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1.
This study expands research on the relationship between community (defined here as a locality) characteristics and child maltreatment. Research in this field is not new, but it is scarce. Our study is unique by examining changes between two periods rather than focusing on one point in time. Furthermore, our study examines structural conditions in small and medium size localities in Israel, a non-Western and non-Christian society. We compare our results with those from studies on inner-city and suburban neighborhoods in Western countries and earlier studies in Israel. We collected data on 169 Israeli localities, ranging from small ones (with as few as 1,500 residents) to medium size localities (i.e., towns) (with as many as 50,000 residents) in which approximately 34% of the Israeli child population resides. Our study tested four hypotheses: (1) Socioeconomic characteristics of the locality will be negatively correlated with the availability of social services; (2) Reported child maltreatment rates will be negatively correlated with the socioeconomic characteristics of the locality; (3) The availability of social services will be positively correlated with reported child maltreatment rates; and (4) Overall reported child maltreatment rates will be negatively correlated with the overall status of the localities. We have supported our second and third hypothesis in full, and partially supported our first and fourth hypothesis. In particular we have demonstrated that while demographics play a different role in Israel than in other countries in regard to child maltreatment, social, economic and cultural context are crucial for understating reported rates of child maltreatment. 相似文献
2.
Children's reports of emotional,physical and sexual maltreatment by educational staff in Israel 总被引：2，自引：0，他引：2
OBJECTIVES: This paper reports on the first nationally representative study on the prevalence of emotional, physical, and sexual victimization of children by school staff in Israel. The study identifies groups of children that are at higher risk for such maltreatment. We examine the differences in staff-induced victimization by the children's gender, age group (junior high vs. high school), cultural groups (Jewish non-religious, Jewish-religious and Arab schools) and by socioeconomic status of the children's families. METHOD: The study is based on a nationally representative sample of 10,410 Israeli students in Grades 7-11 in 161 schools across Israel. Students completed questionnaires during class. In addition, we obtained data on the socioeconomic status of the families of the students in each school. RESULTS: Overall, children reported high rates of victimization by staff members. Almost a quarter of all children participating in this study reported being emotionally maltreated by a staff member, almost a fifth (18.7%) reported being a victim of at least one type of physical forms of maltreatment, and 8.2% reported on at least one sexually inappropriate behavior by a staff member. The most vulnerable groups for all types of maltreatment were males, children in junior high schools, children in Arab schools, and children in schools with a high concentration of students coming from low-income and low-education families. CONCLUSIONS: The overall prevalence rates of staff maltreatment should be considered high and unacceptable. Although rates of physical and sexual maltreatment were lower than emotional maltreatment, they were still high and are worthy of greater attention. Both cultural beliefs and low family socioeconomic status increase vulnerability to staff maltreatment. We suggest conducting an educational campaign to reduce rates of staff maltreatment. We also recommend allocating more resources to support staff in low SES neighborhoods, to alleviate their stress and to provide them with the support that would reduce maltreatment of children in the educational system. 相似文献
3.
OBJECTIVES: This paper reports on the prevalence of emotional and physical maltreatment of students in primary schools by school staff in Israel. Victimization by staff was analyzed according to students' gender, age group (4th, 5th, and 6th grade), cultural group (Jewish-non-religious, Jewish-religious, and Arab schools), school characteristics (school size and class size), and by socio-economic status of the students' families. METHOD: Data were obtained from a nationally representative sample of 5472 students in Grades 4-6 in 71 schools across Israel. The students completed questionnaires during class, which included a scale for reporting physical and psychological maltreatment by staff. Data on the socio-economic status of the families of the students in each school were also obtained. RESULTS: Students reported generally high rates of maltreatment by staff members. Almost a third reported being emotionally maltreated by a staff member, and more than a fifth (22.2%) reported being a victim of at least one type of physical maltreatment. The most vulnerable groups for maltreatment were males, students in Arab schools, and students in schools with a high percentage of students from low-income and low-education families.CONCLUSIONS: These high rates of primary school students' victimization by staff are unacceptable. We recommend educational campaigns among teachers, as well as allocating more resources to support staff in low socio-economic neighborhoods. 相似文献
4.
