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This diploma thesis is comprised of a theoretical section and a practical section. The first theoretical subchapter introduces the CAN syndrome. The second theoretical subchapter focuses on the relevant international and national child protection legislation. The third subchapter "Child Interrogation" deals with the issue of the historical development of child interrogation techniques and methods, and the currently recommended interrogation techniques used to interrogate children in keeping with the Act on Criminal Judicial Procedure No. 141/1961 in the Czech Republic. The third subchapter also concerns with the character traits of the investigator, the qualification requirements of this profession and the fundamental methodology used to prevent a child's secondary victimisation. The fourth theoretical subchapter focuses on the specially designed interrogation room used, among others, for child interrogation. The theoretical part is based on reference literature and relevant legislation. The practical section includes the results of qualitative research. The first subchapter focuses on two case studies of child victims of abuse interrogation. The second subchapter analyses six interviews conducted with a methodological worker and with five investigators, who discuss their experience with the...

La négligence spatiale unilatérale (NSU) est une affection neurologique fréquemment observée après une lésion de l'hémisphère cérébral droit. Les patients ne vont plus être en mesure de prendre en compte les stimuli présentés dans l'hémi-espace gauche. La NSU participe à l'aggravation du handicap des patients, par la réduction des possibilités en rééducation motrice et cognitive à la phase aigue d'un accident vasculaire comme sur le long terme. L'identification des facteurs prédictifs de sa chronicité pourrait permettre une meilleure prise en charge clinique de ces patients. Nous avons étudié les altérations des connexions anatomiques observées en IRM de diffusion sous-tendant la persistance de la NSU. Nos résultats démontrent qu'en plus d'un dysfonctionnement fronto-pariétal hémisphérique droit, la persistance de ce syndrome serait associée à une déconnexion interhémisphérique. L'hémisphère gauche isolé ne serait pas en mesure de compenser les déficits des patients. La récupération devrait s'effectuer par une amélioration dans les capacités d'échange des informations entre les deux hémisphères, notamment dans les régions postérieures pariétales et occipitales. Nous nous sommes intéressés à tester cette hypothèse par le biais d'une méthode de rééducation, l'adaptation prismatique (AP). Il s'agit d'une thérapie dont les effets sur la sémiologie des patients sont remarquables. Nos résultats suggèrent que l'amélioration de la NSU pourrait s'observer par le recrutement du réseau fronto-ponto-cérébelleux. Les régions frontales gauches seraient un relais anatomique entre le cervelet droit et le réseau fronto-pariétal gauche / Unilateral spatial neglect is a frequent neurological condition after right hemisphere damage. Patients behave as if objects on their left did not exist anymore. The presence of neglect has negative prognostic value for functional recovery in the acute and chronic phases after a stroke. Finding predictors of persistent neglect would permit to adapt rehabilitation procedures. We used diffusion MRI to define the state of anatomical connections in neglect and their predictor value for neglect persistence. Our results revealed that, together with right intra-hemispheric fronto-parietal disconnections, persistence of neglect is associated with inter-hemispheric disconnection. We concluded that an isolated left hemisphere may fail to compensate neglect because it cannot take into account left-sided objects. Recovery of neglect would instead occur thanks to the sharing of visual information between the two hemispheres, notably in posterior parietal and occipital cortices. We tested this hypothesis by using prism adaptation (PA) therapy. PA is a non-invasive and convenient technique to rehabilitate neglect. We showed that patients with damaged fronto-ponto-cerebellar pathways did not benefit from PA. This finding strongly suggests that PA can ameliorate signs of neglect by improving inter-hemispheric communication through enhanced activity of these connections. Left frontal areas may constitute the anatomical link between the right cerebellum and the left fronto-parietal network. Thus, connectional anatomy can help predict both neglect recovery and the quality of its response to rehabilitation therapies

The aim of the study was to examine what obstacles and possibilities nurses at the Swedish child health services (CHS) experience in collaborating with social services when suspecting child maltreatment. Empirical data was collected through interviews with three CHS nurses and analyzed with a phenomenological approach. The theoretical perspectives used are Luhmann’s systems theory and domain theory. The results show that the nurses interviewed in this study consider themselves having good opportunities of detecting signs of child maltreatment and that they wanted more cooperation with the social services. Theoretical concepts of systemic and environmental complexity address organizational factors that affect collaboration. How collaboration between the CHS and the social services could be improved are discussed. / Studien syftade till att undersöka vilka hinder och möjligheter BVC-sköterskor upplever i samverkan med socialtjänsten vid misstanke om att ett barn far illa. Studiens teoretiska utgångspunkter är systemteori, specifikt Luhmanns teorier om sociala system, och domänteori. En fenomenologisk ansats har använts vid datainsamlingen och analys av det empiriska materialet, som består av kvalitativa intervjuer med tre BVC-sköterskor. Resultatet visar bland annat att de intervjuade sköterskorna upplever sig ha goda möjligheter att upptäcka missförhållanden i barnets situation och att de önskar mer samverkan med socialtjänsten. Med hjälp av de teoretiska begreppen system- och miljökomplexitet belyses hur betingelser inom och mellan organisationerna påverkar samverkan. Förbättringsmöjligheter angående samverkan mellan BVC och socialtjänsten diskuteras.

