Abstract Children and young people often choose not to disclose sexual abuse, thus preventing access to help and allowing perpetrators to continue undetected. A nuanced understanding of the barriers ...(and facilitators) to disclosure is therefore of great relevance to practitioners and researchers. The literature was systematically searched for studies related to child and adolescent disclosures of sexual abuse. Thirteen studies were reviewed and assessed for methodological quality. Results of the review illustrate the heterogeneous nature of these empirical studies. Findings demonstrate that young people face a number of different barriers such as limited support, perceived negative consequences and feelings of self-blame, shame and guilt, when choosing to disclose. Being asked or prompted, through provision of developmentally appropriate information, about sexual abuse facilitates disclosure. The review highlights the need for robust, longitudinal studies with more sophisticated methodology to replicate findings. The review identifies the need for developmentally appropriate school-based intervention programmes that facilitate children’s disclosure by reducing feelings of responsibility, self-blame, guilt and shame. In addition, prevention programmes should encourage family members, friends and frontline professionals to identify clues of sexual abuse, to explicitly ask children about the possibility of sexual abuse and also to respond supportively should disclosures occur. Facilitating disclosure in this way is key to safeguarding victims and promoting better outcomes for child and adolescent survivors of sexual abuse.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
•The COVID-19 pandemic has caused much of the populace to self-isolate.•Loneliness is significantly higher than normal during the COVID-19 pandemic.•Loneliness was associated with increased ...depression and suicidal ideation.•Public health efforts must address increased loneliness during the COVID-19 pandemic.
In response to the COVID-19 pandemic, most communities in the United States imposed stay-at-home orders to mitigate the spread of the novel coronavirus, potentially leading to chronic social isolation. During the third week of shelter-in-place guidelines, 1,013 U.S. adults completed the UCLA Loneliness Scale-3 and Public Health Questionnaire (PHQ-9). Loneliness was elevated, with 43% of respondents scoring above published cutoffs, and was strongly associated with greater depression and suicidal ideation. Loneliness is a critical public health concern that must be considered during the social isolation efforts to combat the pandemic.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Somebody’s Sunshine Pinto Taylor, Emily
JAMA : the journal of the American Medical Association,
03/2021, Volume:
325, Issue:
11
Journal Article
Peer reviewed
In this narrative medicine essay a geriatrics fellow describes the experience of preparing for and meeting her foster son and discusses her feelings of uncertainties that (mostly) melt away when ...sharing her new child's photo with a colleague the day after bringing him home.
Some individuals are more psychologically resilient to adversity than others, an issue of great importance during the emerging mental health issues associated with the COVID-19 pandemic. To identify ...factors that may contribute to greater psychological resilience during the first weeks of the nation-wide lockdown efforts, we asked 1,004 U.S. adults to complete assessments of resilience, mental health, and daily behaviors and relationships. Average resilience was lower than published norms, but was greater among those who tended to get outside more often, exercise more, perceive more social support from family, friends, and significant others, sleep better, and pray more often. Psychological resilience in the face of the pandemic is related to modifiable factors.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Neglect is a highly prevalent, yet historically understudied form of maltreatment. Recent research has revealed the far reaching and unique effects that neglect has on subsequent cognitive, ...behavioural and socio-emotional development, and on long-term physical and mental health outcomes. Adolescent interpersonal functioning is important to explore given the significant relational transitions that occur during this stage of development, and the known impact that these social changes can have on future life outcomes.
This systematic review synthesises the literature exploring the relationship between neglect and adolescent interpersonal functioning in peer relationships.
Seven databases and three grey literature sites were systematically searched, and identified records screened against inclusion criteria.
Twenty-one articles were included in the final sample, exploring five different indicators of adolescent interpersonal functioning. Around half of the papers investigating quality of peer relationships found that neglect, particularly emotional neglect, is associated with reduced relationship quality, and there is consistent evidence that neglect increases the risk of gang involvement and deviant peer affiliation.
These findings may be used to strengthen a trauma-informed approach to work with adolescents. Research on neglect and adolescent romantic relationships is sparse. Overall, the literature is varied and further research using longitudinal data and consistent measures of neglect would be of value.
