Child Protection and Practice最新文献_第6页

Sudden death of a two-month-old infant: A case report emphasizing safe sleep practices 两个月大婴儿猝死：强调安全睡眠措施的病例报告

Child Protection and Practice

Pub Date : 2024-10-19 DOI: 10.1016/j.chipro.2024.100073

Nefise Zülal Öz , Nicel Yıldız Silahlı , Liljana Mehmetaj

A rare case of sudden cardiopulmonary arrest in a two-month-old infant during overnight breastfeeding is presented in this case report. The infant's respiratory distress prompted an emergency response, highlighting the complexities of managing critical situations in neonates. The report provides a comprehensive overview of the clinical presentation, resuscitation efforts, and laboratory findings. It emphasizes the importance of continuous education on safe sleep practices, breastfeeding techniques, and cultural factors that influence sleep safety. The aim is to raise awareness, foster understanding, and emphasize the necessity of a holistic approach to preventing adverse events in the vulnerable neonatal population. The case emphasizes the importance of establishing a safe sleeping environment by avoiding risk factors such as prone sleeping positions and soft bedding. It also highlights the need for culturally sensitive education. Additionally, the case addresses the challenges related to maternal alertness during night feeds and the controversial practice of bed-sharing. The report highlights the importance of healthcare providers in sharing information, conducting research, and involving communities to encourage a culture of sleep safety that protects the well-being of infants. Continuous education and awareness are crucial in this joint effort to safeguard the most vulnerable members of society.

本病例报告介绍了一例罕见病例，一名两个月大的婴儿在隔夜母乳喂养期间突发心肺骤停。该婴儿的呼吸窘迫引发了紧急反应，突显了处理新生儿危急情况的复杂性。报告全面概述了临床表现、复苏工作和实验室结果。报告强调了持续开展有关安全睡眠实践、母乳喂养技巧以及影响睡眠安全的文化因素的教育的重要性。其目的是提高人们的认识，促进理解，并强调有必要采取综合方法来预防新生儿中易发生的不良事件。案例强调了通过避免俯卧姿势和柔软被褥等风险因素来建立安全睡眠环境的重要性。案例还强调了开展文化敏感性教育的必要性。此外，该病例还讨论了与产妇夜间喂奶时的警觉性有关的挑战以及有争议的分床睡做法。报告强调了医疗保健提供者在分享信息、开展研究和社区参与方面的重要性，以鼓励形成一种保护婴儿福祉的睡眠安全文化。在保护社会中最脆弱成员的共同努力中，持续的教育和宣传至关重要。

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引用次数: 0

Child sex trafficking: A model of survivor inclusion and survivor-informed practice 儿童性贩卖：幸存者融入和幸存者知情实践模式

Child Protection and Practice

Pub Date : 2024-10-16 DOI: 10.1016/j.chipro.2024.100074

Corry Azzopardi , Alex Arruda , Atieno Miguna , Rhonelle Bruder

Survivor inclusion is a fundamental component to the success of efforts to combat child sex trafficking. Recognizing, honoring, and leveraging the wisdom that comes from lived experience with adversity, and centering the voices of survivors of sex trafficking, can help to balance power relations and inform more effective interventions. This critical discussion article responds to appeals for meaningful and ethical engagement of survivor leaders in program development, implementation, and evaluation. We propose a trauma-informed, anti-oppressive, empowerment-based model of survivor inclusion and survivor-informed practice grounded in guiding principles and practice strategies derived from lived experience. This work emerged from a unique collaboration between a diverse group of survivor advisors and pediatric health care program specializing in child sex trafficking. It serves as a survivor-led resource for anti-trafficking and child maltreatment organizations across sectors as they move toward building survivor-centered approaches to care for children exposed to sex trafficking.

