Genetic variants in 5p13.2 and 7q21.1 are associated with treatment for benign prostatic hyperplasia with the α-adrenergic receptor antagonist

Background: The etiology of benign prostatic hyperplasia (BPH) has not been well established. The preferred medical treatment for many men with symptomatic benign prostatic hyperplasia is either an α-adrenergic receptor antagonist (α-blocker), or a 5α-reductase inhibitor. Single nucleotide polymorphism (SNP) is a powerful tool for successful implementation of individualized treatment.

Methods: Eighteen SNPs associated with drug efficacy in a Chinese population were genotyped in 790 BPH cases (330 aggressive and 460 non-aggressive BPH cases) and 1008 controls. All BPH patients were treated with α-adrenergic blockers for at least 9 months. We tested the associations between tagging single nucleotide polymorphism and BPH risk/aggressiveness, clinical characteristics at baseline, including the International Prostate Symptom Score (IPSS) and total prostate volume, and changes in clinical characteristics after treatment.

Results: There were nine SNPs associated with BPH risk, clinical progression and therapeutic effect. (1) There were nine tSNPs been chosen in CYP3A4, CYP3A5 and RANBP3L genes. (2) The SNP, rs16902947 in RANBP3L at 5p13.2 (p?=?.01), was significantly associated with BPH. (3) We found two SNPs, rs16902947 in RANBP3L at 5p13.2 (p?=?.0388) and rs4646437 in CYP3A4 at 7q21.1 (p?=?.0325), associated with drug effect. (4) Allele “G” for rs16902947 was found to be risk alleles for BPH risk (OR=?2.357, 95%CI 1.01–1.48). The “A” allele of rs4646437 was associated with lower IPSS at baseline (β=??0.4232, p=?.03255).

Conclusions: rs16902947, rs16902947 and rs4646437 single nucleotide polymorphisms are significantly associated with the clinical characteristics of benign prostatic hyperplasia and the efficacy of benign prostatic hyperplasia treatment.     

“She Got Spoilt”: Perceptions of Victims of Child Sexual Abuse in Ghana

ABSTRACT

International research has commented on social stigma as a key reason for nondisclosure of child sexual abuse. However, the actual components of this social stigma frequently remain unexplored. The present study deals with perceptions of consequences of child sexual abuse among professionals and laypeople in Ghana (N = 44), employing a bystander perspective. As a qualitative study using a grounded theory framework, it considers these consequences in light of their underlying beliefs about child and adolescent development, particularly in relation to gender-based expectations placed on girls and boys. Consequences of child sexual abuse could be divided into sexual health consequences, beliefs about “destroyed innocence” and beliefs about a “destroyed future,” which were strongly related to the sexual nature of the violence perpetrated. These perceived consequences of child sexual abuse hold implications for what surviving child sexual abuse means on a social level. Implications for practice are discussed on the basis of the data analysis.     

Abusers gaining custody in family courts: A case series of over turned decisions

Abstract

This article presents findings and recommendations based on an in-depth examination of records from 27 custody cases from across the United States. The goal of this case series was to determine why family courts may place children with a parent that the child alleges abused them rather than with the nonoffending parent. We focused on “turned around cases” involving allegations of child abuse that were at first viewed as false and later judged to be valid. The average time a child spent in the court ordered custody of an abusive parent was 3.2?years. In all cases we uncovered the father was the abusive parent and the mother sought to protect their child. Results revealed that initially courts were highly suspicious of mothers' motives for being concerned with abuse. These mothers were often treated poorly and two-thirds of the mothers were pathologized by the court for advocating for the safety of their children. Judges who initially ordered children into custody or visitation with abusive parents relied mainly on reports by custody evaluators and guardians ad litem who mistakenly accused mothers of attempting to alienate their children from the father or having coached the child to falsely report abuse. As a result, 59% of perpetrators were given sole custody and the rest were given joint custody or unsupervised visitation. After failing to be protected in the first custody determination, 88% of children reported new incidents of abuse. The abuse often became increasingly severe and the children's mental and physical health frequently deteriorated. The main reason that cases turned around was because protective parents were able to present compelling evidence of the abuse and back the evidence up with reports by mental health professionals who had specific expertise in child abuse rather than merely custody assessment.     

