Extrafamilial Contacts Research Articles

Rightly blamed the ‘bad guy’? Grandparental childcare and COVID-19

This study explores the link between regular grandparental childcare and SARS-CoV-2 infection rates at the level of German counties. In our analysis, we suggest that a region’s infection rates are shaped by region-, household- and individual-specific parameters. We extensively draw on the latter, exploring the intra- and extra-familial mechanisms fuelling individual contact frequency to test the potential role of regular grandparental childcare in explaining overall infection rates. We combine aggregate survey data with local administrative data for German counties and find a positive correlation between the frequency of regular grandparental childcare and local SARS-CoV-2 infection rates. However, the statistical significance of this relationship breaks down as soon as potentially confounding factors, in particular, the local Catholic population share, are controlled for. Our findings do not provide valid support for a significant role of grandparental childcare in driving SARS-CoV-2 infections, but rather suggest that the frequency of extra-familial contacts driven by religious communities might be a more relevant channel in this context. Our results cast doubt on simplistic narratives postulating a link between intergenerational contacts and infection rates.

The spectrum of tuberculosis in BCG-vaccinated and unvaccinated children

Introduction: Tuberculosis remains a very important communicable disease in many parts of the world and a major health problem in developing countries. The international controversy surrounding the use and effectiveness of the Bacillus Calmette-Guérin vaccine. The aim the study is to evaluate the spectrum of tuberculosis among Bacillus Calmette-Guérin vaccinated and non-vaccinated children’s. Method: A retrospective study depending on data from flow sheet of each patient which include: age, sex, weight, residence, date of diagnosis, Bacillus Calmette-Guérin vaccination status ,the presence of scar or not, intra or extra familial contact, pattern of disease (pulmonary or extra pulmonary), investigations and associated risk factors. Results: 74 (46.8%) patients were males and 84 (53.2%) were females, they were divided into 2 groups: - group 1 those equal or less than 5 years old who 70 (44.3%) patients, and group 2 those more than 5 year old who 88 (55.7%) patients. The BCG vaccinated patients were 124 (78.5%),9 (7.3%) of them were not developed scar. Distribution of total 158 of TB patients according to the years as following: in 2007 were 46 (29.1%) patients, in 2008 were 51 (32.3%) patients, and in 2009 were 61 (38.6%) patients. 60 (38%) patients, Hashimiyah 43 (27.2%) patients.

Assisting decisions in child protection service institutions with the RIC – The Risk Indication in Child sexual abuse

BackgroundThe RIC (Risk Indication in Child sexual abuse) and its screening version (RIC:SV) are actuarial risk assessment instruments, developed at the Austrian Federal Evaluation Centre for Violent and Sexual Offenders and designed for child protection services to assess the likelihood of sexual recidivism in male contact child sexual abusers who still or again live within a family including children. ObjectiveThe RIC was designed to require a minimum of forensic information, with the RIC:SV completely waiving such information. ParticipantsNine factors related to sexual recidivism could be identified by analyzing five-year follow-up data of N = 324 male contact child sexual abusers. SettingThe data was collected retrospectively from files between the years 2002 and 2011. MethodChi-Square Tests and ROC-analyses were calculated. ResultsThe RIC and the RIC:SV were found to significantly predict sexual recidivism with AUC values of .84 (RIC) and .78 (RIC:SV). The items of the RIC are: (a) offender has never had a live-in relationship, (b) unstable family background of the offender, (c) impulsivity of the offender, (d) previous psychiatric treatment(s) of the offender, (e) offender has prior prison sentence/s, (f) problems of the offender to accept rules and norms, (g) offender was a stranger to his former victim(s), (h) offender had at least one male victim, and (i) offender has ever committed an extrafamilial contact child sexual abuse offense. ConclusionThe RIC and the RIC:SV need no extensive training to be used. The results may help CPS workers to justify risk related interventions.

