ; 146(4)2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32943535

RESUMEN

Potential long-lasting adverse effects of child maltreatment have been widely reported, although little is known about the distinctive long-term impact of differing types of maltreatment. Our objective for this special article is to integrate findings from the Mater-University of Queensland Study of Pregnancy, a longitudinal prenatal cohort study spanning 2 decades. We compare and contrast the associations of specific types of maltreatment with long-term cognitive, psychological, addiction, sexual health, and physical health outcomes assessed in up to 5200 offspring at 14 and/or 21 years of age. Overall, psychological maltreatment (emotional abuse and/or neglect) was associated with the greatest number of adverse outcomes in almost all areas of assessment. Sexual abuse was associated with early sexual debut and youth pregnancy, attention problems, posttraumatic stress disorder symptoms, and depression, although associations were not specific for sexual abuse. Physical abuse was associated with externalizing behavior problems, delinquency, and drug abuse. Neglect, but not emotional abuse, was associated with having multiple sexual partners, cannabis abuse and/or dependence, and experiencing visual hallucinations. Emotional abuse, but not neglect, revealed increased odds for psychosis, injecting-drug use, experiencing harassment later in life, pregnancy miscarriage, and reporting asthma symptoms. Significant cognitive delays and educational failure were seen for both abuse and neglect during adolescence and adulthood. In conclusion, child maltreatment, particularly emotional abuse and neglect, is associated with a wide range of long-term adverse health and developmental outcomes. A renewed focus on prevention and early intervention strategies, especially related to psychological maltreatment, will be required to address these challenges in the future.


Asunto(s)
Maltrato a los Niños/psicología , Maltrato a los Niños/estadística & datos numéricos , Adolescente , Conducta del Adolescente , Asma/epidemiología , Déficit de la Atención y Trastornos de Conducta Disruptiva/epidemiología , Australia/epidemiología , Estatura , Niño , Cognición , Estudios de Cohortes , Grasas de la Dieta/administración & dosificación , Escolaridad , Femenino , Humanos , Inteligencia , Estudios Longitudinales , Trastornos Mentales/epidemiología , Embarazo , Embarazo en Adolescencia/estadística & datos numéricos , Calidad de Vida , Conducta Sexual , Trastornos del Sueño-Vigilia/epidemiología , Abandono Escolar/estadística & datos numéricos , Desempleo/estadística & datos numéricos , Adulto Joven
13.
Rev Med Suisse ; 16(701): 1459-1461, 2020 Aug 05.
Artículo en Francés | MEDLINE | ID: mdl-32833369

RESUMEN

During the semi-confinement period linked to the COVID-19 pandemic, the CHUV's Child Abuse and Neglect Team observed a decrease in cases of child abuse. Has confinement made it easier for families to avoid violence or, on the contrary, to hide it? Within the framework of this second hypothesis, we propose that the relaxation of the measures be an opportunity for professionals to explore in families the possible occurrence of domestic abuse.


Asunto(s)
Maltrato a los Niños/estadística & datos numéricos , Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Niño , Humanos , Pandemias
14.
J Fr Ophtalmol ; 43(8): 774-778, 2020 Oct.
Artículo en Francés | MEDLINE | ID: mdl-32800414

RESUMEN

INTRODUCTION: In an environment where strabismus is poorly understood and management centers rare, we studied the epidemiological, clinical and therapeutic aspects of neglected childhood strabismus. MATERIALS AND METHODS: This was a retrospective study carried out from March 1st, 2013 to September 30, 2018. Neglected childhood strabismus was defined as strabismus occurring in the first 5 years of life, for which the patient was over 7-years-old at the time of first consultation. The variables studied were age at first consultation, gender, age of onset, type of strabismus, etiology of strabismus, angle of deviation and rate of surgery. RESULTS: We found 113 cases of neglected childhood strabismus among the 430 cases of strabismus seen during the study period. There were more females (n=64) than males. The mean age was 17.7±10.5 years. There were 73 exotropias (64.6 %). The mean angle of deviation was 41.2±12.2PD. Strabismus was early in 70.8 % of cases. Innervational strabismus accounted for 86.7 % of cases. The most frequent refractive error was hyperopic astigmatism (55.3 %). Of the 45 patients who were seen again after full-time wear of their full cycloplegic correction, 2 were orthotropic. Surgery was performed in 60.5 % of cases. The average postoperative angle of deviation was 6.6±9.4PD. CONCLUSION: Management of neglected childhood strabismus provides good results and should therefore be encouraged in order to improve the quality of life of affected patients.


