Background: Early life stress is a significant public health problem associated with increased rates of psychiatric disorders, especially those related to drug abuse. Objective: To identify the prevalence of early lif...Background: Early life stress is a significant public health problem associated with increased rates of psychiatric disorders, especially those related to drug abuse. Objective: To identify the prevalence of early life stress in drug users, to compare the intensity of trauma in alcohol and crack users, and to relate the power of injury to the severity of drug dependence. Method: Cross-sectional analytical study with a sample of 105 alcohol and crack users treated by an outpatient service. The instruments for data collection were sociodemographic data questionnaire, the Mini-International Neuropsychiatric Interview, and the Severity of Dependence Scale. The categorical variables association was analyzed using the Chi-squared test, considering p Results: High prevalence of early stress and severity of dependence were identified, with higher rates among crack users. The early stress revealed in the Alcohol group high rates of emotional (88.7%) and physical (94.3%) neglect and in the Crack group significant frequency of physical (61.5%) emotional abuse (51.9%), sexual (46.2%), and emotional (78.8%) and physical (90.4%) neglect. Crack users are 2.6 times more likely to have been emotionally abused, and 2.1 times more likely to have been sexually abused during childhood when compared to the alcohol group. Conclusion: Early stress was prevalent with significant intensity in drug users, and evaluation of this problem is essential for a better understanding of these disorders.展开更多
Rates of childhood trauma exposure are extremely high,with approximately 70%of children and adolescents experiencing at least one traumatic event.Among the most common non-specific consequences of stress and trauma ar...Rates of childhood trauma exposure are extremely high,with approximately 70%of children and adolescents experiencing at least one traumatic event.Among the most common non-specific consequences of stress and trauma are disruptions of sleep.Sleep problems,such as shorter sleep duration,difficulty falling asleep,frequent awakenings,nightmares,sleepless nights,and early-morning wakefulness appear to have a higher prevalence among children and adolescents following traumatic events.This review will illustrate the role of sleep problems in traumatized children and adolescents,and emphasize the need to consider a wide range of etiological mechanisms for these symptoms.However,the relationship of trauma exposure to sleep problems among children and adolescents needs further investigation in future research.Moreover,in view of the adverse consequences of long-term disrupted sleep on mental health outcomes following trauma,the need to effectively address sleep disturbances in traumatized children and adolescents is crucial.展开更多
Introduction: Sexual abuse or sexual assault is part of violence against women, as is physical violence, female genital mutilation and forced marriage. According to the Criminal Code, this is any sexual offense commit...Introduction: Sexual abuse or sexual assault is part of violence against women, as is physical violence, female genital mutilation and forced marriage. According to the Criminal Code, this is any sexual offense committed with violence, coercion, threat or surprise on the person of others. It is a criminal act punishable by the laws in force in almost every country in the world. Study Objectives: 1) draw up an epidemiological profile of female victims of sexual abuse;2) develop the treatment protocol. Methodology: This is a 7-year descriptive retrospective study from January 1, 2010 to December 31, 2016 at the Center Hospitalier National de Pikine (Dakar). Included in this study were all of the patients admitted during our investigation period who were the victims of suspected or certain sexual abuse, with or without requisition. For each case, the following parameters were studied: the epidemiological characteristics (age, gestation, parity and place of residence), the circumstances of the attack (time and place), the characteristics of the aggressor (age, link with the victim, number of aggressor), the type of sexual contact, the possible lesions found during the physical examination (genital and extra-genital), the mode of admission, the delay of the consultation, the attitude after the sexual abuse, the gynecological and obstetrical status of the victim, the repercussions and psychological follow-up, the paraclinical assessment, the treatments administered. Data were collected using a survey form and analyzed with SPSS software. Results: During the study period, 183 victims of sexual abuse were received and treated at the level of our structure out of a total of 39,760 patients, representing a frequency of 0.46%. The age of the victims varied between 2 and 36 years with an average of 13 years. The 11 to 15 age group was the most represented. Students were the most represented among victims of sexual abuse (87.4%). Workers represented 9.3% of the victims. Infants made up 3.3% of the victims;the average age of t展开更多
Many independent films provide a realistic interpretation of everyday events. Passive viewing techniques used by independent scriptwriters and filmmakers require active engagement from the viewer in order to interpret...Many independent films provide a realistic interpretation of everyday events. Passive viewing techniques used by independent scriptwriters and filmmakers require active engagement from the viewer in order to interpret characters and/or events. The following proposes that the ＂expositive puzzle＂ is an example of these techniques. It uses the fim Short Term 12 in order to demonstrate how the ＂expositive puzzle＂ works and to encourage use in real-world interactions in order to avoid interaction based on stereotypes.展开更多
