Capri scooter spill leaves ex-French PM in Rome hospital

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Mental Abuse of Kids Leaves Lifelong Scars

HealthDay – 1 hr 4 mins ago MONDAY, July 30 (HealthDay News) -- Constantly belittling, threatening or ignoring children can be as damaging to their mental health as physical or sexual abuse, according to a new report from a pediatricians' group.

But, with no bruises to spot, pediatricians, teachers and family members may have trouble recognizing these and other forms of psychological abuse. Not only are there no obvious physical scars, there is no universally agreed-upon definition of what constitutes psychological maltreatment of children, and a fine line can exist between not-so-great parenting and outright abuse, experts say.

"The main message for child health clinicians and people working with children is that psychological maltreatment is just as harmful as other types of maltreatment," said report co-author Dr. Harriet MacMillan, a professor in the departments of psychiatry, behavioral neurosciences and pediatrics at McMaster University in Ontario, Canada.

"We know that exposure to other types of maltreatment like physical and sexual abuse can be associated with a broad range of types of impairment in physical and mental health, and cognitive and social development," she said. "Similarly, we see these types of impairments associated with psychological maltreatment."

The American Academy of Pediatrics' report is published online July 30 and in the August print issue of Pediatrics.

Estimating the prevalence of the problem is difficult, in part because of the lack of a universally accepted definition of psychological abuse, MacMillan said. Studies in Britain and the United States estimate that 8 percent to 9 percent of women and 4 percent of men report severe psychological abuse during childhood.

Psychological maltreatment of children can take many forms. It can include chronically belittling, humiliating or ridiculing a child for showing normal emotions. There is also neglect, such as leaving an infant alone in a crib all day, except for feeding or changing.

Other forms of psychological maltreatment can include withholding love and warmth from a child, putting children in dangerous or chaotic situations, having rigid or unrealistic expectations accompanied by threats if not met, or confining a child and restricting social interactions. Limiting a child's access to necessary health care for reasons other than affordability is another example, according to the report.

Sometimes, but not always, psychological abuse goes hand in hand with physical abuse.

"I once had a child who talked about being hit by his dad," MacMillan said. "The child said that the dad says things about me that make me feel badly, worse than the hitting."

One of the keys to spotting abuse is the pervasiveness of it, experts say.A single bad parenting day probably isn't abuse. But near-constant ridicule, telling a child he or she is unloved and unwanted, is abuse, MacMillan said.

Similarly, there is "suboptimal" parenting -- in other words, no one is going to nominate these moms or dads for parent of the year vs. parenting that is so damaging it rises to the level of abuse.

Telling the two apart can be difficult, experts say.

"Psychological abuse is so insidious, and is not as easily recognized by the victim or other family members," said Alec Miller, chief of child and adolescent psychology at Montefiore Medical Center, in New York City.

"If you see someone getting beaten, we all know it's against the law," Miller said. "It's demarcated as illegal and very unhealthy. Some of these other things are a little more slippery. If there is no bruising physically, it's harder to be convinced there is abuse."

Research shows the effects of psychological abuse and neglect can be profound and long-lasting, ranging from problems with brain development and a failure to grow properly, to problems with behavior and relating to others.

Some parents who are psychologically abusive aren't even aware that their words and actions are harming their child, experts said.

For example, consider parents going through a very difficult divorce. "The child is subjected to major conflict between the parents and told all sorts of things about the other parent and made to choose an allegiance," MacMillan said. "These sorts of things can be psychologically abusive to a child."

Suspected cases of psychological should be reported to child protective services, the authors say. They also urge pediatricians to look for signs of emotional maltreatment in their patients.

More information

The U.S. Department of Health and Human Services has information on recognizing the signs of child abuse.

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Biology Leaves Gay Men Highly Vulnerable to HIV: Study

HealthDay – 1 hr 23 mins ago FRIDAY, July 20 (HealthDay News) -- New research pinpoints a major reason why gay and bisexual men remain so vulnerable to the AIDS epidemic: When it comes to the transmission of HIV, a man who has unprotected anal intercourse is at especially high risk.

In fact, if that kind of intercourse was only as risky as vaginal intercourse, researchers report, HIV cases among gay and bisexual men would shrink dramatically. It would go down even more, they added, if their rates of casual sex declined.

The reality, however, is much different. "Everywhere we looked, HIV is expanding both in high- and low-income countries among men who have sex with men," said study author Dr. Chris Beyrer, director of the Johns Hopkins Fogarty AIDS International Training and Research Program.

The experts were quick to note that, worldwide, it is heterosexual men and women who are by far the majority of those who are infected with HIV. Still, more than 30 years into the AIDS epidemic, gay and bisexual men remain especially vulnerable to infection despite a heavy emphasis on condoms and HIV testing; these men make up the bulk of HIV cases in the United States and other Western countries.

According to UNAIDS, HIV is more common among gay and bisexual men than adults in general in all areas of the world, even Africa. In North America, an estimated 15 percent of gay and bisexual men are infected with HIV; the rate is the highest, 25 percent, in the Caribbean.

