Changing the future: experiencing adolescence in contemporary Ireland: sexual health and behaviour.

If we create the space in which children and young people can talk openly and in their own language even upon challenging subjects such as sex, then we are likely to learn more from what they tell usâ?T proposes the final UNICEF Ireland report which examines adolescent perspectives on sexual health and behaviour. Key findings in the report included: 63%, and 1 in 5 sixteen year old respondents, reported that they have had sex; 1 in 5 sexually active respondents reported that they did not use a condom the first time that they had sex; 2 in 5 girls who were sexually active reported that they had consumed alcohol before their first sexual experience, compared to 3 in 10 boys; The majority of respondents (54%) reported that they had watched pornography on the internet, and more than one third of the respondents who had watched pornography on the internet believed that it was accurate or educational; Only 1 in 5 respondents reported that they ever speak to their parents about sex. Noting â?~the broad spectrum from which young people living in Ireland draw down information about sexâ?T the UNICEF Ireland report concludes that â?~we must be sure that when a young person is making decisions about their sexual health and behaviour, every opportunity is afforded them in terms of open discussion, understanding, support, information and adviceâ?T Commenting on the Report, Amel Yucef a Youth Health Coordinator at the Base Youth Centre, Ballyfermot said â?oAs the participants in UNICEF Irelandâ?Ts survey have shown, many young people do not feel equipped with the information and support they need to make informed choices about their sexual health. Providing those supports is a priority for us at the Base.â? The Youth Health Programme, that Amel co-ordinates is a HSE funded initiative which was created to respond to the health needs of young people, as identified by the young people of the Dublin 10 area themselves. The Programme delivers community-based and youth-friendly health responses, based upon a harm-reduction model. The Youth Health Programme works towards building the capacity of young people to access health services, while also encouraging those services to deliver in an accessible and youth-friendly way.This resource was contributed by The National Documentation Centre on Drug Use.

Growing up in Ireland. Key findings: infant cohort (at 3 years).

