Childhood Sexual Abuse as a Risk Factor for Subsequent Involvement in Sex Work

Abstract

The following paper is a review of research studies examining the relationship between childhood sexual abuse (CSA) and subsequent involvement in sex work. The vast majority of research studies in this area are conducted on primarily female street-based prostitutes; however, there has been a recent emergence of studies focused on male, predominantly gay/bisexual, participants. Also, more studies have begun to include mixed gender samples and non-sex worker comparison groups. Highlights of the paper include a critique of studies reporting a prevalence of CSA, the intervening effects of family environment, runaway behavior, and abuse characteristics, and a brief overview of research on other sex worker populations. Limitations as well as contributions of current studies are underscored and directions for future research are indicated.     

Does Metabolic Syndrome Impair Sexual Functioning in Adults With Overweight and Obesity?

Objectives: Obesity is a growing public health concern worldwide, and results in increased risk of cardiovascular disease, type 2 diabetes, metabolic syndrome, insulin resistance, dyslipidemia, hypertension, and reduced sex hormone production. Previous research suggests that obesity may contribute to sexual dysfunction. This review aims to determine the relationship between obesity and sexual dysfunction, and ascertain the associated cardiometabolic conditions that may contribute to impaired sexual functioning in individuals with obesity. Methods: Literature searches were conducted through PubMed and Embase from 1980 to 2016, to identify original research articles, reviews including systematic reviews and meta-analyses, using the search terms: obese, obesity, overweight, sexual function, sexual dysfunction, metabolic syndrome, CVD, T2D, hormones and weight loss. Results: This review found that individuals with obesity and cardiometabolic comorbidities were more likely to report the greatest degree or sexual dysfunction and/or reduction in sexual quality of life, compared to those without. Conclusions: Current evidence supports an association between sexual dysfunction and factors associated with obesity, such as reduced insulin sensitivity, dyslipidaemia, hypertension, and low oestrogen or testosterone. To establish efficacious treatments, research examining the impact of weight loss on the conditions associated with obesity, such as hypertension, reduced insulin sensitivity, dyslipidaemia, and low sex hormones and sexual functioning in individuals with overweight and obesity should be a priority.     

Changes in Objective and Self-Reported Measures of Physical Capacity After an Intervention in Obese Older Women

The aim of this study was to determine if objective and self-reported measures of physical capacity are two equivalent methods to detect changes following an intervention in obese older women. 36 obese women aged between 55 and 75 years participated in a 3-month study with the aim of improving physical capacity by caloric restriction and/or resistance training. Physical capacity was measured objectively with 10 different tests and self-reported with the SF-36 physical functioning score (SF-36 PF score). Then the performance-to-objective tests were computed using quartiles to provide a baseline global physical capacity score. The mean percentage of change of the 10 tests as well as the SF-36 PF score were also calculated after the study. Body composition was measured by dual-energy X-ray (DXA) absorptiometry. The baseline global physical capacity score and the SF-36 PF score were significantly correlated at baseline (r = 0.43; P < 0.01). Eight out of the 10 objective tests of physical capacity improved after the intervention, while no improvement was observed for the SF-36 PF score. On average, percentage of change in physical capacity was 4.1 ± 5.9% for the SF-36 PF score and 11.1 ± 2.9% for the objective measures. However, no significant correlation was observed between percentage of changes between the two approaches after the intervention (r = 0.32; P = 0.07). Based on these results, the method used to quantify physical capacity after an intervention may have major implications on the outcomes. The methods used should be carefully analyzed in regard to the objective of the study.     

Exposing College Students to Exercise: The Training Interventions and Genetics of Exercise Response (TIGER) Study

Abstract

Objective: The Training Interventions and Genetics of Exercise Response (TIGER) study is an exercise program designed to introduce sedentary college students to regular physical activity and to identify genetic factors that influence response to exercise. Participants: A multiracial/ethnic cohort (N = 1,567; 39% male), age 18 to 35 years, participated in the study. Methods: Subjects underwent 30 weeks of exercise training, 3 days/week, for 40 minutes at 65% to 85% of age- and gender-predicted maximum heart rate reserve. Multiple measures of body size/composition, heart rate, and blood pressure were obtained. Results: A total of 1,567 participants, (39% male), age 18 to 35 years, participated in the TIGER study. The prevalence of overweight/obesity in participants was 48.0%/19.3% in non-Hispanic Whites, 55.3%/24.2% in Hispanic Whites, 54.9%/25.4% in African Americans, and 38.3%/11.3% in Asians. Average within-semester retention was 68%, but overall retention (30 weeks, 2 semesters) was 20%. Conclusions: The TIGER study represents an efficacious strategy for introducing college-aged individuals to regular aerobic exercise.     

