Parental risk and resilience: How does evidence inform child maltreatment prevention and reduction?

Child Maltreatment is a global concern with a sequela of negative consequences. The Risk and Resilience Ecological Framework is used to enable synthesis of evidence from two systematic reviews, A and B, on evidence of factors that influence parental child maltreatment. Review A comprises non-interventional, empirical studies to determine parental risk and protective factor interplay, lending support to causal and correlational links to child maltreatment. Review B synthesises evidence from intervention evaluations on parental risk factors and intervention provision for child maltreatment. A total of 128 studies, 68 observational studies in Review A and 60 intervention evaluations in Review B, were systematically reviewed. Quality appraisal did not lead to exclusion of studies. Review A findings mirror prior evidence and highlight nuances such as memories of parental childhood maltreatment as risk, emotional support for mothers and companionship support for fathers as protective, and demarcate maltreatment type-specific factors, especially for physical abuse and neglect. A low representation of fathers, under-research of unique factors for sexual and emotional abuse and of macro-level protective factors were identified. Review B provides comprehensive data on potentially effective intervention components including child development education and parental emotional regulation. Behaviour Change Techniques Framework helped identify potentially optimal delivery techniques including Instruction on how to perform a behaviour and Social support (unspecified). Lack of cultural representation, sparsity of interventions targeting fathers, over-reliance on self-reporting measures and under-examination of macro-level intervention components were identified as gaps in knowledge. Both reviews underline a call for consensus in definitions and avoidance of umbrella terms. A final synthesis elucidated the complex interplay of multiple influences on parental child maltreatment. Findings offer valuable insight to move the field forward, inform researchers, policy, and practice to strengthen parental resilience to prevent and reduce child maltreatment

Research helps address ethnic disparities in degree awards

There is a gap in degrees for Black, Asian and Minority Ethnic (BAME) students at UK universities. This is often referred to as an ‘attainment gap’, as if the students were responsible for the inequality. However, many systemic factors – including institutional structures, racism and discrimination – contribute to student success. Leslie M Gutman and Fatima Younas describe their research to create positive change

Parental Risk and Protective Factors in Child Maltreatment: A Systematic Review of the Evidence

This study systematically reviews and synthesizes evidence on parental risk and protective factors along with identifying differences in the presence of these factors based on maltreatment type. In all, 68 quantitative, published, empirical studies were included from electronic databases for the systematic review. Quality appraisal did not exclude any studies and data were extracted from all. Results were narratively synthesized using the Risk and Resilience Ecological framework. The findings revealed more risk factors on the micro (individual and family) ecological level compared to mezzo and macro levels. At the micro level, findings mirror results of prior systematic reviews such as parental substance abuse, history of childhood maltreatment, and intimate partner violence (IPV). Social support was the most significant protective factor across all ecological levels and across all maltreatment types except child sexual abuse but differed in definition widely across studies. Physical abuse had the most risk factors unique to this type followed by neglect, and IPV was a common risk factor across all maltreatment types. Fewer studies on emotional abuse, sexual abuse, and protective factors were identified. The findings of this review delineated key parental risk and protective factors at various ecological levels along with associations between distinct factors and types of maltreatment. Interventions working with parents to reduce child maltreatment risk can use these findings to guide development of targeted programs for families based on risk and maltreatment type. For researchers, the findings can guide further investigation in under-researched areas of parental sexual and emotional abuse and protective factors

Diagnostic accuracy of strain ultrasound elastography in differentiating benign and malignant thyroid nodules, taking histopathology as gold standard

Background: Elastography is a method recently being used in the evaluation of thyroid nodules by comparing tissue elasticity. Strain and shear wave elastography are two types of elastography still being used in clinical practice. Two kinds of elasticity can be assessed by strain elastography. First, colors around and within the nodules are evaluated and visually scored according to the 4-5 scale scoring systems. The aim of this study was to determine the diagnostic accuracy of strain ultrasound elastography in differentiation between benign and malignant thyroid nodules, taking histopathology as gold standardMethods: Total of 101 patients with palpable thyroid nodule of any size of age 30-70 years of either gender were included. Patients with previous thyroid surgery and already proven histopathology were excluded. Strain ultrasound elastography was performed in every patient by using a highresolution unit with a linear array probe centred at 7.5 MHz. Strain ultrasound elastography was performed in every patient by a consultant radiologist in the presence of researcher and benign or malignant thyroid nodules was noted. Strain USG elastography findings were compared with histopathology report.Results: All the patients were subjected to strain ultrasound elastography. USG supported the diagnosis of malignant thyroid nodules in all 52 patients. Histopathology confirmed malignant thyroid nodules in 47 (true positive) cases where as 5 (false positive) had no malignant lesion on histopathology. In USG negative patients, 46 were true negative while 3 were false negative. Overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of strain ultrasound elastography in differentiation between benign and malignant thyroid nodules, taking histopathology as gold standard is 94.0%, 90.20%, 90.38%, 93.88% and 92.08% respectively.Conclusions: According to this study, strain ultrasound elastography is the non-invasive modality of choice with high diagnostic accuracy in diagnosing malignant thyroid nodules