幸存者的融入是打击儿童性贩运工作取得成功的基本要素。承认、尊重和利用来自逆境生活经验的智慧，以性贩卖幸存者的声音为中心，有助于平衡权力关系，为更有效的干预措施提供信息。这篇批判性讨论文章响应了让幸存者领导者以有意义和道德的方式参与项目开发、实施和评估的呼吁。我们提出了一种基于创伤、反压迫、赋权的幸存者融入模式，以及以指导原则和源自生活经验的实践策略为基础的幸存者知情实践。这项工作是由一群不同的幸存者顾问和专门从事儿童性贩卖的儿科医疗保健项目共同合作完成的。它为各部门的反人口贩运和儿童虐待组织提供了以幸存者为主导的资源，帮助他们建立以幸存者为中心的方法，以关爱遭受性贩运的儿童。

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引用次数: 0

Parental education and attitudes towards institutionalization of children in West Java, Indonesia 印度尼西亚西爪哇的父母教育和对儿童机构化的态度

Child Protection and Practice

Pub Date : 2024-10-15 DOI: 10.1016/j.chipro.2024.100072

Michelle Andrina , José Ignacio Nazif-Muñoz , Rebecca Smith , Alice Shirley , Tata Sudrajat , Andri Yoga Utami , Mónica Ruiz-Casares

Background

In low- and middle-income countries, orphanages are often perceived as a means to secure education for children. Consequently, many parents send their children to orphanages, unaware of the potential risks involved.

Objective

This study aims to explore caregivers' attitudes toward child institutionalization in the context of placing children in orphanages.

Participants

Data were collected from 736 caregivers of children aged 0–7 years in Cianjur, West Java, Indonesia, in 2017.

Methods

Descriptive analysis and logistic regression were used to assess caregivers’ attitudes and the likelihood of agreeing or disagreeing with six statements about child institutionalization.

Results

The study found that most caregivers agreed that poor children are better off being raised in orphanages, but parents remain responsible for the child even after placement. Logistic regression showed that caregivers with higher levels of formal education were less likely to agree with placing children in orphanages compared to caregivers with lower levels of formal education.

Conclusions

This study highlights the importance of higher formal education in reducing caregiver support for institutionalization.

背景在中低收入国家，孤儿院通常被视为确保儿童接受教育的一种手段。因此，许多家长将孩子送进孤儿院，却不知道其中的潜在风险。本研究旨在探讨在将儿童送进孤儿院的背景下，照料者对儿童福利院化的态度。参与者数据收集自2017年印度尼西亚西爪哇Cianjur地区736名0-7岁儿童的照料者。方法采用描述性分析和逻辑回归评估照顾者的态度以及同意或不同意有关儿童福利院的六种说法的可能性。结果研究发现，大多数照顾者同意贫困儿童最好在孤儿院抚养，但即使在安置后，父母仍要对儿童负责。逻辑回归显示，与正规教育水平较低的护理人员相比，正规教育水平较高的护理人员不太可能同意将儿童安置在孤儿院。

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引用次数: 0

Does participation in a court-based trauma-focused evaluation program influence permanency outcomes for children involved in the child welfare system? 参与以法庭为基础、以创伤为重点的评估项目是否会影响儿童福利系统所涉儿童的永久性结果？

Child Protection and Practice

Pub Date : 2024-10-15 DOI: 10.1016/j.chipro.2024.100071

Kathleen A. Kemp , Crosby A. Modrowski , Kaitlin Sheerin , Miyah Grant , Charlene Collibee

Background

Children involved in the child welfare system, especially those in out-of-home care, experience high rates of mental health symptoms. Mental health symptoms have been linked to worse permanency outcomes in this population.

Objective

The present study aimed to evaluate whether children who received a trauma-focused evaluation, compared to children who received usual care, experienced differential permanency outcomes, as well as other court-related outcomes (e.g., legal system involvement).

Participants and setting

One-hundred and twenty-five children (58% female, Mage = 10.61) from a family court in the Northeastern United States participated in a trauma-focused evaluation program.

Methods

Data for the current study were collected via a retrospective chart. Participants were recruited at a family court of a Northeastern state. Between-groups differences on court-related outcomes were assessed using logistic regression and Kaplan Meier estimates.

Findings

There were no significant differences between children who received the trauma-focused evaluation program versus usual care in the likelihood for guardianship changes, termination of parental rights, new child welfare petitions or new juvenile legal petitions. The groups significantly differed in the likelihood of case closure; children who received the trauma-focused evaluation program were more likely to experience case closure compared to children who received usual care. Additionally, on average, children who received the trauma-focused evaluation program achieved case closure almost 8 months sooner.

