Systematic review of interventions for the secondary prevention and treatment of emotional abuse of children by primary carers

Background Emotional abuse (or psychological maltreatment, as it is more commonly called in the US) is an inadequately researched and poorly understood concept, despite increasing awareness about the harm it can cause to children‟s lives. Although it unifies and underpins all types of maltreatment it also occurs alone and when it does, tends to elude detection and intervention. There have to date been no systematic reviews of the literature on the secondary prevention and treatment involving the parents or primary carers of emotionally abused children. Objective The objective of the review was to identify studies that evaluate the effectiveness of interventions in the secondary prevention and treatment of child emotional abuse involving the parents or primary carers of children aged 0 – 19 years. Methods Studies were included if they involved any intervention which was directed at emotionally abusive parenting and that measured change in (i) emotional unavailability (ii) negative attributions (i.e. that involve the parent attributing negative intentions, beliefs or attitudes toward the child); (iii) developmentally inappropriate interactions; (iv) lack of recognition of children‟s boundaries; (v) inconsistency of parenting role; (vi) missocialisation or consistent failure to promote the child‟s social adaptation. The primary outcomes evaluated involved proxy measures of a range of parent, family and child outcomes including parental psychopathology, parenting attitudes and practices, family functioning and/or child behaviour and the child‟s development and adaptation. . A broad search strategy was developed in order to identify as many relevant studies as possible. An electronic search of a wide range of databases was carried about. No study type was excluded. The search was augmented by direct contact with academics and practitioners known in this field. The search included studies written in English, Spanish, French and German. Studies were included if the intervention was described, and the impact on at least one indicator of emotional abuse was assessed. Included studies were critically appraised by two reviewers using standard criteria. Data were extracted using a standard proforma, and a qualitative synthesis of results was carried out. Results The initial search yielded 4248 publications of potential interest. Of these, 175 were obtained for possible inclusion or as background material. A total of 21 studies of 18 interventions, met all the inclusion criteria. A further 43 studies were relevant, but did not meet all of the inclusion criteria. Studies were organised according to the type of emotional abuse targeted: emotionally abusive parenting; parents of infants with faltering growth; missocialisation: parenting interventions with substance-abusing mothers. Twelve included studies had quantitative designs. Of these, 6 comprised randomised controlled trials; 1 comprised a follow-up of a randomised controlled trial; 2 were controlled studies; and 3 had one-group pre- and post-designs. The remaining 9 were case studies. Included studies involved a wide range of interventions. The 8 studies for parents which address emotionally abusive parenting (rejection, misattribution, parent-child role reversal and anger management) involved evaluations of cognitive-behavioural training (CBT), behavioural training and parent-infant psychotherapy. Two further case studies involved cognitive-behavioural training, mentalisation and family-based therapy. The 9 interventions with parents of infants with faltering growth evaluated CBT, behavioural training, parent infant psychotherapy and interaction guidance; lay home visitors, and a range of therapeutic options based on the diagnostic condition of the parents. The 3 studies of interventions for substance abusing mothers evaluated a relational psychotherapy group for mothers, and a residential treatment for substance abuse with a parenting component. The sample sizes for quantitative studies were small and ranged from 17 to 98 participants. Ten interventions involved mothers alone, while a further 11 included fathers, either at the outset or at a later stage, and in 3 cases extended family members. Interventions for emotionally abusing parents The findings from the 8 included studies evaluating CBT, psychotherapy, and behavioural approaches suggest that group-based CBT may be an effective means of intervening with this group of parents, although it cannot currently be recommended with parents experiencing symptoms of severe psychopathology. While one comparative study showed a psychotherapeutic intervention to be more effective than a CBT focused intervention, the outcomes measured in this study (i.e. parent and child representations) favoured the former. Behavioural case work involving the use of problem-solving techniques may also have a role to play with some parents, although further research is still needed. Interventions to enhance parental sensitivity The findings from a systematic review of 81 interventions that aimed at enhancing parental sensitivity and / or infant attachment found strong evidence that short term (less than 16 sessions) interventions, with a behavioural focus and aimed exclusively at enhancing maternal sensitivity were also most effective in enhancing infant attachment security. This supports the notion of a causal role of sensitivity in shaping attachment. Interventions that included fathers as well as mothers showed higher effect sizes but results are tentative since they are based on a small number of small scale trials. Parental behaviours associated with faltering growth Nine studies evaluated a range of interventions with parents of babies with faltering growth including interaction guidance, home visiting; parent-child psychotherapy, behavioural casework and multi-component interventions. The findings show that interaction guidance and parent-infant psychotherapy may be potentially effective means of working with this group of clients along with behavioural casework, but that further research is needed before these can be recommended. Missocialisation: Parenting interventions for substance-abusing parents 5 studies (one of which was a 6-month follow-up) evaluated interventions for substance abusing mothers, including a relational psychotherapy group and a residential treatment for substance abusing adults with a parenting component. The findings show that initial gains made in the former were not sustained at 6-months and few benefits from residential intervention. Conclusions Emotional abuse is a complex issue resulting in part from learned behaviours, psychopathology and/or unmet emotional needs in the parents, and often compounded by factors in the families‟ immediate and wider social environment. As such, a „one-approach-fits-all‟ is unlikely to lead to sustained change. The evidence base is weak, but suggests that some caregivers respond well to cognitive behavioural therapy. However, the characteristics that define these parents are not clear. There is currently no evidence to support the use of this intervention alone in the treatment of severely emotionally abusive parents. Some of the evidence suggests that a certain form of emotional abuse (for example, highly negative parent affect, which may be expressed as frightened and frightening behaviours in the parent) stemming from unresolved trauma and loss, is less amenable to CBT. There is some evidence that interaction guidance and psychotherapeutic approaches can generate change in parents with more severe psychopathology. Further research is urgently needed to evaluate the benefits of both psychotherapeutic and cognitive behavioural interventions, including those which take the form of family therapy, with parents at the more severe end of the spectrum, with fathers, and with older children. There is also a need to gain further understanding about which forms of emotional abuse respond best to different treatments