Childhood leprosy in India over the past two decades

Clinico-epidemiological pattern of childhood leprosy in India over the past two decades were analysed from the Indian studies conducted during the years 1990-2009. Twelve studies on childhood leprosy were included. Ten were conducted in health institutions and one was a community-based survey. Voluntary reporting was the principal method of case detection; community survey was adopted in two studies. Occurrence of childhood leprosy in tertiary care hospitals varied from 5.1-11.43%, in one urban clinic and the three leprosy referral hospitals it was 9.81-31.3% and peripheral surveys recorded 7.06-35.5% cases. History of familial contact was present in 0.66-47% cases. Borderline tuberculoid was the commonest clinical type, majority with single lesion. Other types were indeterminate (3.48-10.1%), borderline lepromatous (1.9-19.4%), lepromatous (0.1 to 9.38%), and pure neuritic (3.48-10.1%). Single peripheral nerve trunk was involved in 13.63-40-62% cases and multiple nerve involvement was recorded in 4.54-59.38% cases. The majority of cases were paucibacillary (43.28-98%). Multibacillary (MB) cases ranged from 2-56.6%. Slit-skin smear positive cases ranged from 5.42-25%. Lepra reactions occurred in 0-29.7% cases. Relapse rate varied between 1.16-7.1%. Deformity occurred in 0-24% cases. Multibacillary cases were common among Indian children, some of whom were smear positive. Probably these cases were the source of many new cases. Pure neuritic leprosy was frequent among Indian children, so also the lepra reactions and deformities. The presence of familial and extra-familial contact with leprosy cases may be a cause of concern, as it implies continuing transmission of the disease.

Epidemiological Surveillance of Leprosy in Cameroon Using the ELISA Test with D-BSA and Tris-HCl as Buffer

<b>Background:</b> Early detection of leprosy is important for elimination, but most cases are diagnosed only when lesions occur and nerves and skin are damaged.<SUP> </SUP>The<SUP> </SUP>determination of the risk of contacts to develop leprosy is still unpredictable, and elimination is not possible as long as contacts can still develop the disease. <b>Methods:</b> A<i><b> </b></i>modified PGL-I ELISA using tris-HCl as buffer and D-BSA as antigen evaluated IgM leprosy antibodies for the detection of subclinical leprosy infection and monitor effective chemotherapy. This case-control study took place in a leprosy endemic area among lepers diagnosed clinically and bacteriologically, intra-familial and extra-familial contacts and controls consisting of patients attending a health facility for reasons other than leprosy. <b>Results</b>: The highest mean absorbance of positive sera was from leprosy patients (0.14 ± 0.06), contacts (0.12 ± 0.05) and controls (0.04±0.04). The proportion of sero-positive subjects for IgM anti-bodies to <i>M. leprae</i> was 43.5 % (95% CI: 37.6% - 49.4%). Twenty-three (44.2%) discharged cases since 1985 were still sero-positive for leprosy IgM anti-bodies; 15 years after treatment. We found a<b> </b>risk factor of 6 among contacts and controls suggesting a high level of transmission. Boyo division had a higher seropositivity (51.5%) compared to Mezam division (30%). Positive cases were clustered among students (44.8%), farmers (42.5%), the self-employed (44.7%), those with paid employment (37.5%) and the unemployed (60.0%) (P=0.01). <b>Conclusion:</b> The PGL-I ELISA with D-BSA and tris-HCl as buffer is a useful epidemiological surveillance tool for the detection of sub-clinical leprosy infection and chemotherapy monitoring. The discharged patients who tested positive should be re-evaluated for relapses.

