Cross-sectional and longitudinal risk of physical impairment in a cohort of postmenopausal women who experience physical and verbal abuse.

BackgroundExposure to interpersonal violence, namely verbal and physical abuse, is a highly prevalent threat to women's health and well-being. Among older, post-menopausal women, several researchers have characterized a possible bi-directional relationship of abuse exposure and diminished physical functioning. However, studies that prospectively examine the relationship between interpersonal abuse exposure and physical functioning across multiple years of observation are lacking. To address this literature gap, we prospectively evaluate the association between abuse exposure and physical functioning in a large, national cohort of post-menopausal women across 12 years of follow-up observation.MethodsMultivariable logistic regression was used to measure the adjusted association between experiencing abuse and physical function score at baseline in 154,902 Women's Health Initiative (WHI) participants. Multilevel modeling, where the trajectories of decline in physical function were modeled as a function of time-varying abuse exposure, was used to evaluate the contribution of abuse to trajectories of physical function scores over time.ResultAbuse was prevalent among WHI participants, with 11 % of our study population reporting baseline exposure. Verbal abuse was the most commonly reported abuse type (10 %), followed by combined physical and verbal abuse (1 %), followed by physical abuse in the absence of verbal abuse (0.2 %). Abuse exposure (all types) was associated with diminished physical functioning, with women exposed to combined physical and verbal abuse presenting baseline physical functioning scores consistent with non-abused women 20 years senior. Results did not reveal a differential rate of decline over time in physical functioning based on abuse exposure.ConclusionsTaken together, our findings suggest a need for increased awareness of the prevalence of abuse exposure among postmenopausal women; they also underscore the importance of clinician's vigilance in their efforts toward the prevention, early detection and effective intervention with abuse exposure, including verbal abuse exposure, in post-menopausal women. Given our findings related to abuse exposure and women's diminished physical functioning at WHI baseline, our work illuminates a need for further study, particularly the investigation of this association in younger, pre-menopausal women so that the temporal ordering if this relationship may be better understood

Commercial Sexual Exploitation of Teens

This research explores whether commercially sexually exploited children (CSEC) abuse drugs or face greater histories of abuse than their delinquent peers. This research will evaluate whether girls who are CSEC victims experience more abuse of drugs or experience more physical, emotional, or sexual abuse. The study also explores whether CSEC victims witnessed more abuse than non-CSEC victims. A survey of needs and issues facing delinquent girls was given to 130 girls between the ages of 13 to 18. Questions asked about their drug use, abuse history, and whether they witnessed abuse. This research found that many girls who are CSEC victims experience and witnessed more abuse than non-CSEC victims. The results also showed that CSEC victims and non-CSEC delinquent peers showed no significant difference in drug use

Hidden on the ward : the abuse of children in hospitals

While there have been a small number of high profile cases of the abuse of children by hospital staff, there has been relatively little attention paid to the child protection issues for children staying in hospitals. Drawing on a conceptual framework from work on institutional abuse, we identify three types of abuse: physical and sexual abuse; programme abuse; and system abuse. Physical and sexual abuse can be perpetrated by medical professionals and hospital workers, it can be perpetrated by other children, or it can be perpetrated by the child's own parent(s). Research evidence from the United States suggests that the rate of abuse in hospitals is higher than in the family home. Programme abuse occurs when treatment and care falls below normally accepted standards. Recently, a tragic case of programme abuse concerned the unacceptably high death rate of babies undergoing heart surgery at Bristol Royal Infirmary. System abuse is the most difficult to define but concerns the way in which child health services fail to meet the needs of children. Recent reports have highlighted inadequate services for children and young people, lack of priority given to children's services, and geographical inequalities in the provision of services. Three crucial aspects in safeguarding children from abuse are highlighted: listening to children; the selection support and training of staff; and external systems of inspection, monitoring and standards. The recent government agenda which has placed quality at the centre of NHS service developments are discussed. Only by addressing the abuse of children in hospital openly and honestly will effective child protection be possible

Sh-h-h-h : Representations of perpetrators of sexual child abuse in picturebooks

Children’s picturebooks dealing with the topic of child sexual abuse first appeared in the early 1980s with the aim of addressing the need for age-appropriate texts to teach sexual abuse prevention concepts and to provide support for young children who may be at risk of or have already experienced sexual abuse. Despite the apparent potential of children’s picturebooks to convey child sexual abuse prevention concepts, very few studies have addressed the topic of child sexual abuse in children’s literature. Based on a larger study of 60 picturebooks about sexual child abuse published over the past 25 years, this paper critically examines eight picturebook representations of the perpetrators of sexual child abuse as a way to understand how potentially dangerous adults are explained to the young readers of these texts

Challenges Facing East Asian Immigrant Children in Sexual Abuse Cases

Immigrants from East Asia make up 14.21% of the total number of immigrants in Canada. These families face many challenges as they acculturate to North America but, sadly, some of these children may be at risk for sexual abuse. In this position paper, we outline the ways in which East Asian children are at a particular disadvantage when considering prosecution of those who perpetrate abuse compared to Western non-immigrant children. We focus specifically on two areas of concern: 1) Cultural differences that can impact the disclosure of sexual abuse; and, 2) Language differences which reduce the chances that perpetrators will be prosecuted for sexual abuse. The consequences for East Asian immigrant youth who allege (or are suspected) that they are victims of abuse are serious. East Asian children face an uphill battle to see justice in sexual abuse cases. Thus, a significant portion of immigrant children will not see their abusers punished and, worse, the knowledge that prosecution is unlikely makes East Asian immigrant children a targeted population for those who abuse

No one noticed, no one heard: a study of disclosures of childhood abuse

ReportThis report describes the childhood experiences of abuse of 60 young men and women and how they disclosed this abuse and sought help. These young people experienced high levels and different kinds of violence, including sexual abuse and family violence. It is often asserted that young people who experience abuse do not talk about it. The face to face interviews for this study show that a majority of young people did attempt to disclose their abuse to at least one person although this information was not identified in the surveys for this study. Eighty per cent – 48 of the 60 young people we spoke to – attempted to disclose the abuse before they were 18 years old. Some of these disclosures led to protective action and some did not. Research has suggested that sexual abuse is unlikely to be disclosed – and yet 38 of the 44 young people (86 per cent) who suffered from sexual abuse did disclose during childhood; 66 per cent attempted to disclose when the abuse was happening. However, just like many high profile cases, not all of these disclosures were “heard” or acted upon. Young people generally made more than one disclosure. Of the 203 disclosures in childhood that were made, 117 disclosures (58 per cent) were acted upon by recipients. Suffering from abuse is a distressing experience. It should be no surprise that disclosures that were ignored, denied or badly handled added to the negative experiences of the young people in this study. Policy-makers and people working with children should use the evidence in this report to support better identification of abuse by adults, reduce the barriers to disclosure and to improve the experience of disclosure for young people. Practitioners should particularly consider how they can change their practice to ensure that the experiences of the young people in this report are not repeate