Risk Of Abuse Research Articles

Prevalence, co-occurrence, and associated factors of intimate partner violence among Brazilian university students.

Intimate Partner Violence (IPV) among youth is a public health problem worldwide because of its high prevalence and lifelong serious consequences in health and quality of life. This cross-sectional census aimed to describe the IPV victimization among all freshman students in a Brazilian university (n=1,509), which was selected from a larger population of 2,706 freshmen. We created a 10-item questionnaire inspired by established instruments to measure the prevalence of IPV. Multivariate logistic regression assessed the association between demographic, socioeconomic, and behavioral factors with various types of IPV. We visualized co-occurrence using a Venn diagram and employed multinomial logistic regression to examine the relationship between covariates and the cooccurrence of IPV types. The chance of IPV was higher in males, those who were currently in a relationship, and those with a higher risk of alcohol abuse. These same characteristics were also associated with an increased likelihood of experiencing the co-occurrence of two or more types of IPV. Prevention strategies should consider those groups and monitoring of those who abuse alcohol, which can be a predictor behavior or a mechanism to deal with the stress arising from IPV.

The unmet promise of trustworthy AI in healthcare: why we fail at clinical translation.

Artificial intelligence (AI) has the potential to revolutionize healthcare, for example via decision support systems, computer vision approaches, or AI-based prevention tools. Initial results from AI applications in healthcare show promise but are rarely translated into clinical practice successfully and ethically. This occurs despite an abundance of "Trustworthy AI" guidelines. How can we explain the translational gaps of AI in healthcare? This paper offers a fresh perspective on this problem, showing that failing translation of healthcare AI markedly arises from a lack of an operational definition of "trust" and "trustworthiness". This leads to (a) unintentional misuse concerning what trust (worthiness) is and (b) the risk of intentional abuse by industry stakeholders engaging in ethics washing. By pointing out these issues, we aim to highlight the obstacles that hinder translation of Trustworthy medical AI to practice and prevent it from fulfilling its unmet promises.

Opioids: Analgesia, Euphoria, Dysphoria, and Oblivion: Observations and a Hypothesis

Introduction: In a previous paper, we inquired into the root causes of the two opioid crises our nation is facing, one evolved from the effects of political and psychosocial forces, one manufactured by the Centers for Disease Control and Prevention. This inquiry led us to suspect that the very different opioid consumption patterns of various groups of people were driven by very different motivations related to the opioid experience. Here we explore four potential motivations or disincentives: analgesia, euphoria, dysphoria, and the search for oblivion. We particularly focus on two populations more likely to be motivated by the search for oblivion: people addicted to opioids and terminal cancer patients, and the problem of tolerance. Methods: Analytic review of the scientific literature. Results and Discussion: Essentially all patients managed in American clinics, including many patients with cancer, are motivated by a simple desire for analgesia. A search for euphoria almost certainly motivates the population of people who use mind-altering drugs, including opioids, for recreation. Dysphoria is a feeling of unpleasantness associated with a particular opioid sufficient to motivate a patient to refuse the drug. It represents a common challenge in managing patients in chronic pain. The search for oblivion appears to be the primary motivation for people with opioid addiction. It may also be a motivating factor in certain patients with terminal cancer who suffer not just pain but also agonizing existential crisis. Conclusion: A greater appreciation on the part of clinicians, scientists and policy makers of the different factors that motivate use of opioids could have major implications for how we handle different people consuming opioids. It could disabuse us of the suspicion that every patient in pain is seeking euphoria rather than analgesia and help us to understand their vanishingly small risk of drug abuse or addiction. It could lead to serious study of the mechanisms of dysphoria and the development of means to circumvent it. It could lead to improved approaches to patients with pain from terminal cancer and optimal strategies for dealing with the addiction crisis in the streets. Methods: Analytic review of the scientific literature. Results and Discussion: Essentially all patients managed in American clinics, including many patients with cancer, are motivated by a simple desire for analgesia. A search for euphoria almost certainly motivates the population of people who use mind-altering drugs, including opioids, for recreation. Dysphoria is a feeling of unpleasantness associated with a particular opioid sufficient to motivate a patient to refuse the drug. It represents a common challenge in managing patients in chronic pain. The search for oblivion appears to be the primary motivation for people with opioid addiction. It may also be a motivating factor in certain patients with terminal cancer who suffer not just pain but also agonizing existential crisis.

