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PubMed2002

Exploring psychological abuse in childhood: I. Developing a new interview scale.

Definitions of psychological abuse are reviewed and a new definition proposed, operationalized as an extension of an existing measure of childhood, the Childhood Experience of Care and Abuse (CECA). This semistructured, investigator-based interview is designed for use with adults to collect retrospective accounts of childhood adverse experience. The CECA extension identifies nine subtypes of psychological abuse, with a single global severity rating. The definition is clearly differentiated from other adverse experiences with emotionally abusive elements such as parental antipathy (hostile parenting), neglect, and role reversal. Examples are given. A community-based series of 301 women were interviewed using the extended CECA to gather a range of experiences of childhood maltreatment on which to devise the new measure. Interrater reliability was satisfactory, and several features of psychological abuse were examined, including its prevalence, frequency, and the characteristics of the abused child and perpetrator. The new scale is discussed in terms of its potential use not only by researchers but also by practitioners such as clinicians and social workers in the child protection field in order to more accurately identify and assess multiples of abuse in childhood. A companion article (Bifulco, Moran, Baines, Bunn, & Stanford, 2002) examines the relationship of psychological abuse to adult major depression.

Child↗

PubMed1992

How to deal with sexual acting-out on the child psychiatric inpatient ward.

1. Although the management of sexually abused children is not new, a comprehensive approach is often lacking, especially as it pertains to dealing with sexually acting-out children. 2. In addition to the usual social work measures of child protection, a program of developmentally and psychoeducationally based interventions supplemented by behavioral techniques were found to be most effective. 3. Acting-out children often provoke reactions of rage, betrayal, and impotence among the staff. Discussions of interventions must take into account the staff's own philosophy about how sexuality should be taught to these children. 4. The treatment team leader must decide whether the sexual acting-out among children is due to active solicitation from sexually abused children, delinquent acting-out, or age-appropriate exploration.

Acting Out↗

PubMedDate not supplied

Stages of change in physical exercise: a test of stage discrimination and nonlinearity.

OBJECTIVES: To investigate the utility of the protection motivation theory (PMT), social-cognitive theory (SCT) and transtheoretical model's (TTM) processes of change (POC) by (1) discriminating between TTM's stages with planned comparisons and (2) examining higher-ordered trends across stages. METHODS: 1582 individuals were included in the analyses that tested severity, vulnerability, response-efficacy, self-efficacy, POC, pros and cons, social and environmental support. RESULTS: The findings provide evidence for the utility of the PMT and TTM's POC for stage discrimination; stage discontinuity patterns are supported. CONCLUSIONS: Promotion of health behavior should target stage-specific variables, such as threat appraisals for early stage movements.

Adult↗

PubMed1999

Ethics of assisted suicide and euthanasia.

Nursing's social contract includes respecting and protecting human life. Issues surrounding assisted suicide challenge these ethics, not to mention the legal system.

American Nurses' Association↗

PubMed2002

Circumcision in boys: time for doctors to reconsider.

The Convention of the Rights of the Child from 1989 states in Article 19 that States "shall take all appropriate legislative, administrative, social and educational measures to protect the child from all forms of physical or mental violation, injury or abuse..." Article 24.3 urges all States "to take all effective and appropriate measures with a view to abolishing traditional practices prejudical to the health of children". Article 37 states that "no child shall be subjected to torture or other cruel, inhuman or degrading treatment...". In the UNICEF Implementation Handbook for the Convention (1998) it is stated in relation to Article 24.3 that a review is to be undertaken regarding "all forms of genital mutilation and circumcision". Other traditional practices which are to be reviewed include "binding, scarring, burning, branding, forced holding under water..." and similar cruel treatment of children. No doubt it is time to act! Apparently no such action has been taken and the Convention is not applied in any country as regards circumcision of boys--let alone regarding mutilation of girls (which is done by the hundreds of thousands every year).

Child↗

PubMed2002

[World report on violence and health].