An Examination of Drinkers’ Consequences by Sexual Orientation

Abstract

Objective: This study examined college student drinkers by sexual orientation (SO), alcohol use, and negative consequences in a national sample that self-identified gender and SO. Participants: Students completing the Spring 2005 National College Health Assessment (N = 54,111). Methods: A secondary analysis was conducted examining student responses by SO to items regarding negative consequences associated with alcohol. Results: Bisexual students had the highest mean scores on an index of alcohol-related harm. Significant differences were found by SO among male high-risk drinkers for alcohol-related consequences of “fighting” and “injuring another,” and females for “injuring another” and “unprotected sex.” Bisexual students had significantly greater than expected cell counts for significant results, including a significant finding for bisexual low-risk female students for alcohol-related “regret.” Conclusion: These findings suggest that more research is necessary to discern real differences in alcohol-related risk among college students by sexual orientation.     

Prevalence analysis of urinary incontinence after radical prostatectomy and influential preoperative factors in a single institution

Aims: To assess prevalence of urinary incontinence (UI) after radical prostatectomy (RP) and to analyze which preoperative characteristics of the patients have influence on UI.

Methods: Between 2002 and 2012, 746 consecutive patients underwent RP for clinically localized prostate cancer. We defined UI according to International Continence Society (ICS) definition: “the complaint of any involuntary leakage of urine” after 12?months of recovery, international consultation on incontinence questionnaire (ICIQ-SF) and pads/day was collected too. Clinical features and magnetic resonance imaging measurements were assessed. A multivariable logistic regression model predicting incontinence were built-in after adjust by cofounding factors and bootstrapping.

Results: About 172 (23%) of the patients were classified as incontinent according to the ICS definition. The mean value of the ICIQ-SF was 10.87 (±4). 17.8% of patients use at least one pad/day, 11.9% use more than one pad/day. The preoperative factors independently influential in UI are: age [OR: 1.055; CI 95% (1.006–1.107), p?=?.028], urethral wall thickness [OR: 5.03; CI 95% (1.11–22.8), p?=?.036], history of transurethral resection of the prostate [OR: 6.13; CI 95% (1.86–20.18), p?=?.003] and membranous urethral length [OR: 0.173; CI 95% (0.046–0.64), p?=?.009]. The predictive accuracy of the model is 78.7% and the area under the curve (AUC) value 71.7%.

Conclusions: Urinary incontinence after radical prostatectomy has different prevalence depending on the definition. Age, prior transurethral resection of the prostate (TURP), membranous urethral length (MUL) and urethral wall thickness (UWT) were risk factors.     

Three Types of Memory for Childhood Sexual Abuse: Relationships to Characteristics of Abuse and Psychological Symptoms∗

ABSTRACT

Data from a clinical sample (N?=?88) reporting childhood sexual abuse was compared by types of memory, abuse characteristics, and psychological symptoms. Three types of memory were identified from a questionnaire (“Always” n?=?27 [31%], “Recovered” n?=?41 [46%], and “Both” n?=?20 [23%]). When compared with narrative reports from a subset (n?=?30) of the sample, the lines between “Always,” “Recovered,” and “Both” types of memory were ambiguous. Consistency across reports, however, was 83%. Memories classified as either “Recovered” or “Both” were associated with earlier age-at-onset and more severe psychological symptoms compared to those who “Always” remembered CSA. No significant differences were found between the “Both” and “Recovered” groups.     