Conclusions

The findings suggest that initiatives aimed at identifying mental health concerns and linking children placed in out-of-home to relevant mental health services care can have a significant and positive impact on permanency outcomes.

背景卷入儿童福利系统的儿童，尤其是接受家庭外照料的儿童，出现心理健康症状的比例很高。本研究旨在评估与接受常规护理的儿童相比，接受以心理创伤为重点的评估的儿童是否会经历不同的永久性结果，以及其他与法庭相关的结果（如：法律系统参与）、美国东北部一个家事法庭的 125 名儿童（58% 为女性，Mage = 10.61）参加了以创伤为重点的评估项目。本研究的数据是通过回顾性图表收集的，参与者是在美国东北部某州的一个家事法庭招募的。研究结果在监护权变更、父母权利终止、新的儿童福利申请或新的青少年法律申请的可能性方面，接受创伤焦点评估项目的儿童与接受常规护理的儿童之间没有显著差异。在结案的可能性方面，各组之间存在明显差异；与接受常规护理的儿童相比，接受以创伤为重点的评估项目的儿童更有可能结案。结论研究结果表明，旨在识别心理健康问题并将被安置在家庭外的儿童与相关的心理健康服务护理联系起来的措施可以对永久性结果产生重大而积极的影响。

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引用次数: 0

Enduring strengths: How childhood adversity shapes adult resilience in Kosovo 持久的力量：童年的逆境如何塑造科索沃成年人的复原力

Child Protection and Practice

Pub Date : 2024-10-15 DOI: 10.1016/j.chipro.2024.100070

Kaltrina Kelmendi , Sherry Hamby

This study investigates how adults who faced childhood adversity develop resilience, using the Resilience Portfolio Model to assess the impact of early victimization on adult well-being and posttraumatic growth. A sample of 689 adults aged 18 to 60 (average age 25.2 years, SD = 9.62) was recruited online in Kosovo, a collectivist and post-conflict society. Participants completed a survey on youth victimization, psychosocial strengths, subjective well-being and posttraumatic growth. Findings from the study show that 93% experienced some form of victimization, including 40% who were exposed to parental violence. Blockwise logistic regressions indicated that poly-strengths (an indicator of the breadth of one's resilience portfolio), sense of purpose, optimism, and religious meaning making were associated with higher levels of posttraumatic growth, controlling for polyvictimization and demographics (total R² = 0.39). Poly-strengths, sense of purpose, optimism, and psychological endurance were associated with higher subjective well-being (total R² = 0.34). Unexpectedly, some strengths were associated with lower posttraumatic growth, including coping, anger management, and moral-based meaning making. Findings from this highly victimized sample show that several strengths seem promising in promoting resilience. Intervention and prevention programs should consider focusing on promoting a sense of purpose or broadening resilience portfolios. More research is needed in other collectivist and post-conflict societies.

本研究采用复原力组合模型（Resilience Portfolio Model）来评估早期受害对成人福祉和创伤后成长的影响，从而探讨面临童年逆境的成年人如何发展复原力。研究在科索沃这个集体主义和冲突后社会中在线招募了 689 名 18 至 60 岁的成年人（平均年龄 25.2 岁，SD = 9.62）。参与者完成了一项关于青少年受害情况、社会心理力量、主观幸福感和创伤后成长的调查。研究结果表明，93%的人曾遭受过某种形式的伤害，其中 40%的人曾遭受过父母暴力。顺时针逻辑回归表明，在控制多重受害和人口统计学因素的情况下，多重优势（一个人复原力组合广度的指标）、目标感、乐观主义和宗教意义塑造与较高水平的创伤后成长相关（总 R2 = 0.39）。多重优势、目的感、乐观主义和心理耐力与较高的主观幸福感相关（总 R2 = 0.34）。意想不到的是，一些优势与较低的创伤后成长相关，包括应对、愤怒管理和基于道德的意义建构。这个受害严重的样本的研究结果表明，有几种优势在促进复原力方面似乎很有前景。干预和预防计划应考虑将重点放在促进目的感或扩大复原力组合上。还需要在其他集体主义社会和冲突后社会开展更多的研究。

