The association between witnessing spousal violence (SV) as a child and the increased adult victimization is well-established, and explained in terms of neural adaptation. But establishing causation requires addressing issues of underreporting of both witnessing and facing violence, and endogeneity due to confounding variables. Moreover, the role of social pathways like nonrandom selection of partners also needs to be analyzed. Using India's Demographic Health Survey data (2019-2021), an endogenous treatment effects model is estimated allowing for different levels of predicted underreporting. Witnessing violence increases the chances of subsequent exposure to SV by 39-70% and may be explained in terms of assortative matching.
Distinguishing factors between pedohebephebophilic actors and non-actors remain a critical area of research for understanding offending behavior and developing targeted interventions. This meta-analysis synthesizes evidence on motivating, facilitating, situational, and other factors that differentiate individuals who have committed sexual offenses against children from those who have not. Following PRISMA guidelines, systematic searches were conducted across PsycNet, ProQuest, Web of Science, PubMed, and PSYNDEX, supplemented by manual searches. Data were analyzed using fixed and random effects models. From 2,185 records screened, 34 studies from 22 datasets met inclusion criteria. We conducted meta-analyses for 50 potential distinguishing factors. The strongest effect sizes were discovered for intelligence (g = -.86), stigma (g = .61), male sex (g = .51), age (g = .48), therapy attendance (g = .43) and interest (g = .43), and sexual (g = .38) and non-sexual (g = .38) adverse childhood experiences. The average quality score was 11.13 (SD = 1.82) out of maximum score of 16. Findings provide support for some motivating, facilitating, situational, and other factors distinguishing pedohebephilic actors from non-actors. These findings offer opportunities for improved risk assessment, prevention strategies, and therapeutic interventions, however, they are limited by the cross-sectional nature of the results.
Growing research evidence has shown that grandparents who provide care to their grandchildren as kinship caregivers (termed grandparent kinship care) experience several challenges, including abuse by the children in their care. We argue that grandmother kinship caregivers in Ghana may be subjected to severe and continuous abuse due to the legitimacy of myths about witchcraft accusations against older people. Following narrative interviews with 31 grandmother kinship caregivers in Ghana, who have experienced abuse and harm from children in their care, we found that the grandmothers used physical punishment and discipline, neglect, and other violence strategies to control and mitigate abusive behaviors of the children in their care. Grandmothers need protection from abuse; thus, we recommend the development of parenting programs to enable grandparent kinship caregivers to develop skills to protect themselves and prevent future harm by children in their care.
Hajara Bentum, Alhassan Abdullah, Vicki Banham et al.
OBJECTIVE: Positive childhood experiences (PCEs) are protective events against the impact of childhood trauma. Previous research has found that children and youth with special health care needs (CYSHCN) are more likely to experience adverse childhood experiences, but the prevalence of PCEs among this population has not been examined. Therefore, this study seeks to evaluate the prevalence of PCEs among CYSHCN. METHODS: Cross-sectional data from the 2021 to 2022 National Survey of Children's Health (n = 47,207) was used to evaluate differences in the prevalence of PCEs between CYSHCN and non-CYSHCN, and to evaluate predictors of PCE exposure among CYSHCN. Rao-Scott χ 2 test and multivariable logistic regression, using appropriate survey weights, were used. RESULTS: Compared with non-CYSHCN, CYSHCN had lower odds of having at least one PCE (adjusted odds ratio [aOR]: 0.35, 95% Confidence Intervals [CIs]: 0.15‒0.83), and having specific types of PCEs: having constructive social engagement (aOR: 0.24, 95% CIs: 0.21‒0.27), having nurturing and supportive relationships (aOR: 0.80, 95% CIs: 0.72‒0.89), living in a safe, stable, and equitable environment (aOR: 0.75, 95% CIs: 0.68‒0.82), and creating social and emotional competency (aOR: 0.62, 95% CIs: 0.56‒0.69). Among CYSHCN, children of color, those with greater poverty, and those with more complex needs have lower odds of experiencing most PCEs. CONCLUSION: The results of this study indicate a need for programs aimed at fostering resilience among CYSHCN. There is also a need for additional research creating better measures of evaluating PCEs among CYSHCN and examining how PCEs mitigate the effects of adverse childhood experiences in this population.
Emma Kathryn Boswell, Maushmi Patel, Taryn Farrell et al.