Multiple approaches to understanding and preventing elder abuse: Introduction to the cross-disciplinary National Institutes of Health workshop

ABSTRACT

On October 30, 2015, the National Institutes of Health (NIH) convened a workshop, “Multiple Approaches to Understanding and Preventing Elder Abuse,” in Bethesda, Maryland. The workshop brought together experts from across disciplines to discuss research challenges, opportunities, and lessons learned from other fields. Participants included experts in elder abuse, child abuse, intimate partner violence (IPV), emergency medicine, and neuroscience. In this special issue of the Journal of Elder Abuse and Neglect, participants address topics explored before, during, and after the day-long workshop.     

Domestic Abuse Assessment in Child Custody Disputes: Beware the Domestic Violence Research Paradigm

ABSTRACT

In some states, custody assessors are now required to become familiar with the dynamics of prevalence of domestic abuse since the presence of one or more abusive parents in the house has an impact on the “best interests of the child.” The domestic abuse literature is misleading in setting a framework for abuse incidence and threat source for children. Males are represented as primary perpetrators of physical abuse although data from meta-analytic studies show otherwise. Indirect aggression is scarcely mentioned in the literature, although prevalent in research on aggression. Physical violence directed towards children is actually more likely to be mother-perpetrated. Child safety may be compromised if attention is focused solely on the possibility of abuse from a male perpetrator.     

Family Characteristics and Structure as Determinants of Sexual Abuse Among Female Secondary School Students in Nigeria: A Brief Report

ABSTRACT

Child sexual abuse is associated with factors that enhance the vulnerability of the child, raising physical and mental health complications in adulthood. Three hundred and fifty students participated in this cross-sectional study. Important determinants of sexual abuse were parents not living together, not living with parents, family type, and current parents’ marital status (p < 0.05). Respondents living with both parents were two times less likely to experience sexual abuse (OR = 0.5, CI: 0.3, 0.9) than respondents living with their guardians. Respondents whose parents were living together were about two times less likely to experience sexual abuse (OR = 0.6, CI: 0.3–0.9) than respondents whose parents were not living together. Respondents whose parents were either divorced or separated were about six times more likely to experience sexual abuse (OR = 5.6, CI: 1.1–27.2) than respondents with widowed parents. The study showed that parental togetherness protected against child vulnerability and risk of being sexually abused.     

Psychometrics of a Child Report Measure of Maternal Support following Disclosure of Sexual Abuse

ABSTRACT

The study examined a new child report measure of maternal support following child sexual abuse. One hundred and forty-six mother–child dyads presenting for a forensic evaluation completed assessments including standardized measures of adjustment. Child participants also responded to 32 items considered for inclusion in a new measure, the Maternal Support Questionnaire–Child Report (MSQ-CR). Exploratory factor analysis of the Maternal Support Questionnaire–Child Report resulted in a three factor, 20-item solution: Emotional Support (9 items), Skeptical Preoccupation (5 items), and Protection/Retaliation (6 items). Each factor demonstrated adequate internal consistency. Construct and concurrent validity of the new measure were supported in comparison to other trauma-specific measures. The Maternal Support Questionnaire–Child Report demonstrated sound psychometric properties. Future research is needed to determine whether the Maternal Support Questionnaire–Child Report provides a more sensitive approximation of maternal support following disclosure of sexual abuse, relative to measures of global parent–child relations and to contextualize discrepancies between mother and child ratings of maternal support.     

Risk Management in Treating Child Sexual Abuse Victims and Adult Survivors

ABSTRACT

Before the 1990s, mental health professionals were rarely sued for “talking cures.” Today, hundreds and hundreds of cases have been brought against therapists working with child sexual abuse issues. Risk management needs to accommodate the current wave of lawsuits so that mental health professionals can avoid litigation. This commentary presents some of the issues involved in these cases, and suggests techniques for therapists to utilize for risk management.     