Poverty,undernutrition, and child mortality: Some inter-regional puzzles and their implicationsfor research and policy

This paper examines the relationship between measures of income poverty, undernourishment, childhood undernutrition, and child mortality in developing countries. While there is, as expected, a close aggregate correlation between these measures of deprivation, the measures generate some inter-regional paradoxes. Income poverty and child mortality is highest in Sub Saharan Africa, but childhood undernutrition is by far the highest in South Asia, while the share of people with insufficient calories (undernourishment) is highest in the Caribbean. The paper finds that standard explanations cannot account for these inter-regional paradoxes, particularly the ones related to undernourishment and childhood undernutrition. The paper suggests that measurement issues related to the way undernourishment and childhood undernutrition are measured might play a significant role in affecting these inter-regional puzzles, and points to implications for research and policy. An erratum to this article can be found at     

A Longitudinal Examination of Family Processes,Demographic Variables,and Adolescent Weight

Nationally representative studies estimate that almost one in five adolescents in the United States is overweight. This is a major concern for individuals' physical and psychological health and the overall economy in terms of health care costs and loss of productivity. A 12- to 14-year-old subsample of 4,688 adolescents from the NLSY97 cohort was used to address the association between family processes, demographic variables, and adolescent body mass index (BMI) percentile over 4 years. The final model indicated that frequency of family meals, gender, race, control, and mothers' BMI were important predictors of adolescent BMI percentile over time. Mothers' BMI was the strongest predictor of adolescent BMI percentile. More frequent family meals led to decreases in BMI percentile over time, whereas males, African Americans, and Latinos had higher average BMI percentiles than other groups.     

Childhood maltreatment and motivation for treatment in girls in compulsory residential care

The first objective of the current study was to examine the relationship between childhood maltreatment, trauma-related symptoms and motivation for treatment in girls in compulsory residential treatment facilities. The second objective was to examine the extent to which various forms of childhood maltreatment, trauma-related symptoms and motivation for treatment predicted (time to) dropout from these facilities. Participants were 154 adolescent girls recruited from three residential treatment settings in The Netherlands. Multiple linear regression analysis revealed that age and ethnicity were associated with motivation for treatment. Furthermore, emotional abuse contributed to motivation for treatment. In addition, internalizing symptoms (e.g., anxiety and depression) significantly predicted level of distress; symptoms of dissociation predicted doubt about treatment. Logistic regression analyses with multiple imputation and competing risk regression analyses revealed no significant predictors for (time to) dropout. The findings suggest that clinicians and therapists should focus on experiences of emotional abuse, traumatic symptoms and treatment motivation in girls in compulsory residential care settings.     

Exploring the Climate for Overweight and Obese Students in a Student Health Setting

Attitudes and beliefs of health care providers, in conjunction with a nonthreatening physical environment, are important components in establishing a constructive and supportive climate for care of overweight and obese students. Objective: The authors explored providers' attitudes about obesity and assessed the physical environment in a student health clinic to identify areas that may be detrimental to the care of overweight and obese students. Participants: Eighteen direct care providers participated in the project. Methods: The authors conducted focus groups with direct care providers and assessed their experiences and perceived challenges in working with overweight and obese students. The authors also conducted a walk-through assessment of the physical environment. Results: Direct care providers expressed discomfort in deciding how and when to discuss weight with students. The authors found that elements of the physical environment could present barriers to care for overweight and obese students. Conclusions: The authors make recommendations for improving the health care climate for overweight and obese students.     

The E.S.S.E. Group Model

Social work practitioners today are having to deal with ever-increasing numbers of families falling into the at risk category. At the same time, the issues and problems facing these family units are often overwhelming and challenging to resolve. The E.S.S.E. Group Model, outlined in this article, is a new research based approach that was designed to address the most relevant concerns facing families today. It is a unique program that combines family life education within a support group framework. Initially, the model was developed for several school districts in the midwest. Counseling personnel had identified a need for a parent training program that would elicit higher levels of participation. The E.S.S.E. Model accomplishes that goal through its structured yet individualized curriculum along with its parallel and conjoint group set-up. The specific content and process guidelines of this new approach make it easy for clinicians to duplicate in a wide variety of settings. One of the model's curriculums is outlined in detail in this article. Readers will find that the E.S.S.E. program serves as an excellent example of the type of group intervention needed today to help revitalize at-risk families.     

Pilot Study on Childhood Sexual Abuse,Diurnal Cortisol Secretion,and Weight Loss in Bariatric Surgery Patients

Childhood sexual abuse increases risk for adult obesity. A potential contributing factor is altered cortisol secretion. In this pilot study, relationships among childhood sexual abuse, diurnal salivary cortisol secretion, and weight loss were explored in 17 bariatric surgery patients. Measurement points were before surgery (baseline) and 3 and 6 months after surgery. Childhood sexual abuse was measured by the Childhood Trauma Questionnaire. The results showed moderate but nonsignificant positive correlations between the childhood sexual abuse subscale score and baseline morning cortisol, evening cortisol, and daily mean cortisol. An unexpected positive correlation was noted between the Childhood Trauma Questionnaire total score and weight loss at six months. Diurnal cortisol secretion did not change over time after surgery nor correlate significantly with weight loss at six months.