In 1996, the World Health Assembly declared violence a major public health issue. To follow up on this resolution, on October 3 this year, WHO released the first World Report on Violence and Health. The report analyses different types of violence including child abuse and neglect, youth violence, intimate partner violence, sexual violence, elder abuse, self-directed violence, and collective violence. For all these types of violence, the report explores the magnitude of the health and social effects, the risk and protective factors, and the types of prevention efforts that have been initiated. The launch of the report will be followed by a 1-year Global Campaign on Violence Prevention, focusing on implementation of the recommendations. This article summarises some of the main points of the world report.

Humans↗

PubMedDate not supplied

[Standards of health services at child day care centers].

The number of homeless children has been growing due to an unfavorable social-and-economic situation. The establishment of specialized facilities of a new type, i.e. orphanages, has been underway to cope with the above social problem. Advancing of health protection in orphanages is based on the organizational, procedural and qualitative standards of medical care.

Child↗

PubMed2006

Suicide in farmers in Scotland.

INTRODUCTION: Farmers and farm workers have higher than expected rates of suicide and undetermined deaths in UK studies, and some rural areas of Scotland have higher than average male suicide rates. Firearm access seems to be an influencing factor in England and Wales. Type of farming, and farming social networks may also be important. This article describes suicide and undetermined deaths in male farmers and farm workers in Scotland from 1981-1999 using anonymised, routine data. METHOD: Deaths of men aged 15-74 years from suicide or undetermined cause were identified from anonymised Scottish death records. Farmers and farm workers were identified using occupation codes. Methods of suicide used by farmers were compared with those of the general male population of the same age. A multiple linear regression was used to examine the influence of farm type, and the proportion of farmers in the working population of an area. RESULTS: 307 male farmers or farm workers died by suicide or undetermined cause in the time period. The overall rate was 31.4/100,000 per year (95% CI 28.1-35.1). Deaths using firearms were over-represented (29% of farming deaths compared with 3.6% in the general male population). There was no significant association between the male suicide rate in an area, and the farming suicide rate. Areas with lower proportions of farmers tended to have higher rates of farming suicide and undetermined deaths. This one factor described 85% of the variance among areas. CONCLUSION: Deaths were substantially more likely to involve firearms than suicide and undetermined deaths in the general male population. Less use of other methods did not completely compensate for this, indicating that method availability is likely to contribute to farming suicide rates. Farmers in areas where farming is less common were more likely to die by suicide, and this described most of the differences among areas. Networks and social supports may be important protective factors for farmers.

Accidental Falls↗

PubMed2006

Child slavery in Hong Kong: case report and historical review.

An 11-year-old girl was admitted with multiple injuries sustained during a 1-year servitude of domestic labour. She was acquired from her parents in Mainland China by a relative in Hong Kong. The child's parents received a sum of money that the child had to repay with work. Her hardship was characterised by long hours of incessant labour and physical torture when she failed to meet the demands of her mistress or her mistress' children. This case resembles Mui Tsai, a form of child slavery and exploitative domestic labour that was rife in Hong Kong a century ago, and illustrates the new challenges to child rights and protection consequent to the increasing social and economic integration between the Hong Kong Special Administrative Region and Mainland China.

Child↗

PubMed1991

[Suicidal behavior as a socio-hygienic problem].

An assessment of changes in the incidence of suicides is provided. An analysis is made of age- and sex-related features, motivation, methods, the level of alcohol intoxication at the moment of autoaggression; the extent of impact is determined which suicide and autoaggression make on the main economic-demographic indices. It has been found that the established level of suicidal actions incidence influences the main economical and demographic indices. Positive changes occurring recently in the life of society, the realization of measures to combat hard drinking and alcoholism resulted in the reduction of suicide incidence. However, despite the decrease in suicide incidence the proportion of persons among suicides who resorted to the act of autoaggression during alcohol intoxication remains practically at the same level. Suicidal behavior leading to the tragic outcome should be considered as a socio-hygienic problem as it is caused by lifestyle, insufficient social and medico-psychological protection, close association with alcohol abuse and has a considerable impact on the medico-demographic indices characterizing the state of population's health.

Adult↗

PubMed1989

On research on HIV infection and AIDS in correctional institutions.

