Children's response to the medical visit for allegations of sexual abuse: maternal perceptions and predicting variables

This study examined maternal perceptions of their child's response to the medical evaluation for alleged sexual abuse. A total of 50 mothers were interviewed 6 months after a visit to a Child Protection Clinic for a medical evaluation of alleged sexual abuse. The mothers answered a questionnaire on their child's reactions to the medical visit. More than 60% of children were perceived as being reassured about physical integrity. The degree of psychological distress was independent of perpetrator's identity and severity of the abuse. Mothers considered that a hypothetical second visit would generate in their child a level of anxiety that increased with perceived intensity of fear of the examination and decreased with perceived kindness of the physician. These results suggest that the physician's behaviour during the medical evaluation for alleged sexual abuse has an influence on the child's degree of distress that is independent of type and severity of abuse. Copyright © 2001 John Wiley & Sons, Ltd.     

Relational Aggression in Peer and Dating Relationships: Links to Psychological and Behavioral Adjustment

We examined the contribution of relational aggression in adolescents' peer and dating relationships to their psychological and behavioral adjustment. In the Fall and again four months later, 1279 (646 female) grade 9 students reported on relational aggression perpetration and victimization in their romantic and peer relationships, depression/anxiety symptoms (psychological adjustment) and delinquency (behavioral adjustment). Using hierarchical regression analyses, controlling for Time 1 adjustment/behavior, peer relational aggression perpetration predicted depression/anxiety. Dating relational victimization also predicted depression/anxiety, but only for girls. Furthermore, girls who were perpetrators of relational aggression in both peer and dating contexts were most likely to show increases in delinquent behavior. We conclude that dating and peer relationships are not redundant, but make independent and additive contributions to adolescent adjustment. Girls, in particular, may be at greatest risk for poor outcomes when they have relationally aggressive relationships. Results also highlight the need for greater awareness of the complexity and significance of adolescent dating relationships.     

Using Discrete-Time Event History Fertility Models to Simulate Total Fertility Rates and Other Fertility Measures

Event history models, also known as hazard models, are commonly used in analyses of fertility. One drawback of event history models is that the conditional probabilities (hazards) estimated by event history models do not readily translate into summary measures, particularly for models of repeatable events, like childbirth. In this paper, we describe how to translate the results of discrete-time event history models of all births into well-known summary fertility measures: simulated age- and parity-specific fertility rates, parity progression ratios, and the total fertility rate. The method incorporates all birth intervals, but permits the hazard functions to vary across parities. It can also simulate values for groups defined by both fixed and time-varying covariates, such as marital or employment life histories. We demonstrate the method using an example from the National Survey of Family Growth and provide an accompanying data file and Stata program.     

Symbols Build Communication and Thought: The Role of Gestures and Words in the Development of Engagement Skills and Social‐emotional Concepts during Toddlerhood

Social skills and symbol skills are positively associated in middle childhood, but the relation between these domains is less clear in newly verbal toddlers. Vygotsky proposed that symbols are both tools for interaction and mental tools for thought. Do symbols help even very young children build skills for interacting with and conceptualizing the social world? Longitudinal data from 108 children and mothers were collected when children were 14, 24, and 36 months. Children's gestures and words during mother–child interactions were used as symbol skill indicators to predict children's abilities to engage others and the number of social‐emotional concepts children portray during play. In a series of growth models, words had a stronger effect on engagement skills whereas early gesture use predicted later development of social‐emotional concepts. Therefore, even in early development, symbols serve as both communication tools and mental tools to construct understanding of the social‐emotional world.     

The McMaster Model of Family Functioning

The model of family functioning being presented is the product of over twenty years of research in clinical work with family units. A method of family therapy has been developed based upon this model and will be described in a future issue. The model utilizes a general systems theory approach in an attempt to describe the structure, organization, and transactional patterns of the family unit. It allows examination of families along the total spectrum ranging from healthy to severely pathological in their functioning. It is based upon a Judaeo-Christian value set, and allows attention to be paid to cultural differences and other issues of cultural relativity .     