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引用次数: 0

Navigating treatment trajectories for families with young children after domestic violence: A Delphi-study exploring the priorities in terms of trauma-therapy and attachment-based intervention 为遭受家庭暴力后有年幼子女的家庭的治疗轨迹导航：探索创伤治疗和依恋干预优先事项的德尔菲研究

Child Protection and Practice

Pub Date : 2024-10-10 DOI: 10.1016/j.chipro.2024.100069

Willemien M. van den Dorpel , Lenneke R.A. Alink , Anja van der Voort , Carlo Schuengel , Ashwina R. Kesarlal , Carlijn de Roos , Karine Zuidgeest , Sabine van der Asdonk

Background

In families with young children who have experienced domestic violence, both parents and children are at risk to develop post-traumatic stress disorder (PTSD) symptoms, and there is a risk for disrupted parent-child interactions.

Objective

To identify the factors on which expert-clinicians agree that they should be considered when deciding on the order of trauma therapy for the parent, trauma therapy for the child, and attachment-based intervention.

Participants

and settings: Participants were 16 experienced clinicians, trained in attachment-based intervention for parents and their young children, trauma therapy for adults, and trauma therapy for young children.

Methods

A classic three-round Delphi approach was used. Anonymous online surveys were filled out by the participants. Consensus was defined as agreement among 70% of the participants.

Results

After the third survey round, there were eleven factors for which there was consensus. These included the preference of the parent for one of the three individual therapies, impaired parental mentalizing capacity, insensitive/disrupted parenting, a problematic attachment history between parent and child, a high level of child PTSD symptoms, a high level of parental PTSD symptoms, severe risks for the development of the child, a very young age of the child, and exposure of the child to one or more traumatic events.

Conclusions

Agreement was found on which factors to consider in planning the order of treatments for families who have experienced domestic violence. These factors can provide a starting point from where clinicians can design a treatment plan with a specific family.

背景在有幼儿遭受家庭暴力的家庭中，父母和孩子都有可能出现创伤后应激障碍（PTSD）症状，亲子间的互动也有可能受到干扰。目的确定专家-临床医生一致认为在决定对父母进行创伤治疗、对孩子进行创伤治疗和基于依恋的干预的顺序时应考虑的因素：方法：采用经典的三轮德尔菲法。参与者填写匿名在线调查问卷。结果经过第三轮调查，有 11 个因素达成了共识。这些因素包括父母偏好三种个人疗法中的一种、父母的心智能力受损、父母对子女的教育不敏感/中断、父母与子女之间有问题的依恋史、子女创伤后应激障碍症状严重、父母创伤后应激障碍症状严重、子女发育面临严重风险、子女年龄非常小以及子女遭受过一次或多次创伤事件。这些因素可以提供一个起点，临床医生可以据此为特定家庭设计治疗计划。

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引用次数: 0

‘I had nothing and drugs don't leave’: A qualitative study exploring the drug use trajectories of young people in contact with the justice system 我一无所有，但毒品不会离去"：探索与司法系统有接触的青少年吸毒轨迹的定性研究

Child Protection and Practice

Pub Date : 2024-10-09 DOI: 10.1016/j.chipro.2024.100068

Emily Deans , Joseph Abdo , Jioji Ravulo , Elizabeth Conroy

引用次数: 0

Young adults’ perceptions of adverse childhood experiences as context and causes of mental health conditions: Observations from the United States 青壮年对童年不良经历作为精神健康状况的背景和原因的看法：来自美国的观察

Child Protection and Practice

Pub Date : 2024-10-09 DOI: 10.1016/j.chipro.2024.100067

Kathryn Sabella , Ian A. Lane , Murron O'Neill , Natalie Tincknell

Background

The relationship between adverse childhood experiences (ACEs) and mental health later in life has been well-established. However, first-person qualitative narratives describing how ACEs negatively impact mental health of young adults are rare.

