RESUMO
Hip developmental disorders are the most common musculoskeletal disease in newborns in Central Europe. The definition of hip developmental disorder includes both dysplastic and dislocated joints. In a dysplastic joint, shearing forces induce a growing disorder in the acetabulum. If this growing disorder persists, the femoral head first displaces the acetabular cartilage cranially and finally the femoral head dislocates posteriorly into the gluteal fossa - progressively losing contact to the acetabulum. Therefore nowadays there is general support for the concept of a developmental instead of a congenital dislocation of the hip. From the first day of life, the different stages of hip developmental disorder be exactly classified by an ultrasound examination of the infant hip joint according to Graf. Therefore the Graf hip ultrasound examination has been an integral part of the paediatric guidelines in Germany since 1996. All newborns must receive Graf hip ultrasound screening examination, ideally at the age of 4-5 (maximal 8) weeks as part of the U3 screening examination. Newborns with historical or clinical risk factors must receive an ultrasound examination in the first week of life, additionally to the clinical examination of the hip joints of all newborns according to the second screening examination U2. In the case of pathological results, therapy should be initiated according to measured hip type within one week. Dislocated joints need reduction and as soon as the contact between the femoral head and the acetabulum has been restored, the head should be retained securely within the acetabulum. This phase of retention is followed by the maturation phase for dislocated joints, which is also sufficient therapy for dysplastic joints. In order to avoid femoral head necrosis as an early complication or as a new hip developmental disorder in the course of further growth, the femoral head during the retention phase and the maturation phase should be placed deeply into the socket. This can be achieved by retaining hip flexion of 100-110° with simultaneous hip abduction of 50° to a maximum of 60°.
RESUMO
The use of corporal punishment (CP) is controversial despite the negative consequences of its use that have been documented. Consequences include the use of CP by those who experienced CP themselves, described in the theory of the cycle of violence. There are little data on the cycle of violence, especially on those who break it and in representative samples. This study examines the cycle of violence in a representative sample by analyzing experiences of and attitudes toward CP. Attitudes toward, and own experiences of, CP by their parents were assessed in a sample of 2,519 individuals (female 54.6%, age range = 14-99 years, M = 48.9 years). Latent class analysis (LCA) was used to identify subgroups of participants who support and oppose CP. Breaking the cycle, defined as having experienced CP and opposing CP, was examined. Factors associated with positive and negative attitudes toward CP were identified using group comparisons and binary logistic regression. The majority of the sample opposed CP (56%), whereas one third supported less severe forms of CP and 8.2% also supported severe CP. Those supporting CP reported having experienced CP by their parents more often. Of those who had experienced CP, 47% were identified as breaking the cycle. Female gender, younger age, not being divorced, and being married and living together, as well as a higher level of education were associated with breaking the cycle. Even though CP was legally banned in Germany, a relatively high proportion still reports positive attitudes toward and experiences of CP. The ban of CP by the federal government seems to be an effective measure to change attitudes on a societal level as rates were lower in comparison with earlier studies. Future studies should examine interactions between different types of CP, attitudes toward its use, and additional mediating factors.