Asunto(s)
Diagnóstico Tardío , Estrabismo/diagnóstico , Estrabismo/epidemiología , Estrabismo/terapia , Adolescente , Adulto , Edad de Inicio , Niño , Maltrato a los Niños/estadística & datos numéricos , Estudios Transversales , Diagnóstico Tardío/estadística & datos numéricos , Esotropía/diagnóstico , Esotropía/epidemiología , Esotropía/terapia , Exotropía/diagnóstico , Exotropía/epidemiología , Exotropía/terapia , Femenino , Humanos , Perdida de Seguimiento , Masculino , Procedimientos Quirúrgicos Oftalmológicos/estadística & datos numéricos , Calidad de Vida , Estudios Retrospectivos , Adulto Joven
16.
J Psychol ; 154(7): 467-486, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32730724

RESUMEN

Violence against children is a major public health concern and involves significant consequences. However, compared to research on the impact of violence on children, far less is known about the perpetrators of violence against children. The present study aimed to evaluate the psychosocial characteristics and motives of perpetrators of filicide in order to identify their psychosocial profile. Our study analyzed 50 perpetrators of filicides committed in the province of Quebec between 1997 and 2012. Data was obtained from the Office of the Chief Coroner of Quebec, and additional information were retrieved from newspapers. Descriptive analyzes identified the sociodemographic, criminological, psychological-psychiatric characteristics and the motivations of these men. The results indicate that male perpetrators of filicide are, on average, 34.8 years old (SD = 11.9), 46% between the ages of 18 and 35, 48% between the ages of 36 and 55, and 4% are 56 years of age and over. Most filicides were committed following a marital separation (34%), the victims were between 0 and 5 years old (78%) and they were killed with bare hands (78%). Half of the perpetrators of filicide had a criminal record (42%) or history of domestic violence (50%). Some of these men had traits or borderline personality disorder (32%) and depressive symptoms (24%). The addition of clinical cases expands our understanding of the different profiles of perpetrators of filicide. Our study provides avenues for intervention and to promote a better prevention of this type of homicide.


Asunto(s)
Maltrato a los Niños/psicología , Maltrato a los Niños/estadística & datos numéricos , Homicidio/psicología , Homicidio/estadística & datos numéricos , Trastornos Mentales/epidemiología , Trastornos Mentales/psicología , Motivación , Adolescente , Adulto , Maltrato a los Niños/prevención & control , Preescolar , Femenino , Homicidio/prevención & control , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Quebec/epidemiología , Adulto Joven
17.
Rev Bras Epidemiol ; 23 Suppl 1: e200003.SUPL.1, 2020.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-32638985

RESUMEN

OBJECTIVE: To describe the factors associated with domestic violence against Brazilian adolescents. METHODOLOGY: Descriptive analysis of the variables and calculation of the prevalence of intrafamily violence reported by the students was performed, followed by multinomial regression with calculation of the adjusted odds ratio to analyze the association between the variables and the outcome investigated. RESULTS: Black skin color (ORa = 1.9; 95%CI 1.4 - 2.7) and brown (ORa = 1.4; 95%CI 1.0 - 1.9), insomnia (ORa = 1.8; 95%CI 1.4 - 2.4), bullying (ORa = 2.5; 95%CI 1.7 - 3.7) and alcohol consumption (ORa = 1.5; 95%CI 1.1 - 1.9) increased the chances of adolescents suffering an episode of intrafamily violence. Bullying (ORa = 3.9; 95%CI 2.8 - 5.3) and alcohol consumption (ORa = 2.2; 95%CI 1.7 - 2.7) contributed up to 4 times more not to suffer more than one episode of domestic violence. Habits such as eating with family (ORa = 0.7; 95%CI 0.5 - 1.0) and having parents who understand their problems (ORa = 0.6; 95%CI 0.5 - 0,7) proved to be protective factors for intrafamily violence. CONCLUSION: Intrafamily violence against adolescents is related to family interactions, psychoactive substance use and violence in the school environment. Thus, it reveals the importance of the participation of parents and guardians in the prevention of violence and risk behaviors in the lives of Brazilian adolescents.


Asunto(s)
Maltrato a los Niños/estadística & datos numéricos , Adolescente , Consumo de Bebidas Alcohólicas/epidemiología , Brasil/epidemiología , Acoso Escolar/estadística & datos numéricos , Humanos , Relaciones Padres-Hijo , Factores Protectores , Factores de Riesgo , Estudiantes/estadística & datos numéricos
18.
BMC Psychiatry ; 20(1): 332, 2020 06 24.
Artículo en Inglés | MEDLINE | ID: mdl-32580785

