Injuries of non-lethal child physical abuse to the crania and orofacial regions: a scientific review

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Child Abuse and Mental Disorders in Iranian Adolescents

Background: Child abuse is a serious social health problem all over the world with important adverse effects. Objectives: The aim of this study was to extend our understanding of the relation between mental disorders and child abuse. Materials and Methods: The study was designed as a cross-sectional survey on 700 students in secondary schools using multiple cluster sampling in Yazd, Iran in 2013. We applied 2 self reported questionnaires: DASS (depression anxiety stress scales)-42 for assessing mental disorders (anxiety, stress and depression) and a standard self-reported valid and reliable questionnaire for recording child abuse information in neglect, psychological, physical and sexual domains. The collected data was analyzed using SPSS software. P-values < 0.05 were considered as significant. Results: There was a statically significant correlation between mental disorder and child abuse score (Spearman rho: 0.2; P-value < 0.001). The highest correlations between mental disorders and child abuse were found in psychological domain, Spearman’s rho coefficients were 0.46, 0.41 and 0.36 for depression, anxiety and stress respectively (P-value < 0.001). Based on the results of logistic regression for mental disorder, females, last born adolescents and subjects with drug or alcohol abuser parents had mental disorder odds of 3, 0.4 and 1.9 times compared to others; and severe psychological abuse, being severely neglected and having sexual abuse had odds 90, 1.6 and 1.5 respectively in another model. Conclusions: Programming for mandatory reporting of child abuse by physicians and all health care givers e.g. those attending schools or health centers, in order to prevent or reduce its detrimental effects is useful and success in preventing child abuse could lead to reductions in the prevalence of mental disorders.

Covalent Protein Adduction by Drugs of Abuse

Recreational abuse of the drugs cocaine, methamphetamine, and morphine continues to be prevalent in the United States of America and around the world. While numerous methods of detection exist for each drug, they are generally limited by the lifetime of the parent drug and its metabolites in the body. However, the covalent modification of endogenous proteins by these drugs of abuse may act as biomarkers of exposure and allow for extension of detection windows for these drugs beyond the lifetime of parent molecules or metabolites in the free fraction. Additionally, existence of covalently bound molecules arising from drug ingestion can offer insight into downstream toxicities associated with each of these drugs. This research investigated the metabolism of cocaine, methamphetamine, and morphine in common in vitro assay systems, specifically focusing on the generation of reactive intermediates and metabolites that have the potential to form covalent protein adducts. Results demonstrated the formation of covalent adduction products between biological cysteine thiols and reactive moieties on cocaine and morphine metabolites. Rigorous mass spectrometric analysis in conjunction with in vitro metabolic activation, pharmacogenetic reaction phenotyping, and computational modeling were utilized to characterize structures and mechanisms of formation for each resultant thiol adduction product. For cocaine, data collected demonstrated the formation of adduction products from a reactive arene epoxide intermediate, designating a novel metabolic pathway for cocaine. In the case of morphine, data expanded on known adduct-forming pathways using sensitive and selective analysis techniques, following the known reactive metabolite, morphinone, and a proposed novel metabolite, morphine quinone methide. Data collected in this study describe novel metabolic events for multiple important drugs of abuse, culminating in detection methods and mechanistic descriptors useful to both medical and forensic investigators when examining the toxicology associated with cocaine, methamphetamine, and morphine.

Suicide among young people and adults in Ireland: method characteristics, toxicological analysis and substance abuse histories compared