OBJECTIVE: To examine how country-level gender inequality relates to adolescent chronic pain prevalence and sex disparities. METHODS: We linked country-level Gender Inequality Index (GII) and lifetime prevalence of intimate partner violence (IPV) against women to 2017/18 Health Behavior in School-aged Children data from 244,097 adolescents ages 11-15 in 47 countries. Relative sex disparities in pain prevalence (female:male prevalence ratio [PR]) were examined with modified Poisson regression with country-cluster-robust standard errors; absolute disparities (prevalence difference [PD]) with multilevel linear probability models. RESULTS: Chronic pain prevalence ranged from 32.30% to 58.72% across countries (overall 44.32%; I2 = 98.36%). Female-male PDs ranged from 0.29 to 18.26 percentage points (pooled 13.28; I2 = 79.80%); PRs ranged from 1.01 to 1.69 (pooled 1.36; I2 = 83.71%). Higher GII was associated with greater pain prevalence (PR = 1.11, 95% CI: 1.04, 1.19) yet smaller sex disparities, due to steeper increase in boys' pain prevalence as GII increases. Higher IPV prevalence, though unrelated to overall pain prevalence, was associated with larger female-male percentage-point differences (β = 1.28%, 95% CI: 0.16%, 2.39%). CONCLUSIONS: Structural gender inequality shapes both the population burden of adolescent chronic pain and sex disparities, underscoring the relevance of structural context and the need for more research in lower-income countries.
BACKGROUND: Child abuse is a global public health concern with long-term behavioral, psychological, and physical health consequences. Schools play a crucial role in addressing abuse, with teachers uniquely positioned to observe signs of abuse, such as behavioral changes. OBJECTIVE: To explore teachers' perceptions of child abuse, existing support systems, and barriers to addressing it. PARTICIPANTS AND SETTING: Thirty-three teachers from different public and private schools in Dhulikhel Municipality, Bagmati Province, Nepal, were purposefully selected. METHODS: After obtaining informed written consent, a qualitative study was conducted using five focus group discussions. Discussions were audio-recorded, transcribed in Nepali, translated into English, and analyzed using content analysis. RESULTS: Teachers identified various forms of child abuse, including culturally-specific practices such as forcing children to eat against their will, parental pressure for academic performance, making children perform hard physical work without food and/or assigning tasks beyond their physical capacity, and caste-based discrimination. Some misconceptions about child abuse included normalizing excessive academic pressure on students and equating substance (drug) use with child abuse. Participants perceived key risk factors for child abuse as child disability, poverty, low parental education, and weak law enforcement, whereas protective factors were teachers' awareness and collaboration. Teachers expressed a strong interest in receiving training to better identify and respond to cases of child abuse. CONCLUSIONS: Teachers showed a generally accurate but limited understanding of child abuse. These findings can guide training programs and updates to local child protection policies in Nepal.
OBJECTIVE: The article deals with the structural ecclesiastical-institutional and socio-historical factors of (sexualized) violence against minors during the period of the Soviet Occupation Zone (SOZ)/German Democratic Republic (GDR), i.e. 1946-1989, based on the former East German region of Mecklenburg. METHODS: Semi-structured, problem-centered interviews with 13 survivor and 11 Church representatives as well as 1503 files from Catholic Church and State Security Authority archives were analyzed by qualitatively content analysis. The criminological approach of routine activity according to Lawrence. E. Cohen and Marcus Felson, which states that three factors must be present simultaneously for deviant behavior, was used to explain the factors that promoted violence. RESULTS: The study showed that (sexualized) violence within the Catholic Church was also a predominantly structural/cultural problem in the GDR and was tabooed by both the State and the Church. We identified 40 minors who were abused by 19 priests. The abuse was enabled by the interplay of clergy as motivated perpetrators, children from precarious living conditions as suitable victims of abuse, a lack of protection of children and intervention due to the desire to protect the Catholic Church as an institution in the diaspora, and the aim of the dictatorial State to preserve its socialist ideology. CONCLUSION: Consequently, specific interactions of factors encouraged the acts of violence. The situational conditions were particularly important in determining whether criminal behavior had taken place or not within the Catholic Church in the SOZ/GDR (Mecklenburg region) in the period 1946 to 1989.
OBJECTIVE: To assess the adult Hungarian population's knowledge about and attitude toward epilepsy and compare the present findings with previous ones in 1994 and 2000. METHODS: We performed a cross-sectional survey of the Hungarian adult population from 28th February to 8th March 2023. A non-probability quota sampling with a random walk method was used. We applied the computer-assisted personal interviewing (CAPI) method and used a multicriteria weighting procedure to correct for bias along the main sociodemographic variables. To detect changes over time, we used chi-squared tests, and to analyze the effect of sociodemographic characteristics, we applied multivariate logistic regression. RESULTS: One thousand participants (53.1% women, mean age 48.1 ± 16.75 years) representing Hungary's population were interviewed yielding a response rate of 80.3%. 26.3% knew someone with epilepsy (55.9% in 1994 and 51.9% in 2000), and 30.8% saw an epileptic seizure (58% in 1994 and 55.3% in 2000). Compared to the young, fewer adults and elderly people knew someone with epilepsy or had seen a seizure. Like in 1994 and 2000, 16.6% reported objection to their children's interaction with people with epilepsy; however, in the present study, significantly fewer people opposed their children marrying or working together with epileptic people, indicating a change in attitude (p < 0.0001). Rural residents had less objection to their children's interaction with people with epilepsy (p < 0.05). People with secondary education objected significantly more often than those with primary education to their children's interaction (p = 0.037), marriage to people with epilepsy (p = 0.043), or their having equal employment (p = 0.008). Higher education people were as "permissive" as those with primary education. SIGNIFICANCE: Certain parameters of familiarity and attitude markers of the Hungarian population toward epilepsy have improved. These tendencies are promising, but work is still needed; our results will hopefully evoke educational programs and campaigns against negative attitudes. PLAIN LANGUAGE SUMMARY: The knowledge of the Hungarian population about epilepsy and their attitude toward people with epilepsy has been improved since 1994. People from rural areas have shown more acceptance for people with epilepsy. Those people who completed secondary education were significantly more prone to stigmatization than those with primary education.