Objective

Qualitative data explores how young adults with serious mental health conditions (SMHC) describe childhood adversities and relate those experiences to their mental health conditions.

Participants and setting

Young adult participants (n = 55; ages 25–30) who self-reported being diagnosed with an SMHC were recruited from one state in United States. In-person interviews were conducted to gather narratives related to mental health, education, training, and employment.

Methods

Young adults with lived experience actively participated in the research process. Iterative coding and thematic analysis were employed to assess ACEs reported and analyze how participants described those experiences as influential.

Results

Most participants identified as White, non-Hispanic women. Major depression and anxiety disorders were the most prevalent diagnoses. Over 80% reported experiencing trauma, familial mental illness, or substance use challenges. Young adults connected their ACEs to fear and anxiety, emotional processing difficulties, poor coping behaviors, delayed help-seeking, and later negative interpersonal relationships.

Conclusions

This study is the first to qualitatively describe how young adults with SMHC describe ACEs and relate those experiences to their own mental health conditions. Future research should seek similar first-hand accounts in vulnerable populations and consider the unique impact of the COVID-19 pandemic. Findings and future research can inform policy, practice, and mental health treatment for young adults who have experienced ACEs, especially in the post-pandemic era.

背景童年逆境经历（ACEs）与日后心理健康之间的关系已经得到证实。然而，描述童年逆境（ACE）如何对年轻人的心理健康产生负面影响的第一人称定性叙述却很少见。目标通过定性数据探索患有严重心理健康疾病（SMHC）的年轻人如何描述童年逆境，并将这些经历与他们的心理健康状况联系起来。我们进行了面对面访谈，以收集与心理健康、教育、培训和就业相关的叙述。我们采用了迭代编码和主题分析法来评估所报告的 ACE，并分析参与者如何描述这些经历的影响。重度抑郁症和焦虑症是最常见的诊断。超过 80% 的人表示曾遭受过精神创伤、家庭精神疾病或药物使用方面的挑战。年轻成年人将他们的 ACE 与恐惧和焦虑、情绪处理困难、不良应对行为、延迟寻求帮助以及后来的消极人际关系联系起来。未来的研究应在弱势群体中寻找类似的第一手资料，并考虑 COVID-19 大流行的独特影响。研究结果和未来的研究可以为政策、实践以及对经历过 ACE 的年轻成年人的心理健康治疗提供参考，尤其是在大流行后的时代。

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引用次数: 0

Intersectional disparities in access to mental health services among youth aging out of foster care 脱离寄养家庭的青少年在获得心理健康服务方面的交叉差异

Child Protection and Practice

Pub Date : 2024-10-03 DOI: 10.1016/j.chipro.2024.100066

Lauren Pryce McCarthy , Yanfeng Xu , Sally Hageman , Yao Wang

Background

Youth aging out of the child welfare system lack support in accessing needed mental health care, as do youth of color and LGBTQ + youth in the general population. Similar disparities may exist among youth aging out of foster care who hold intersecting social identities.

Objective

This study aimed to explore the presence of mental health care access disparities among youth aging out of foster care using an intersectional lens.

Participants

and Setting: The current study was a cross-sectional, exploratory analysis of secondary data from the Jim Casey Youth Opportunities Initiative (JCYOI) dataset. The sample included 2650 youth aging out of care.

Methods

The current study utilized bivariate tests to explore the association between access to mental health care and key variables, a rate ratio to measure access disparities, and logistic regression to determine the main effect of identity on mental health care access.

Findings

Lower rates of mental health care access were found among youth of color compared to White youth and among LGBTQ + youth compared to non-LGBTQ + youth. Disparities increased when youth of color also identified as LGBTQ+, however identity was not a significant predictor of mental health care access when controlling for insurance coverage and other variables.

Conclusions

Disparities in access to needed mental health care found in the general population are also present among youth aging out of foster care. These findings suggest the need for targeted efforts from practitioners to ensure equitable access to mental health care for transition aged youth.