Objective: Information on factors associated with suicide among young individuals in Ireland is limited. The aim of this study was to identify socio-demographic characteristics and circumstances of death associated with age among individuals who died by suicide. Methods: The study examined 121 consecutive suicides (2007–2012) occurring in the southern eastern part of Ireland (Cork city and county). Data were obtained from coroners, family informants, and health care professionals. A comparison was made between 15-24-year-old and 25-34-year-old individuals. Socio-demographic characteristics of the deceased, methods of suicide, history of alcohol and drug abuse, and findings from toxicological analysis of blood and urine samples taken at post mortem were included. Pearson’s χ2 tests and binary logistic regression analysis were performed. Results: Alcohol and/or drugs were detected through toxicological analysis for the majority of the total sample (79.5%), which did not differentiate between 15-24-year-old and 25-34-year-old individuals (74.1% and 86.2% respectively). Compared to 25-34-year-old individuals, 15-24-year-old individuals were more likely to engage in suicide by hanging (88.5%). Younger individuals were less likely to die by intentional drug overdose and carbon monoxide poisoning compared to older individuals. Younger individuals who died between Saturday and Monday were more likely to have had alcohol before dying. Substance abuse histories were similar in the two age groups. Conclusion: Based on this research it is recommended that strategies to reduce substance abuse be applied among 25-34-year-old individuals at risk of suicide. The wide use of hanging in young people should be taken into consideration for future means restriction strategies.

Child Abuse: A guide for Mandatory Reports, November 16, 2012

Child abuse is not a new phenomenon. The abuse and neglect of children has been documented for more than two thousand years. However, attempts to prevent child abuse are relatively new.

Review of Preventative Controls for Fraud, Waste, and Abuse in the Supplemental Nutrition Assistance Program (SNAP), Department of Social Services

This review of preventative controls for fraud, waste, and abuse in the Supplemental Nutrition Assistance Program (SNAP), administered by the Department of Social Services, was self-initiated by the State Inspector General as part of a broader statewide review of preventative fraud, waste, and abuse management controls of major benefit programs in State agencies. This review’s scope and objectives were: Assess SNAP’s preventative management controls for fraud, waste, and abuse; Identify SNAP preventative management control best practices; and Identify opportunities to improve SNAP management controls to cost/effectively mitigate risks of fraud, waste, and abuse.

Review of Abuse, Neglect, and Exploitation Allegations Involving SC Mentor, a Private Provider for the South Carolina Department of Disabilities and Special Needs

This review was requested by the Department of Disabilities and Special Needs for an independent review of allegations of abuse, neglect, and exploitation at SC Mentor, a private provider of residential services for DDSN consumers. An analysis of incidents did not indicate systemic abuse towards consumers inasmuch as the majority of the ANE reporting system contained allegations more akin to staff/facility performance issues and the vast majority of all allegations were unsustained by independent investigations. In the future, DDSN should expand the level of detail in its ANE reporting, which currently only reports total allegations and sustained criminal incidents.

Abuse and neglect of elderly and independence in instrumental and basic activities of daily living.

Introduction: One of the known risk factors for abuse and neglect of the elderly is the decrease in functional capacity, contributing to self care dependency of instrumental activities of daily living and basic activities of daily living (OMS, 2015). Methods: Cross-sectional study with non probabilistic sample of 333 elderly, performed in a hospital, homes and day centers for the elderly. The data collection protocol included socio-demographic data, Questions to elicit Elder Abuse (Carney, Kahan & Paris, 2003 adap. By Ferreira Alves & Sousa, 2005), scale of instrumental activities of daily living Lawton and Brody and Katz index to assess the level of independence in activities of daily living. Objectives: To evaluate the association between abuse and neglect in the elderly, instrumental activities of daily living and level of independence in activities of daily living. Results: Emotional abuse is significantly correlated with the level of independence in activities of daily living (p = 0.000), older people with less independence tend to have higher levels of emotional abuse. The total abuse is significantly correlated with the levels of independence in activities of daily living (p = 0.002), less independent elderly tend to suffer greater abuse and neglect. There were no statistically significant associations between abuse and neglect and instrumental activities of daily living. Conclusions: The less independent elderly are more vulnerable to situations of abuse and neglect, being more exposed to emotional abuse. These results point to the need for health professionals/ nurses develop prevention interventions, including strategies to support carers and early screening in less independent elderly.