Abuse of infants and children is a public health problem that warrants immediate attention. It is estimated that over 7 million children are affected by child abuse yearly, with the highest rate of abuse in those less...Abuse of infants and children is a public health problem that warrants immediate attention. It is estimated that over 7 million children are affected by child abuse yearly, with the highest rate of abuse in those less than one year of age. Approximately 60% of child abuse victims are children under the age of three years, making infants and young children a particularly vulnerable population. Interventions targeting the perinatal period can be effective in mitigating child abuse, including parent education programs and trauma-informed care services. This paper provides an overview of the current evidence base related to child abuse following the COVID-19 pandemic, with a focus on prevention and intervention strategies that can be utilized to increase caregiver support and reduce child abuse rates during the perinatal period.展开更多
Purpose: To identify, analyze and synthetize the scientific evidences that support Early Life Stress (ELS) diagnosis using the Childhood Trauma Questionnaire (CTQ), since it assumes the use of psychoactive substances ...Purpose: To identify, analyze and synthetize the scientific evidences that support Early Life Stress (ELS) diagnosis using the Childhood Trauma Questionnaire (CTQ), since it assumes the use of psychoactive substances later in adolescence and adulthood. Individuals that experienced some form of childhood stress may present, in adulthood, consequences that manifest into mental disorders such as problematic use of psychoactive substances. Methods: An integrative review of the literature on the subject in the databases: PubMed, Web of Science, LILACS and Psycinfo, regards studies that have been indexed in the last ten years (2003-2014). Combination of controlled and uncontrolled factors in the use and abuse of psychoactive substances, CTQ and ELS adapted to each database. Findings: The alcohol was the most used drug by the participating subjects of these research;mostly, the use of psychoactive drugs, started when they were still in adolescence;ELS and the later use of psychoactive drugs can be found more frequently in female;the lack of internal resources for dealing with stress in adulthood after ELS occurrence may have as a consequence the use of psychoactive drugs as a coping mechanism. Conclusions: It was possible to identify scientific evidences that support the ELS diagnosis, measured by the CTQ, as a determining factor for the use and abuse of alcohol and/or other psychoactive drugs in adolescence and adulthood. Implications: Investigate the ELS as a strategy to improve the therapeutic project of patients in nursing care, which will be built based on scientific evidence, so it can be more effective.展开更多
Contemporary biomechanical theory of traumatic brain injury has its foundation in Holbourn’s thesis on shear strain and Ommaya’s primate experimentation demonstrating the role of rotation in a variety of lesions inc...Contemporary biomechanical theory of traumatic brain injury has its foundation in Holbourn’s thesis on shear strain and Ommaya’s primate experimentation demonstrating the role of rotation in a variety of lesions including subdural hematoma(SDH)and diffuse axonal injury.Empirical human observations have since confirmed,for the most part,the early concepts.Ethical concerns regarding primate research,however,have prompted in vitro models,which in turn has led to challenges with respect to the correlation between in vitro observations and the clinical data.Despite these challenges,medicolegal proceedings may call upon biomechanical engineers to reconstruct complex injury scenarios and offer opinions on the scientific plausibility of clinical disease states,such as SDH,hemorrhagic retinopathy,and cerebral edema,associated with hypothetical or proffered action sequences during the course of an unwitnessed homicide.It is important to note,however,that in vitro models by their nature are low‑evidence quality studies that attempt to advance hypotheses but do not address cause and effect.As a whole,biomechanical models,as they pertain specifically to the brain and spine,are mathematically imprecise.Often,endpoints of limited relevance are relied upon(e.g.,skull fracture thresholds),which predictably overestimate the in vivo risk of significant injury.Given the increasing role of biomechanical engineering in the interpretation of fatal pediatric head trauma,a heightened awareness of the limitations warranted.展开更多
The pathogenesis of ocular hemorrhage in abusive head trauma/shaken baby syndrome(AHT/SBS)is complex.Whereas severe hemorrhagic retinopathy has a robust association with AHT/SBS,mild disease is less specific.We report...The pathogenesis of ocular hemorrhage in abusive head trauma/shaken baby syndrome(AHT/SBS)is complex.Whereas severe hemorrhagic retinopathy has a robust association with AHT/SBS,mild disease is less specific.We report the ocular and cerebral findings in an 8‑month‑old girl with spastic torticollis who presented following confessed,violent sagittal plane acceleration‑deceleration with impact.Autopsy revealed subdural hemorrhage over the convexities,ischemic brain injury,and preexisting polymicrogyria.Ocular examination showed extensive but unilateral retinal hemorrhage,extending broadly to the ora serrata,with perimacular retinal folds and retinoschisis.The retina of the right globe was entirely normal.The findings in this case,suggest that movement of the globe within the orbit with acceleration‑deceleration,in this case greater on one side due to torticollis,may be the primary factor for severe hemorrhagic retinopathy associated with AHT/SBS.The findings argue against putative global mechanisms,such as intracranial hypertension.展开更多