 The latest results from the study paint a picture of how these families are faring across a range of areas in their lives including their health, family life and financial and economic circumstances. In general the findings show that three-year-olds in Ireland are in good health with a few notable public health and related issues (including overweight and obesity), there is overall stability in family structures over the short term and that the recession has had a substantial effect on families with young children over the last number of years. These are the first longitudinal findings from the study. The first wave of fieldwork with the families of the Infant Cohort included approximately 11,100 nine-month-olds, their parents and carers. Interviews began in September 2008 and were completed in March 2009. Interviews for the second round of interviews with this cohort took place between January and August 2011. A total of 90% of the original sample of nine-month-olds were successfully re-interviewed. (A full download of the results released today, presented in three briefing documents can be found by clicking here. Key findings include: Health â?¢ Most of the children were described as being in good health; 75% were rated as very healthy and a further 23% were rated as healthy, but a few minor problems. Girls were more likely to be reported as very healthy (78%) compared with boys (72%). â?¢ One in four or almost one quarter of three-year-old children were overweight (19%) or obese (6%). â?¢ Childrenâ?Ts weight was related to household social class. 5% of children in families in the professional/managerial group were classified as obese at three years of age compared with 9% of those in the most disadvantaged social class group. However, at least one-fifth of children in every social class were overweight. â?¢ Childrens consumption of energy-dense foods such as crisps, sweets, chips, and non-diet fizzy drinks increased as parental education fell. 63% of children whose mother had a lower secondary education or less ate at least one portion of crisps compared with 36% of those from degree-level backgrounds, although consumption of biscuits/chocolates was over 70% for both groups of children. â?¢ Two-thirds (66%) of three-year-olds had received at least one course of antibiotics in the 12 months preceding the interview. Children with a full medical card (35% of the sample) or a GP-only medical card (5% of the sample) were more likely to have received a course of antibiotics than â?¢ Children with a full medical card received a higher number of antibiotic courses on average (2.6) compared with those without a medical card (2.1). â?¢ Just under 16% of three-year-old children were reported as having at least one longstanding illness, condition or disability. The most commonly reported illness types included Asthma (5.8%), Eczema/Skin allergies (3.9%) and Food/digestive allergies (1.2%) Family Life and Childcare â?¢ While the overall distribution of family structure was stable, there have been transitions from one-parent families to two-parent families and vice-versa over the 27 months between interview â?" approximately 2 to 3 percent in each direction. â?¢ 50% of three year olds were in some form of non-parental childcare for eight or more hours a week. The most common form used was centre-based childcare which almost tripled between nine months and three years, from 11% to 30%. â?¢ A similar percentage of grandparents were caring for children at both nine months and three years, 12% and 11% respectively. A total of 10% of three-year-olds were being minded by a childminder, an increase of 3 percentage points from when the children were nine months of age. â?¢ Children who were in some form of non-parental childcare were spending an average of 23 hours a week in their main type of childcare. â?¢ At time of interview the vast majority of mothers reported that they had regular contact with the Study Childâ?Ts grandparents (91%). In offering support to parents, grandparents were most likely to babysit (50%), and buy clothes (40%) at least on a monthly basis. One-parent families were more likely than two-parent families to receive financial support from grandparents with just under one-third (66%) of one-parent families receiving financial support from grandparents at least once every three months. â?¢ The most frequently used discipline technique was â?~discussing or explaining why the behaviour was wrongâ?T, with 63% of mothers saying they always did this. â?¢ 12% of mothers said they used â?~smackingâ?T as a form of discipline now and again and less than 1% used â?~smackingâ?T as a form of discipline more frequently. Over half reported that they never smacked the Study Child. Financial and Economic Circumstances â?¢ Just over half (53%) of mothers of three-year-olds worked outside the home, 38% said they were on home duties and 6% said they were unemployed. â?¢ The biggest change in terms of the work status of three-year-oldsâ?T parents was an increase in the percentage of unemployed fathers â?" 6% when the child was nine months rising to almost 14% when s/he was three years of age. â?¢ 61% of families of three-year-olds reported experiencing difficulties in making â?~ends meetâ?T. This was a substantial increase from 44% in the first round of interviews when the children were nine-months-old. â?¢ Almost two thirds (63%) of all families with three-year-olds reported that the recession had had a very significant or significant effect on them. â?¢ The most frequently recorded effects were: a reduction in wages (63%); canâ?Tt afford luxuries (54%), social welfare reduction (53%) and canâ?Tt afford/cut back on basics (32%). Growing Up in Ireland is a Government funded study tracking the development of two nationally representative cohorts of children: an Infant Cohort which was interviewed initially at nine months and subsequently at three years of age; and a Child Cohort which was interviewed initially at nine years and subsequently at 13 years of age. The study is being conducted by a consortium of researchers led by the Economic and Social Research Institute (ESRI) and Trinity College Dublin. For Further Information Please Contact: Jillian Heffernan Communications Officer, Growing Up in Ireland Tel: 01 896 3378 Mobile: 087 9016880This resource was contributed to our repository by the National Documentation Centre on Drug Use.

Growing up in Ireland. Key findings: 13-year-olds. No. 2. Physical activity and obesity among 13-year-olds.

This Key Finding reports on data from the second wave of interviews with Growing Up in Ireland's Child Cohort. The 8,568 children and their families were first interviewed when the children were 9 years old, and then at age 13 years, when 7,400 were reinterviewed between August 2011 and February 2012.The findings show that boys and young people from more socially advantaged backgrounds were more likely to exercise, and that 13-year-olds who took more exercise (whether hard or light exercise) were less likely to be overweight or obese.While most of the young people in Growing Up in Ireland maintained a healthy weight over time, one in four was either overweight or obese, a finding similar to that at 9 years. Girls were also more likely to be classified as overweight or obese than boys. The majority of 13-year-olds were quite positive about their physical appearance, although a quarter rated themselves as below average in this respect, and girls tended to be less positive about their body image than boys. Dieting behaviours had also become evident at 13.To understand more fully the origins and course of overweight and obesity, the descriptive data in this Key Finding can be used in more complex analyses drawing on the rich data available on the child, family and other important contextual variables.This resource was contributed by the National Documentation Centre on Drug Use.