Abuse and neglect of elderly and independence in instrumental and basic activities of daily living

Introduction: One of the known risk factors for abuse and neglect of the elderly is the decrease in functional capacity, contributing to self care dependency of instrumental activities of daily living and basic activities of daily living (OMS, 2015). Methods: Cross-sectional study with non probabilistic sample of 333 elderly, performed in a hospital, homes and day centers for the elderly. The data collection protocol included socio-demographic data, Questions to elicit Elder Abuse (Carney, Kahan & Paris, 2003 adap. By Ferreira Alves & Sousa, 2005), scale of instrumental activities of daily living Lawton and Brody and Katz index to assess the level of independence in activities of daily living. Objectives: To evaluate the association between abuse and neglect in the elderly, instrumental activities of daily living and level of independence in activities of daily living. Results: Emotional abuse is significantly correlated with the level of independence in activities of daily living (p = 0.000), older people with less independence tend to have higher levels of emotional abuse. The total abuse is significantly correlated with the levels of independence in activities of daily living (p = 0.002), less independent elderly tend to suffer greater abuse and neglect. There were no statistically significant associations between abuse and neglect and instrumental activities of daily living. Conclusions: The less independent elderly are more vulnerable to situations of abuse and neglect, being more exposed to emotional abuse. These results point to the need for health professionals/ nurses develop prevention interventions, including strategies to support carers and early screening in less independent elderly.

Fabricating reconciliation : Howard's forgettable speech

In this chapter, John Howard’s policy speech to The Sydney Institute, a conservative think tank, on October 11, 2007 as the Australian Prime Minister of the day, is analysed within the frame of discourse analysis to make visible how the speech works in old ways to dress up neoliberal policy as new and reformist. Taking centre stage, Howard pointed to concrete steps undertaken to achieve what he called a “new reconciliation.” This cynical manoeuvre, which put reconciliation back onto the election agenda (after it was earlier derided for its divisive and muddle headed symbolism), constituted a “neoliberal quickstep” (Reiger, 2006) or quickfix of sorts. The speech was also used as a place to reintroduce the Northern Territory Intervention, which at the time was purported to be a response to child abuse and Indigenous community dysfunction.

Multi-victim sexual assault : a case study in rural Australia

Objective: There is a paucity of information regarding cases of multi-victim sexual assault of children. The reported incidence suggests that these cases are rare. The aim of this paper is to provide practitioners with information about effective intervention strategies arising out of the direct experience of managing a case of multi-victim sexual assault in an Australian rural community. --------- Method: A descriptive, case-report methodology summarizing the investigation and intervention in a case of multi-victim sexual assault is reported. A community based intervention arising out of the disclosures of 21 male children is described. The intervention occurred at an individual, group, and community level using a coordinated multi-disciplinary team and natural helping networks. ---------- Results: The coordination of police and welfare services increased the communication flow to victims, their families, and the community. The case also demonstrated the utility in regularly briefing political and bureaucratic authorities as well as local officials about emergent issues. Coordinating political and bureaucratic responses was essential in obtaining ongoing support and sufficient researching to enable the effective delivery of services. ---------- Conclusions: Interventions were focused at an individual, group, and community level using a coordinated multi-disciplinary team and natural helping networks. This provided a choice of services which were sensitive to the case setting. Recommendations are offered for practitioners who are confronted with similar events. While this paper describes an approach for intervening in a case of multi-victim sexual assault, further empirical research is needed to enable service deliverers to efficaciously target interventions which offer choice to victims and their families.

Learning to reflect in the first year of legal education : the key to surviving legal education and legal practice

Lawyers and law students suffer significant rates of depression and substance abuse. This paper suggests that Law Schools have an obligation to assist students to develop the emotional intelligence necessary in order to cope with the stressful nature of legal practice. We draw on Schön’s discussion of the indeterminate zone of professional practice to suggest that reflective practice is the means by which students can become sufficiently emotionally intelligent to become balanced and happy lawyers. We suggest that incorporating reflective practice in intentional curriculum design in the first year of law is an effective first step in assisting students to develop the emotional intelligence necessary to survive the study and practice of law.