Previous research has shown that being on the receiving end of anal intercourse is equally risky whether you're a man or a woman. The risk was estimated at 1.4 percent per sex act with an infected person -- about 18 times more risky than male-to-female vaginal intercourse.

The study authors estimate that if receptive anal intercourse were only as risky as vaginal intercourse, HIV cases would fall by 80 percent to 98 percent among gay and bisexual men over five years. They also estimate that cases would fall by 29 percent to 51 percent if more gay and bisexual men had sex in long-term relationships instead of casual encounters.

The findings appear in the July 20 issue of The Lancet, along with several other studies that examine the prevalence of HIV -- the virus that causes AIDS -- in gay and bisexual men and offer suggestions about prevention.

Two studies examined the higher risk of HIV infection among black men.

One study found that black gay and bisexual men outside Africa are much more likely to be HIV-positive than the general population and other blacks. The other found that black gay and bisexual men in the United States were more likely to be infected with HIV than other gay and bisexual men, but less likely to have a history of substance abuse. If infected, they were also less likely to have started to take life-extending drugs that fight HIV.

There were other differences: black men were less likely to have access to medical care and more likely to have sex with other black men.

What to do? Another study suggests the greater use of prevention approaches -- such as condoms, more medical treatment for those who are already infected and use of medication that prevent infection -- could shrink new HIV cases among gay and bisexual men by one-fourth over the next decade. "But it's not simple as choosing the best ones. There are existing technologies, but we need to put them together" and expand them, said Dr. Patrick S. Sullivan, an associate professor at Emory University's Rollins School of Public Health.

It's also important, he said, to change societies that stigmatize homosexuality and turn it into a criminal offense.

More information

For more about AIDS, try the U.S. National Library of Medicine.

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Biology Leaves Gay Men Highly Vulnerable to HIV: Study

HealthDay – 1 hr 22 mins ago FRIDAY, July 20 (HealthDay News) -- New research pinpoints a major reason why gay and bisexual men remain so vulnerable to the AIDS epidemic: When it comes to the transmission of HIV, a man who has unprotected anal intercourse is at especially high risk.

In fact, if that kind of intercourse was only as risky as vaginal intercourse, researchers report, HIV cases among gay and bisexual men would shrink dramatically. It would go down even more, they added, if their rates of casual sex declined.

The reality, however, is much different. "Everywhere we looked, HIV is expanding both in high- and low-income countries among men who have sex with men," said study author Dr. Chris Beyrer, director of the Johns Hopkins Fogarty AIDS International Training and Research Program.

The experts were quick to note that, worldwide, it is heterosexual men and women who are by far the majority of those who are infected with HIV. Still, more than 30 years into the AIDS epidemic, gay and bisexual men remain especially vulnerable to infection despite a heavy emphasis on condoms and HIV testing; these men make up the bulk of HIV cases in the United States and other Western countries.

According to UNAIDS, HIV is more common among gay and bisexual men than adults in general in all areas of the world, even Africa. In North America, an estimated 15 percent of gay and bisexual men are infected with HIV; the rate is the highest, 25 percent, in the Caribbean.

Previous research has shown that being on the receiving end of anal intercourse is equally risky whether you're a man or a woman. The risk was estimated at 1.4 percent per sex act with an infected person -- about 18 times more risky than male-to-female vaginal intercourse.

The study authors estimate that if receptive anal intercourse were only as risky as vaginal intercourse, HIV cases would fall by 80 percent to 98 percent among gay and bisexual men over five years. They also estimate that cases would fall by 29 percent to 51 percent if more gay and bisexual men had sex in long-term relationships instead of casual encounters.

The findings appear in the July 20 issue of The Lancet, along with several other studies that examine the prevalence of HIV -- the virus that causes AIDS -- in gay and bisexual men and offer suggestions about prevention.

Two studies examined the higher risk of HIV infection among black men.

One study found that black gay and bisexual men outside Africa are much more likely to be HIV-positive than the general population and other blacks. The other found that black gay and bisexual men in the United States were more likely to be infected with HIV than other gay and bisexual men, but less likely to have a history of substance abuse. If infected, they were also less likely to have started to take life-extending drugs that fight HIV.

There were other differences: black men were less likely to have access to medical care and more likely to have sex with other black men.

What to do? Another study suggests the greater use of prevention approaches -- such as condoms, more medical treatment for those who are already infected and use of medication that prevent infection -- could shrink new HIV cases among gay and bisexual men by one-fourth over the next decade. "But it's not simple as choosing the best ones. There are existing technologies, but we need to put them together" and expand them, said Dr. Patrick S. Sullivan, an associate professor at Emory University's Rollins School of Public Health.

It's also important, he said, to change societies that stigmatize homosexuality and turn it into a criminal offense.

More information

For more about AIDS, try the U.S. National Library of Medicine.

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CNN "train wreck" comment on healthcare case leaves a mark

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