Public policy has been shifting from child abuse and neglect (CAN) intervention toward prevention, using public health style frameworks, which emphasize shared community and legislative responsibilities to support families (Browne, 2014; CDC, 2014). Analysis of qualitative data from statewide focus groups held in 2019 in Alabama with 99 community-based CAN prevention workers shows strengths in community collaboration, but also, struggles to help families meet basic needs because of lack of community resources, such as transportation and quality child care, and other barriers, including stigma. The results demonstrate confusion between prevention, which is intended to build family resilience to avert crisis, and intervention, meant to reunite families after child protection services involvement. We recommend researchers consistently link CAN research to prevention frameworks so as to build meaningful understanding how to create better prevention programs. Future practitioners should understand prevention, and be prepared to document their work so as to demonstrate need.

Bakgrund: Barnsjuksköterskor omfattas av anmälningsskyldighet redan vid misstanke om ett barn far illa. Risk finns för att etiska svårigheter kan förhindra eller påverka beslutet om en orosanmälan. Forskning inom ämnet visar att illafarande hos barn kan leda till psykisk och fysisk ohälsa och i värsta fall död. För att dessa barn skall få tillgång till stöd samt för att förstå varför underrapporteringar av orosanmälningar föreligger är det betydelsefullt att förstå vad som påverkar barnsjuksköterskan i beslutsprocessen.  Syfte: Syftet var att beskriva barnsjuksköterskans erfarenheter av beslutsprocessen kring orosanmälan vid misstanke om barn som far illa. Metod: Kvalitativ metod med induktiv ansats tillämpades. Barnsjuksköterskor från öppenvård och slutenvård valdes genom bekvämlighetsurval och semistrukturerade intervjuer genomfördes. Antal år inom professionen varierade och arbetsplatserna gav en geografisk spridning över hela Sverige. Kvalitativ innehållsanalys genomfördes enligt Elo och Kyngnäs. Resultat: I resultatet framkom tre generiska kategorier: Att känna osäkerhet i beslutsprocessen, Behov av stöd i beslutsprocessen samt Orosanmälans påverkan på vårdrelationen. Barnsjuksköterskornas erfarenheter av att göra en orosanmälan visade att det kunde vara ett svårt beslut. Känslor av osäkerhet och rädsla för eventuell framtida påverkan på vårdrelationen eller barnsjuksköterskans eget privatliv var något som försvårade beslutsprocessen. Slutsats: Barnsjuksköterskorna beskrev anmälningsplikten som diffus, vilket gav rum för egen tolkning. Därför är det viktigt att utbildning och tydliga riktlinjer tillhandahålls.

Unilateral spatial neglect (USN) is a common disorder after stroke. An application especially developed for stroke rehabilitation, the RehAtt Mixed Reality (MR) intends to train cognitive and motor functions that are affected by USN, by the means of interactive 3D games played in mixed reality, through smart glasses. The present study targets one specific cognitive function, namely spatial attention, and compares individual performances in one of the games (scenarios) to performances in a widely used test for detection of deficits in spatial attention – the Posner test. The hypothesis is that user reaction times in the RehAtt MR scenario correlates with user reaction times in the Posner test. Another test, including a questionnaire, to validate the usability of the RehAtt MR is also conducted. The sample for the usability test and questionnaire includes a total of 74 participants (47 women, 27 men, M = 39.6 years of age), of which 29 individuals (13 women, 16 men, M = 35 years of age) carried out the experimental part of the study. The results suggest that there is a significant correlation, r(27) = .411, p = .027, between reaction times in the Posner test and the scenario in the RehAtt MR, and that the product usability shows high quality. It is concluded that the results support that the scenario explored in the RehAtt MR trains spatial attention, although further research is needed for full validation. / Unilateraltspatialt neglekt (USN) är en vanlig funktionsnedsättning efter stroke. En applikation som utvecklats speciellt för strokerehabilitering - RehAtt Mixed Reality (MR) - har som mål att träna kognitiva och motoriska funktioner som är påverkade av USN, med hjälp av 3D-spel som spelas i mixed reality, genom smarta glasögon. Den aktuella studien siktar in sig på en specifik kognitiv funktion – spatial uppmärksamhet – och jämför individuella prestationer i ett av spelen i RehAtt MR med prestationer i ett vanligt, ofta använt test för att upptäcka nedsättningar i spatial uppmärksamhet – Posner-testet. Hypotesen är att användares reaktionstider i spelet i RehAtt MR korrelerar med användares reaktionstider i Posner-testet. Ett annat test, inklusive en enkät, görs också, för att validera användbarheten i RehAtt MR. 74 deltagare (47 kvinnor, 27 män, M = 39.6 år) finns med i användbarhetstestet och enkäten, av vilka 29 individer (13 kvinnor, 16 män, M = 35 år) medverkade i den experimentella delen av studien. Resultaten indikerar att det är en signifikant korrelation, r(27) = .411, p = .027, mellan reaktionstiderna i Posner-testet och spelet i RehAtt MR, och att användbarheten hos produktenvisar hög kvalitet. Slutsatsen är att vad som hittats i den aktuella studien stödjer idéen att spelet i RehAtt MR tränar spatial uppmärksamhet, även om vidare studier krävs för en full validering.