Saskia Euser Lenneke R.A. Alink Fieke Pannebakker Ton Vogels Marian J. Bakermans-Kranenburg Marinus H. Van IJzendoorn 《Child abuse & neglect》2013
The prevalence of child maltreatment in the Netherlands was in 2005 first systematically examined in the Netherlands’ Prevalence study on Maltreatment of children and youth (NPM-2005), using sentinel reports and substantiated CPS cases, and in the Pupils on Abuse study (PoA-2005), using high school students’ self-report. In this second National Prevalence study on Maltreatment (NPM-2010), we used the same three methods to examine the prevalence of child maltreatment in 2010, enabling a cross-time comparison of the prevalence of child maltreatment in the Netherlands. First, 1,127 professionals from various occupational branches (sentinels) reported each child for whom they suspected child maltreatment during a period of three months. Second, we included 22,661 substantiated cases reported in 2010 to the Dutch Child Protective Services. Third, 1,920 high school students aged 12–17 years filled out a questionnaire on their experiences of maltreatment in 2010. The overall prevalence of child maltreatment in the Netherlands in 2010 was 33.8 per 1,000 children based on the combined sentinel and CPS reports and 99.4 per 1,000 adolescents based on self-report. Major risk factors for child maltreatment were parental low education, immigrant status, unemployment, and single parenthood. We found a large increase in CPS-reports, whereas prevalence rates based on sentinel and self-report did not change between 2005 and 2010. Based on these findings a likely conclusion is that the actual number of maltreated children has not increased from 2005 to 2010, but that professionals have become more aware of child maltreatment, and more likely to report cases to CPS. 相似文献
5.
Sheikhattari P Stephenson R Assasi N Eftekhar H Zamani Q Maleki B Kiabayan H 《Child abuse & neglect》2006,30(3):231-245
OBJECTIVE: This study examines the determinants of three types of child maltreatment: physical maltreatment, mental maltreatment, and child neglect among school children in the Kurdistan Province of Iran. The analysis examines the impact of socioeconomic, familial, demographic, and household dynamic factors on the three child maltreatment outcomes, and compares the differential impact of these factors across the three types of child maltreatment. A greater understanding of the factors associated with child maltreatment has the potential to inform public health interventions aimed at reducing specific forms of maltreatment and at identifying at risk populations. METHODS: Data were collected from 1,370 school students, age 11-18. Separate logistic models are fitted for six binary outcomes examining self-reported experiences of physical maltreatment in the home or school, mental maltreatment in the home or school, and child neglect in the home or school. RESULTS: Male children were more likely to report experiencing any kind of child maltreatment than girls. Residency in a rural area, poor parental relationships and the use of addictive substances by household members were associated with increased odds of reporting child maltreatment. Poor school performance was associated with the reporting of experiencing maltreatment at school. CONCLUSION: Each of the forms of child maltreatment is highly correlated with socioeconomic, demographic, and living condition factors. The results point to the strong influence that familial factors have in shaping a child's likelihood of reporting maltreatment. Characteristics of the mother were associated with maltreatment, but not characteristics of the father. The results highlight a number of mechanisms through which public health interventions may seek to reduce the prevalence of child maltreatment in Kurdistan; different approaches are needed to reduce child maltreatment in the home and school environments. 相似文献
6.
7.
School professionals have a unique vantage point for identifying child maltreatment and they are a frequent source of referral to child protective services. Disturbingly, past studies have found that maltreatment concerns reported by educators go unsubstantiated by child protective services at much higher rates than suspected maltreatment reported by other professionals. This study explores whether there are systematic differences in the characteristics of cases reported by educators as compared to other professionals and examines whether such variation might account for differences in investigation outcome. Analyses were based on 7,725 cases of suspected maltreatment referred by professionals to child protective services from the Canadian Incidence Study of Reported Child Abuse and Neglect – 2003 a national database on the characteristics of children and families investigated by child protective services. School professionals were responsible for 35.8% of professional referrals. Reports by educators were much more likely to be unsubstantiated (45.3%) than those by other professionals (28.4%) in subsequent child protective investigation. Cases reported by educators were found to contain significantly more child risk factors (e.g., child emotional and behavioural problems) and fewer caregiver and family risk factors (e.g., caregiver mental health problem, single parent family) than cases reported by other professionals. Even controlling for these differences, educator-reported concerns were still 1.84, 95% CI [1.41, 2.40] times as likely to be unsubstantiated as reports from other professionals. Contrary to the notion that educators are mostly reporting non-severe cases, suspected/substantiated cases reported by school professionals were more likely to be judged as chronic and more likely to involve families with a previous child protection history. Results are concerning for the capacity of the education and child protection systems to work together to meet their shared goal of promoting healthy child development. Additional research is needed on the way in which child risks and problems influence child protective service, particularly in the context of chronic abuse and neglect and lack of availability of child and family mental health interventions. Potential problems with credibility of school professionals as reporters of child maltreatment concerns also warrant further investigation. 相似文献
8.