文摘Background: Early life stress is a significant public health problem associated with increased rates of psychiatric disorders, especially those related to drug abuse. Objective: To identify the prevalence of early life stress in drug users, to compare the intensity of trauma in alcohol and crack users, and to relate the power of injury to the severity of drug dependence. Method: Cross-sectional analytical study with a sample of 105 alcohol and crack users treated by an outpatient service. The instruments for data collection were sociodemographic data questionnaire, the Mini-International Neuropsychiatric Interview, and the Severity of Dependence Scale. The categorical variables association was analyzed using the Chi-squared test, considering p Results: High prevalence of early stress and severity of dependence were identified, with higher rates among crack users. The early stress revealed in the Alcohol group high rates of emotional (88.7%) and physical (94.3%) neglect and in the Crack group significant frequency of physical (61.5%) emotional abuse (51.9%), sexual (46.2%), and emotional (78.8%) and physical (90.4%) neglect. Crack users are 2.6 times more likely to have been emotionally abused, and 2.1 times more likely to have been sexually abused during childhood when compared to the alcohol group. Conclusion: Early stress was prevalent with significant intensity in drug users, and evaluation of this problem is essential for a better understanding of these disorders.
文摘Rates of childhood trauma exposure are extremely high,with approximately 70%of children and adolescents experiencing at least one traumatic event.Among the most common non-specific consequences of stress and trauma are disruptions of sleep.Sleep problems,such as shorter sleep duration,difficulty falling asleep,frequent awakenings,nightmares,sleepless nights,and early-morning wakefulness appear to have a higher prevalence among children and adolescents following traumatic events.This review will illustrate the role of sleep problems in traumatized children and adolescents,and emphasize the need to consider a wide range of etiological mechanisms for these symptoms.However,the relationship of trauma exposure to sleep problems among children and adolescents needs further investigation in future research.Moreover,in view of the adverse consequences of long-term disrupted sleep on mental health outcomes following trauma,the need to effectively address sleep disturbances in traumatized children and adolescents is crucial.
文摘Introduction: Sexual abuse or sexual assault is part of violence against women, as is physical violence, female genital mutilation and forced marriage. According to the Criminal Code, this is any sexual offense committed with violence, coercion, threat or surprise on the person of others. It is a criminal act punishable by the laws in force in almost every country in the world. Study Objectives: 1) draw up an epidemiological profile of female victims of sexual abuse;2) develop the treatment protocol. Methodology: This is a 7-year descriptive retrospective study from January 1, 2010 to December 31, 2016 at the Center Hospitalier National de Pikine (Dakar). Included in this study were all of the patients admitted during our investigation period who were the victims of suspected or certain sexual abuse, with or without requisition. For each case, the following parameters were studied: the epidemiological characteristics (age, gestation, parity and place of residence), the circumstances of the attack (time and place), the characteristics of the aggressor (age, link with the victim, number of aggressor), the type of sexual contact, the possible lesions found during the physical examination (genital and extra-genital), the mode of admission, the delay of the consultation, the attitude after the sexual abuse, the gynecological and obstetrical status of the victim, the repercussions and psychological follow-up, the paraclinical assessment, the treatments administered. Data were collected using a survey form and analyzed with SPSS software. Results: During the study period, 183 victims of sexual abuse were received and treated at the level of our structure out of a total of 39,760 patients, representing a frequency of 0.46%. The age of the victims varied between 2 and 36 years with an average of 13 years. The 11 to 15 age group was the most represented. Students were the most represented among victims of sexual abuse (87.4%). Workers represented 9.3% of the victims. Infants made up 3.3% of the victims;the average age of t
文摘Many independent films provide a realistic interpretation of everyday events. Passive viewing techniques used by independent scriptwriters and filmmakers require active engagement from the viewer in order to interpret characters and/or events. The following proposes that the ＂expositive puzzle＂ is an example of these techniques. It uses the fim Short Term 12 in order to demonstrate how the ＂expositive puzzle＂ works and to encourage use in real-world interactions in order to avoid interaction based on stereotypes.