Anxiety disorders as comorbid conditions in neuropsychiatric diseases in children

The variants of heterotypic comorbidity of anxiety disorders (AD) with attention deficit hyperactivity disorder, autism spectrum disorders, speech and language development disorders, specific learning disabilities (dyslexia, dysgraphia, dyscalculia), migraine, tension type headache in children and adolescents are discussed. In cases of heterotypic comorbidity the patients with AD referrals to specialists may be primarily associated with their emotional problems. Meanwhile, the comorbidity of AD with these diseases leads to a deterioration of their clinical manifestations and a worsening of the prognosis, and anxiety symptoms often not only persist, but also increase with age. It should be borne in mind that AD in children with neurodevelopmental disorders contribute to a decrease in the quality of life, academic failure, have a negative impact on peer relationships and the family environment, and in young adulthood, patients have an increased risk of depression and substance abuse. Therefore, early intervention and a comprehensive therapeutic approach with a dynamic assessment of the patient's condition are becoming important. When choosing pharmacotherapy, it is advisable to choose medictions that have a complex effect on the pathogenetic mechanisms of the underlying disease and concomitant AD, which include Tenoten for children.

Children of parents with substance abuse: assessing impacts and available support

Parental substance misuse and abuse pose significant public health challenges, potentially impacting minors across all developmental stages from pregnancy to adolescence. Such issues can result in medical, psychiatric, and behavioral disorders, along with an elevated risk of child abuse. In Switzerland, around 100 000 children and adolescents live with a parent facing substance abuse. This article aims to succinctly outline the effects of parental substance abuse on children and propose effective intervention strategies and relevant resources for professionals. The goal is to enable the detection of such situations, offer appropriate support, and prevent adverse consequences on the development and health of children and adolescents.

Association between history of interparental violence and alcohol abuse among reproductive-age women: Evidence from the Peruvian Demographic and Health Survey.

Exposure to domestic violence by triggering repetitive distress and fear can affect neurodevelopmental and mental health in the short and long term. This, in turn, has been linked to an increased risk of substance abuse, such as alcohol abuse in adulthood. The present study aimed to evaluate the association between exposure to violence from the father toward the mother and alcohol abuse in Peruvian women. Cross-sectional study. We conducted a secondary analysis of data from the Peruvian Demographic and Family Health Survey (ENDES) of 2019. A total of 19,980 reproductive-aged women (15-49 years old) were surveyed using the Health Questionnaire during 2019. The dependent variable of the study was alcohol abuse, collected through self-report, according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. Intimate partner violence (IPV; violence perpetrated by the father against the mother) was considered as the exposure variable. To assess the association of interest, we only considered observations with complete data and used binary logistic regression models, calculating crude odds ratios and adjusted odds ratios (aOR). For the multivariable model, we adjusted for confounding variables (age, marital status, education level, wealth index, ethnicity, residence, current smoker, depression, and IPV). We analyzed a final sample of 9953 women. The prevalence of interparental violence and alcohol abuse was 41.3% and 1.5%, respectively. We found that interparental violence was associated with higher odds of alcohol abuse (aOR: 2.10; 95% CI: 1.03-4.28) after adjusting for age, marital status, education level, wealth level, ethnicity, area of residence, current smoking, depression, and IPV. We identified that women of reproductive age who have been exposed to interparental violence were at higher odds of experiencing alcohol abuse issues.

Prescription Opioid Use before and after Diagnosis of Cancer Among Older Cancer Survivors With Non-Cancer Chronic Pain Conditions (NCPCs): An Application of Group-Based Trajectory Modeling (GBTM).