•Evidence suggests a relationship between emotional neglect and poorer relationship quality in adolescence.•Neglect increases the risk of gang involvement during adolescence.•A strengthening of validity and consistency of neglect measures is needed.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
The majority of the U.S. population has been under stay-at-home restrictions to reduce the spread of COVID-19 since March 2020. Over the first three months of restrictions, 3,121 U.S. adults ...completed the UCLA Loneliness Scale-3 and Patient Health Questionnaire-9 (PHQ-9). Despite relaxation of lockdowns and shelter-in-place orders over that time, loneliness scores increased significantly, particularly from April to May 2020, and appear to have plateaued by June. Loneliness was correlated with depression and suicidal ideation at all time points and was most prevalent among individuals who reported that they were still under community restrictions to socially isolate due to the novel coronavirus. Loneliness remains elevated despite the reopening of many communities.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
During the first 6-months of the COVID-19 pandemic, the primary weapons against the spread of the virus have included local government orders for restriction of movement and broad implementation of ...face masks and social distancing policies. While some early reports suggested increases in loneliness during the pandemic restrictions, others reported no changes. Here, we provide an update on self-reported loneliness over the first 6-months of community lockdown restrictions from a nationwide sample of 6,186 U.S. adults who completed the UCLA Loneliness Scale-3 and Public Health Questionnaire-9 during the pandemic. Loneliness scores increased significantly from April through September 2020 and were significantly higher for those reporting they were under stay-at-home, shelter-in-place, or lockdown orders compared to those reporting no restrictions. Greater loneliness was positively correlated with depression and suicidal ideation. Loneliness has increased over the first half-year of the pandemic, particularly for those under lockdown restrictions, and remains a significant mental health concern.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Suicide is a major problem in Western society. However we have very little understanding of suicidal behaviour among individuals with autism spectrum disorders. The purpose of this review is to ...synthesise primary research on suicidal behaviour among adolescents and young adults with autism spectrum disorders in order to estimate prevalence and to identify and critically evaluate risk factors for suicidal behaviour in this population. Four primary research studies were identified for this review following a comprehensive literature search. The available research provides little empirical evidence for the processes underlying suicidal behaviour in adolescents and young adults with autism.
•We reviewed primary research on suicidal behaviour among young people, <25years, with ASD.•Four papers reported primary data on suicidal behaviour in young people with ASD.•Prevalence of suicidal behaviour among young people with ASD ranges from 7 to 42%.•Depression and abuse are risk factors for suicidal behaviour in this population.•Research in this area has important methodological limitations including small sample size and lack of verification of ASD diagnoses.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
A widening evidence base across low- and middle-income countries (LMICs) points towards mutually reinforcing linkages between poverty and mental health problems. The use of validated and culturally ...relevant measures of mental health outcomes is crucial to the expansion of evidence. At present, there is a paucity of measures that have been tested and validated in contexts of extreme poverty. Using data from adult women living in extreme poverty in rural Haiti this study assesses the cross-cultural validity of the widely used Rosenberg Self-Esteem Scale (RSES) and its applicability in assessing linkages between poverty and mental health outcomes. We find no evidence for a one-dimensional 10-factor structure of the RSES within our data and agree with other authors that the standard self-esteem model does not fit well in this cultural context. Comparisons with another widely used measure of mental health-the K6 measure-indicate that the RSES cannot be used as a proxy for mental health outcomes. We conclude that the use of the RSES in different cultural contexts and with samples with different socioeconomic characteristics should be undertaken with caution; and that greater consideration of the validity of psychosocial constructs and their measurement is vital for gaining robust and replicable insights into breaking the cycle between poverty and mental health problems.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Background
Despite the health benefits of breastfeeding, initiation and duration rates continue to fall short of international guidelines. Many factors influence a woman's decision to wean; the main ...reason cited for weaning is associated with lactation complications, such as mastitis.
Mastitis is an inflammation of the breast, with or without infection. It can be viewed as a continuum of disease, from non‐infective inflammation of the breast to infection that may lead to abscess formation.
Objectives
To assess the effectiveness of preventive strategies (for example, breastfeeding education, pharmacological treatments and alternative therapies) on the occurrence or recurrence of non‐infective or infective mastitis in breastfeeding women post‐childbirth.
Search methods
We searched Cochrane Pregnancy and Childbirth’s Trials Register, ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform (ICTRP) (3 October 2019), and reference lists of retrieved studies.
Selection criteria
We included randomised controlled trials of interventions for preventing mastitis in postpartum breastfeeding women.
Quasi‐randomised controlled trials and trials reported only in form were eligible. We attempted to contact the authors to obtain any unpublished results, wherever possible.
Interventions for preventing mastitis may include: probiotics, specialist breastfeeding advice and holistic approaches.
Data collection and analysis
Two review authors independently assessed trials for inclusion and risk of bias, extracted data and assessed the certainty of the evidence using GRADE.