J E McCarroll J H Newby L E Thayer R J Ursano A E Norwood C S Fullerton 《Child abuse & neglect》1999,23(9):855-861
OBJECTIVE: To examine trends by year in reports of victims of child maltreatment in the US Army Central Registry (ACR) during the period 1975-97. We report the rates/1,000 children of Army families of initial substantiated cases from 1988-97 and the number of cases of maltreatment as a percentage of total victims for each year from 1975-97. Army data are compared to published reports from military service child abuse registries. METHODS: Numbers of cases of child maltreatment for each year were obtained from the ACR for major, minor, and total physical abuse, sexual abuse, emotional abuse, and neglect. Population figures for numbers of children were obtained from the Defense Manpower Data Center. RESULTS: The rates/1,000 for neglect have decreased by 24% from 1991-97, although the decrease has not been steady. The rates/1,000 of minor physical abuse declined 28% from 1993-97. The rates/1,000 of major physical abuse were basically unchanged from 1988-96, although the highest rate was recorded in 1997. The rates/1,000 of sexual abuse were also basically unchanged with the exception of increases in 1992-94 after which time the rates/1,000 returned to the pre-1992 levels. The rates/1,000 of emotional abuse cases more than doubled from 1988-97. CONCLUSIONS: While minor physical abuse and neglect have shown decreases over the past decade, major physical abuse has remained virtually unchanged and sexual and emotional abuse have shown fluctuations. All these forms of maltreatment are challenges to the Army Family Advocacy Program. 相似文献
9.
OBJECTIVES: This cross-sectional survey was conducted to evaluate the awareness and actual professional experience of pediatricians in Kuwait regarding child maltreatment, a topic rarely explored in this part of the world. METHODS: Data were obtained from all pediatricians in public hospitals with pediatric emergency services using a structured detailed self-completed questionnaire. RESULTS: The experience of child neglect was more common than that of child abuse in the clinical practice of surveyed pediatricians. Fifty percent of 117 pediatricians (69% of all eligible) reported having encountered at least 1 case of abuse and up to 3 cases of neglect in the past year. Women and younger doctors more commonly recognized hypothetical situations as maltreatment, and believed child abuse and neglect as being common or very common in Kuwait. Other demographic or professional variables did not affect recognition of maltreatment. Participants would most likely alert social workers about suspected maltreatment cases. More than 80% did not know whether there is a legal obligation to report or which legal authorities should receive reports of suspected cases. DISCUSSION AND CONCLUSIONS: National ethical guidelines regarding reporting suspected cases of maltreatment must be established. Laws protecting maltreated children and reporting physicians must be immediately enacted. Additional training is required to help pediatricians, especially expatriates from other cultures, to diagnose with certainty cases of child maltreatment in their practice in Kuwait. 相似文献
10.
Kenny MC 《Child abuse & neglect》2004,28(12):1311-1319
OBJECTIVE: The purpose of this study was to determine teachers' self-reported knowledge of the signs and symptoms of child maltreatment, reporting procedures, legal issues surrounding child abuse and their attitudes toward corporal punishment. In addition, a factor analysis was performed on the Educators and Child Abuse Questionnaire (ECAQ) (Kenny, 2001a). METHOD: Two hundred teachers, who work in the southeast region of the US in a large, ethnically diverse school system, were administered the ECAQ which contains questions on knowledge concerning: (1) signs and symptoms of child abuse, (2) laws, and (3) procedures for reporting child abuse as well as number of reports filed. RESULTS: Most teachers reported being unaware of the signs and symptoms of child maltreatment, as well as reporting procedures. They also felt administration would not be supportive and were in disagreement with their legal role as mandated reporters. The ECAQ was found to be a reliable measure with four factors: (1) Awareness of signs and symptoms of child abuse, (2) Knowledge of reporting procedures, (3) Attitudes toward discipline, and (4) Seriousness of child abuse. CONCLUSIONS: In general, teachers reported a lack of awareness of the signs of child abuse and reporting procedures, which may affect their ability to report cases of suspected abuse. There is a need for standardized training in child maltreatment for all teachers as well as clear, concise institutional guidelines for reporting child abuse and support for teachers confronted with suspected victims. 相似文献
11.