Mengesha Srahbzu Biresaw, József Vitrai, Péter Halász et al.
BACKGROUND: Anaemia in pregnancy is a major cause of maternal death especially, in developing countries. OBJECTIVES: The study was aimed at determining the prevalence of anaemia and its associated socio-demographic and obstetric factors among pregnant women in Nsukka Area of Enugu State, Nigeria. METHODS: Pregnant women numbering 386 participated in the study. Respondents' socio-demographic and obstetric data were collected using validated structured questionnaire. Haemoglobin concentration (Hb conc) was determined and used to categorize the women following WHO classification. Data were analyzed using descriptive statistics, Duncan's new multiple range tests, T-test and Pearson's correlation coefficient. RESULTS: More than half (55.9%) of the respondents had low Hb conc; with 39% and 16.9% having mild and moderate anaemia, respectively. Hb conc was significantly influenced by age, occupation, educational and income levels (P<0.05). Hb conc significantly increased with increase in educational and income levels. Negative correlation existed between respondents' parity and Hb (r=-0.281; P<0.05).Women with 4 - 6 previous pregnancies had the lowest Hb conc (10.18±0.86g/dl) among the respondents. CONCLUSION: Anaemia in pregnancy is highly prevalent in Nsukka, and was associated with younger age, low educational and income levels, and higher parity. Girl-child/women's education must be highly prioritized, and adolescent marriage/pregnancy prevented through community-based approaches.
Scholastica Ngozi Eze, Peace Nwanneka Ani, Cyril Onyinyechukwu Anoshirike
BACKGROUND: In Zambia, 3.8% of young women and men aged 15-24 are HIV positive. However, like in most developing nations, HIV prevalence is higher among young women than young men (5.6% versus 1.8%). Despite the recognition of the rights of young people to sexual reproductive health (SRH) information and services, adolescent and young people (AYP) still face challenges in accessing healthcare in public health institutions including access to comprehensive knowledge on HIV/AIDs, HIV testing and contraceptives. The overall objective of the study was to collect baseline HIV, SRH and gender based violence (GBV) data at district level to inform the design of interventions targeting adolescent girls and young women (AGYW) aged 10-24 years in 20 districts of Zambia. METHODS: A cross-sectional, mixed-methods study was conducted in 20 districts of Zambia with the highest incidence of HIV. Data was collected between August and October 2022 with a total response rate of 92% (12,813/13960), constituting 5979 (46.7%) in-school and 6834 (53.3%) out-of-school participants. RESULTS: Overall, Mwinilunga, Chinsali, Chisamba and Chembe districts had the highest number of respondents, while Sinazongwe and Mungwi districts contributed the least. The overall age distribution was such that 12.6% (n = 1617) of those interviewed were aged 10 to 14 years, 35.4% (n = 4536) were aged 15-19 years, and 52.0% (n = 6660) were aged 20-24 years. The overall mean age at first sex among AGYW interviewed was 16.6 years which was broken down as follows: 16.2 years for in-school and 16.8 years for out of school. Overall, most of the respondents had first time sex with either their boyfriend (80.4%) or husband (15.6%), with 2.4% of the in-school participants reporting to have had their sexual debut in marriage compared to 21.0% among out-of-school AGYW. Prevalence of HIV was higher in the out-of-school compared to the in-school participants (5.5% vs 2.0%), Similarly, the prevalence of syphilis was higher in the out-of-school than the in-school participants (4.1% vs 1.5%). CONCLUSION: The study focused on assessing the prevalence and vulnerability of HIV, syphilis, GBV, and SRH services uptake among adolescent girls and young women, and exploring factors affecting girls' stay-in-school and re-engagement. The study found that HIV and syphilis are still significant public health problems among adolescent girls and young women in Zambia, emphasizing the need for increased efforts to prevent and manage these infections.
Patrick Musonda, Hikabasa Halwiindi, Patrick Kaonga et al.