AIDS presents unique problems and opportunities in jails and prisons for epidemiological research on HIV infection and its sequelae. If correctional institutions constrain inmates' access to social benefits, means exist to protect incarcerated people's rights in health studies. A reading of federal regulations indicates that research involving prisoners should be subject to scrutiny by an institutional review board (IRB); inmates participating in IRB-approved clinical trials on AIDS-related drugs should not receive placebos alone, moreover, given that some medications are partially effective against the syndrome. As in other domains of public health and public policy, HIV infection and AIDS in prisons compel new perspectives on justice and equity.

Acquired Immunodeficiency Syndrome↗

PubMed1989

Cigarette smoking and ulcerative colitis. A case control study.

In order to examine the relationship between cigarette smoking and ulcerative colitis (UC), we carried out a case-control study of smoking habits in 84 patients with UC and in two different types of controls: 84 taken from a hospital population and 84 from the general population, matched to the cases for age, sex, school education and social class. Non-smokers were found to have a greater UC risk than smokers in both internal controls (Odds ratio = 4.6, 95% CL = 1.8-11.7) and external controls (OR = 10, 95% CL = 3.6-26.9). There was a larger number of ex-smokers among patients with UC than among the controls. Evaluations at the time of disease onset also demonstrated that ex-smokers had a greater relative risk. Furthermore, 84% of the ex-smoker patients had stopped smoking before the onset of symptoms. Conditional multiple logistic regression with the introduction of alcohol (wine) and coffee as additional variable factors to age, sex, education and social class confirmed the independent protective effect of smoking on UC (OR for internal controls = 4.2, 95% CL = 1.7-10.2, OR for external controls = 5.7, 95% CL = 2.3-14.1). These results indicate that non-smokers and especially ex-smokers of cigarettes have a greater risk of UC, and thus confirm the results of other studies.

Adolescent↗

PubMed1985

Quantification of urethral closure function by SUI threshold after pubococcygeal sling operation.

Thirty-one female patients were investigated 4.8 +/- 2.5 years after pubococcygeal repair for stress urinary incontinence (SUI). Eighteen patients had a successful operation with total cure or marked improvement and 13 had a failed operation. The results of the operation were further evaluated clinically by detailed patient history and urodynamically by urethrocystometry (UCM). The severity of the SUI symptoms was evaluated by recording the physical stress causing incontinence, restrictions of daily activities and social life and use of protective pads. The symptoms were graded by the SUI score ranging from 0 to 10. The bladder pressure rise necessary for urinary leakage during coughing (The SUI threshold) was measured by UCM. The mean SUI score was 2.2 +/- 1.0 and 6.9 +/- 4.8 after successful and failed operations, respectively and the SUI threshold was 85 cm H2O and 57.5 cm H2O after successful and failed operations, respectively. The SUI threshold had a significant negative correlation with the SUI score. It is suggested that the SUI threshold is a valuable addition to UCM determining objectively the results of incontinence surgery. It should be measured each time an UCM is performed.

Aged↗

PubMed1994

Psychological consequences of battering. Implications for women's health and medical practice.

Battering means more than just physical assault. It means pain and injury from physical assault plus continuous psychological degradation, sustained fear, diminished power and control, and loss of identity and self-esteem. Women often feel trapped in violent relationships because of their partners' threats to kill them if they leave, and because police, medical, and social services systems often inadequately protect and help them. Battering is best understood as a continuous traumatic experience and, like many other forms of trauma, it takes a considerable psychological toll on its victims. Battered women are at risk for chronic physical and psychological health problems including PTSD, depression, chronic pain, and substance abuse. The high prevalence of battering, and its psychological and physical consequences, means that battered women present with a multitude of acute and chronic symptoms and are not easily identified. The most practical and effective way to identify battering is to routinely ask all women patients about it. Identification gives physicians a way to understand complex and confusing symptoms and an opportunity to help battered women undertake the difficult and dangerous process of leaving abusive partners. In addition, doctors, in collaboration with battered women patients and other professionals, can help develop comprehensive plans to reduce this complex public health problem.

