Child Maltreatment Prevention Readiness Assessment in Oman

Objectives: This study aimed to evaluate Oman’s readiness for implementing large-scale child maltreatment prevention (CMP) programmes. Methods: This cross-sectional study was conducted between May and August 2016 in Oman. Participants, referred to as key informants, were individuals with influence and decision-making powers over CMP. The multidimensional Readiness Assessment for the Prevention of Child Maltreatment tool, developed by the World Health Organization with the help of collaborators from middle- and low-income countries, was used to assess 10 dimensions of readiness, each with a maximum score of 10. Results: A total of 49 participants were included in this study (response rate = 98%). The mean total score for the 10 dimensions was 50.17 out of 100 possible points. The participants showed high mean readiness scores on legislation, mandates and policies (9.08) followed by knowledge of CMP (7.55), institutional resources and links (6.12), willingness to address the problem (5.35), informal social resources (5.15) and current programme implementation and evaluation (5.10). Participants had low scores in readiness in association with human and technical resources (2.44), attitudes towards CMP (2.90), scientific data on CMP (3.06) and material resources (3.46). Conclusion: The results of this study indicate that Oman has a moderate level of readiness to implement largescale evidence-based prevention programmes against child maltreatment; however, several dimensions still need to be strengthened. It is important to develop a national strategy that outlines a framework for organising and prioritising efforts towards CMP.Keywords: Child Maltreatment; Program Development; Attitude; World Health Organization; Oman

Non-suicidal self-strangulation among adolescents in Saudi Arabia: Case series of the choking game

AbstractAdolescence is known to be a time of exploration and initiation of risky behaviors. Much attention has been given to risk behaviors such as smoking, violence, and sexual promiscuity; other serious behaviors such as self-strangulation or the choking game, which is carried out by adolescents in response to peer pressures or to gain a transient sense of euphoria, have received little attention, with the available literature coming from the developed world.This is the first report of cases of non-suicidal self-strangulation from the Arab World. In this case series, we report 5 cases of non-suicidal self-strangulation that presented to the Emergency Department of a tertiary care hospital in Riyadh, Saudi Arabia during 2010–2012. All of the 5 cases were young male adolescents aged 10–13 years. This activity resulted in the death of 2 boys; one boy sustained hypoxic ischemic insult to the brain with clinical deficits; and the remaining 2 were fortunate to be discharged home in healthy condition. None of the cases had underlying mental health problems, and multidisciplinary involvement ruled out suicide and homicide activities.Non-suicidal self-strangulation is a fatal behavior that adolescents engage in. Increased efforts are needed to address this serious and preventable public health issue. Awareness and education of adolescents and their parents is crucial. Awareness of healthcare providers is also necessary in order to avoid misdiagnosis of such cases

Pathways to a more peaceful and sustainable world:The transformative power of children in families

This article provides an overview of selected ongoing international efforts that have been inspired by Edward Zigler’s vision to improve programs and policies for young children and families in the United States. The efforts presented are in close alignment with three strategies articulated by Edward Zigler: (a) conduct research that will inform policy advocacy; (b) design, implement, and revise quality early child- hood development (ECD) programs; and (c) invest in building the next generation of scholars and advocates in child development. The intergenerational legacy left by Edward Zigler has had an impact on young children not only in the United States, but also across the globe. More needs to be done. We need to work together with a full commitment to ensure the optimal development of each child

Brucella melitensis infection of ventriculo-peritoneal shunt: A form of neurobrucellosis manifested as gastrointestinal symptoms

Summary: A report of a 9 year-old child with Myelomeningocele who has a ventriculo-peritoneal (VP) shunt presented with gastrointestinal symptoms and peritonitis. The patient had no CNS symptoms but the cerebrospinal fluid was positive for Brucella melitensis. We discuss neurobrucellosis in children, its various presentations, complications and challenges in treatment, choice of antibiotics and duration. Keywords: Brucellosis, Ventriculo-peritoneal shunt, Peritonitis, Neurobrucellosi

Paecilomyces/Purpureocillium Infection in Children, Case Report, and Review of the Literature

Paecilomyces/Purpureocillium has recently been recognized as an emerging human pathogen, causing serious infection in immunocompromised and immunocompetent patients. Several predisposing factors have been reported, including foreign body implants, previous surgery, or trauma. Treatment with antifungal drugs often fails as species-specific differences in antifungal susceptibilities are one of the management challenges. Surgical debridement with or without antifungal therapy was sufficient to cure the infection in a few reported cases. Nonetheless, the surgical approach has been found to decrease the chance of dissemination and recurrence. Here, we report the first pediatric patient with chronic osteomyelitis of the femur secondary to Paecilomyces species, with no predisposing risk factors. Our case was successfully treated with a combination of antifungal therapy and surgical debridement. Additionally, we describe the first extensive literature review of previously reported Paecilomyces/Purpureocillium species infections in pediatric age groups