背景脱离儿童福利系统的青少年在获得所需的心理健康护理方面缺乏支持，有色人种青少年和 LGBTQ + 青少年在一般人群中也是如此。本研究旨在从交叉性视角探讨脱离寄养家庭的青少年在获得心理健康护理方面是否存在差异：本研究是对吉姆-凯西青少年机会倡议（Jim Casey Youth Opportunities Initiative，JCYOI）数据集中的二手数据进行的一项横断面探索性分析。研究结果：与白人青年相比，有色人种青年获得心理健康护理的比率较低；与非 LGBTQ 青年相比，LGBTQ 青年获得心理健康护理的比率较高。当有色人种青少年也被认定为 LGBTQ+ 时，差距就会增大，但在控制了保险范围和其他变量后，身份并不能显著预测心理健康护理的获得情况。结论在普通人群中发现的获得所需心理健康护理方面的差距也存在于脱离寄养家庭的青少年中。这些研究结果表明，从业人员需要做出有针对性的努力，以确保过渡年龄段的青少年能够公平地获得心理保健服务。

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引用次数: 0

Expanding ACES in child and family service systems: Incorporating context and resilience 在儿童和家庭服务系统中扩展 ACES：纳入背景和复原力

Child Protection and Practice

Pub Date : 2024-09-30 DOI: 10.1016/j.chipro.2024.100065

Ana Maria Meléndez Guevara , Stephanie Cottam , Charlie Wall , Sarah Lindstrom Johnson

The Adverse Childhood Experiences (ACEs) framework has been instrumental in illustrating the profound and long-term impact of early-life stressors in the developmental trajectories of children and families and well-being of our communities. However, despite its groundbreaking contributions, the ACEs framework predominately adopts a deficit-oriented lens, focusing on risk factors while often neglecting the protective and positive experiences children and families also experience. In the United States, communities that have been historically marginalized, including racial and ethnic minorities, are disproportionately impacted by ACEs due to systemic inequities and historical injustices, leading to persistent sociodemographic health and social disparities. Recent advances to the ACEs framework argue that the traditional ACEs model inadequately addresses the broader socio-structural, political, and economic contexts that influence adversity, including living in under-resourced communities, ongoing community violence and poor access to service systems. As a result, child, and family service systems (CFSS) may fail to consider how socio-structural factors, may potentially reinforce disparities in service access, delivery, and outcomes. This paper discusses the limitations of the traditional ACEs framework and advocates for a more comprehensive approach that incorporates socio-ecological and strengths-based perspectives like the Social Determinants of Health Framework and the Protective and Compensatory Experiences (PACEs) Framework. By shifting towards this holistic perspective, researchers and practitioners alike can better understand the interplay of systemic inequalities and socio-structural conditions in shaping ACEs exposure and outcomes, and, therefore, inform more effective practices, policies and services that can address both the immediate impact and root causes of adversity.

童年不良经历（ACEs）框架在说明早期生活压力对儿童和家庭发展轨迹以及社区福祉的深远和长期影响方面发挥了重要作用。然而，尽管 ACEs 框架做出了开创性的贡献，但它主要采用了以缺陷为导向的视角，关注风险因素的同时往往忽视了儿童和家庭也会经历的保护性和积极的经历。在美国，由于系统性的不平等和历史性的不公正，历史上被边缘化的社区，包括少数种族和少数民族，受到 ACEs 的影响尤为严重，导致了持续的社会人口健康和社会差异。ACEs 框架的最新进展认为，传统的 ACEs 模型没有充分考虑到影响逆境的更广泛的社会结构、政治和经济背景，包括生活在资源不足的社区、持续的社区暴力和难以获得服务系统。因此，儿童和家庭服务系统（CFSS）可能没有考虑到社会结构因素可能会如何加剧服务获取、提供和结果方面的差异。本文讨论了传统 ACEs 框架的局限性，并主张采用一种更全面的方法，将社会生态学和基于优势的观点（如健康的社会决定因素框架和保护与补偿经历（PACEs）框架）结合起来。通过转向这种全面的视角，研究人员和从业人员都能更好地理解系统性不平等和社会结构条件在形成 ACEs 暴露和结果方面的相互作用，从而为更有效的实践、政策和服务提供信息，以解决逆境的直接影响和根本原因。

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引用次数: 0