Adaptation, Psychological↗

PubMedDate not supplied

[Anniversaries of the Serbian Medical Society. 1947. 75 years since the founding of the Society].

During the Second World War the country was again occupied by the enemy, and the Allies were liberating it--but it was bombarded by both! Graves and tombs covered the country once again--once again Serbian people had to suffer the greatest possible sacrifies as an ally with the progressive part of the world. Serbian medical association (SMA) had to restrain its activities once again in 1941 and share the fate of its people. Since the country was occupied the University of Belgrade and Medical school were closed. SMA restored its activities in 1946 and since then it turned to creating a new organization--establishing local branches and specialist groups all over the country. The Association initiated activities on improving professional skills of its members in order to fulfil its goals: solving the most important health care problems "which have flooded the country after the occupation of the country and plight of the people". As soon as the first post-war conference in the Autumn of 1946 took place, the Association brought resolutions concerning the "question of tuberculosis, question of paediatrics and question of dentistry in attempts to protect the people from the social disaster (tuberculosis)" and to deal adequately with the problem of health care of the young, as the most important task of the health care policy," and also to establish a "University School of Dentistry as soon as possible, in order to provide a sufficient number of dentists". The established tasks are being fulfilled, local branches and specialist groups are formed, thanks to commitment of the members of the SMA board, and above all because of the "hearty response of the Medical school colleagues--to go to all parts of the country"--as it was stated in the annals of the SMA. Engaged entirely in organizing its activities and professional improvement of its members, the SMA was most widely involved in dealing with basic problems of health care of the population. Therefore, the 75th Jubilee of the SMA is a crucial part of its history and a period of great success in creating a health-care system which brought our country among the most advanced in the world, regarding the accessibility of health care to the population!

History, 20th Century↗

PubMed2006

The social shaping of childhood vaccination practice in rural and urban Gambia.

Improving childhood vaccination coverage is a key health policy objective in Africa, and as availability increases, it will depend on addressing issues of demand and timely schedule completion. This paper explores vaccination demand in urban and rural areas of The Gambia as shaped by prevailing local vaccination cultures (comprising maternal knowledge and understandings, socio-cultural contexts and interactions with health providers). A survey of 1,600 mothers constructed on the basis of prior ethnography finds a high level of social demand for vaccination, based on lay theories of the general value of immunization in complementing traditional child protection practices. For most rural mothers, strong social networks encourage routine clinic attendance and vaccination 'default' arises only through day-to-day problems and contingencies. However, more pervasive patterns of schedule non-completion are found amongst poorer urban mothers, including recent immigrants, who experience social exclusion at infant welfare clinics. These findings point to the need for health education dialogue grounded in mothers' own understandings and for particular policy attention to improving the clinic experiences of vulnerable social groups in rapidly expanding urban areas.

Data Collection↗

PubMed2005

Psychosocial predictors of cannabis use in adolescents at risk.

This research has tested a social disintegration model in conjunction with risk and protection factors that have the power to differentiate relative, weighted interactions among variables in different socially disintegrated groups. The model was tested in a cross-sectional sample of 1082 at-risk youth in Switzerland. Structural equation analyses show significant differences between the social disintegration (low, moderate, high) groups and gender, indicating that the model works differently for groups and for gender. For the highly disintegrated adolescents results clearly show that the risk factors (negative mood, peer network, delinquency) are more important than the protective factors (family relations, secure sense of self). Family relations lose all protective value against negative peer influence, but personal variables, such as secure self, gain protective power.

Adolescent↗

PubMedDate not supplied

Presidential Address-1976. Social support as a moderator of life stress.

Social support is defined as information leading the subject to believe that he is cared for and loved, esteemed, and a member of a network of mutual obligations. The evidence that supportive interactions among people are protective against the health consequences of life stress is reviewed. It appears that social support can protect people in crisis from a wide variety of pathological states: from low birth weight to death, from arthritis through tuberculosis to depression, alcoholism, and the social breakdown syndrome. Furthermore, social support may reduce the amount of medication required, accelerate recovery, and facilitate compliance with prescribed medical regimens.

Affective Symptoms↗