The cross-sectional study of anxiety levels and ratio of severity of thirteen symptoms of anxiety among medical students

Background: Anxiety is defined as physical, behavioral, social and psychological response to treat self-concept characterized by subjective, consciously perceived feelings of tension. Nowadays anxiety is most commonly found among medical students. This study was conducted to find out the anxiety levels and ratio of severity of thirteen symptoms of anxiety.Methods: A questionnaire based study was conducted among 178 medical students which tests the level of anxiety and severity of symptoms of anxiety. The questionnaire used was hamilton anxiety rating scale (HAM-A).Results: Out of 178 students, 80 (44.94%) students scored mild anxiety levels, 63 (35.39%) students scored moderate anxiety levels and 35 (19.66%) students scored severe anxiety levels.Conclusions: Mild form of anxiety is much more common among medical students and majority of these medical students are females. Moreover, the symptoms of anxiety including tension, anxious mood, depressed mood, insomnia, fear and CVS symptoms appear with moderate severity in majority of medical students while on the other hand some symptoms including general somatic muscular and sensory symptoms, difficulties in concentration and memory, genitor-urinary symptoms, respiratory symptoms, GIT symptoms and other autonomic symptoms appear with least severity among majority of medical students

Pediatric Head Injury: A Study of 120 Cases

Objectives:  This study aimed to evaluate incidence, mode, and severity of injury, treatment options and to determine the outcome in pediatric age group patients with head injury. Patients & Methods:  120 pediatric patients with a head injury, with ages up to 15 years or less, were included. Detailed history, general and neurological examination including GCS were noted. The CT scans were conducted and the patients managed as per said protocol. Various surgical procedures were performed including craniotomies and evacuation of hematoma, the elevation of depressed fractures and repair of the dura, decompression craniotomies, and evacuation of Subdural collections and contusions. Results:  60.1% of patients were boys and 39.16% were girls. In the majority (63%) of the children, the ‘fall’ was reported. The majority of children (68.3%) in our study had a mild head injury with GCS 13 – 15. 35.83% patients had normal CT scans, and 23.33% had isolated skull fractures. 68.75% patients were with a severe head injury and had a poor outcome. A poor outcome was noted in patients having brain edema, subdural hematoma, and brain contusions. Conclusion:  Head injury in the pediatric age group still continues to be a significant cause of mortality and morbidity. The outcome is directly being related to the severity of injury i.e., GCS. Falls and RTAs are the most common causes and preventive measures in different forms need to be addressed

sj-docx-1-tva-10.1177_15248380221134634 – Supplemental material for Parental Risk and Protective Factors in Child Maltreatment: A Systematic Review of the Evidence

Supplemental material, sj-docx-1-tva-10.1177_15248380221134634 for Parental Risk and Protective Factors in Child Maltreatment: A Systematic Review of the Evidence by Fatima Younas and Leslie Morrison Gutman in Trauma, Violence, & Abuse</p

Impact of vitamin C supplementation on composition, stability, fatty acids profile, organic acids, antioxidant properties and sensoric acceptability of cultured buttermilk

Buttermilk is a fermented drink widely used all over the world. It is produced widely both traditionally and commercially through pasteurization. Buttermilk, produced during churning of cultured cream, was supplemented with vitamin C at four different concentrations i.e., 100, 200, 300, 400 mg/100 ml, and zero concentrations (T1, T2, T3, T4 and control) and was evaluated for different parameters. Vitamin C supplementation at all concentrations had no effect on compositional attributes of buttermilk (p>0.05). The results also showed that concentration of vitamin C supplemented buttermilk in T1, T2, T3, T4, and control was 98.81, 196.14, 277.38, 382.19, and 0 mg/100 ml (p0.05) respectively. Oleic acid content in control, T1, T2, T3, T4 was 35.79, 35.75, 35.65, 35.63 and 35.19% (p>0.05). Linoleic acid content in control, T1, T2, T3, and T4 was 7.49, 7.05, 7.13, 7.10 and 7.33% (p0.05) but the variation is due to storage period. Total antioxidant capacity of T1, T2, T3, T4 and control was 35.72, 42.74, 52.93, 68.77 and 84.66% (p0.05). According to trained judges, sensory evaluation of all the treatments were performed on a 9 point hedonic scale and the results showed a non-significant difference between control and treatments. From commercial point of view, sensory results were promising as vitamin C did not affect sensory attributes of buttermilk which is quite acceptable from consumer perspective. It is therefore concluded from the results that buttermilk can be supplemented with vitamin C