Rise & Shine Breakfast Club

The Rise ‘n’ Shine club was set up in January 2013. The main aims of the club are to improve attendance, increase participation in class, and reinforce healthy eating policy in pupils. The club is run each morning by a group of volunteers which includes teachers, parents and 6th class children. The Home School Community Liaison Officer co-ordinates the club. On average, 20 – 25 girls attend each morning. A selection of cereals is served each morning along with toast and fruit juice. Different foods are served for special occasions, such as pancakes on Pancake Tuesday. This club is part of the Pilot Programme of Breakfast Clubs which is funded through Kellogg's Corporate Citizenship Fund. Part of theBreakfast Clubs Pilot Programme Initiative Type Breakfast Clubs Location Dublin 5 Target Groups Children ( 4-12 years) Funding This club is part of the Pilot Programme of Breakfast Clubs which is funded through Kellogg's Corporate Citizenship Fund. Start 13th Jan 2013

WTID Nutrition and Cooking Classes

In partnership with the VEC WTID has delivered Nutrition Level 5 FETAC to a group of 24 learners, 4 being members of the Travelling community.  This module was also delivered to 5 Childcare staff at WTIDs pre-school service. Staff of the Harmony Afterschool Service undertakes baking activities each week with the children. Group work has been facilitated with 16 men who were on a BTEI on salt, sugar, caffeine and fibre, as well as with a young girls group on food tasting of various fruits, cheeses and how to make healthy potato wedges and other healthy snacks. WTID as part of the local Traveller Interagency Group are writing a well-being manual to be used with community groups working with Travellers- Healthy Eating is a module of this manual. Plans are in place to run a First Instincts Men's Health programme which will run over an 8 week period with workshops, weigh ins and provision of a healthy breakfast on each morning. HSE West; FAS CE scheme; Involve: Senior Youth Worker; Department of Children and Youth Affairs: Childcare Service; Pobal Initiative Type Community Food Centres Nutrition Education and Training Programmes Location Galway Target Groups At risk youth Children ( 4-12 years) Children (0-4 years) Children (13-18 years) Families Lone parents Men Older people People with mental health difficulties Travellers Unemployed Women Funding HSE West; FAS CE scheme; Involve: Senior Youth Worker; Department of Children and Youth Affairs: Childcare Service; Pobal Partner Agencies Equal Ireland FÁS Galway County Council GCCCC GRD HSE Involve RAPID VEC Adult Education Service

Body dissatisfaction on top of depressive mood among adolescents with severe dysmenorrhea.

OBJECTIVES: This study aims to determine whether adolescent girls with severe dysmenorrhea (SD) have different psychological characteristics from their peers. STUDY DESIGN: Cross-sectional survey (SMASH 02). SETTINGS: Nationally representative sample of adolescents attending post-mandatory education. PARTICIPANTS: N = 7548, of whom 3340 were females, aged 16-20 years. INTERVENTION: Self-administered, anonymous survey consisted of 565 items on 4 main topics: sociodemographic determinants of health, health status, health behaviors, and health care use. OUTCOMES: Body image variables, mental health, and associated variables like sexual abuse and health perceptions. Bivariate analysis and binomial logistic regression controlling for explanatory variables were performed. RESULTS: 12.4% (95% confidence interval [CI]: 11.0-14) declared SD. Compared to their peers, subjects with SD were more likely to report depressive symptoms (adjusted odds ratio [AOR]: 1.73; 95% CI: 1.38-2.15), have a higher gynecological age (AOR: 1.13; 95% CI: 1.05-1.20), and attend vocational school (AOR: 1.33; 95% CI: 1.00-1.76). Moreover, the proportion of those reporting dissatisfaction with their body appearance was higher (AOR: 1.50; 95% CI: 1.02-2.22). CONCLUSION: Patients with SD not only show a different profile from their peers in terms of their mental health academic track and gynecological age, but they are also more dissatisfied with their body appearance. Clinicians should pay particular attention to patients with SD and offer them a global evaluation, bearing in mind what factors can be associated with SD.

Secular trends in height and weight among children and adolescents of the Seychelles, 1956-2006

Background: Few data is available on long-term secular trends in height and weight in children in countries in transition. We assessed the secular trends in height and weight among representative samples of children and adolescents from the Seychelles (African region). Methods: Weight and height data from all students of all schools in four selected school grades (kindergarten, 4th, 7th and 10th years) were collected by cross-sectional surveys for periods 1998-9 (3,676 boys, 3,715 girls) and 2005-6 (4,867 boys, 4,846 girls). Data from 1956-7 was extracted from a previously published report. Results: Height increased, in boys, by 1.6 cm/decade for the period 1956-7 to 1998- 9, and 1.1 cm/decade for the period 1998-8 to 2005-6; in girls, the corresponding figures were 0.9 cm/decade and 1.8 cm/decade. At age 15.5 years, boys/girls were taller by 10/13 cm in 2005-6 than in 1956-7. Weight increased, in boys, by 1.4 kg/decade for the period 1956-7 to 1998-9, and by 2.2 kg/decade for the subsequent period; the corresponding figures in girls were 1.1 kg/decade and 2.5 kg/decade. Conclusion: Marked upward secular trends in body height and weight were documented in children and adolescents aged <16 years in the Seychelles, consistent with large changes in socio-economic and nutritional indicators in the considered 50- year interval. However, indirect evidence suggests that the secular height gain reflects accelerated growth during childhood over time with less than commensurate impact on adult height. Conversely, the largely steeper secular increase in weight than height is consistent with a pediatric obesity epidemic.

