The Canadian Incidence Study of Reported Child Abuse and Neglect: Implications for Federal Responses to Child Maltreatment

In Canada, provinces and territories directly deliver services related to child maltreatment, but various federal departments share responsibility for responding in other ways. The Canadian Incidence Study of Reported Child Abuse and Neglect (CIS) is one of the Public Health Agency's contributions. This paper presents an overview of its key findings, and points to some implications for program and policy development. CIS data suggest that neglect is the most common type of child maltreatment in Canada, followed by physical abuse, emotional maltreatment and sexual abuse. Because CIS data suggest that parents and other adult relatives are most often the perpetrators of child maltreatment, and that the maltreatment rarely results in severe physical harm, federal support of parenting education programs may be a useful response to the problem of child maltreatment.     

Saving lives versus life‐years in rural Bangladesh: an ethical preferences approach

Using a random sample of individuals in rural Bangladesh, this paper investigates people's ethical preferences regarding relative values of lives when it comes to saving lives of individuals of different ages. By assuming that an individual has preferences concerning different states of the world, and that these preferences can be described by an individual social welfare function, the individuals' preferences for life‐saving programs are elicited using a pair‐wise choice experiment involving different life‐saving programs. In the analyses, we calculate the social marginal rates of substitution between saved lives of people of different ages. We also test whether people have preferences for saving more life‐years rather than only saving lives. In particular, we test and compare the two hypotheses that only lives matter and that only life‐years matter. The results indicate that the value of a saved life decreases rapidly with age and that people have strong preferences for saving life‐years rather than lives per se. Overall, the results clearly show the importance of the number of life‐years saved in the valuation of life. Copyright © 2010 John Wiley & Sons, Ltd.     

Metric properties of the mini‐mental Parkinson and SCOPA‐COG scales for rating cognitive deterioration in Parkinson's disease

Parkinson's disease (PD) is a chronic neurodegenerative disorder that causes cognitive impairment and dementia in ～30% of patients. Objective: Compare metric qualities of Mini‐Mental Parkinson (MMP) and scales for outcomes in Parkinson's disease‐cognition (SCOPA‐COG) with respect to their relative reliability, validity and ability to predict symptoms (mobility, quality of life, social repercussions, and mood) in PD patients. Outpatients (n=123, 78 males/45 females) diagnosed with PD were included in the study. A multilevel (hierarchical) modeling analysis was performed along with tests of reliability and validity to ascertain which of the two models better predicts symptoms related to PD. Results: The MMP differed significantly between patients with Hoehn and Yahr (H&Y) stages 1, 2 or versus 4/5 (grouped together). The SCOPA‐COG showed differences only between patients in H&Y stages 2 versus 4/5. Both scales were dependent on educational background and age. The SCOPA‐COG had a higher coefficient of variation (0.303) than the MMP (0.184), indicating that it was the more discriminative of the two. Conclusions: The SCOPA‐COG has some advantages over the MMP, the most important being a greater discriminative ability. Multilevel hierarchical analysis clarified the necessity of stratifying the PD population according to educational background, years of illness, and H&Y stage when using these scales. © 2010 Movement Disorder Society     

Factors Associated With Involvement in Marriage Preparation Programs

Abstract: Little is known empirically about the characteristics of couples who do and do not participate in marriage preparation. This study assessed the individual, couple, family, and sociocultural context variables that distinguish couples who become involved in marriage preparation from those who do not, using a sample of 7,331 couples. The results showed that the individual characteristics of valuing marriage, being kind and considerate, and being mature, and the couple context factor of perceived relationship problems, predicted involvement. Implications for increasing attendance in marriage preparation interventions include maximizing efforts to reach the “likely‐to‐attend group,” as identified in our findings. With this base of support for the value of interventions, we can then look to the less‐likely‐to‐attend group, who will take more resources of time, energy, and money to get to attend.     