Prescription opioids are essential in managing pain among adults with chronic pain conditions. However, persistent use over time can lead to negative health consequences. Identifying individuals with persistent use over time and their characteristics can inform clinical decision-making and aid in reducing the risk of abuse and overdose deaths. This study aims to examine trajectories of prescription opioid use over time and factors associated with these trajectories among older cancer survivors with any non-cancer pain conditions (NCPC). We conducted a retrospective cohort study design with longitudinal data of older (age at cancer diagnosis ≥67years) cancer (incident breast, colorectal, and prostate cancers, or non-Hodgkin lymphoma) survivors with any NCPC. Data were derived from the 2007-2015 linked Surveillance, Epidemiology, and End Results (SEER)-Medicare dataset (N = 35,071). Group-Based Trajectory Modeling (GBTM) was used to identify homogeneous subgroups (distinct trajectories) of individuals based on every 90-day prescription opioid use during pre-cancer diagnosis (t1-t4), acute cancer treatment (t5-t8), and post-cancer treatment (t9-t12) periods. Biological factors, social determinants of health (SDoH), physical and mental health, medication use, health care use, and external factors associated with a trajectory membership were analyzed with multivariable multinomial logistic regressions. Four distinct trajectories of opioid use were identified: (1) increase-decrease use (6.1%); (2) short-term use after cancer diagnosis (40.6%); (3) low-use (41.0%); and (4) persistent use (12.3%). In the fully-adjusted multinomial logistic regression, the SDoH such as Non-Hispanic Black [adjusted odds ratios (AOR) = 1.69; 95%CI = 1.48, 1.93)] and rural residence (AOR = 1.49; 95%CI = 1.15, 1.94)], comorbid anxiety (AOR = 1.33; 95%CI = 1.18, 1.51), and medication use (NSAIDs - AOR = 1.20; 95%CI = 1.10, 1.30) were associated with membership in the persistent use group. Persistent use was less likely among those with higher fragmented care index (AOR = 0.95, 95%CI = 0.93, 0.97) and those living in counties with higher Medicare advantage penetration (AOR = 0.96; 95%CI = 0.95, 0.97). One in eight older adults had persistent opioid use over time. The profile characteristics of this group were different from the other trajectory groups. Policies and programs to reduce chronic opioid use need to consider the intra- and inter-individual variability to reduce opioid-related morbidity and mortality.

Balancing the Right to Privacy and National Security Interests in the Digital Age

In order to protect national security, the states widely use secret surveillance measures and monitor electronic communications, which poses high risks of arbitrariness and abuse of power. Modern technologies enable the states to collect and process personal data on an unprecedented scale. Therefore, the most important challenge in today’s world is to determine how to protect national security and prevent serious crimes without violating human rights. 
 The judgments of the European Court of Human Rights provide guidance in terms of balancing the right to privacy and security interests. The present article aims to discuss the development of the case law of the European Court and the legal safeguards for protecting the right to privacy when the state carries out secret surveillance measures.

Affective-Sexual Health Promotion in Early Childhood: Critical Review in The Context of Childcare and Education in Costa Rica

This critical review describes research on affective and sexual development in early childhood in preschool and childcare settings. Studies are analyzed from the point of view of the regulatory and operational frameworks on which education on this topic in Costa Rica is based. The review was carried out using 4 international databases, examining empirical studies and review studies. Costa Rica has put in place a broad national-level policy framework that supports a comprehensive understanding of affective-sexual development from infancy. However, implementation of the policy in the national preschool program does not always meet the framework’s standards. We find that the risk of sexual abuse tends to be prioritized in early sexual-affective education. Sexual-affective development is often addressed from a moralistic standpoint, advising for instance that the genitals should be named only in the last levels of preschool and not when the other parts of the body are first named. From a health-promotional perspective on national childcare and early education, we here propose a broader view that takes fully into account the complexities around the social determinants of sexual-affective development. We conclude that an update of the preschool program is required, accompanied by continuous training for staff and families of infants.