TITLE: Abused child: Child abuse and its referential framework in individuals placed to a diagnostic institute AUTHOR: Jiřina Víravová DEPARTMENT: The Department of Special Education SUPERVISOR: Doc. Boris Titzl, Ph.D. ABSTRACT: The submitted thesis focuses on the phenomenon of child abuse and neglect. The theoretical background for these issues had to be found in the science branches which have so far made the contribution to the explanation of the child abuse and neglect. Medicine (mainly traumatology) explains the mechanism of physical abuse, psychiatric- psychological approach not only enhances the topic with the psychical abuse and neglect, but also offers a backup to a non-moralizing explanation why abusing persons behave in such way. Sociological and ethological approach helps to understand the contextual factors which could foster the child abuse and neglect. The social work point of view is used to introduce the system of care of the abused children. Special pedagogy part of this thesis approaches the situation and education of the abused children mainly from the ethopedical point of view and reflects specific questions of institutional education. This part of the thesis is illustrated by real stories of abused and neglected children from the institutional education. In the research part of the...

Depression affects over 17 million American adults yearly and has been identified as the leading cause of disability in people between the ages of 15 and 44 years. There is evidence that feeling neglect or a lack of parental attachment during childhood is associated with depression. One construct that has been overlooked is love from a parent. The purpose of this study was to analyze the association between individuals who felt not wanted/loved during adolescence and lifetime depression and to examine this association by gender. We examined 5114 participants aged 24–32 years at Wave IV of the National Longitudinal Study of Adolescent Health (Add Health) public use dataset. We used logistic regression analysis to determine the association between an individual feeling not wanted/loved by their parent/caregiver prior to age 18, covariates, and lifetime depression. We then stratified by gender and ran logistic models for both men and women separately. Overall, 16.2% (n = 827) reported lifetime depression diagnosis, while 16.5% of the participants reported feeling not wanted/loved “often,” while 29.8% reported it as “sometimes.” Feeling not wanted/loved “often” was associated with higher odds of depression (AOR = 3.00; 95% CI, 2.45–3.66; p < .001) versus “sometimes” (AOR = 1.59; 95% CI, 1.31–1.90; p < .001). When stratified by gender, feeling not loved/wanted was associated with depression among both men (AOR = 3.70; 95% CI, 2.60–5.25; p < .001) and women (AOR = 2.73; 95% CI, 2.13–3.48; p < .001). Feeling not loved or wanted by a parent/caregiver during adolescence has serious implications, for both men and women. Future studies should further examine this construct and identify family-based interventions that focus on parent/caregiver and child relationships.

