Health care utilization pattern prior to maltreatment among children under five years of age in Taiwan

BackgroundSeveral studies have hypothesized that the pattern of health care utilization among maltreated children differ from others without the experience. However, the conclusions have not been consistent.ObjectiveThe study aims to examine whether the pattern of health care utilization among children 0–5 years old with maltreatment different from their counterparts without maltreatment in Taiwan.Subjects and SettingAll children born in 2007 in Taiwan.MethodThis is a population-based and case-controlled study. Cases are children under five years of ago with maltreatment-related diagnosis in the claims data of the National Health Insurance in Taiwan during the 2007–2013 period. For each case, there were 10 birth date-matched controls. Exposure variables include the number of injury or non-injury-related outpatients, emergency department (ED) visits, and hospitalization. Multivariate models were employed, with adjustment for sex, urbanization level, and comorbidities of children.ResultsOf children born in 2007, 382 had maltreatment-related diagnosis during the age of 0–5. The adjusted odds ratio (aOR) for having two or more ED visits with or without injury-related diagnosis is 3.52 (95% CI 1.75–7.07) and 2.0-0 (95% CI 1.47–2.72), respectively. Children with maltreatment also had significantly higher number of hospitalization without injury-related diagnosis and aOR for those having two more hospitalizations stands at 2.47 (95% CI 1.59–3.83).ConclusionsChildren with maltreatment when 0–5 years old had higher number of ED visits with injury-related diagnosis, as well as hospitalization without injury-related diagnosis. Recognition of the health care utilization is conducive to early identification of children with risk for maltreatment.     

Trends in US physician diagnosis of child physical abuse and neglect injuries, 2006–2014

ObjectiveTo determine if US child physical abuse and neglect injury rates changed from 2006 to 2014, whether definitive diagnoses of physical abuse and neglect were used more often over time, and what patient factors influenced definitive physical maltreatment diagnoses.MethodsNationally estimated rates of definitive and suggestive physical abuse and neglect injuries for children <10 years were generated using the Nationwide Emergency Department Sample, the National Inpatient Sample, and census estimates. Trends over time were evaluated, including the trend in the proportion of definitive diagnoses to all diagnoses (definitive plus suggestive). Logistic regression was used to evaluate whether patient characteristics and hospital patient volumes were associated with definitive versus suggestive diagnoses.ResultsThe population rates of child physical maltreatment medically treated injuries were unchanged from 2006 to 2014; the trends were not statistically significant for ED or hospitalized patients. Over time, physician definitive diagnoses as a proportion of all physical maltreatment diagnoses (definitive plus suggestive) increased in admitted children from 17.6% in 2006 to 22.0% in 2014 (p = 0.02). Older age, white race, lower income by zip code, and public insurance as well as larger patient volumes increased the odds of definitive rather than suggestive diagnoses of physical abuse and neglect injuries.ConclusionsDefinitive diagnoses of physical abuse and neglect increased over the study period and were associated with hospital volume and patient characteristics which may reflect provider experience and possible bias. The use of electronic medical records may have influenced the coding of definitive diagnoses.     

From care to education and work? Education and employment trajectories in early adulthood by children in out-of-home care

BackgroundTemporal dynamics during the early adulthood transition among children in out-of-home care is a neglected research area, leaving the possibility of coping with childhood adversity over time a poorly understood topic.ObjectiveTo explore early adulthood education and employment trajectories among young adults who experienced out-of-home care during childhood and to examine how various care history factors predict these trajectories.ParticipantsWe use longitudinal birth cohort data comprising individual-level information from national registers of all children born in Finland in 1987 (N = 59,476, of whom 1893 were in care).Setting and methodsWe use trajectory clustering from a previous study on the 1987 birth cohort to compare trajectories between children in care and a propensity score–matched group of peers never in care. We investigated the association between care history factors and trajectories with multinomial logistic regression modeling.ResultsCompared with the matched peer group, children in care were less likely to enter trajectories characterized by education and employment (38%) and more likely to enter trajectories involving early parenthood (14%) or long periods of fragmented social assistance benefit receipt and unemployment (21%). Those on early parenthood trajectories were almost exclusively women, whereas those receiving social assistance benefits and experiencing unemployment for lengthy periods were mostly men. Entering disadvantaged trajectories was associated with, inter alia, placement as an adolescent, residential care, and aging out of care.ConclusionThe study demonstrates the relevance of examining longitudinal trajectories in children in care’s early adulthood. Many young adults with care experience need support in education and employment beyond young adult age.     