Impact of Immigration on Pulmonary Tuberculosis in Spanish Children

Tuberculosis causes significant morbidity and mortality worldwide. In the last years, international travel and immigration have led to important changes in the epidemiology of this disease. Drug resistance has emerged as an important threat to tuberculosis control. Data regarding the impact of immigration and the incidence of drug-resistant strains in children are lacking. Retrospective review of patients diagnosed with pulmonary tuberculosis at La Paz Children's Hospital in a 30-year period. Data were collected with regard to the clinical, radiologic, microbiologic, and demographic characteristics of patients, and data from the 3 decades of the study were compared using chi test and Fisher exact test. A total of 507 cases of tuberculosis were identified, 414 of which had pulmonary involvement. During the study, there was a significant decrease in tuberculous meningitis: 10.4% in 1978-1987, 5.6% in 1988-1997, and 2.9% in 1998-2007 (P < 0.05). The most frequent reason for a consultation was case contact investigation. The adult source case was identified in 64% of patients. We observed an increase in extrafamilial contacts (8% in 1978-1987 and 18% in 1998-2007, P < 0.01), including 4 cases of immigrant caretakers. Tuberculosis in immigrant children has increased with time: 2% in the period 1978-1987, 6% in 1988-1997, and 46% in 1998-2007 (P < 0.001). The primary resistance rate to isoniazid in our population was 6.5%. Tuberculosis in our area continues to be a major health problem, especially among foreign-born children. As drug-resistant strains are increasing, initial therapy with 4 drugs is recommended in our population.

Leprosy in children: a prospective study.

Leprosy has been identified as an important health problem in the pediatric age group. The study of leprosy in children is imperative as it may unravel the missing links in the natural evolution of the disease and dispel the uncertainty of the precise incubation period. The study was undertaken on patients attending the Urban Leprosy Centre. There were 161 children in the age group of 0 to 14 years, amongst 3184 cases of leprosy, detected between 1981 and 1991. The diagnosis in each was formed after meticulously recording the clinical features, slit-skin smear examination, and histopathologic characteristics. In addition, a detailed history of duration of the disease was elicited by complement recall method. The study revealed an incidence of 5.06% amongst leprosy patients, in an urban setting. The boys:girls ratio was 2.6:1. The mean duration of the disease was 1.2 years in paucibacillary and 2.8 years in multibacillary. History of intra- or extrafamilial contact was elicited in 8.7%. The typical lesion was a "hypopigmented macule," either of indeterminate, tuberculoid, borderline tuberculoid, or borderline borderline leprosy. Borderline lepromatous, lepromatous, and polyneuritic leprosy were uncommon. Leprosy in children is a well-established distinct entity. Any hypopigmented macule in pediatric age group should arouse suspicion of leprosy. The diagnosis is clinical. Other investigative parameters, namely slit-skin smear, and histopathology may supplement but not supplant the diagnosis.

Longitudinal Analysis of the Developmental Process in Chronically Ill and Healthy Persons—Empirical Findings from the Bonn Longitudinal Study of Aging (BOLSA)

Chronically ill and healthy persons are compared as to social roles, dominant concerns, and in coping with stress. The comparison is based on a longitudinal analysis of data which was collected in the Bonn Longitudinal Study of Aging (BOLSA). The empirical analysis indicates that both groups show great success in mastering life situations and in coping with challenges and restrictions. This competence persists over the eight measurement points. The empirical analysis also makes clear that chronically ill patients often cope actively with stress, that they are able to accept restrictions and to look simultaneously for new possibilities in life. Social contacts have a predominant position in coping with chronic disease. Intrafamilial and extrafamilial contacts are important and helpful for chronically ill patients. As the longitudinal analysis reveals, coping with challenges and demands of life is influenced by the individual life-style. The analysis points to the aging process as a process of growth and of new potentials. This applies not only to persons who are in good health, but to chronically ill persons as well.

Family characteristics and long-term consequences associated with sexual abuse.

As opposed to father-daughter incest, little attention has been paid to the long-term consequences and family dynamics associated with child sexual abuse of females perpetrated by extended family members or extrafamilial contacts. Female undergraduates (n = 586) completed questionnaires on family history, sexual experiences, and current functioning. Results confirmed other research suggesting that father-daughter incest is associated with a traditional patriarchal family structure. However, sexual abuse overall, regardless of perpetrator, was associated with certain uniform family characteristics. Moreover, sexual abuse had certain long-term consequences, regardless of perpetrator. These results suggest the importance of attention to family characteristics in all cases of child sexual abuse.