Consequences of Teen Parents' Child‐Care Arrangements for Mothers and Children

Using the nationally representative Early Childhood Longitudinal Study, Birth Cohort (2001–2006; N ?7,900), the authors examined child‐care arrangements among teen parents from birth through prekindergarten. Four latent classes of child care arrangements at 9, 24, and 52 months emerged: (a) “parental care,” (b) “center care,” (c) “paid home‐based care,” and (d) “free kin‐based care.” Disadvantaged teen‐parent families were overrepresented in the “parental care” class, which was negatively associated with children's preschool reading, math, and behavior scores and mothers' socioeconomic and fertility outcomes compared with some nonparental care classes. Nonparental care did not predict any negative maternal or child outcomes, and different care arrangements had different benefits for mothers and children. Time spent in nonparental care and improved maternal outcomes contributed to children's increased scores across domains. Child‐care classes predicted maternal outcomes similarly in teen‐parent and nonteen‐parent families, but the “parental care” class predicted some disproportionately negative child outcomes for teen‐parent families.     

What Happens When There Is Presumptive 50/50 Parenting Time? An Evaluation of Arizona’s New Child Custody Statute

ABSTRACT

The current study presents the findings of an evaluation of Arizona’s 2013 revisions to the child custody statutes that directed courts to “maximize” the child’s parenting time with both parents. A state-wide survey of the four family law professions (i.e., conciliation court staff, judges, mental health providers, and attorneys) assessed their perceptions of the law 4 years after implementation. We averaged the ratings across the four professions to obtain a comprehensive perspective that gave equal weight to each profession. Results revealed that the law functions as a rebuttable presumption of equal parenting time; that it is evaluated positively overall and in terms of children’s best interests; that it is has a neutral impact on legal and interparental conflict; and that it has led to small increases in allegations of domestic violence, child abuse, and substance abuse.     

Study of Cases of Child Sexual Abuse Referred for Medico-Legal Examination in Cairo and Giza,Egypt,2007–2011

ABSTRACT

Child sexual abuse is a complex problem that results in detrimental effects on its victims. This study aimed to investigate the pattern of child sexual abuse in cases referred for medico-legal examination in Cairo and Giza governorates in the period between 2007–2011. The study included 813 cases of child sexual abuse. Female gender was more predominant than male gender (52.8%, 4.29 cases), and adolescents were the most frequent age group identified as victims of sexual abuse (43.8%, 356 cases). All perpetrators were male and most of them were persons outside the victims’ families (89.9%, 731 cases). It was recommended to teach and encourage children to tell their caregivers if they have been assaulted and to educate parents and caregivers on how to respond when the child discloses sexual abuse.     

Analysis of cardiovascular risk factors associated with serum testosterone levels according to the US 2011–2012 National Health and Nutrition Examination Survey

Objective: To investigate associations between cardiovascular disease risk factors, including fasting glucose, cholesterol, high density lipoprotein cholesterol (HDL-c), LDL-c, blood pressure, body mass index (BMI), C-peptide, creatinine kinase, smoking, alcohol use, physical activity, C-reactive protein as well as homocysteine levels and cardiovascular events.

Methods: Data from 1545 men aged ≥40?years, with testosterone deficiency (TD) (<300?ng/dL) and non-TD (≥300?ng/dL) which were extracted from the National Health and Nutrition Examination Survey database 2011–2012 and analyzed.

Results: Multivariate logistic regression analysis showed positive associations between TD and BMI (≥35 vs.?p?=?.016), HDL-c (<0.91 vs. ≥0.91: OR?=?1.60, 95% CI: 1.14–2.24, p?=?.006) and diabetes (diabetes vs. non-diabetes: OR?=?1.48, 95% CI: 1.14–1.92, p?=?.004) as well as negative associations between TD and metabolic equivalent scores (≥12 vs. <12: OR?=?0.69, 95% CI: 0.52–0.91, p?=?.009) and smoking (Ever vs. never: OR?=?0.69, 95% CI: 0.51–0.94, p?=?.018). Furthermore, total serum testosterone levels were lower in patients with heart failure (p?=?.04) and angina/angina pectoris (p?=?.001) compared with subjects without these cardiac problems.

Conclusion: Low serum testosterone was associated with multiple risk factors for CHD.     