Cumulative stress and substantiated maltreatment: the importance of caregiver vulnerability and adult partner violence 总被引：1，自引：0，他引：1
OBJECTIVE: Our goal is to assess the effect of caregiver vulnerabilities, singly and in combination, on the substantiation of child abuse (physical, sexual) and neglect, while controlling for relevant background variables. We test the moderator role of adult partner violence in qualifying the relationship between caregiver vulnerabilities and maltreatment substantiation. METHOD: Secondary analyses of the 1998 Canadian Incidence Study of Reported Child Maltreatment (CIS) are used to predict child protective service investigation substantiation versus non-substantiation from a range of caregiver vulnerability factors. Involvement in partner violence was examined as a moderator in the relation between caregiver vulnerabilities and maltreatment substantiation. The CIS is an epidemiological survey of first-reported cases to child protective services, using a random sample of child welfare agencies across Canada. Child welfare workers completed a research form on the child, primary caregiver, family, perpetrator, severity and type of maltreatment, as well as services and court outcomes. All maltreatment classifications were assigned according to the Canadian legal definition of child abuse and neglect. Hierarchical logistic regression analyses were used, with stepped entry of: (1) demographic factors, socioeconomic disadvantage, and caregiver's own history of maltreatment; (2) caregiver vulnerability factors; (3) involvement in partner violence; (4) the interaction between caregiver vulnerability and partner violence. RESULTS: Caregiver substance abuse was found to be the single most potent kind of caregiver vulnerability in predicting maltreatment substantiation. When the total number of vulnerabilities was used as the predictor, prediction across all types of maltreatment increased, especially for substantiated neglect. Analyses also showed that the presence of partner violence in the home exacerbated the effect of caregiver vulnerability on substantiation. CONCLUSIONS: The total number of caregiver vulnerabilities was the best predictor of the substantiation of child abuse and neglect. This relationship was moderated by the existence of partner violence: high caregiver vulnerability and high partner violence increased the likelihood of substantiation versus non-substantiation. These results suggest that caregiver issues should be considered in tandem with partner relationships. Among child welfare cases, caregiver vulnerability and partner violence are critical targets for child maltreatment prevention and early child protective services intervention. 相似文献
12.
OBJECTIVE: This study investigates the opinions of social workers, pediatricians, and physician assistants in their support for the existing child maltreatment mandated reporting policy and an alternative reporting policy. Differences in professional training, age, gender, reporting behavior, attitudes towards reporting, and level of certainty needed to report were considered in determining which group of mandated reporters was most likely to support either the existing or an alternative policy. METHOD: A total of 382 social workers, pediatricians, and physician assistants in Connecticut and Massachusetts completed a self-report questionnaire. This sample represented an overall adjusted response rate of 76%. RESULTS: There was slightly more support for the existing reporting policy compared to the alternative policy. After controlling for age, attitudinal variables, and reporting behavior, social workers were significantly more likely to favor an alternative child maltreatment reporting policy than pediatricians or physician assistants. Also, those mandated reporters who had not consistently reported all suspected cases of maltreatment were significantly more likely to favor the alternative policy than consistent reporters. CONCLUSIONS: Because the majority of mandated reporters do not consistently report all suspected cases of maltreatment and support for an alternative reporting policy varies among different groups, consideration of alternative strategies and policies that address the concerns of different types of professionals may be appropriate. 相似文献
13.