ОСОБЕННОСТИ РОЗЫСКНЫХ МЕРОПРИЯТИЙ ПРИ РАССЛЕДОВАНИИ ПРЕСТУПЛЕНИЙ, СОВЕРШАЕМЫХ В СФЕРЕ КОМПЬЮТЕРНОЙ ИНФОРМАЦИИ

It is difficult to overestimate the issues of improving the tactics of investigative measures in the investigation of crimes in the field of computer information. In recent years, due to the significant growth of digitalization, both quantitative indicators of crimes in the field of computer information and their qualitative level have been steadily increasing. It becomes more difficult for investigative bodies to collect the necessary evidence, detect electronic and digital traces, determine their authorship and establish cause-and-effect relationships. Modern operational investigative measures assume that law enforcement officers have the skills to detect and analyze digital data, extract electronic traces, as well as record these data as evidence. The investigation of crimes in the field of computer information requires specialized knowledge and skills to effectively counter the new methods and technologies used by offenders. The relevance of the search tactics is due to the need to adapt to the ever-changing cyber threat and ensure the security of information systems. It is determined that law enforcement agencies need to constantly improve their skills and enrich their knowledge, the need for appropriate material and technical equipment, assuming the availability of specialized tools, is obvious. It is especially important to modernize the tactics of searching for suspects. It has been revealed that wiretapping is an important element in conducting operational search activities. Listening involves installing audio tracking devices on telephone communication lines, as well as concluding an agreement with telecom operators to gain access to Internet traffic and telephone conversations. However, there are significant risks of abuse of authority by law enforcement agencies. Unfortunately, the law does not define a list of criteria by which it is possible to determine whether listening should be used in a particular case or not. This creates threats to users’ personal data and introduces uncertainty into law enforcement activities.

Patient-GP-Pharmacist cooperation towards individualized tapering schemes for long term benzodiazepine users

Long-term use of benzodiazepines and Z-drugs is associated with multiple side effects, such as increased sedation, fall risk, and an elevated risk of dependency and abuse. Avoiding initiation of treatment, or stopping treatment after a few weeks, is definitely the best-case scenario. But for patients that are already using benzodiazepines for more than 3 months (up to 20 years or more), a deprescribing methodology should be deployed. Abrupt withdrawal, particularly if the individual has been taking the drug in high doses, can result in severe symptoms, including psychotic reactions. The recommendation is for slow withdrawal, tapering the dosage gradually over a period of several months.
 Pharmacy compounding of capsules has been a possibility for many years, and allows to prepare and dispense individualized dosages to patients. Medical practitioners such as GP’s have always had the possibility to prescribe dose reduction schemes for patients motivated to taper off. Unfortunately, as benzodiazepines are not reimbursed in Belgium, this came at a high cost for patients.
 In 2022, pharmacy associations together with health insurance funds and the National Institute for Health and Disability Insurance (NIHDI) worked on a reimbursement scheme that allowed tapering off benzodiazepines. The patient-GP-pharmacist triangle is at the core of the scheme:
 -Pharmacists raise awareness when dispensing prescribed benzodiazepines, and prepare and dispense individualized doses
 -GP’s motivate patients to consider tapering and prescribe the programme
 -Patients engage in a tapering path and are intensively followed by the GP and the pharmacist
 Apart from the roles and responsibilities of the 3 parties, there are some rules set out to increase the change of successful tapering whilst keeping expenditure under control. For instance, a maximum daily consumption of 3 DDD set out, there is choice between 3 tapering schemes (5, 7 or 10 steps), and the total duration of the programme should not exceed 360 days.
 Critical success factors of these programs are: intrinsic motivation of the patient, therapeutic contract with 3 parties concerned, absence of financial penalty for patients, and smooth communication between prescriber and preparer/dispenser.