Control of urinary schistosomiasis on Zanzibar (Unguja Island): a pilot evaluation of the educational impact of the Juma na Kichocho health booklet within primary schools

To improve health education within primary schools, the health education booklet Juma na kichocho was evaluated during a study within 5 schools using key-informant questionnaires that recorded children's knowledge and attitude (KA) towards schistosomiasis before and after daily structured-use of booklets. A total of 229 schoolchildren (114 boys : 115 girls) of between 11 and 15 years of age were interviewed and re-assessed after a working school week. Existing and putative booklet-induced changes in KA scores for schistosomiasis were compared directly against equivalent KA scores for malaria. In total 47.4% of children were already aware that schistosomiasis was a water-borne disease while only 10.5% knew of its exact aetiology; after booklet intervention these levels increased to 54.6 and 15.7%, respectively. The majority of children still failed, however, to realise that re-infection could take place soon after treatment. While a positive increase was observed for children's total KA questionnaire scores for both malaria and schistosomiasis after booklet intervention, these were not statistically significant. In the context of control, further educational efforts are needed to promote and guide behavioural change, especially in relation to reduction of environmental water contact.

A mi què m'expliques?

Els alumnes i les alumnes de primer cicle d'ESO s'enfronten amb les dificultats de la nova etapa i la necessitat de demostrar les seves competències lingüístiques, quant al redactat i la correcció en l'elaboració de textos diversos. Les noves tecnologies de la informació i la comunicació poden ajudar (i han de propiciar-ho) a desenvolupar aquestes capacitats, i han de ser un element motivador perquè els nois i les noies sentin la necessitat de crear produccions escrites pròpies, adequades lingüísticament, coherents i amb les idees ben organitzades.És necessari, a més, que l'avaluació d'aquestes tasques els serveixi per millorar l'expressió en llengua catalana, gramaticalment i ortogràficament, tot ajudant-los a establir sistemes d'autocorrecció i rectificació d'errors.L'exposició pública (en un mitjà com el d'internet) de les seves obres hauria de reblar l'aspecte de la motivació en la creació d'escrits, de manera que els aporti noves expectatives de comunicació i els animi a participar de l'espai virtual que els ofereix aquesta finestra oberta al món. El meu treball té la intenció de ser un projecte educatiu per aconseguir una millora en l'expressió escrita dels alumnes del primer curs d'ESO amb l'ajuda de les eines de les Tecnologies de la Informació i la Comunicació.

Self-reported health needs and use of primary health care services by adolescents enrolled in post-mandatory schools or vocational training programmes in Switzerland.

BACKGROUND: The second Swiss Multicenter Adolescent Survey on Health (SMASH02) was conducted among a representative sample (n = 7428) of students and apprentices aged 16 to 20 from the three language areas of Switzerland during the year 2002. This paper reports on health needs expressed by adolescents and their use of health care services over the 12 months preceding the survey. METHODS: Nineteen cantons representing 80% of the resident population agreed to participate. A complex iterative random cluster sample of 600 classes was drawn with classes as primary sampling unit. The participation rate was 97.7% for the classes and 99.8% for the youths in attendance. The self-administered questionnaire included 565 items. The median rate of item non-response was 1.8%. Ethical and legal requirements applying to surveys of adolescent populations were respected. RESULTS: Overall more than 90% of adolescents felt in good to excellent health. Suffering often or very often from different physical complaints or pain was also reported such as headache (boys: 15.9%, girls: 37.4%), stomach-ache (boys: 9.7%, girls: 30.0%), joint pain (boys: 24.7%, girls: 29.5%) or back pain (boys: 24.3%, girls: 34.7%). Many adolescents reported a need for help on psychosocial and lifestyle issues, such as stress (boys: 28.5%, girls: 47.7%) or depression (boys: 18.9%, girls: 34.4%). Although about 75% of adolescents reported having consulted a general practitioner and about one-third having seen another specialist, reported reasons for visits do not correspond to the expressed needs. Less than 10% of adolescents had visited a psychiatrist, a family planning centre or a social worker. CONCLUSIONS: The reported rates of health services utilisation by adolescents does not match the substantial reported needs for help in various areas. This may indicate that the corresponding problems are not adequately detected and/or addressed by professionals from the health and social sectors.