OBJECTIVES: To explore pediatricians' attitudes and experiences with the court system in child maltreatment cases. DESIGN: An anonymous, cross-sectional survey of a random sample of pediatricians registered with the North Carolina Medical Board. RESULTS: The response rate of the study was 60% (N=270). Few pediatricians (10%) reported that they had "ever" suspected maltreatment but decided not to report it. Pediatricians were equally likely to recall positive and negative experiences in court for child abuse cases. Pediatricians with negative court experiences were more likely to view reporting as time-consuming and were more than twice as likely not to report suspected cases of maltreatment (OR 2.4, 95% CI 1.04, 6.0). Seventy-five percent of pediatricians felt that court is harmful or distressing for children. CONCLUSIONS: The majority of pediatricians report suspected cases of child maltreatment. Pediatrician's court experiences play a role in the response to child maltreatment cases, influencing attitudes towards the legal system and the process of caring for maltreated children. Future research efforts should address physicians' concerns about the impact of court on children, ways to improve the working relationship between the legal system and physicians, and the training needs of physicians in child maltreatment, including testifying and understanding the court process. 相似文献
14.
OBJECTIVE: This study examined whether children who received child welfare services (e.g., in-home or out-of-home placement) were more or less likely to become incarcerated as serious and violent youthful offenders than those children who were investigated as victims of abuse and neglect but received no further child welfare intervention. METHOD: Administrative data on child abuse reporting, foster care, birth records, and juvenile corrections (CYA) were linked to prospectively examine the risk of incarceration as an adolescent following an investigation of abuse or neglect after age 6. The 10 county California sample included 159,549 school-aged children reported for abuse and neglect after 1990. RESULTS: About 8 per 1,000 children in the sample were later incarcerated in CYA. African American and Hispanic children who received in-home or foster care services after the index investigation event had a lower risk of incarceration than those whose cases were closed after the investigation. Among females, the rate of incarceration was highest for those who experienced foster or group care placements. Children initially reported for neglect were more likely to be incarcerated than those reported for physical or sexual abuse. CONCLUSIONS: Public child welfare services have rarely been assessed in terms of future negative child outcomes. This study finds that one serious negative outcome, CYA involvement, can only be understood when a number of factors are considered. The importance of understanding the differences between how different subpopulations respond to services is highlighted. Specifically, our findings suggest that more attention should be focused on children who are now receiving no services after an investigated child abuse and neglect report, on females, and on victims of child neglect. 相似文献
15.
Using central registry data for Texas for 1975–1977 of validated cases of abuse and of neglect, a study was conducted to investigate empirically the relationship of child maltreatment to ethnicity, addressing methodological issues that merit consideration in such studies.The ethnic composition of the at-risk population was 61% Anglos, 15% Blacks, and 24% Mexican-Americans. The annual rates for all abuse and neglect were 2.87, 3.17, and 3.94 per 1,000 under 18 population for Anglos, Mexican-Americans, and Blacks, respectively. Abuse was more predominant among Anglos, accounting for 33.5% of the validated cases of maltreatment, than among Mexican-Americans and Blacks, accounting for 25.2% and 29.4% of the maltreatment, respectively. Neglect was the major dynamic of maltreatment for Mexican-Americans and Blacks, accounting for 65.6% and 61.2% of the maltreatment, respectively, with Anglos having 55.4% of the maltreatment due to neglect. These relationships were not altered when rural-urban differences were taken into consideration. 相似文献
16.
N B Guterman 《Child abuse & neglect》1999,23(9):863-890
OBJECTIVE: Seeking to discern optimal programmatic strategies and inform the "universal versus targeted" debate in early home visitation services to prevent physical child abuse and neglect, a meta-analysis was conducted examining enrollment approaches in early home visitation studies and their reported outcomes. METHOD: Quantitative meta-analytic techniques were used to compare effect sizes from 19 controlled outcome studies across screening-based and population-based enrollment strategies. Effect sizes were calculated on protective services data and on child maltreatment related measures of parenting. RESULTS: On protective services report data, population-based studies reported a weighted mean effect size attributable to early home visitation of +3.72%, in comparison to -.07% for screening-based studies. On child maltreatment related measures of parenting, population-based studies reported a weighted mean effect size (r) attributable to early home visitation of +.092, in comparison to +.020 for screening-based studies. CONCLUSIONS: The findings indicate that population-based enrollment strategies appear favorable to screening-based ones in early home visitation programs seeking to prevent physical child abuse and neglect. It may be that psychosocial risk screens serve to enroll higher proportions of families for which early home visitation services are less likely to leverage change, and to exacerbate a mismatch between early home visitation service aims and family needs. 相似文献
17.