Administrative and economic sanctions under French commercial law

The publication examines the provisions on administrative and economic sanctions of the French Commercial Code and other acts of French legislation. It was concluded that the French experience of regulation of commercial relations is based on complex solutions involving a combination of private-law and public-law regulation.
 It is substantiated that during the last century the commercial legislation of France was saturated with public legal provisions. The new French Commercial Code of 2000 incorporated a significant number of provisions that are public law, including administrative and criminal sanctions.
 The presence of provisions in the French Commercial legislation, which by nature of administrative influence on business entities can be recognized as administrative and economic sanctions, is established in many spheres of relations. These sanctions include typical penalties imposed on economic entities for antitrust violations, violations of reporting and other rules of conducting commercial activities, as well as other numerous sanctions of an organizational nature. It is substantiated that the disciplinary responsibility of certain professions in commerce defined in the FCC can be qualified as a type of administrative and economic sanctions relevant to the Ukrainian legal sense.
 Taking into account the experience of French commercial law, it was concluded that the ideas of reducing the discretion of state bodies when applying sanctions to business to eliminate the risks of corruption and abuse are not confirmed in modern European legislation. It is obvious that this follows from the quite reasonable assumption that the fight against corruption should affect the specific offender, and not destroy the effectiveness of the state's response to offenses, including in the business sphere.
 Several trends in the legislative regulation of administrative and economic sanctions in France have been identified, including attempts to solve the problems of the ratio of administrative sanctions and criminal penalties on legal entities, the expansion of judges' approaches to the assessment of administrative sanctions imposed on merchants from the point of view of compliance with procedural provisions and respect for human rights.
 It was concluded that the introduction of criminal liability of legal entities into national law cannot take place without an analysis of the problems caused by relevant institutions in foreign countries, in particular in France.

CHARACTERISTICS OF THE ACCOUNTING SYSTEM AT COMPANIES

The article describes the main features of the contemporary accounting system and evaluates the impact of its development factors at the company level from the perspective of practicing accountants. In particular, the authors examine the influence of information technologies on the organization of accounting; the tendency to separate tax and financial accounting; overloading of the accounting regulatory framework, changes in accounting related to integration processes in Ukraine. In addition, the study defines the problems of contemporary accounting, including: the complexity of the regulatory and legal framework; risk of abuse; development of information technologies; the need for additional accountant qualifications; the need to standardize rules and formats of financial reporting; the complication of accounting associated with the development of the world economy. The authors proposed directions for solving problems of the accounting system.

DISRUPTED SOCIAL LIFE MEDIATES ASSOCIATION BETWEEN PANDEMIC WORRIES AND RISK OF ELDER ABUSE

Abstract Social isolation is an important risk factor for elder abuse. This study investigated the mediating effects of pandemic-related disruptions of social life between worry about the pandemic and risk of elder abuse. A total of 1078 community dwelling older persons participated in this community survey. They provided information on their demographics, worry about the pandemic, pandemic related disruptions of social life, and risk of elder abuse as measured by a 10-item scale derived from Dong et al. (2015). Participants age ranged from 60 to 100 (mean= 76.2, SD=7.9), majority of them were female (81.6%), single, divorced or widowed (52.8%). Prevalence of risk of abuse was high (21.5%), with the most prevalent type being family conflicts at home (16.6%), followed by feeling uncomfortable with someone in the family (8.1%). Participants who were not in a marital relationship, of larger household, reported feeling worried about the pandemic and felt their social life disrupted were at greater risk of abuse. Logistic regression results show that pandemic related disruptions of social life partially mediated the association between worry about the pandemic and risk of abuse. In the final model, participants who reported feeling worry about the pandemic and those who reported that the pandemic has caused disruptions in their social life were at greater odds of reporting risk of abuse (OR=1.14 and 1.13 respectively, p<.05). The effects of the former diminished after the latter was entered into the model. This finding highlights the importance of social life in protecting older persons against abuse.