Technical skills for weight loss: preliminary data from a randomized trial

BACKGROUND: Optimal behavioral interventions for sustainable weight loss are uncertain. We therefore conducted a study among overweight/obese women comparing conventional dietary counseling of individuals (counseling-based intervention) to a novel, group-based skill-building intervention. METHODS: Eighty subjects were randomly assigned to either the counseling-based or to the skill-building intervention. Outcomes included weight loss, dietitian hours per group and per unit weight loss, and dollars spent per group and per unit weight lost. RESULTS: Weight loss at 6 months (follow-up rate 61.3%) in the counseling-based group was 8.8 lb (P = 0.0001), and in the skill-building group was 3.8 lb (P = 0.01). A total of 160 dietitian hours were required for the counseling-based group, and 131 for the skilled-building group. The counseling-based group cost an average of $21 per pound lost, while the skill-building cost an average of $48 per pound lost (P = 0.16). CONCLUSIONS: At 6 months, individualized office-based counseling produced more weight loss than a skill-building approach and cost less than half as much per pound of weight loss. Longer-term follow-up is required to determine if, as hypothesized, the skill-building intervention produces more sustainable weight loss.     

Day hospitalization programs for eating disorders: a systematic review of the literature

OBJECTIVE: Partial day hospitalization programs for the treatment of eating disorders are increasingly being developed worldwide. METHOD: First, a systematic database search of day hospitalization programs for eating disorders, published in either English or German, was conducted. Programs that provided sufficient information on their program structure were summarized and compared across various dimensions. Second, the responsible program directors were contacted to provide additional information regarding outcome data, current trends, challenges, and future directions of their programs. Third, outcome data from day programs presented at international conferences were included to expand the base of the review. DISCUSSION: Although the programs from different countries and health care environments varied in terms of their purpose and operated within very different health care systems, many similarities were found to exist, including the use of a multidisciplinary staff and reliance on group treatment as the primary means of therapy. Marked differences were noted in terms of inclusion criteria and intensity of care.     

Child Neglect: Developmental Consequences, Intervention, and Policy Implications

This paper reviews the literature on child neglect with respect to child outcomes, prevention and intervention, and implications for policy. First, the prevalence of the problem is discussed and then potential negative outcomes for neglected children, including behavior problems, low self-esteem, poor school performance, and maladjustment/psychopathology, are discussed. Risk factors and current child neglect interventions are then reviewed. Popular family support programs, such as family preservation, have mixed success rates for preventing child neglect. The successes and shortcomings of other programs are also examined with a focus on implications for future research and policy. Overall, the research supports a multidisciplinary approach to assessment, intervention, and research on child neglect. Furthermore, the need for a combined effort among parents, community members, professionals, and policymakers to increase awareness and prevention endeavors is discussed. Targeted attempts to educate all involved parties should focus on early intervention during specific encounters with at-risk families via medical settings, school settings, and parent education programs.     

New Zealand community pharmacist attitudes toward opioid-dependent clients

Aim: To survey New Zealand community pharmacists to explore levels of training, attitudes towards providing services for drug users, and associations with current and past practice.

Methods: Postal survey of 898 randomly selected community pharmacists. Questions included demography, training and a 20-question attitude scale. Principle component analysis was conducted to identify the main attitude factors. Multiple linear regressions were used to model the effect of different independent variables on the factors.

Findings: Twenty-six percent of respondents had previously undertaken training about the management of opioid misuse. Four principal factors explained 57% of the variance within the attitude questions. These were attitudes towards: 'the general results of dispensing methadone to opioid misusers'; 'the effect of opioid-dependent clients on a pharmacy'; 'reducing harm associated with drug use'; and 'engaging with drug users'. Training (having it or wanting to have it) was positively associated with the four attitude factors.

Conclusions: The results of this study indicate that attitudes towards various aspects of service provision to drug misusers may not be as simple as previously perceived.     

Describing safe motherhood programs for priority setting: the case of Burkina Faso.

OBJECTIVE: This study was implemented to describe safe motherhood programs in Burkina Faso for planning and programming purposes. METHODS: Twenty safe motherhood programs were described from November 2003 through May 2004 using a structured questionnaire, interviews with safe motherhood program managers and document reviews. RESULTS: Only 2 of the 20 programs were designed to improve the availability of comprehensive emergency obstetric care, and only 2 comprehensively addressed all components of skilled attendance at delivery. Other gaps identified included poor availability of baseline data, few monitoring measures, and lack of planning for evaluation needs. National geographical coverage was also uneven. CONCLUSION: A systematic overview of safe motherhood programs in a country can help to set priorities and aid in decision making for the allocation of resources towards contextually relevant strategies to curtail maternal mortality and severe morbidity. Planning for program design and evaluation may also be aided by such a process.