Social isolation among schizophrenic out-patients

This study analyses various aspects of social isolation in 74 schizophrenic patients who, at the time of the investigation, were undergoing out-patient psychiatric treatment. Most of the patients were disabled, had no partner and lived alone or with their parents. Only 57% had friends outside the family. Psychopathological symptoms showed little relation to the number of social contacts, though their presence was related to subjective feelings of isolation. Surprisingly, a positive correlation was found between the duration of previous in-patient admissions and the number of social contacts outside the family. Patients living with partners had the highest number of extrafamilial contacts, whereas patients living with their parents had the highest number of familial contacts, but felt most isolated. The results of this study show that the social isolation of schizophrenics must always be investigated from several viewpoints and at various levels; in particular, it is necessary to distinguish, on the one hand, between the familial and the extrafamilial areas and, on the other, between objective and subjective aspects of social isolation.

AGEING AND LEISURE

ABSTRACT Observing the leisure behavior of the elderly, it must, for example, be kept in mind, that precisely in the 6th and 7th life decade a great number of social changes come into existence. Both retirement and children's departure from home may bring about an extensive change of the everyday situation. This may lead to a reduction of certain contacts. It is demonstrated that family-related contacts will be intensified; extrafamilial contacts will partly be reduced. At the same time, the use of the mass media is intensified according to the author's results. The results predominantly showing constancy refer rather to an extreme stability. Therefore, the increased attention to communication media cannot be interpreted as increasing passivity. In that case a decrease should also have been found for some other activities. The changes may therefore be attributed largely to determining variables, which are intrinsic to the individual and his given situation. Cross-sectional analysis (SCHMITZ-SCHERZER 1969)...

Tuberculosis Control in Argentina

ACCORDING to Dr. Hugo J. D'Amato, secretary of the National Department, of Health of Argentina (Bol. Of. San. Panamer., 21, 772 ; 1942), family contacts have been examined in the last few years at the tuberculosis dispensaries of this department in order to discover unrecognized cases. As this procedure, however, did not include extra-familial contacts a new organization is being planned which will involve systematic and repeated examinations of the entire population. At present all public employees and all applicants for Government positions have to undergo clinical and radiological examinations of the thorax as well as tuberculin tests. Of 10,863 persons examined 104 were rejected and 51 were accepted with a temporary certificate while under treatment. Only six of the 10,708 applicants declared to be healthy or 60 per 100,000 have developed tuberculosis in the course of two years, whereas before examination was made compulsory the rate of infection was 520 per 100,000. In August 1941 the National Commission of Tuberculosis was created, which besides centralizing the administration of the tuberculosis control campaign, has power to propose measures regarding salaries, housing, nutrition and industrial hygiene.

How Tuberculosis Spreads in a Rural Community

IT is a well established fact that human aggregation greatly facilitates the spread of diseases like tuberculosis which are transmitted by way of the respiratory tract. Consequently, a rural area such as Cattaraugus .County, N. Y., with its population about equally divided between two small urban areas and scattered farms and villages, offers an unusual opportunity for observing the spread of tuberculosis under fairly simple conditions. As a part of an epidemioldgical study of tuberculosis based upon observation of tuberculous families in Cattaraugus County, a special effort has been made to learn how the disease is introduced into the families of that rural area, and what proportion of the total active cases occurring in the community is made up of cases due to contact within the family, and what due to extra-familial contact. This particular problem has been studied by obtaining detailed data for the families of all new active cases reported during 3>2 years, January, 1932, to July 1, 1935. Data on the following points were secured through visits to the home and interviews with patients in the sanatorium by an investigator especially trained for this type of work.