ELDER ABUSE RISK ASSESSMENT MODEL FOR ALZHEIMER’S DISEASE WITH SOCIAL DETERMINANTS OF HEALTH AND MEDICAL FACTORS

Abstract Older adults with Alzheimer’s Disease and Related Dementias (ADRD) are at an increased risk for elder abuse (EA). Using a 20% national Medicare database, we developed an EA risk-assessment model, including older adults with and without ADRD. Beneficiaries aged 66 and older in 2016, without an EA diagnosis in 2015 or 2016, and Medicare Part A/B/D eligible with no HMO through 2018 were included (N=2,261,166; ADRD, n=187,805, 8.3%). Outcome of interest was an EA diagnosis. The cohort was split into three subsets, training (50%), testing (25%), and validation (25%). Predictive models included demographics, comorbidities, symptoms, injury history, claims-based frailty scores (0-1), medical screening and procedures, and social determinants of health (SDoH). Only 0.2% had an EA diagnosis. EA models were conducted using logistic regression and machine learning methods (random forest, gradient-boosted tree classification, and multilayer perceptron classification). The logistic regression model was the best predictive model (AUC=0.73; Sensitivity=0.80; Specificity=0.47; GINI Impurity=0.50; Agreement=46.77%). Many SDoHs (e.g., primary support and marital problems, housing/income problems and dual eligibility, Black Race), STI testing, behavioral health and medical conditions, and greater frailty were associated with increased risk of EA at 2 years for the total sample (with and without ADRD). For those with ADRD, SDoHs (e.g., marital and housing/income problems), male sex, aged 71-75 (vs 66-70), lung cancer, PTSD , and greater frailty were associated with increased EA risk. Coupled with qualitative interviews, our findings will guide the selection of the most pertinent risk and protective factors to incorporate into an EA screening intervention tool.

DIGITAL DANGERS: TECHNOLOGY-FACILITATED ABUSE AMONG ADULTS AGE 50+

Abstract Older adults (age 50+ years) are adopting new technologies to increase their independence, prevent social isolation, and help them to age in place. However, digitalization introduces new risks for technology-facilitated abuse (TFA). TFA is any form of online abuse including threats, identity theft, financial fraud, among other forms of victimization. Limited research has explored TFA in general population samples among older adults in the U.S. With support from the U.S. Department of Justice, NORC at the University of Chicago conducted a survey of TFA experiences in a nationally representative sample of n=1,011 U.S. adults aged 50 years and older. Latent class analyses were applied to understand the pattern of older adults’ exposure to ten different forms of TFA, resulting in three classes distinguished by the number of different forms of TFA experienced. This session describes findings from the study, such as socio-economic characteristics associated with TFA profiles, the respondents’ relationship to the perpetrator, behaviors taken in response to TFA, and resulting harms. Among key findings are that six in 10 community-dwelling adults age 50+ have experienced at least one form of TFA in their lifetime. The most common forms of TFA experienced were financial abuses and identity theft. Different demographic groups of older adults experienced different victimization patterns. For example, those who identify as LGBQA were at a much higher risk of experiencing TFA. This session concludes with research and education opportunities for preventing TFA across multiple levels among older adults.

Risk Factors for Opioid Misuse, Abuse, and Dependence Among Pain Clinic Patients: A Cross-Sectional Study at King Khalid University Hospital during 2020.

BACKGROUND Physicians are faced with the risk of patients developing opioid use disorders (OUDs) when prescribing patients opioids for long periods of time. Therefore, it is highly recommended to continuously monitor and evaluate long-term non-cancer pain patients who are prescribed opioids. This study aims to estimate the prevalence of OUDs in 103 patients with active opioid prescriptions attending the Pain Clinic at King Khalid University Hospital. MATERIAL AND METHODS A cross-sectional study was conducted at King Khalid University Hospital's pain clinic from 2020 to 2022. A list of all patients attending the Pain Clinic with an opioid prescription was provided by the hospital. Through telephone interviews, consent was secured followed by the collection of demographic variables and prescription-related variables. Additionally, patients were asked to complete the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST 3.1) opioid questionnaire. RESULTS Most of the 103 patients were at moderate risk for abuse (91.3%), while a smaller percentage were at high risk (dependence) (5.8%) and low risk (misuse) (2.9%). Tramadol was the most-prescribed opioid (43.7%). Young age (<50) (Z=2.534; P=0.011), opioid use for more than 90 days (Z=2.788; P=0.005), and the prescription of tramadol (Z=4.124; P<0.001) were associated with higher risk of OCDs. CONCLUSIONS Younger patients, opioid use >90 days, and tramadol are associated with a higher risk of opioid misuse. However, further studies on a larger scale and in various settings are needed to provide evidence accurately reflecting the general population, as this study focused on the population of pain clinic attendees.