Gender-based disparities in the impact of adverse childhood experiences on adult health: findings from a national study in the Kingdom of Saudi Arabia

Abstract Background Adverse Childhood Experiences (ACEs) have been linked to an increased risk of health and social problems throughout life. Studies on gender differences from developing countries are scarce. In this paper, we will examine gender variations in the types of reported ACEs and gender-specific relationships between cumulative ACEs and physical and mental health, and Risky Health Behaviors (RHB) in adulthood in the Kingdom of Saudi Arabia (KSA). Methods A cross sectional national study was conducted in all of the 13 regions in KSA in 2013 using the ACE- International Questionnaire (ACE-IQ). We used multivariate logistic regression to examine the relationship between 4 + ACEs and physical, mental health and RHBs for both men and women separately after adjusting for age, education, marital status and current employment. Results The total number of participants was 10,156 and women comprised 48% of the sample. The majority of respondents (80%) reported at least one ACE. Women had higher percentages of < =2 ACEs (65% vs 55%; p <0.05) while men were more likely to have 4+ ACEs (33% vs 25%; p < 0.05). When compared to participants with 0 ACE, men who reported 4+ ACEs were associated with the highest likelihood of using drugs (OR = 9.7; 95% CI: 6.4-14.5) and drinking alcohol (OR = 9.2; 95% CI: 6.3-13.6). On the other hand, women who experienced 4+ ACEs were associated with the highest likelihood of depression (OR = 7.0; 95% CI: 5.2-9.4), anxiety (OR = 6.4; 95% CI: 5.0-8.2) and other mental illnesses (OR = 7.4; 95% CI: 5.2-10.6). As for chronic diseases, abused men and women in childhood showed similarly a twofold increased risk of developing diabetes, hypertension, coronary heart disease and obesity when compared to non-abused participants. Conclusion Findings highlight the need to consider gender specific differences in the development of preventive strategies to address ACEs in KSA

Child maltreatment prevention strategies: Saudi youth perspectives

Background and Objectives: Child maltreatment (CM) is a global problem that has long-term negative outcomes. The objective of this study is to explore the knowledge and perceptions of youth regarding CM prevention. Methods: The study was conducted in Saudi Arabia using International Child Abuse Screening Tool (ICAST). Answers to open-ended questions were analyzed and a list of CM prevention strategies was generated. Results: Participants identified a range of preventive strategies that were grouped into three main themes: 1) collective preventive efforts; 2) recognizing and responding to CM; 3) gaining closure. For each overarching theme, a list of subthemes were derived. Subthemes included raising awareness through the mass media; school professionals’ capacity building and curriculum advancement; strengthening family relationships; enact CM preventive legislations and policies; monitoring media content and video games and limiting access to firearms for the first theme. The second theme comprised the subthemes reporting services and protective services. As for the third theme it included rehabilitation; punishment for CM crimes and connection to spirituality. Conclusion: Gathering youth perspectives on CM prevention will help us in designing future prevention strategies

Adverse Childhood Experiences and Chronic Diseases: Identifying a Cut-Point for ACE Scores

Adverse Childhood Experiences (ACEs) contribute to many negative physiological, psychological, and behavioral health consequences. However, a cut-point for adverse childhood experience (ACE) scores, as it pertains to health outcomes, has not been clearly identified. This ambiguity has led to the use of different cut-points to define high scores. The aim of this study is to clarify a cut-point at which ACEs are significantly associated with negative chronic health outcomes. To accomplish this aim, a secondary analysis using data from a cross-sectional study was conducted. The Adverse Childhood Experiences-International Questionnaire (ACE-IQ) was used for data collection. Descriptive statistics, nonparametric regression, and logistic regression analyses were performed on a sample of 10,047 adults. Data from demographic and self-report health measures were included. The results showed that a cut-point of four or more ACEs was significantly associated with increased rates of chronic disease. Participants with at least one chronic disease were almost 3 times more likely (OR = 2.8) to be in the high ACE group. A standardized cut-point for ACE scores will assist in future research examining the impact of high ACEs across cultures to study the effect of childhood experiences on health