Health related quality of life of obese adolescents in Kuwait

Obesity impairs health related quality of life (HRQL) in adolescents, but most evidence in this area has mostly come from western societies. We wanted to test the hypothesis that obesity impairs HRQL in Kuwaiti adolescents, and to test for differences in HRQL assessed by self-report and parent-proxy report. In 500 Kuwaiti 10-14 year olds HRQL was assessed using the Peds QL (TM) with both adolescent self-reports (n = 500) and parent-proxy reports (n = 374). Obesity was not significantly associated with HRQL in regression analysis. In a paired comparison of 98 pairs of obese adolescents vs. 98 healthy weight peers, impairment of HRQL reached significance only for physical score (95% CI = -1.5, -9.4), not for psychosocial score or total score. In a paired comparison of parent-proxy vs. self-reports for the obese adolescents, total score (95% CI = -4.9, -10.9), physical score (95% CI = -3.2, -11.0), and psychosocial score (95% CI = -4.2, -10.8) were all significantly lower in the parent reports. Obesity is not associated with marked impairment of HRQL in adolescents in Kuwait, in contrast to studies in western societies. This may reflect cultural differences in attitudes towards obesity

The context of child sexual abuse, and points of departure

This chapter sets out the context of child sexual abuse and marks out several points of departure from which the rest of the book proceeds. It first defines the concept of child sexual abuse. Then, it reviews the best literature on the prevalence of child sexual abuse both generally, and in specific contexts, around the world. It reviews other important epidemiological features, referring to evidence about gender, age of onset, the relationship between those who inflict abuse and the child, frequency of offending, factors influencing offending, and theories of offending. It notes the common health and behavioural consequences of child sexual abuse. Significantly, it then reviews literature on the common non-disclosure of child sexual abuse by both girls and boys: a critical feature of this context. The chapter than shows that the gravity of child sexual abuse should be and is recognised in international policy and in most social norms. An appropriately nuanced approach is then urged, in recognition of a spectrum of cases that demand appropriately differentiated responses. Finally, the chapter explains that the book also proceeds on the basis that in any civilised society, individuals, institutions and broader social systems and nation states have a deep ethically-based duty to prevent and identify child sexual abuse, and to respond appropriately to it after it occurs. These ethical duties are consistent with bodies of political and public health theory, the Capabilities Approach, and human dignity informing the book’s entire conceptual approach