OBJECTIVE: This study examines how the availability of alcohol and illicit drugs (as measured by alcohol outlet density and police incidents of drug sales and possessions) is related to neighborhood rates of child abuse and neglect, controlling for other neighborhood demographic characteristics. METHOD: Data from substantiated reports of child abuse and neglect in 304 block groups in a northern California city were analyzed using spatial regression techniques. RESULTS: This study found that higher concentration of bars (B=6.66, p<.05) and higher numbers of incidents of drug possession (B=.53, p<.001) were positively related to rates of child maltreatment in neighborhoods when controlling for neighborhood demographic characteristics. Thus, areas with more bars and drug possession incidents per 1000 population have higher rates of child maltreatment. CONCLUSIONS: The presence of more bars per population may represent a lack of resources available to residents, may increase the stress on neighborhoods by "attracting" populations prone to participating in dangerous activities, or increase the frequency of alcohol use that then leads to maltreatment. Areas with more drug possession incidents may also contribute to the overall level of neighborhood stress and disorganization or act as a marker for drug use that leads to maltreatment. These results suggest that the neighborhood substance availability may deserve special attention when developing preventive interventions to reduce child abuse and neglect in neighborhood areas. 相似文献
18.
Prenatal exposure to illicit substances is a finding that typically requires reporting to a child protective services agency. We examine whether there is differential reporting to two public agencies, and whether it varies by race/ethnicity and region. We also study predictors of indicating a maltreatment report as credible. Data on positive neonatal toxicology reports were obtained from the Illinois Department of Public Health (IDPH) and the Illinois Department of Children and Family Services (DCFS). Variation in reporting rates by race/ethnicity and region were compared with Pearson chi-square analysis. Multivariate logistic regression examined factors related to the likelihood of DCFS indicating a report as credible for maltreatment. IDPH recorded 1838 reports of substance-exposed newborn infants while DCFS only recorded 459 reports. There was a greater percentage of whites than blacks reported to DCFS as compared to those reported to IDPH (p < 0.001). There was a greater percentage of whites than blacks found to be indicated by DCFS as compared to those reported to IDPH (p < 0.001). Infants reported in rural areas were indicated less often (OR:0.34, 95% CI:0.17–0.67, p = 0.002) than those from urban areas. In conclusion, there was variation in reporting patterns between the two agencies. To optimize health outcomes for substance-exposed newborn infants (SEIs), the law should be clarified to provide clear standards for reporting and managing SEIs. Clinicians should ensure they are acting within the confines of existing law, and should engage in an interprofessional process with a broad array of stakeholders to develop statewide drug testing and reporting protocols. 相似文献
19.
V Ashton 《Child abuse & neglect》2001,25(3):389-399
OBJECTIVE: This study examined the effect of workers' attitudes toward corporal punishment on the workers' perception and reporting of child maltreatment. Three hundred twenty-five (325) potential entry level workers participated in this study. METHOD: Responding to vignettes in multi-item scales, study participants 1) rated their approval of parental discipline involving corporal punishment; 2) rated the seriousness of incidents of probable maltreatment; and 3) indicated whether or not they would report the incidents of maltreatment to child protective services. Data were analyzed using correlation analyses and multiple regression procedures. RESULTS: 1) Respondents with higher scores for approval of corporal punishment were less likely to perceive maltreatment; 2) respondents with higher scores for approval of corporal punishment were less likely to report maltreatment; 3) the likelihood that a respondent would report maltreatment was a joint function of the respondent's perception of the seriousness of an incident and approval of corporal punishment. CONCLUSION: Attitudes about corporal punishment are important predictors of reporting behavior. Social service agencies face a challenge to provide workers with training which will enable them to detect and report maltreatment despite workers' individual beliefs about discipline and punishment. 相似文献
20.
This report reviews research on the community dimensions of child maltreatment and presents a study conducted in the United States designed to illuminate further the importance of social environmental effects on family functioning. The study involves 77 community areas within the Chicago, Illinois, metropolitan area. Child maltreatment rates are related to indicators of socioeconomic and demographic well being for these neighborhoods and for the subunits within them. The results reveal a strong influence of socioeconomic and demographic factors on child maltreatment rates. A further analysis involves selecting pairs of neighborhoods for additional study. In this phase of the research the character of socioeconomically similar areas with contrasting patterns of child maltreatment is revealed. The high-risk areas are characterized by social disorganization and lack of social coherence, in contrast to the low-risk areas which evidence a stronger social fabric. These effects extend to differences in child abuse fatalities. 相似文献