Reducing consequences of child maltreatment during adulthood by public health actions : a Delphi study

Background: Child maltreatment (CM) is associated with long-lasting poor health outcomes, as well as increased levels of disability and health-services consumption across the life-span. However, less is known about how CM consequences can be reduced during adulthood. We investigated professional opinions on how to mitigate long-term consequences of CM in a public health (PH) perspective. Methods: Using the Delphi method in three rounds, we inquired 91 professionals, mostly European researchers and clinicians about potential PH actions to mitigate CM consequences during adulthood. Results: Most experts agreed that PH actions are needed. Increasing community awareness and training emotional regulation in affected adults were prioritized strategies. Enlarging curricular knowledge about CM for professionals and developing evidence-based interventions were considered preferred methods. Reducing the barriers for access to interventions for adults, such as those provided by trauma-informed services were also suggested. Participants highlighted the possibility to reduce CM consequences across generations as a significant benefit. Conclusions: PH programmes to reduce the burden of CM can be enhanced by specific actions to facilitate the recognition of difficulties in affected adults and to expand the availability of helpful resources. The application of these programmes could be assisted by the use of modern information-technology

Child maltreatment, revictimization and Post-Traumatic Stress Disorder among adults in a community sample

Background/Objective: Childhood maltreatment (CM) has been associated with revictimization and post-traumatic stress disorder (PTSD). However, this relation is hardly examined in South European countries, and in community samples. We tested these associations in a convenience sample of 1,200 Portuguese adults in the community. Method: Data were collected using self-report questionnaires, the Post Traumatic Diagnostic Scale (PDS) and the Childhood Trauma Questionnaire–Short Form (CTQ-SF). Odds ratios, logistic and hierarchical regression were used to analyze the data. Results: Exposure to CM increased more than twofold the risk of being revictimized and threefold a PTSD diagnosis. Highly prevalent traumatic events such as accidents were associated with CM. More than 30% of adults with PTSD were exposed to emotional abuse. After adjusting for demographics, emotional abuse remained a significant predictor for revictimization and PTSD, having the largest effect on the prediction of PTSD severity (β = .24). Conclusions: Findings underline the injurious potential of emotional abuse during childhood in adults in the community. More knowledge is needed about the mechanisms linking CM with further traumatic exposure and PTSD across the lifespan to better inform preventive and therapeutic actions

Reducing consequences of child maltreatment during adulthood by public health actions: a Delphi study

Background: Child maltreatment (CM) is associated with long-lasting poor health outcomes, as well as increased levels of disability and health-services consumption across the life-span. However, less is known about how CM consequences can be reduced during adulthood. We investigated professional opinions on how to mitigate long-term consequences of CM in a public health (PH) perspective. Methods: Using the Delphi method in three rounds, we inquired 91 professionals, mostly European researchers and clinicians about potential PH actions to mitigate CM consequences during adulthood. Results: Most experts agreed that PH actions are needed. Increasing community awareness and training emotional regulation in affected adults were prioritized strategies. Enlarging curricular knowledge about CM for professionals and developing evidence-based interventions were considered preferred methods. Reducing the barriers for access to interventions for adults, such as those provided by trauma-informed services were also suggested. Participants highlighted the possibility to reduce CM consequences across generations as a significant benefit. Conclusions: PH programmes to reduce the burden of CM can be enhanced by specific actions to facilitate the recognition of difficulties in affected adults and to expand the availability of helpful resources. The application of these programmes could be assisted by the use of modern information-technology

Child maltreatment, revictimization and Post-Traumatic Stress Disorder among adults in a community sample

Background/Objective: Childhood maltreatment (CM) has been associated with revictimization and post-traumatic stress disorder (PTSD). However, this relation is hardly examined in South European countries, and in community samples. We tested these associations in a convenience sample of 1,200 Portuguese adults in the community. Method: Data were collected using self-report questionnaires, the Post Traumatic Diagnostic Scale (PDS) and the Childhood Trauma Questionnaire–Short Form (CTQ-SF). Odds ratios, logistic and hierarchical regression were used to analyze the data. Results: Exposure to CM increased more than twofold the risk of being revictimized and threefold a PTSD diagnosis. Highly prevalent traumatic events such as accidents were associated with CM. More than 30% of adults with PTSD were exposed to emotional abuse. After adjusting for demographics, emotional abuse remained a significant predictor for revictimization and PTSD, having the largest effect on the prediction of PTSD severity (β = .24). Conclusions: Findings underline the injurious potential of emotional abuse during childhood in adults in the community. More knowledge is needed about the mechanisms linking CM with further traumatic exposure and PTSD across the lifespan to better inform preventive and therapeutic actions

Lithothamnium calcareum no tratamento de osteotomia experimental em coelhos (Oryctolagus cuniculus)

Avaliaram-se os efeitos da suplementação com Lithothamnium calcareum na consolidação de osteotomia experimental em coelhos, por meio de exames radiográfico e histológico. Utilizaram-se 10 coelhos machos da raça Nova Zelândia, de quatro a cinco meses de idade, com massa corporal média de 2,5kg, os quais foram submetidos à osteotomia do terço médio da tíbia direita e à fixação interna com dois pinos intramedulares. Os coelhos foram distribuídos aleatoriamente em dois grupos experimentais (A e B) com cinco animais cada. O grupo A recebeu diariamente dieta contendo 0,75% de L. calcareum, e o grupo B constituiu o controle sem tratamento adicional à fixação da osteotomia. A evolução clínica ocorreu sem intercorrências. As radiografias foram realizadas antes do estudo e em intervalos de 15 dias até o final do experimento, e a histologia foi realizada aos 60 dias. As avaliações radiográficas permitiram acompanhar a evolução do processo de consolidação que ocorreu em todos os casos. Histologicamente, verificou-se consolidação completa em todos os animais do grupo B (controle) e em 75% do grupo A. Dos resultados pode-se concluir que, embora tenha ocorrido a consolidação clínica e a radiográfica aos 60 dias em todos os casos, histologicamente o grupo-controle (B) foi melhor, mostrando que o organismo sadio não necessita de estímulo para o processo de reparação óssea. Novas pesquisas devem ser realizadas para avaliar o efeito da suplementação mineral em animais portadores de deficiências nutricionais