Criminologic knowledge about the forms, victims and perpetrators in child abuse and neglect

In order to clarify how and why this form of crime occurs, the different kinds of child abuse und neglect are presented from the criminological and factual standpoint. The causes are elucidated on the basis of pertinent investigations on the victim-perpetrator relationship, and the special characteristics of both victims and perpetrators are pointed out.     

Practitioner Review: The victims and juvenile perpetrators of child sexual abuse – assessment and intervention

Background: The assessment of victims of child sexual abuse (CSA) is now a recognized aspect of clinical work for both CAMH and adult services. As juvenile perpetrators of CSA are responsible for a significant minority of the sexual assaults on other children, CAMH services are increasingly approached to assess these oversexualized younger children or sexually abusive adolescents. A developmental approach to assessment and treatment intervention is essential in all these cases. Method: This review examines research on the characteristics of child victims and perpetrators of CSA. It describes evidence‐based approaches to assessment and treatment of both groups of children. A selective review of MEDLINE, Psycinfo, Cochrane Library, and other databases was undertaken. Recommendations are made for clinical practice and future research. Findings: The characteristics of CSA victims are well known and those of juvenile perpetrators of sexual abuse are becoming recognized. Assessment approaches for both groups of children should be delivered within a safeguarding context where risk to victims is minimized. Risk assessment instruments should be used only as adjuncts to a full clinical assessment. Given high levels of psychiatric comorbidity, assessment, treatment, and other interventions should be undertaken by mental health trained staff. Conclusions: Victims and perpetrators of CSA present challenges and opportunities for professional intervention. Their complex presentations mean that their needs should be met by highly trained staff. However, their youth and developmental immaturity also give an opportunity to nip problem symptoms and behaviors in the bud. The key is in the earliest possible intervention with both groups. Future research should focus on long‐term adult outcomes for both child victims and children who perpetrate CSA. Adult outcomes of treated children could identify problems and/or strengths in parenting the next generation and also the persistence and/or desistence of sexualized or abusive behavior.     

Asymptomatic hypercalciuria : Prevalence and metabolic characteristics

Hypercalciuria is of continuing interest as a risk factor for kidney stones in children. We screened 592 healthy Turkish children (308 boys, 284 girls, aged 3 month-16 years) for hypercalciuria by measurement of urinary calcium/creatinine (UCa/Cr) ratio in the second-morning urine samples. Hypercalciuria was noted in 17 children (2.9 %), 9 of them were boy and 8 of them were girl. Oral calcium-loading test could only be done in 7 children who were diagnosed as having hypercalciuria, and it revealed absorptive hypercalciuria in 2 cases and renal hypercalciuria in no cases. The frequency of a family history of urolithiasis in asymptomatic hypercalciuric children was 50%. Median UCa/Cr ratios and urinary magnesium/creatinine (UMg/Cr) ratios were 0.11 and 0.10 and the 97th percentiles were 0.32 and 0.23 respectively. The UCa/Cr ratio in second-morning urine samples was correlated with the UMg/Cr ratio (r = 0.44) and was independent of age and sex.     

The new Brazilian traffic code and some characteristics of victims in southern Brazil

OBJECTIVE: The aim was to study characteristics of traffic accident victims before and after the implementation of the new Brazilian traffic code, in January 1998. SUBJECTS AND METHODS: The study population was car and motorcycle occupants seen in a pre-hospital care service in Londrina, Parana State (Brazil) before the introduction of the new Brazilian traffic code, from 22 January to 21 July 1997, and after its implementation during the same period in 1998. Victims were analyzed over the time periods according to helmet and seat belt use, gender, underage driving, and alcohol on the breath. RESULTS: Use of seat belts increased from 45% to 62.6% and of helmets from 31.2% to 66.2% after the introduction of the new Brazilian code. The proportion driving under age 18 and with perceptible alcoholic breath declined significantly only among motorcycle riders. There was a 20% decline in car occupant injuries along with a 9% reduction in motorcycle related injuries after the change of the law. CONCLUSION: Results favor the hypothesis that rigorous legislation increases safer practices in traffic, at least during the first months of its implementation.     

The effects of bullying

Bullying is a major problem for children. There are well-defined risk factors for bullying that are individual and social. Beyond the immediate trauma of experiencing bullying, victims are at high risk of later physical and emotional disorders. Bullies are the generators of this trauma but also suffer poor long-term effects as a result of their participation. Bystanders are also not immune from bullying's toxic effects nor innocent from its occurrence. While most often occurring at schools, paediatric clinicians can identify and support children suffering from bullying. They also have the unique opportunity to engage the schools and wider society on anti-bullying initiatives. This article will outline the risk, signs and symptoms of bullying to help clinicians identify and address these children in need.     