PREVALENCE OF ELDER ABUSE AND NEGLECT OF PERSONS WITH DEMENTIA: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract People with dementia (PWD) are at high risk for abuse and neglect. Little is known about the synthesized prevalence rate of abuse among this population though. This study reviewed articles on abuse and neglect among PWD to learn about the pooled prevalence estimates of elder abuse among this population with a meta-analytic approach and examined the heterogeneity associated with the prevalence estimates through meta-regression and subgroup analyses. A total of 27 studies were selected from 479 relevant studies after careful identification using eight academic databases (e.g., ProQuest, CINAHL Plus). All 27 studies received acceptable scores on study quality and demonstrated no significant publication biases. All the studies included a total sample of 11,246 care recipient and caregiver dyads. In addition to overall abuse, three subtypes of elder abuse including physical abuse, emotional abuse, and neglect were examined. Results showed that the pooled prevalence of overall elder abuse was 41% (95%CI [0.31,0.49], p &amp;lt; 0.001). The pooled prevalence of abuse subtypes were 43%(95% CI [0.35, 0.52], p &amp;lt; .001) for emotional abuse, followed by neglect at 16%, and physical abuse at10% (95% CI [0.07, 0.13], p &amp;lt; 0.01). Overall, studies with caregiver average age below 60. reported higher abuse rates than those with caregivers’ age over 60. These results call for more policy and practice efforts to assist PWD who are victims of abuse and neglect, and more so, to prevent caregivers from exerting abuse and neglect behaviors toward PWD via education, skills training and support.

Child sexual abuse prevention: A qualitative study of teachers' educational needs.

Child sexual abuse (CSA) has emerged as a global concern, particularly affecting children in Indonesia. However, there remains a scarcity of research on CSA within the Indonesian context.Objective: This study aimed to explore the educational needs of primary school teachers in preventing child sexual abuse. A qualitative descriptive study design was employed, with eight teachers and school principals selected through purposive sampling. Data were collected through focus group discussions and analyzed using content analysis. Six categories emerged: 1) The risk of sexual abuse, 2) The necessity for clear CSA preventive regulations and sanctions for abusers, 3) Lack of CSA program socialization, 4) The need for structured CSA prevention education for children, 5) The importance of effective coordination with various relevant stakeholders, and 6) The presence of barriers and obstacles. This study provides valuable insights into the educational prerequisites for teachers to implement CSA prevention measures effectively. The findings emphasize the pressing need for school teachers to develop and implement CSA prevention programs, with the government's and nursing professionals' support, to enhance educators' abilities in combating CSA. Nurses have a pivotal role in preventing and addressing child sexual abuse, and they should actively contribute to improving child safety and well-being through knowledge, collaboration, and advocacy for comprehensive prevention strategies.

Mental health of transgender children and adolescents: a systematic review

Introduction: Studies on the mental health of transgender children and adolescents express high rates of depression, anxiety, and suicide. It is important to highlight that this is probably due to the minority stress with which these individuals deal since the infrastructures and social policies are designed to treat and welcome cisgenders, based on a normative character. This configuration is associated with a long and past history, of continuous prejudice, stigmatization, and discrimination, conflicts between appearance and gender identity, and rejection in social and family environments. All of these factors contribute decisively to the serious psychiatric morbidity perceived in this population. Objective: The present article aims to identify the relevant aspects of the mental health of transgender children and adolescents and explore other factors associated with the reduction of psychopathological disorders in this population. Methods: A systematic review of the scientific literature was conducted in the PubMed and Virtual Health Library indexed databases, using the descriptors "mental health", "transgender persons" and "children" with the Boolean operator AND. Studies discussing the subject, published between 2010 and 2020 in all available languages, were included, and those that did not meet the criteria were excluded. The survey and screening were carried out in parallel by three researchers, disclosing in the selection of 56 articles. Results: The studies indicated a higher frequency of psychological disorders like depression, anxiety, ideation and suicide, self-harm, low self-esteem, substance abuse, and other risk behaviors in the studied population when compared to the rest of the population. The studies also presented other aspects related to the mental health, such as the importance of family support, social transition, and institutional, medical, and psychological support. Conclusion: The evidence presents the challenges faced by this population in their needs and assured rights, culminating in the developing or worsening of psychological disorders.