当代大学生的性现状研究

面对当前大学生呈现的各种性问题,可从生理、心理和社会等多个角度进行研究,从中揭示性的伦理学意义。对于发生在大学生身上的性问题,我们的态度应该是教育和引导,而不是逃避和漠视。     

困境与出路：我国性侵运动员犯罪行为的刑事规制探究

近年来,性侵运动员的犯罪行为频发,成为国际社会聚焦的热点。以此审视我国运动员性法益的保护,虽有强奸罪、强制猥亵罪的刑事立法,却缺乏对该犯罪行为特殊性的深入思考,既不能在惩治犯罪人方面达到理想效果,亦不能在预防犯罪方面发挥良好功能。同时,司法中的“以纪代法”、针对性缺乏、未回应被害人需求等诸多问题,亦使该犯罪行为的刑事规制效果大打折扣。所以,在该犯罪立法上应有针对性采用附属刑法进行修正,完善犯罪的特别预防与一般预防制度;司法上,积极回应被害人的诉求,努力克服刑事规制过程中的各种困境,让运动员的性法益得到全面而充分的保护。     

反性骚扰立法研究——以劳动法为新视野

性骚扰已经成为一个严重的社会问题,美国、英国和我国台湾对反性骚扰的立法都有各自不同的特色,值得借鉴。美国将性骚扰定性为性别歧视,规制性骚扰以工作场所为主,范围不断扩大,并确立了雇主责任原则。我国台湾的反性骚扰立法明确界定了性骚扰的概念,特别是直接将性骚扰纳入了劳动法的调整范畴,认为工作场所性骚扰侵犯的是劳动者的工作环境权,开创了劳动立法的新篇章,并建立了完整的反性骚扰法律体系。我国应当在劳动法特别是《劳动合同法》中用工作环境权构建反性骚扰制度,以规制工作场所的性骚扰,在民法(民法典)中建立反性骚扰民事侵权制度,以之为反性骚扰的一般法。     

Educational program on evaluation of alleged sexual abuse victims

Increased awareness of the problem of child sexual abuse has resulted in increasing numbers of children presenting to professionals for the evaluation of possible sexual victimization. A multidisciplinary project to develop professionals' knowledge and skills in the identification and evaluation of possible victims is described. The program focused on the child as a victim and emphasized developmental perspectives with regard to identification, interviewing children, the medical examination, and children in the legal system. Fifty-one medical and social work professionals from ten Indiana counties attended the program and responded to questionnaires about their experience and knowledge. Of 40 (78%) respondents, 63% had had no previous training in the medical evaluation for child sexual abuse. Child protective workers referred alleged victims primarily to the child's regular physician (37%) or emergency room (31%) for medical examination. Knowledge about child sexual abuse improved significantly at two weeks postsymposium (p = .001) and remained improved at six months postsymposium (p less than .02). These original participants have subsequently organized similar multidisciplinary programs in their local communities for medical, social, law enforcement, and legal professionals; thus, they have been "seeds" for further educational and cooperative efforts throughout the state.     

儿童青少年体能发展敏感期相关热点问题

近年来,旨在提高儿童青少年体质健康的研究众多,其中儿童青少年体能发展敏感期问题的研究正成为热点研究。通过文献资料法和逻辑分析法等,对近30年来“敏感期”相关文献进行梳理。研究表明：国内外“敏感期”的界定标准不统一,难以形成科学成果;“敏感期”干预方法单一,缺乏综合干预方法;“敏感期”与“非敏感期”干预效果的研究还存在争议。研究认为：“敏感期”不仅受儿童青少年生理、心理因素的影响,同时遗传、环境、社会经济等对“敏感期”也具有重要作用。因此,未来应深入研究“敏感期”的构成因素,重视理论研究与实践研究相结合,强化“敏感期”的综合研究。     

Questioning the no-touch discourse in physical education from a children's rights perspective

In this paper we question the rationality of ‘no-touch policies’ and offer an alternative approach to the matter of physical contact between teachers and students in the context of physical education (PE) in schools. Earlier research has drawn attention to how a discourse of child protection is starting to affect how physical contact is viewed in PE practice. The avoidance of intergenerational touch is increasingly justified by referring to the children's rights agenda. Here, arguments for ‘no-touching’ are linked to children's right to be protected from harm. In the paper we explore a children's rights-based viewpoint that supports the use of and need for physical contact in PE teaching by developing theoretical and practice-based arguments. An alternative children's rights perspective, based on rights theorising, is used to formulate the theoretical argument. Interviews with 16 PE teachers about their experiences of physical contact in their pedagogical work form the practice-based arguments. The two arguments provide a way of looking at intergenerational touch in education from the vantage point of children's human right to develop to their full potential, which can support a need for physical touch in pedagogical situations.     

Emotional energy and sub-cultural politics: alternative bands in post-1997 Hong Kong

The paper attempts to work out the link between the structuring of the public domain and hegemonic masculinities in contemporary Kerala, South India. Using the debates around an incident of sexual harassment that happened in 1999, it argues for a conjunctural understanding of the contemporary where various events and moments in history are replayed through narrativization and popular memory. The paper goes on to analyse the debates around the incident that produce a ‘narrative public domain’, to foreground the various notions of masculinity that construct and structure it in relation to notions of female sexuality and changing structures of family. These notions of masculinity could be, the paper argues, a starting point for a historical inquiry into Kerala's modernity – an inquiry that would throw light on the past and the ways in which the contemporary is produced through its historical legacies.