Collisional stripping of planetary crusts

Geochemical studies of planetary accretion and evolution have invoked various degrees of collisional erosion to explain differences in bulk composition between planets and chondrites. Here we undertake a full, dynamical evaluation of 'crustal stripping' during accretion and its key geochemical consequences. We present smoothed particle hydrodynamics simulations of collisions between differentiated rocky planetesimals and planetary embryos. We find that the crust is preferentially lost relative to the mantle during impacts, and we have developed a scaling law that approximates the mass of crust that remains in the largest remnant. Using this scaling law and a recent set of N-body simulations, we have estimated the maximum effect of crustal stripping on incompatible element abundances during the accretion of planetary embryos. We find that on average one third of the initial crust is stripped from embryos as they accrete, which leads to a reduction of ~20% in the budgets of the heat producing elements if the stripped crust does not reaccrete. Erosion of crusts can lead to non-chondritic ratios of incompatible elements, but the magnitude of this effect depends sensitively on the details of the crust-forming melting process. The Lu/Hf system is fractionated for a wide range of crustal formation scenarios. Using eucrites (the products of planetesimal silicate melting, thought to represent the crust of Vesta) as a guide to the Lu/Hf of planetesimal crust partially lost during accretion, we predict the Earth could evolve to a superchondritic 176-Hf/177-Hf (3-5 parts per ten thousand) at present day. Such values are in keeping with compositional estimates of the bulk Earth. Stripping of planetary crusts during accretion can lead to detectable changes in bulk composition of lithophile elements, but the fractionation is relatively subtle, and sensitive to the efficiency of reaccretion.Comment: 15 pages, 9 figures. Accepted for publication in EPSL. Abstract shortened. Accompanying animations can be found at http://www.star.bris.ac.uk/pcarter/crust_strip

Universal health care and equity: evidence of maternal health based on an analysis of demographic and household survey data