Maltreated children in the early years : international perspectives on the teacher’s role

Child abuse and neglect is a significant health and social problem with serious consequences for children, families and communities. This chapter provides students, early childhood teachers, and administrators with an evidence base for understanding their role in relation to child abuse and neglect. The chapter draws from international and interdisciplinary research to address four key areas of responsibility: i) recognising signs of child abuse and neglect; ii) reporting child abuse and neglect; iii) supporting children in the classroom; and iv) teaching children to protect themselves (Watts, 1997).

My place through my eyes : a social constructionist approach to researching the relationships between socioeconomic living contexts and physical activity

There is a growing evidence-base in the epidemiological literature that demonstrates significant associations between people’s living circumstances – including their place of residence – and their health-related practices and outcomes (Leslie, 2005; Karpati, Bassett, & McCord, 2006; Monden, Van Lenthe, & Mackenbach, 2006; Parkes & Kearns, 2006; Cummins, Curtis, Diez-Roux, & Macintyre, 2007; Turrell, Kavanagh, Draper, & Subramanian, 2007). However, these findings raise questions about the ways in which living places, such as households and neighbourhoods, figure in the pathways connecting people and health (Frolich, Potvin, Chabot, & Corin, 2002; Giles-Corti, 2006; Brown et al, 2006; Diez Roux, 2007). This thesis addressed these questions via a mixed methods investigation of the patterns and processes connecting people, place, and their propensity to be physically active. Specifically, the research in this thesis examines a group of lower-socioeconomic residents who had recently relocated from poorer suburbs to a new urban village with a range of health-related resources. Importantly, the study contrasts their historical relationship with physical activity with their reactions to, and everyday practices in, a new urban setting designed to encourage pedestrian mobility and autonomy. The study applies a phenomenological approach to understanding living contexts based on Berger and Luckman’s (1966) conceptual framework in The Social Construction of Reality. This framework enables a questioning of the concept of context itself, and a treatment of it beyond environmental factors to the processes via which experiences and interactions are made meaningful. This approach makes reference to people’s histories, habituations, and dispositions in an exploration between social contexts and human behaviour. This framework for thinking about context is used to generate an empirical focus on the ways in which this residential group interacts with various living contexts over time to create a particular construction of physical activity in their lives. A methodological approach suited to this thinking was found in Charmaz’s (1996; 2001; 2006) adoption of a social constructionist approach to grounded theory. This approach enabled a focus on people’s own constructions and versions of their experiences through a rigorous inductive method, which provided a systematic strategy for identifying patterns in the data. The findings of the study point to factors such as ‘childhood abuse and neglect’, ‘early homelessness’, ‘fear and mistrust’, ‘staying indoors and keeping to yourself’, ‘conflict and violence’, and ‘feeling fat and ugly’ as contributors to an ongoing core category of ‘identity management’, which mediates the relationship between participants’ living contexts and their physical activity levels. It identifies barriers at the individual, neighbourhood, and broader ecological levels that prevent this residential group from being more physically active, and which contribute to the ways in which they think about, or conceptualise, this health-related behaviour in relationship to their identity and sense of place – both geographic and societal. The challenges of living well and staying active in poorer neighbourhoods and in places where poverty is concentrated were highlighted in detail by participants. Participants’ reactions to the new urban neighbourhood, and the depth of their engagement with the resources present, are revealed in the context of their previous life-experiences with both living places and physical activity. Moreover, an understanding of context as participants’ psychological constructions of various social and living situations based on prior experience, attitudes, and beliefs was formulated with implications for how the relationship between socioeconomic contextual effects on health are studied in the future. More detailed findings are presented in three published papers with implications for health promotion, urban design, and health inequalities research. This thesis makes a substantive, conceptual, and methodological contribution to future research efforts interested in how physical activity is conceptualised and constructed within lower socioeconomic living contexts, and why this is. The data that was collected and analysed for this PhD generates knowledge about the psychosocial processes and mechanisms behind the patterns observed in epidemiological research regarding socioeconomic health inequalities. Further, it highlights the ways in which lower socioeconomic living contexts tend to shape dispositions, attitudes, and lifestyles, ultimately resulting in worse health and life chances for those who occupy them.