RESUMEN

BACKGROUND: Borderline personality disorder (BPD) is caused by a variety of biological and environmental factors. Accumulating evidence suggests that childhood maltreatment is a risk environmental factor in the development of BPD, but research on the genetic pathology of BPD is still in its early stages, and very little is known about the oxytocin receptor (OXTR) gene. The purpose of this study is to further explore the interactive effects between OXTR gene polymorphisms and childhood maltreatment on BPD risk. METHODS: Among the 1804 Chinese Han male inmates, 765 inmates who had BPD or antisocial personality disorder (ASPD) or highly impulsive or violent crime were considered as high-risk inmates and included in this study. Childhood maltreatment, BPD, antisocial personality disorder (ASPD) and impulsivity were measured by self-reported questionnaires. Peripheral venous blood was collected for the genotype test. RESULTS: Analyses revealed that the BP group (inmates with BPD features) had higher rs53576 AA genotype frequency and rs237987 AA genotype frequency than the non-BP group, while the statistical significances were lost after Bonferroni correction. Total childhood maltreatment score, emotional abuse and neglect could positively predict BPD risk. Among the high-risk samples, rs53576 GG genotype carriers had higher BPD scores at higher levels of physical abuse and sexual abuse and had lower BPD scores at lower levels of physical abuse and sexual abuse. CONCLUSIONS: The findings suggest that the interaction between OXTR gene variations and childhood maltreatment is an important mechanism for the development of BPD. The moderating role of the OXTR gene provides evidence for gene plasticity.


Asunto(s)
Trastorno de Personalidad Limítrofe/epidemiología , Trastorno de Personalidad Limítrofe/genética , Maltrato a los Niños/estadística & datos numéricos , Prisioneros/psicología , Prisioneros/estadística & datos numéricos , Receptores de Oxitocina/genética , Adulto , Niño , Maltrato a los Niños/psicología , China/epidemiología , Humanos , Masculino , Polimorfismo Genético
19.
J Pediatr ; 222: 35-44.e1, 2020 07.
Artículo en Inglés | MEDLINE | ID: mdl-32418814

RESUMEN

OBJECTIVE: To assess factors impacting child-welfare involvement and child abuse and neglect outcomes among prenatally substance-exposed infants. STUDY DESIGN: This was a retrospective review of case registry data regarding substance-exposed infants tracked statewide in Delaware from 2014 to 2018. Differences in maternal, infant, and substance exposure factors by level of child-welfare involvement (screened-in vs screened-out case status) and child abuse and neglect outcomes were examined. Screened-in status was defined as case acceptance for investigation, family assessment, or treatment referral. Using logistic regression, associations between factors and screened-in status and between factors and child abuse and neglect outcomes were assessed. Cases involving child abuse and neglect were analyzed qualitatively. RESULTS: Among 1222 substance-exposed infants, 70% were screened-in by child welfare for ongoing involvement; 28 (2.3%) of substance-exposed infants were identified as child abuse and neglect victims sustaining serious physical or fatal injury before 1 year of age. Most substance-exposed infants remained with caregivers; few entered foster care. Polysubstance exposure and maternal mental health condition were factors associated with screened-in status. Neither substance exposure type nor maternal mental health condition reliably predicted future child abuse and neglect. CONCLUSIONS: Substance-exposed infants had a significant risk for child abuse and neglect. Although maternal and substance exposure factors were associated with screened-in case status, they unreliably predicted future risk of child abuse and neglect.


Asunto(s)
Maltrato a los Niños/estadística & datos numéricos , Bienestar del Lactante/estadística & datos numéricos , Complicaciones del Embarazo , Efectos Tardíos de la Exposición Prenatal/epidemiología , Efectos Tardíos de la Exposición Prenatal/etiología , Trastornos Relacionados con Sustancias , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Embarazo , Estudios Retrospectivos , Factores de Riesgo
20.
BMC Public Health ; 20(1): 657, 2020 May 12.
Artículo en Inglés | MEDLINE | ID: mdl-32397975

RESUMEN

BACKGROUND: Adverse Childhood Experiences (ACEs) such as abuse, neglect or household adversity may have a range of serious negative impacts. There is a need to understand what interventions are effective to improve outcomes for people who have experienced ACEs. METHODS: Systematic review of systematic reviews. We searched 18 database sources from 2007 to 2018 for systematic reviews of effectiveness data on people who experienced ACEs aged 3-18, on any intervention and any outcome except incidence of ACEs. We included reviews with a summary quality score (AMSTAR) of 5.5 or above. RESULTS: Twenty-five reviews were included. Most reviews focus on psychological interventions and mental health outcomes. The strongest evidence is for cognitive-behavioural therapy for people exposed to abuse. For other interventions - including psychological therapies, parent training, and broader support interventions - the findings overall are inconclusive, although there are some positive results. CONCLUSIONS: There are significant gaps in the evidence on interventions for ACEs. Most approaches focus on mitigating individual psychological harms, and do not address the social pathways which may mediate the negative impacts of ACEs. Many negative impacts of ACEs (e.g. on health behaviours, social relationships and life circumstances) have also not been widely addressed by intervention studies.


Asunto(s)
Experiencias Adversas de la Infancia/estadística & datos numéricos , Maltrato a los Niños/psicología , Maltrato a los Niños/terapia , Resiliencia Psicológica , Sobrevivientes/psicología , Sobrevivientes/estadística & datos numéricos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Maltrato a los Niños/estadística & datos numéricos , Preescolar , Femenino , Humanos , Masculino , Persona de Mediana Edad
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