L'étude des interactions précoces est complexe mais essentielle à la compréhension de la psychopathologie de la petite enfance. La négligence émotionnelle est une forme courante mais discrète de maltraitance. Elle correspond à une défaillance chronique de la part du parent à offrir à l'enfant, au sein de leur relation, un environnement affectif suffisamment bon pour son développement. Notre recherche explore les interactions précoces mère-enfant de ces situations de négligence émotionnelle par une approche transdisciplinaire à travers deux dimensions : la synchronie et la mentalisation réflexive maternelle. La synchronie est une caractéristique dyadique et temporelle de l'interaction qui traduit la fluidité et la qualité d'un échange par une adaptation dynamique et réciproque des comportements et états émotionnels des partenaires interactifs. Elle constitue un signal social en soi, facteur de qualité de l'interaction. La mentalisation réflexive, traduction du terme Insightfulness (Oppenheim, 2001), évoque la capacité du parent à prendre le point de vue de l'enfant et à comprendre, de façon empathique, les motivations sous-jacentes à ses comportements. Les objectifs de cette recherche sont (1) d'analyser la dynamique comportementale des interactions précoces en élaborant une méthodologie d'analyse computationnelle et (2) d'évaluer l'influence des capacités maternelles de mentalisation réflexive et notamment de leur dynamique intrapsychique, sur la dynamique interactive, dans les situations de négligence émotionnelle. Des mères et leur enfant de 13 à 38 mois, appartenant au groupe en situation de négligence émotionnelle (N=10) et au groupe contrôle sans trouble des interactions (N=9), sont filmés au cours d'un jeu interactif libre. Les vidéos font l'objet d'une double évaluation clinique et computationnelle. La première permet d'obtenir une évaluation clinique globale de la qualité de l'interaction par le Coding Interactive Behavior (Feldman et Keren 1998; Viaux 2014). La seconde, par les techniques de traitement du signal social, offre l'accès à une micro-analyse computationnelle des mouvements des partenaires et de leurs échanges dyadiques. Dans un second temps, 14 mères (n=7 mères en situation de négligence et n=7 mères sans trouble des interactions) ont visionné des extraits de la vidéo de leurs interactions, au cours d'un entretien semi-structuré, l'Insightfulness Assessment (Oppenheim et Koren-Karie, 2001) afin d'évaluer leurs capacités de mentalisation réflexive. Une analyse additionnelle des verbatim a permis d'accéder à des éléments de la dynamique intrapsychique. Les résultats mettent en évidence de nombreuses corrélations significatives les dimensions du CIB (notamment la sensibilité, l'intrusivité maternelle et la réciprocité dyadique) et la micro-analyse automatique (à travers l'activité du corps de la mère). Par ailleurs, les situations de négligence émotionnelle présentent des difficultés de mentalisation empathique. Les entretiens sont caractérisés par des représentations appauvries de leur enfant et des difficultés d'élaboration autour des affects et de la relation mère enfant. La dynamique intrapsychique, influencée par les problématiques inconscientes, s'associe en partie à la dynamique interactive comportementale. Il apparaît que la compréhension de la qualité de l'interaction peut passer par une observation sur une échelle de temps réduite de la dynamique interactive. Par ailleurs, un entretien avec support vidéo étaye l'élaboration de la mère et favorise une mise en mouvement intrapsychique, pouvant constituer ainsi un levier thérapeutique. / Studying early interaction is complex but essential for understanding psychopathology during infancy. Emotional Neglect is a common but insidious form of child maltreatment. It refers to parental failure to give children an emotional environment that allows adequate psychological, cognitive and physical development. We explore mother-infant interaction in these situations following a transdisciplinary approach which consider Synchrony and Insightfulness. Synchrony is a dynamic and reciprocal adaptation of the temporal structure of behaviour and shared affect between interactive partners. It is regarded as a social signal per se. Insightfulness involves the parents' ability to see things from the child point of view and to empathically think about and consider the motives underlying their childrens' behaviour. The aims of this research are (A) to report a novel method to assess features of interactive behavioral dynamics and (B) to assess/underline the impact of Insighfulness, in particular its dynamics, on interactive behavioral dynamics in case/situations of severe emotional neglect. Mothers and children aged from 13 to 38 months (10 in situation of severe emotional neglect and 10 controls) are video recorded during free play. Features of social signal extract by our automatic computational method are compared to qualitative interaction assessment by using the Coding Interactive Behaviour in its French version (Feldman et Keren 1998; Viaux 2014). Secondly, 14 mothers (7 in situation of emotional neglect and 7 without interaction problem) are interviewed during a video-feedback session by using the Insightfulness Assessment (Oppenheim, Koren-Karie, 2001) to assess Insightfulness. An additional qualitative verbatim analysis was performed to explore intrapsychic dynamics. Self-administered questionnaires (BITSEA and Care Support) are proposed to mothers. Results show that individual and synchrony motion features perfectly correlates CIB composite scores trough maternal sensitivity, intrusivity and dyadic reciprocity. Furthermore, pathological mothers are mostly categorised as non-Insighful. Interviews are characterized by poor representations and a lack of elaboration. Intrapsychic dynamics is partly associated with interactive behavioral dynamics. We conclude that computational method might be promising for future studies. It opens an observation window to understand early interactions by changing the time scale. Moreover, interview with a video support seems to underpin maternal elaboration and enhance an intrapsychic movement.