Training health professionals by CST is a promising approach to change communication behaviour and attitudes. Patients might also benefit from specifically trained health professionals but strong studies are lacking. However, feasibility and economic aspects have to be kept in mind when considering providing a training of optimal length.

ObjectiveTo estimate the health and economic burdens of child maltreatment in China.MethodsWe did a systematic review for studies on child maltreatment in China using PubMed, Embase, PsycInfo, CINAHL-EBSCO, ERIC and the Chinese National Knowledge Infrastructure databases. We did meta-analyses of studies that met inclusion criteria to estimate the prevalence of child neglect and child physical, emotional and sexual abuse. We used data from the 2010 global burden of disease estimates to calculate disability-adjusted life-years (DALYs) lost as a result of child maltreatment.FindingsFrom 68 studies we estimated that 26.6% of children under 18 years of age have suffered physical abuse, 19.6% emotional abuse, 8.7% sexual abuse and 26.0% neglect. We estimate that emotional abuse in childhood accounts for 26.3% of the DALYs lost because of mental disorders and 18.0% of those lost because of self-harm. Physical abuse in childhood accounts for 12.2% of DALYs lost because of depression, 17.0% of those lost to anxiety, 20.7% of those lost to problem drinking, 18.8% of those lost to illicit drug use and 18.3% of those lost to self-harm. The consequences of physical abuse of children costs China an estimated 0.84% of its gross domestic product – i.e. 50 billion United States dollars – in 2010. The corresponding losses attributable to emotional and sexual abuse in childhood were 0.47% and 0.39% of the gross domestic product, respectively.ConclusionIn China, child maltreatment is common and associated with large economic losses because many maltreated children suffer substantial psychological distress and might adopt behaviours that increase their risk of chronic disease.

Many of the child welfare policies and practices in Switzerland before the law reform of 1981 were rather invasive and were exercised under a legal context that sometimes threatened basic human rights. The inclusion of survivors of such measures in the research process has been vigorously requested in Switzerland. Therefore, four individuals who had been placed in institutions as children have been included in the process of preparing a recently initiated, 60-year follow-up study of individuals placed in infant care institutions in Switzerland in the late 1950s and early 1960s. Using focus interviews and “think-aloud” methods, the interviewees commented on two parts of the planned research process: (a) how to contact the cohort, and (b) finalising the assessment instruments. Data were analysed using qualitative content analysis. Interviewees felt their participation was a sign of recognition of their experience and expertise. Their input contributed to the research in a host of ways. For example, they helped to make documents more understandable, identified errors and redundancies, and pointed out wording that might cause insecurities or negative reactions. They also pointed to shortcomings in some of the items used in the assessment instruments. In addition, they made significant contributions regarding how best to approach and work with the cohort. This study shows that, when researching historical compulsory social measures, the inclusion of formerly institutionalised individuals in development and implementation is not only feasible, but is of significant benefit to the quality of the research.

No abstract