Main results
We included 10 trials (3034 women). Nine trials (2395 women) contributed data. Generally, the trials were at low risk of bias in most domains but some were high risk for blinding, attrition bias, and selective reporting. Selection bias (allocation concealment) was generally unclear. The certainty of evidence was downgraded due to risk of bias and to imprecision (low numbers of women participating in the trials). Conflicts of interest on the part of trial authors, and the involvement of industry funders may also have had an impact on the certainty of the evidence.
Most trials reported our primary outcome of incidence of mastitis but there were almost no data relating to adverse effects, breast pain, duration of breastfeeding, nipple damage, breast abscess or recurrence of mastitis.
Probiotics versus placebo
Probiotics may reduce the risk of mastitis more than placebo (risk ratio (RR) 0.51, 95% confidence interval (CI) 0.35 to 0.75; 2 trials; 399 women; low‐certainty evidence). It is uncertain if probiotics reduce the risk of breast pain or nipple damage because the certainty of evidence is very low. Results for the biggest of these trials (639 women) are currently unavailable due to a contractual agreement between the probiotics supplier and the trialists. Adverse effects were reported in one trial, where no woman in either group experienced any adverse effects.
Antibiotics versus placebo or usual care
The risk of mastitis may be similar between antibiotics and usual care or placebo (RR 0.37, 95% CI 0.10 to 1.34; 3 trials; 429 women; low‐certainty evidence). The risk of mastitis may be similar between antibiotics and fusidic acid ointment (RR 0.22, 95% CI 0.03 to 1.81; 1 trial; 36 women; low‐certainty evidence) or mupirocin ointment (RR 0.44, 95% CI 0.05 to 3.89; 1 trial; 44 women; low‐certainty evidence) but we are uncertain due to the wide CIs. None of the trials reported adverse effects.
Topical treatments versus breastfeeding advice
The risk of mastitis may be similar between fusidic acid ointment and breastfeeding advice (RR 0.77, 95% CI 0.27 to 2.22; 1 trial; 40 women; low‐certainty evidence) and mupirocin ointment and breastfeeding advice (RR 0.39, 95% CI 0.12 to 1.35; 1 trial; 48 women; low‐certainty evidence) but we are uncertain due to the wide CIs.
One trial (42 women) compared topical treatments to each other. The risk of mastitis may be similar between fusidic acid and mupirocin (RR 0.51, 95% CI 0.13 to 2.00; low‐certainty evidence) but we are uncertain due to the wide CIs. Adverse events were not reported.
Specialist breastfeeding education versus usual care
The risk of mastitis (RR 0.93, 95% CI 0.17 to 4.95; 1 trial; 203 women; low‐certainty evidence) and breast pain (RR 0.93, 95% CI 0.36 to 2.37; 1 trial; 203 women; low‐certainty evidence) may be similar but we are uncertain due to the wide CIs. Adverse events were not reported.
Anti‐secretory factor‐inducing cereal versus standard cereal
The risk of mastitis (RR 0.24, 95% CI 0.03 to 1.72; 1 trial; 29 women; low‐certainty evidence) and recurrence of mastitis (RR 0.39, 95% CI 0.03 to 4.57; 1 trial; 7 women; low‐certainty evidence) may be similar but we are uncertain due to the wide CIs. Adverse events were not reported.
Acupoint massage versus routine care
Acupoint massage probably reduces the risk of mastitis compared to routine care (RR 0.38, 95% CI 0.19 to 0.78;1 trial; 400 women; moderate‐certainty evidence) and breast pain (RR 0.13, 95% CI 0.07 to 0.23; 1 trial; 400 women; moderate‐certainty evidence). Adverse events were not reported.
Breast massage and low frequency pulse treatment versus routine care
Breast massage and low frequency pulse treatment may reduce risk of mastitis (RR 0.03, 95% CI 0.00 to 0.21; 1 trial; 300 women; low‐certainty evidence). Adverse events were not reported.
Authors' conclusions
There is some evidence that acupoint massage is probably better than routine care, probiotics may be better than placebo, and breast massage and low frequency pulse treatment may be better than routine care for preventing mastitis. However, it is important to note that we are aware of at least one large trial investigating probiotics whose results have not been made public, therefore, the evidence presented here is incomplete.
The available evidence regarding other interventions, including breastfeeding education, pharmacological treatments and alternative therapies, suggests these may be little better than routine care for preventing mastitis but our conclusions are uncertain due to the low certainty of the evidence.
Future trials should recruit sufficiently large numbers of women in order to detect clinically important differences between interventions and results of future trials should be made publicly available.
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