Randomized Controlled Trial of a Parenting Program to Reduce the Risk of Child Maltreatment in South Africa

Parenting programs in high-income countries have been shown to reduce the risk of child maltreatment. However, there is limited evidence of their effectiveness in low- and middle-income countries. The objective of this study was to examine the initial effects of a parenting program in reducing the risk of child maltreatment in highly-deprived and vulnerable communities in Cape Town, South Africa. Low-income parents (N = 68) with children aged three to eight years were randomly assigned to either a group-based parenting program or a wait-list control group. Observational and parent-report assessments were taken at baseline and at immediate post-test after the intervention was delivered. Primary outcomes were parent-report and observational assessments of harsh parenting, positive parenting, and child behavior problems. Secondary outcomes were parent-report assessments of parental depression, parenting stress, and social support. Results indicated moderate treatment effects for increased frequency of parent-report of positive parenting (d = 0.63) and observational assessments of parent-child play (d = 0.57). Observational assessments also found moderate negative treatment effects for less frequent positive child behavior (d = −0.56). This study is the first randomized controlled trial design to rigorously test the effectiveness of a parenting program on reducing the risk of child maltreatment in sub-Saharan Africa using both observational and self-report assessments. Results provide preliminary evidence of effectiveness of reducing the risk of child maltreatment by improving positive parenting behavior. Further development is required to strengthen program components regarding child behavior management and nonviolent discipline strategies. Future research would benefit from a larger trial with sufficient power to determine program effectiveness

Bullying Victimisation, Internalising Symptoms, and Conduct Problems in South African Children and Adolescents: A Longitudinal Investigation

Bullying victimisation has been prospectively linked with mental health problems among children and adolescents in longitudinal studies in the developed world. However, research from the developing world, where adolescents face multiple risks to social and emotional development, has been limited by cross-sectional designs. This is the first longitudinal study of the psychological impacts of bullying victimisation in South Africa. The primary aim was to examine prospective relationships between bullying victimisation and internalising and externalising symptoms in South African youth. Secondary aims were to examine gender and age-related differences in experiences of bullying victimisation. Children and adolescents (10–17 years, 57 % female, n = 3,515) from high HIV-prevalent (>30 %) communities in South Africa were interviewed and followed-up 1 year later (97 % retention). Census enumeration areas were randomly selected from urban and rural sites in two provinces and door-to-door sampling included all households with a resident child/adolescent. Exposure to multiple experiences of bullying victimisation at baseline predicted internalising symptoms and conduct problems 1 year later. Additionally, baseline mental health scores predicted later bullying victimisation, demonstrating bi-directionality of relationships between bullying victimisation and mental health outcomes in this sample. Expected gender differences in physical, verbal, and relational bullying victimisation were evident and predicted declines in bullying victimisation over time were observed. In the developed world, school-based anti-bullying programmes have been shown to be effective in reducing bullying and victimisation. Anti-bullying programmes should be implemented and rigorously evaluated in South Africa, as this may promote improved mental health among South African children and adolescents

Risk and protective factors for bullying victimization among AIDS-affected and vulnerable children in South Africa

OBJECTIVES: To examine whether bullying is a risk factor for psychological distress among children in poor, urban South Africa. To determine risk and protective factors for bullying victimization. METHOD: One thousand and fifty children were interviewed in deprived neighborhoods, including orphans, AIDS-affected children, streetchildren, and child-headed households. Using standardized scales, children reported on bullying victimization, psychological problems, and potential risk and protective factors at individual, peer, family, and community levels. RESULTS: 34% of children reported bullying victimization. Bullied children showed higher levels of anxiety, depression, suicidal ideation, and post-traumatic stress, as well as higher levels of clinical-level disorder. Risk factors for being bullied were being a victim of physical or sexual abuse or domestic violence at home, living in a high-violence community, and experiencing AIDS-related stigma (independent of sociodemographic cofactors and child psychological disorder). Protective factors were sibling support and support from friends, although findings suggest that friendship groups may also be sources of bullying for AIDS-affected children. CONCLUSIONS: Bullying is an independent and important risk factor in child psychological distress in South Africa. Children victimized at home or in the community are more likely to be bullied, suggesting a cycle of violence. PRACTICE IMPLICATIONS: Those working with children in Southern Africa should be alert to risk of bullying, especially among abused or AIDS-affected children. Interventions combating community violence and AIDS-related stigma may have additional positive impacts on bullying, and promotion of peer and sibling support may reduce bullying victimization among high-risk children.</p