Health Risk Assessment After Decontamination of the Beaches Polluted by the Wrecked ERIKA Tanker

Following the wreck of the oil tanker ERIKA off the north-west coast of France in December 1999, cleaning up of the beaches involved considerable work, which in any case could not be perfect. This raised the question of the short- and long-term health risks for the future bathers related to the toxicity of the remaining oil polycyclic aromatic hydrocarbons (PAHs). This risk assessment study was conducted to help health authorities plan risk management policies and inform the public. Thirty-six beaches were selected, representing a sample of the most frequently encountered topographic and beach usage situations; seven "control" beaches, unspoiled by ERIKA, were also investigated. Samples of water and sand were taken from each site, as well as from the surface of rocks. The 16 PAHs selected by the U.S. EPA were quantified in each environment. Several scenarios of exposure were contemplated: (1) a child between 2 and 4 years accidentally ingesting a small ball of fuel, (2) a child daily exposed throughout his holiday-time stay, (3) an adult (including a pregnant woman) spending his/her holidays on the coast, (4) an adult working on the beach, (5) and an adult practicing water sports. Among the available and significant toxicological values, the most conservative ones were selected for computing risks. The sand and water, after decontamination, were slightly polluted (respectively, 7.8 microg/kg and 23.3 ng/l of total 16 PAHs), with values similar to those found in the control beaches. By contrast, the rocky areas in some places were still highly polluted (up to 23 mg/kg on the surface layer). No lethal risk was found for a young child who had accidentally ingested a small ball of fuel. The life-long excess risks for skin cancer and for all other cancers were about 10-5 in scenarios including contact with the polluted rocks. In all other cases, excess risks were considerably lower. The hazard quotient for teratogenic effects was very small, except in scenarios where pregnant women would walk among rocks containing high pollution levels. In conclusion, exposure was mainly associated with polluted water among children, and with spoiled rocks for adults. Despite uncertainties, mainly dealing with the prediction of long-term risks following a short-term exposure, this study showed that beaches where pollution was no longer visible after decontamination did not entail any significant health risks and could be opened to the public.     

Steps in the Right Direction,Against the Odds,An Evaluation of a Community‐Based Programme Aiming to Reduce Inactivity and Improve Health and Morale in Overweight and Obese School‐Age Children

The study describes an evaluation of a 48‐week physical activity and nutritional education programme for overweight/obese school‐age children using quantitative and qualitative methods. The majority of participants were obese or severely obese when enrolled, and while some improvements in body mass index, self‐esteem and engagement in a range of physical activities were noted, difficulties in evaluating a complex community‐based intervention were highlighted. Children, parents and health professionals described a range of benefits from attending the programme but more intensive services are likely to be needed for the most seriously obese children and for those families resisting intervention.     

'I made some mistakes . . . but I love them dearly' the views of parents of children in informal kinship care

In-depth semi-structured interviews with 30 parents of children living with relatives in informal kinship care arrangements revealed the parents' views of the reasons for the informal kinship care arrangements, quality of their relationships with the children and their caregivers, their current and future roles in their children's lives, feelings experienced when with and away from the children, positive and negative aspects of kinship care, future goals and dreams for their children, and their assessments of their own strengths and challenges. Results of these interviews suggest several implications for social work practice and research.     

Ethical challenges in conducting research with hard to reach families

This paper reflects on some of the ethical challenges encountered by the authors whilst undertaking sensitive qualitative research with parents and children who are traditionally hard to reach. The research aimed to provide more holistic and in‐depth accounts of parenting on a low income in diverse social circumstances than already exist. The nature of the sample and the subject matter that was covered inevitably raised many familiar ethical dilemmas and some that are less often encountered in practice, particularly in relation to child protection. In this article we discuss our approach to ethics, some of the ethical challenges we encountered undertaking work with families and discuss the complexity of decision‐making around risk of harm to children. We conclude that a clear framework to avoid harm should be developed at the outset and a transparent approach to child protection issues should be used. Additional time and resources need to be incorporated at the planning stage of similar projects in order to develop appropriate methods, ensure effective decision‐making and support researchers. Copyright © 2008 John Wiley & Sons, Ltd.