Antecedents, psychiatric characteristics and follow-up of adolescents hospitalized for suicide attempt of overwhelming suicidal ideation.

To evaluate the socio-demographic as well as the health and psychiatric profiles of adolescents hospitalised for suicide attempt or overwhelming suicide ideation and to assess repetition of suicide attempt over a period of 18 months. Between April 2000 and September 2001, all patients aged 16 to 21 years admitted to the University Hospitals of Geneva and Lausanne for suicide attempt or ideation were included in the study. At this time (T0) semi-structured face to face interviews were conducted to identify socio-demographic data, mental health and antecedents regarding suicidal conducts. Current psychiatric status was assessed with the MINI (Mini International Neuropsychiatric Instrument). At T1 and T2, reassessments included psychiatric status (MINI) as well as lifestyles, socio-professional situation and suicidal behaviours. At T0, 269 subjects met the study criteria, among whom 83 subjects (56 girls and 27 boys) left the hospital too quickly to be involved or refused to participate in the study (final sample at T0: 149 girls; 37 boys). The participation rate at T1 and T2 was respectively 66% and 62% of the original sample. The percentage of adolescents meeting the criteria for psychiatric diagnoses (91%) was high: affective disorder (78%); anxiety disorder (64%); substance use disorder (39%); eating disorder (9%); psychotic disorder (11%); antisocial personality (7%) with most subjects (85%) having more than one disorder. Around 90% of the subjects interviewed at T1, and/or T2, had received follow-up care after their hospitalisation, either by a primary care physician or a psychotherapist or both. Two subjects died of violent death and 18% made a further suicide attempt. Most adolescents hospitalised for suicidal episodes suffer from psychiatric problems which should be addressed by a careful psychiatric assessment, followed up if needed by a structured after care plan.

Patrones de consumo de alcohol en la adolescencia

Este estudio analiza los patrones de consumo de alcohol y el papel de la influencia social y la percepción de peligrosidad de esta sustancia en dicho consumo en una muestra de 1.624 estudiantes de Secundaria de Girona con edades comprendidas entre los 12 y los 18 años (49,4% chicos). Losresultados muestran que un 20,9% de los adolescentes se consideran consumidores habituales de alcohol, y que el consumo se incrementa con la edad, independientemente del género. Un porcentaje elevado de consumidores supera el umbral de alto riesgo para la salud, principalmente entre las chicas debido a las diferencias de género en la metabolización alcohólica. Asimismo se confirma la influencia del entorno (amigos y familiares) y de la percepción de peligrosidad del alcohol tanto en el consumo de esta sustancia como en su uso de alto riesgo. Alcohol consumption patterns in adolescence

Solució mental i solució motriu en la iniciació als esports col·lectius en l'Educació Primària

The adjustment of the teaching learning contents in Physical Education, requires of a rigorous analysis that permits to adjust them to the maximum with the educational needs of the student body. It has been approached an investigation study in the one which have intervened pupils, boys and girls, of two different populations, Girona and Madrid in order to prove and analyse the motor and mental components of the student body in the real situation of the game. The hypothesis that we have treated are:if it exists differences between the boys and girls of the educational levels studied in the motor and mental solution in the sports initiation, additionally, the differences that they can exist between the courses and what distance is verified between the study ages to approach a physical activity that implies an initial step to the hour of teaching the collective sports in the classes of Physical education. They have been employed three measure instruments: the first permits to analyse the mental solution without need of practice employing situation photographs of the real game with those which the pupils must choose to who to happen; the second is a pass test that permits to prove the technical dominance to use in a collective sport and the third is a real game situation that permits to put in manifesto the relationship between the mental behaviour and the motor of the pupil. This real game situation is ‘the game of ten pass’ (Blázquez,1986; Torres,1993). The results demonstrate that it do not exist differences between the two sexes in the study ages. In the case of the technical execution level, there is a considerable increase with the age and it is slightly greater in the kids that in the girls. In the case of the real game, we find ourselves with a great variability in the results and we cannot conclude that there are relative differences to the sex in none of the three courses. Respect at participation level during the game is confirmed that the pupils that more participate are not the pupils than more balls lose, what permits to guarantee the idea of the fact that it is convenient to use the real game practice as direct learning element. Finally, there is no a high correlation between the execution level measured in the test of technical execution and the decision execution during the game

F+0 renography in neonates and infants younger than 6 months: an accurate method to diagnose severe obstructive uropathy.