Exploring the Relationship Between Adverse Childhood Experiences and Hope

ABSTRACT

To explore the relationship between adverse childhood experiences and hope, a convenience sample of caregivers bringing in children for medical investigation of child abuse at a regional child advocacy center were surveyed for adverse childhood experiences and dispositional hope. Hope in this sample had a significant negative correlation to the adverse childhood experiences subscale “abuse” (r = –.19; p < .05). The relationship between hope and the other adverse childhood experiences subscales “neglect” (r = –.14) and “dysfunctional family” (r = –.16) was not statistically significant. An analysis of variance was performed to determine if caregivers who have experienced both sexual and physical abuse (M = 29.67; SD = 15.96) have lower hope scores compared to those caregivers who have experienced neither physical nor sexual abuse (M = 42.64; SD = 18.44). This analysis (F (1, 84) = 5.28; p < 0.05) showed that caregivers who experienced both physical and sexual abuse scored significantly lower on hope compared to their counterparts who experienced no adverse events, with an estimated effect size of moderate strength (d = 0.70). Higher adverse childhood experiences scores are associated with lower hope. This result was especially true for those adult caregivers who reported experiencing both physical and sexual abuse when compared to adults who did not experience either form of child trauma. While the empirical literature continues to demonstrate the negative consequences of adverse childhood experiences across the life span, hope offers a compelling new line of inquiry in child maltreatment research especially for studies targeting prevention or intervention.     

Adverse Life Experiences and Homelessness Among Adolescents: an examination of the conditions for convergence

Abstract

There are two factors that limit our knowledge of the risk factors associated with homelessness among runaway adolescents, namely (1) the samples used are often composed of youth homeless service users and/or youths living on the streets (visible homelessness), whereas most adolescents in fact use “private” resources (hidden homelessness), and (2) failure to use an adequate control group to identify risk factors associated specifically with homelessness. Our study compares the characteristics of two groups of youths under the supervision oftheyouth protection system, according to the presence or absence of periods of homelessness. The results throw light on the factors underlying the shiftfrom “at risk” to “homeless”, showing that youths with experience of homelessness are more likely to have been placed in substitute home environments, have experienced significant relationship difficulties with one of their parents (deterioration ofthe parent/youth relationship and parental abuse) and to have been diagnosed with behavioral disorders. The findings suggest that the decision to place young people under supervision is based more on the dynamic between risk factors rather than on the existence of behavioral problems.     

Tackling child abuse in the european community

Abstract

It is now increasingly realised that child abuse exists in all societies. Finkelhor (1988), in a seminal paper, suggests that the main focus of internatinal concern should be “parental battering, selective neglect and sexual abuse”.

Here we describe die climate of opinion and the procedures adopted to protect children in three EC countries: the Netherlands, France and West Germany, taking material from sources in the respective countries and from pesonal contacts.     

A response to 'factitious disorders by proxy: A trap for the unwary' Parent induced illness,factitious illness by proxy (Munchausen by proxy)

Abstract

Introduction This form of child abuse is quite rare but perhaps not as unusual as the figures imply. The name itself and the recent changes confirm that there is increasing awareness of its significance; Munchausen Syndrome by proxy has been changed to factitious illness by proxy or parent induced illness. Roy Meadow (1977, 1982, 1990), first drew attention to this form of abuse where parents present their child with an organic illness. Bools et al (1994) has developed the work and there has been a recent important article from Gray and Bentovim (1996), based on work at Great Ormond Street Hospital. The complexity and diversity of these cases and the range of presentations seem to be part of the problem in recognition. An outline of the emergence of awareness of this form of child abuse and a review of the literature is well covered in the article 'Factitious disorders by proxy' (Randall & Parker, 1997). While drawing this difficult and complex form of abuse to the attention of professionals, what we would suggest is also needed is both an outline of the various forms of presentations and some thoughts about the processes that are present both within the professional system, intrafamilially, and intraphysically.