Risk and protective factors for bullying victimization among aids-affected and vulnerable children in south africa. Child Abuse and Neglect, 34(10), 793-803. Retrieved from http://www.sciencedirect.com.libservprd.bridgew.edu/science/article/pii/S014521341

a b s t r a c t Objectives: To examine whether bullying is a risk factor for psychological distress among children in poor, urban South Africa. To determine risk and protective factors for bullying victimization. Method: One thousand and fifty children were interviewed in deprived neighborhoods, including orphans, AIDS-affected children, streetchildren, and child-headed households. Using standardized scales, children reported on bullying victimization, psychological problems, and potential risk and protective factors at individual, peer, family, and community levels. Results: 34% of children reported bullying victimization. Bullied children showed higher levels of anxiety, depression, suicidal ideation, and post-traumatic stress, as well as higher levels of clinical-level disorder. Risk factors for being bullied were being a victim of physical or sexual abuse or domestic violence at home, living in a high-violence community, and experiencing AIDS-related stigma (independent of sociodemographic cofactors and child psychological disorder). Protective factors were sibling support and support from friends, although findings suggest that friendship groups may also be sources of bullying for AIDSaffected children. Conclusions: Bullying is an independent and important risk factor in child psychological distress in South Africa. Children victimized at home or in the community are more likely to be bullied, suggesting a cycle of violence. Practice implications: Those working with children in Southern Africa should be alert to risk of bullying, especially among abused or AIDS-affected children. Interventions combating community violence and AIDS-related stigma may have additional positive impacts on bullying, and promotion of peer and sibling support may reduce bullying victimization among high-risk children

Circulating Chemerin Is Elevated in Women With Preeclampsia

Background: Preeclampsia is a severe complication of pregnancy. Chemerin is an adipokine secreted from adipose tissue and highly expressed in placenta. This study evaluated the biomarker potential of circulating chemerin to predict preeclampsia. Methods: Maternal plasma and placenta were collected from women with early-onset preeclampsia (&lt;34 weeks), with preeclampsia and eclampsia, or before preeclampsia diagnosis (36 weeks). Human trophoblast stem cells were differentiated into syncytiotrophoblast or extravillous trophoblasts across 96 hours. Cells were cultured in 1% O2 (hypoxia) or 5% O2 (normoxia). Chemerin was measured by enzyme-linked immunosorbent assay (ELISA) and RARRES2 (gene coding chemerin) by reverse transcription-quantitative polymerase chain reaction. Results: Circulating chemerin was increased in 46 women with early-onset preeclampsia (&lt;34 weeks) compared to 17 controls (P &lt; .0006). Chemerin was increased in placenta from 43 women with early-onset preeclampsia compared to 24 controls (P &lt; .0001). RARRES2 was reduced in placenta from 43 women with early-onset preeclampsia vs 24 controls (P &lt; .0001). Chemerin was increased in plasma from 26 women with established preeclampsia (P = .006), vs 15 controls. Circulating chemerin was increased in 23 women who later developed preeclampsia vs 182 who did not (P = 3.23 × 10−6). RARRES2 was reduced in syncytiotrophoblast (P = .005) or extravillous trophoblasts (P &lt; .0001). Hypoxia increased RARRES2 expression in syncytiotrophoblast (P = .01) but not cytotrophoblast cells. Conclusions: Circulating chemerin was elevated in women with early-onset preeclampsia, established preeclampsia, and preceding preeclampsia diagnosis of preeclampsia. RARRES2 was dysregulated in placenta complicated by preeclampsia and may be regulated through hypoxia. Chemerin may have potential as a biomarker for preeclampsia but would need to be combined with other biomarkers