芦山地震和汶川地震中儿童伤员的临床特征比较及急救经验

目的：为了更为全面地认识地震中儿童伤员的临床特征和救治状况,总结地震中儿童伤员救治经验。方法：收集四川大学华西医院2013年芦山地震和2008年汶川地震中收治的儿童伤员的临床信息,分析比较两次地震中儿童伤员的有关数据。结果：截至2013年4月30日,该院共收治了芦山地震14岁以下伤员34人。与汶川地震的数据比较,芦山地震儿童伤员的年龄更小（P<0.01）,地震到入院的平均时间更短（P<0.01）。芦山地震中,67.6%的伤员有不同程度的肢体骨折,儿童颅脑损伤比例明显高于汶川地震（29.4% vs 9.5%,P<0.05）。芦山地震收治患儿没有截肢,没有死亡,13位极危重症和重症儿童伤员均顺利进入康复阶段。 结论：芦山地震儿童伤员中重症患儿及颅脑损伤患儿比例较高,但治疗转归较好,这可能与及时的现场救援和转运及多部门、多级医疗机构、多学科的通力合作有关。     

Incarcerated adolescents' experiences as perpetrators of sexual assault

OBJECTIVES: To identify self-reported characteristics of past sexual assaults perpetrated by incarcerated juveniles and to determine potential precursors of this behavior. PARTICIPANTS AND METHODS: Participants completed an anonymous written questionnaire regarding their experiences of sexual abuse and/or assault as both a victim and a perpetrator. The questionnaire was incorporated into an existing annual survey of gang-related behaviors. RESULTS: A total of 805 adolescents (707 boys, 91 girls, and 7 gender-not-designated) participated. Of these teens, 79 males (11% of the males), 9 females (10% of the females), and 5 (71%) gender-not-designated said they had forced sex on someone (165 did not answer the question). Twenty-eight males (30% of the male perpetrators) and 4 females (44% of the female perpetrators) were both victims and perpetrators. Drugs and/or alcohol were frequently used by both the assailant (58% of the males and 55% of the females) and the victim (56% for the males and 66% for the females). The attributes of adolescent boys at highest risk of becoming perpetrators were all related to violence, including exposure to parents who were violent in the home (adjusted odds ratio, 2.68), being a victim of physical or sexual assault (adjusted odds ratio, 2.83), having parents who encouraged gang membership (adjusted odds ratio, 3.58), and knowing a perpetrator of sexual violence (adjusted odds ratio, 3.83). CONCLUSIONS: Adolescent boys and girls were both victims and perpetrators of sexual assault. Programs that identify and target violence in young children's lives, particularly intrafamilial violence, may reduce the risk of teenagers becoming perpetrators of sexual violence. Anticipatory guidance during teen years, regarding risk and avoidance of sexual exploitation, may be helpful in reducing the chances of sexual assaults.     

Prevalence and characteristics of children with special health care needs

BACKGROUND: Children with special health care needs (SHCNs) are an important population from health care services, economic, and policy perspectives. However, until recently, no national data on their prevalence and health care service needs that use a commonly accepted definition have existed. OBJECTIVE: To provide national estimates of the number of children with SHCNs and their characteristics, including an assessment of how well their needs are being met. SETTING: The United States. PARTICIPANTS: Interviews were conducted by telephone with the families of 38 866 children with SHCNs younger than 18 years using the State and Local Area Integrated Telephone Survey platform developed by the Centers for Disease Control and Prevention, Atlanta, Ga. MAIN OUTCOME MEASURES: Prevalence of SHCNs, demographic and socioeconomic correlates of SHCNs, access to care, satisfaction with care, and impact on the family. RESULTS: An estimated 12.8% of US children experienced an SHCN in 2001. Prevalence was highest among boys, school-age children, and children in lower-income families. A substantial minority of these children experienced unmet health needs (17.7%) or lacked critical elements of family-centered health care (33.5%). The impact on families was pronounced, as 20.9% reported their child's health care caused financial problems, and 29.9% reported cutting back or quitting work because of their child's condition. These adverse child- and family-level impacts were concentrated among low-income and uninsured children with SHCNs. CONCLUSIONS: Children with SHCNs and their families represent an important underserved population. In addition, substantial disparities are present in access, satisfaction, and family impact.     

Prevalence and characteristics of migraine among adolescents: a questionnaire survey

A screening questionnaire was distributed to 1000 boys and 1000 girls, studying in classes VI to X (11 to 15 years) in two public schools of Jaipur. Questionnaire A consisted of a single question to parents. "Does your child suffer from recurrent headache?" To those who responded in the affirmative, a detailed questionnaire (B) was distributed Questionnaire B consisted of twenty questions pertaining to characteristics and associations of headache. From questionnaire B a diagnosis of common migraine was made according to IHS criteria (1988). The prevalence of recurrent headache was found to be 18% in boys and 21% in girls, while the prevalence of migraine was 9% in boys and 14% in girls. Among the other causes of recurrent headache tension type headache was seen in 3.6%, eye problems in 0.389% sinusitis in 0.22%, and undetermined etiology in 2.14% children. The clinical characteristics of migraine are described.