INTRODUCTION: The drive toward universal health coverage (UHC) is central to the post 2015 agenda, and is incorporated as a target in the new Sustainable Development Goals. However, it is recognised that an equity dimension needs to be included when progress to this goal is monitored. WHO have developed a monitoring framework which proposes a target of 80 % coverage for all populations regardless of income and place of residence by 2030, and this paper examines the feasibility of this target in relation to antenatal care and skilled care at delivery.METHODOLOGY: We analyse the coverage gap between the poorest and richest groups within the population for antenatal care and presence of a skilled attendant at birth for countries grouped by overall coverage of each maternal health service. Average annual rates of improvement needed for each grouping (disaggregated by wealth quintile and urban/rural residence) to reach the goal are also calculated, alongside rates of progress over the past decades for comparative purposes.FINDINGS: Marked inequities are seen in all groups except in countries where overall coverage is high. As the monitoring framework has an absolute target countries with currently very low coverage are required to make rapid and sustained progress, in particular for the poorest and those living in rural areas. The rate of past progress will need to be accelerated markedly in most countries if the target is to be achieved, although several countries have demonstrated the rate of progress required is feasible both for the population as a whole and for the poorest.CONCLUSIONS: For countries with currently low coverage the target of 80 % essential coverage for all populations will be challenging. Lessons should be drawn from countries who have achieved rapid and equitable progress in the past.<br/

Hiding in the Shadows II: Collisional Dust as Exoplanet Markers

Observations of the youngest planets ($\sim$1-10 Myr for a transitional disk) will increase the accuracy of our planet formation models. Unfortunately, observations of such planets are challenging and time-consuming to undertake even in ideal circumstances. Therefore, we propose the determination of a set of markers that can pre-select promising exoplanet-hosting candidate disks. To this end, N-body simulations were conducted to investigate the effect of an embedded Jupiter mass planet on the dynamics of the surrounding planetesimal disk and the resulting creation of second generation collisional dust. We use a new collision model that allows fragmentation and erosion of planetesimals, and dust-sized fragments are simulated in a post process step including non-gravitational forces due to stellar radiation and a gaseous protoplanetary disk. Synthetic images from our numerical simulations show a bright double ring at 850 $\mu$m for a low eccentricity planet, whereas a high eccentricity planet would produce a characteristic inner ring with asymmetries in the disk. In the presence of first generation primordial dust these markers would be difficult to detect far from the orbit of the embedded planet, but would be detectable inside a gap of planetary origin in a transitional disk.Comment: Accepted for publication in Ap

Resource exploitation at late neolithic domuztepe: Faunal and botanical evidence

Domuztepe, in southeastern Turkey, is one of the largest known Late Neolithic sites in the Near East. Ecofactual remains recovered at Domuztepe indicate that the site’s inhabitants relied on a well‐established mixed economy of domestic plants and animals to sustain the settlement’s large population, which may have peaked at more than 1,500 people. Evidence of a long and continuous occupation of this site attests to a successful agropastoral economy, even though Domuztepe was situated at the intersection of uplands, an alluvial plain, and marshy zones, an environment not traditionally considered ideal for agriculture. Integrated faunal and botanical analyses explore the diversity of domestic and wild resources used by the site’s inhabitants. The typical suite of Near Eastern domesticates dominates the excavated assemblage, with sheep, goats, cattle, pigs, and cereals prominent. In addition to a nutritional role, these food products were used for clothing, storage, and construction and had symbolic importance in ritual and prestige. Combined archaeobiological data point to a seasonal cycle of activities

Creation of backdoors in quantum communications via laser damage

Practical quantum communication (QC) protocols are assumed to be secure provided implemented devices are properly characterized and all known side channels are closed. We show that this is not always true. We demonstrate a laser-damage attack capable of modifying device behaviour on-demand. We test it on two practical QC systems for key distribution and coin-tossing, and show that newly created deviations lead to side channels. This reveals that laser damage is a potential security risk to existing QC systems, and necessitates their testing to guarantee security.Comment: Changed the title to match the journal version. 9 pages, 5 figure

Practicalities of HCR-20 implementation within secure psychiatric services

The HCR-20 is established as the de-facto tool for the assessment of violence risk within forensic psychiatric services. Although much has been written about the value of the tool, less has been written about the practicalities of achieving meaningful completion of HCR-20 assessments at a service level. The present paper seeks to review recommendations within the literature and also those based upon the authors’ own experiences in HCR-20 implementation, reviewing a number of the common issues and barriers encountered within the development of a strategic, service-level, approach to completion of the HCR-20. Possible solutions to these problems are also considered. We conclude that although there is not necessarily a single approach that is right for every service, certain principles need to be followed to ensure high quality assessments. Further, we develop a number of ‘good practice points’ which will be useful for services considering this issue on a strategic level, as well as commissioners evaluating the quality of HCR-20 completion within services