We studied the response to F+0 renography and the relative and absolute individual kidney function in neonates and &lt; 6-mo-old infants before and after surgery for unilateral ureteropelvic junction obstruction (UJO). METHODS: The results obtained at diagnosis and after pyeloplasty for 9 children (8 boys, 1 girl; age range, 0.8-5.9 mo; mean age +/- SD, 2.4 +/- 1.5 mo) with proven unilateral UJO (i.e., affected kidney [AK]) and an unremarkable contralateral kidney (i.e., normal kidney [NK]) were evaluated and compared with a control group of 10 children (6 boys, 4 girls; age range, 0.8-2.8 mo; mean age, 1.5 +/- 0.7 mo) selected because of symmetric renal function, absence of vesicoureteral reflux or infection, and an initially dilated but not obstructed renal pelvis as proven by follow-up. Renography was performed for 20 min after injection of (123)I-hippuran (OIH) (0.5-1.0 MBq/kg) immediately followed by furosemide (1 mg/kg). The relative and absolute renal functions and the response to furosemide were measured on background-subtracted and depth-corrected renograms. The response to furosemide was quantified by an elimination index (EI), defined as the ratio of the 3- to 20-min activities: An EI &gt; or = 3 was considered definitively normal and an EI &lt; or = 1 definitively abnormal. If EI was equivocal (1 &lt; EI &lt; 3), the response to gravity-assisted drainage was used to differentiate AKs from NKs. Absolute separate renal function was measured by an accumulation index (AI), defined as the percentage of (123)I-OIH (%ID) extracted by the kidney 30-90 s after maximal cardiac activity. RESULTS: All AKs had definitively abnormal EIs at diagnosis (mean, 0.56 +/- 0.12) and were significantly lower than the EIs of the NKs (mean, 3.24 +/- 1.88) and of the 20 control kidneys (mean, 3.81 +/- 1.97; P &lt; 0.001). The EIs of the AKs significantly improved (mean, 2.81 +/- 0.64; P &lt; 0.05) after pyeloplasty. At diagnosis, the AIs of the AKs were significantly lower (mean, 6.31 +/- 2.33 %ID) than the AIs of the NKs (mean, 9.43 +/- 1.12 %ID) and of the control kidneys (mean, 9.05 +/- 1.17 %ID; P &lt; 0.05). The AIs of the AKs increased at follow-up (mean, 7.81 +/- 2.23 %ID) but remained lower than those of the NKs (mean, 10.75 +/- 1.35 %ID; P &lt; 0.05). CONCLUSION: In neonates and infants younger than 6 mo, (123)I-OIH renography with early furosemide injection (F+0) allowed us to reliably diagnose AKs and to determine if parenchymal function was normal or impaired and if it improved after surgery.

Sexueller Missbrauch bei Kindern und Jugendlichen- Aufdeckung, Untersuchung und Erstbetreuung [Sexual abuse of female children and adolescents--detection, examination and primary care].

Epidemiological studies show a prevalence of sexual abuse experience among girls from 14-33%. Although indicators of abuse are unspecific, the combination of several findings may be indicative: Somatic signs may be sexually transmitted diseases, vulvovaginal complaints. Psychosocial nonsexual indicators are abrupt behavioural changes, running away from home, eating disorders. Psychosexual signs are hypersexualisation of the language and behaviour, disturbed body image and gender identity. Indirect evidence of abuse is given not only in cases of old vaginal and anal lesions but also in situations, where deep tears of the hymen in the typical localization at the posterior part can be found. The workup and care for children in whom there is suspicion of abuse but no clear evidence asks for highly competent professionals in a multidisciplinary cooperation including pediatric gynecologists, child psychiatrists, children-protection groups and other specialists to avoid on one hand unjustified destabilisation or even destruction of familial structures but to assure on the other hand, that the child victims are treated and followed after in a short and long term comprehensive medical and psychosocial care.