文摘Abuse of infants and children is a public health problem that warrants immediate attention. It is estimated that over 7 million children are affected by child abuse yearly, with the highest rate of abuse in those less than one year of age. Approximately 60% of child abuse victims are children under the age of three years, making infants and young children a particularly vulnerable population. Interventions targeting the perinatal period can be effective in mitigating child abuse, including parent education programs and trauma-informed care services. This paper provides an overview of the current evidence base related to child abuse following the COVID-19 pandemic, with a focus on prevention and intervention strategies that can be utilized to increase caregiver support and reduce child abuse rates during the perinatal period.
文摘Purpose: To identify, analyze and synthetize the scientific evidences that support Early Life Stress (ELS) diagnosis using the Childhood Trauma Questionnaire (CTQ), since it assumes the use of psychoactive substances later in adolescence and adulthood. Individuals that experienced some form of childhood stress may present, in adulthood, consequences that manifest into mental disorders such as problematic use of psychoactive substances. Methods: An integrative review of the literature on the subject in the databases: PubMed, Web of Science, LILACS and Psycinfo, regards studies that have been indexed in the last ten years (2003-2014). Combination of controlled and uncontrolled factors in the use and abuse of psychoactive substances, CTQ and ELS adapted to each database. Findings: The alcohol was the most used drug by the participating subjects of these research;mostly, the use of psychoactive drugs, started when they were still in adolescence;ELS and the later use of psychoactive drugs can be found more frequently in female;the lack of internal resources for dealing with stress in adulthood after ELS occurrence may have as a consequence the use of psychoactive drugs as a coping mechanism. Conclusions: It was possible to identify scientific evidences that support the ELS diagnosis, measured by the CTQ, as a determining factor for the use and abuse of alcohol and/or other psychoactive drugs in adolescence and adulthood. Implications: Investigate the ELS as a strategy to improve the therapeutic project of patients in nursing care, which will be built based on scientific evidence, so it can be more effective.
文摘Contemporary biomechanical theory of traumatic brain injury has its foundation in Holbourn’s thesis on shear strain and Ommaya’s primate experimentation demonstrating the role of rotation in a variety of lesions including subdural hematoma(SDH)and diffuse axonal injury.Empirical human observations have since confirmed,for the most part,the early concepts.Ethical concerns regarding primate research,however,have prompted in vitro models,which in turn has led to challenges with respect to the correlation between in vitro observations and the clinical data.Despite these challenges,medicolegal proceedings may call upon biomechanical engineers to reconstruct complex injury scenarios and offer opinions on the scientific plausibility of clinical disease states,such as SDH,hemorrhagic retinopathy,and cerebral edema,associated with hypothetical or proffered action sequences during the course of an unwitnessed homicide.It is important to note,however,that in vitro models by their nature are low‑evidence quality studies that attempt to advance hypotheses but do not address cause and effect.As a whole,biomechanical models,as they pertain specifically to the brain and spine,are mathematically imprecise.Often,endpoints of limited relevance are relied upon(e.g.,skull fracture thresholds),which predictably overestimate the in vivo risk of significant injury.Given the increasing role of biomechanical engineering in the interpretation of fatal pediatric head trauma,a heightened awareness of the limitations warranted.
文摘The pathogenesis of ocular hemorrhage in abusive head trauma/shaken baby syndrome(AHT/SBS)is complex.Whereas severe hemorrhagic retinopathy has a robust association with AHT/SBS,mild disease is less specific.We report the ocular and cerebral findings in an 8‑month‑old girl with spastic torticollis who presented following confessed,violent sagittal plane acceleration‑deceleration with impact.Autopsy revealed subdural hemorrhage over the convexities,ischemic brain injury,and preexisting polymicrogyria.Ocular examination showed extensive but unilateral retinal hemorrhage,extending broadly to the ora serrata,with perimacular retinal folds and retinoschisis.The retina of the right globe was entirely normal.The findings in this case,suggest that movement of the globe within the orbit with acceleration‑deceleration,in this case greater on one side due to torticollis,may be the primary factor for severe hemorrhagic retinopathy associated with AHT/SBS.The findings argue against putative global mechanisms,such as intracranial hypertension.