Smokers’ beliefs about the tobacco control potential of “a gene for smoking”: A focus group study

BACKGROUND: Several genetic variations associated with nicotine dependence and lung cancer exist. Translating this knowledge into tobacco control policy relies on smokers’ perceptions of the implications of the research. This study explored smokers’ beliefs about the tobacco control uses for research examining genomics, smoking, and addiction. METHOD: Smokers (N = 85) participated in one of thirteen focus groups and one interview, stratified by race (eight black, six white) and education (seven < Bachelor’s degree, seven ≥ Bachelor’s degree). Data were analyzed by two independent coders using standard analysis and validation techniques. RESULTS: Nearly all groups suggested using genetic information for youth-oriented tobacco prevention education. Beliefs about the effectiveness of such actions varied. Many participants believed that providing smokers personalized genetic testing results or informing them about the existence of a gene would not motivate people to quit. All smokers emphasized the need for improved smoking cessation treatment options. Using genomics research to develop gene therapies and personalized drug treatments were also mentioned, yet perceptions of such treatments were mixed. Whereas some participants viewed the possibility positively, others expressed concern about cost and access. Participants who were skeptical of the effectiveness of using genetic information for tobacco control noted that the harms of tobacco use are widely known and genetic information does not add much of a deterrent. CONCLUSION: Participants generated several possible tobacco control uses for genomics research findings. Our findings suggest that tobacco control experts should consult with smokers prior to implementing tobacco control measures. The potential public health benefits of genetics and genomics research related to tobacco use cannot be realized until communication strategies that are most likely to encourage and support tobacco avoidance decisions, and minimize mistrust and backlash, are identified

Effects of experimental harvest on red sea urchins (Strongylocentrotus franciscanus) in northern Washington

Commercial harvest of red sea urchins began in Washington state in 1971. Harvests peaked in the late 1980s and have since declined substantially in Washington and other areas of the U.S. west coast. We studied effects of experimental harvest on red sea urchins in San Juan Channel (SJC), a marine reserve in northern Washing-ton. We recorded changes in density and size distribution of sea urchin populations resulting from three levels of experimental harvest: 1) annual size-selective harvest (simulating cur-rent commercial urchin harvest regulations), 2) monthly complete (non–size selective) harvest, and 3) no harvest (control) sites. We also examined re-colonization rates of harvested sites. The red sea urchin population in SJC is composed of an accumulation of large, old individuals. Juvenile urchins represent less than 1% of the population. Lower and upper size limits for commercial harvest protect 5% and 45% of the population, respectively. Complete harvest reduced sea urchin densities by 95%. Annual size-selective harvest significantly decreased sea urchin densities by 67% in the first year and by 47% in the second year. Two years of size-selective harvest significantly altered the size distribution of urchins, decreasing the density of legal-size urchins. Recolonization of harvested sites varied seasonally and occurred primarily through immigration of adults. Selective harvest sites were recolonized to 51% and 38% of original densities, respectively, six months after the first and second annual harvests. Yields declined substantially in the second year of size-selective harvest because of the fishing down of the population and because of low recolonization rates of harvested sites. We recommend that managers consider the potential efficacy of marine harvest refuges and reevaluate the existing upper and lower size limits for commercial harvest to improve long-term management of the sea urchin fishery in Washington

The Ted Trueblood Collection at Boise State University : A Guide to the Papers of One of America\u27s Foremost Outdoor Writers and Conservationists

Ted Trueblood (1913-1982) loved to write about the outdoors almost as much as he loved the outdoors itself. Raised on a family farm in the southwestern corner of Idaho, Trueblood made a living by writing and taking pictures of the things he liked to do best -hunting, fishing, camping, and cooking in the great outdoors. From his home in Idaho, he contributed hundreds of articles to Field & Stream and other outdoor journals, edited several book-length anthologies of his work, and, as the years went by, played an evermore influential role in the conservation and environmental movements in the American West. The Ted Trueblood collection at Boise State University preserves the extraordinary literary and photographic legacy of a legendary outdoorsman and writer.https://scholarworks.boisestate.edu/uni_books/1002/thumbnail.jp