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Background: Population-level prevalence estimates for a broad range of adverse childhood experiences (ACEs), which are known to affect health across the lifespan, are currently unavailable in Canada. The purpose of this study was to estimate the prevalence of individual ACEs by sociodemographic factors among middle-aged and older adults. Methods: Data for this cross-sectional analysis were obtained from the first follow-up (2015–2018) of the Canadian Longitudinal Study on Aging (baseline recruitment from 2011 to 2015). Participants included individuals aged 45–85 years and residing in the community in the 10 Canadian provinces. Exposure to ACEs was assessed using a retrospective, self-report questionnaire. Logistic regression was used to obtain the adjusted prevalence estimates of ACEs within groups formed by the sociodemographic characteristics and each variable was adjusted for all other sociodemographic variables. Results: Of the 44 817 participants in the first follow-up, 61.6% (weighted) reported exposure to at least 1 ACE. Exposure to physical abuse (weighted prevalence of 25.7%), intimate partner violence (22.4%) and emotional abuse (21.8%) were the most prevalent types of ACEs. Individuals younger than 65 years (born in 1950–1969), with no postsecondary education or education below a bachelor's degree, or with annual household income less than $20 000 reported greater exposure to ACEs. Reporting for many ACEs was higher among women and those of nonheterosexual orientation. Overall, British Columbia, Alberta, Manitoba, Ontario and Quebec reported relatively higher prevalence for several examined categories of ACEs. Interpretation: Adverse childhood experiences were highly prevalent across all demographic groups with substantial heterogeneity in the distribution among the middle and older age population. The high prevalence of ACEs and their potential negative consequences on health and well-being emphasize the need to develop and promote trauma-informed care to assist individuals affected by ACEs. [ABSTRACT FROM AUTHOR]

Background: Despite growing public concern about child maltreatment, the scope and severity of this significant public health issue remains poorly understood. This article examines the nature and severity of the physical harm associated with reports of child maltreatment documented in the Canadian Incidence Study of Reported Child Abuse and Neglect (CIS). Methods: The CIS collected information directly from child welfare investigators about cases of reported child abuse or neglect. A multistage sampling design was used to track child maltreatment investigations conducted at selected sites from October to December 1998. The analyses were based on the sample of 3780 cases in which child maltreatment was substantiated. Results: Some type of physical harm was documented in 18% of substantiated cases; most of these involved bruises, cuts and scrapes. In 4% of substantiated cases, harm was severe enough to require medical attention, and in less than 1% of substantiated cases, medical attention was sought for broken bones or head trauma. Harm was noted most often in cases of physical abuse compared to other forms of maltreatment. Interpretation: Rates of physical harm were lower than expected. Current emphasis on mandatory reporting, abuse investigations and risk assessment may need to be tempered for cases in which physical harm is not the central concern. [ABSTRACT FROM AUTHOR]

Presents letters to the editor on topics related to medicine. The physician-patient relationship, emergency medicine, and Bill 114 in Quebec province; Letter to the Canadian Medical Association from the editorial board of this journal; The ethics of editorializing; Issue of free enterprise in the practice of medicine; Medicare reform; Protecting youth from tobacco addiction in Saskatchewan.

Presents a study to update the 1993 report from the Canadian Task Force on the Periodic Health Examination by reviewing evidence for the effectiveness of interventions aimed at preventing child maltreatment. Options; Outcomes; Evidence; Suggestion of education programs for children to prevent sexual abuse.

Offers the results of a Canadian study on the possible long-term psychiatric effects of slapping and spanking in childhood. How those who reported being spanked often or sometimes had a significantly higher rate of anxiety disorders and/or alcohol abuse; Background; Methods; Results; Interpretation.

Provides information on several medical programs for the prevention of mental health problems of children in Canada. Services included in the nurse-family partnership program of the U.S.; Significance of the community-based group parenting program to early childhood development; Efficiency of the lifeskills training program for older children.

Summarizes the recommendation of the Canadian Task Force on the prevention of violence against women. Evaluation of several interventions; Potential benefits and harms; Comparison from the recommendations by the U.S. Preventive Services Task Force.

Presents a response by Harriet MacMillan and C. Nadine Wathen to a letter to the editor about their article on violence against women, which appeared in the 2003 issue of the "Canadian Medical Association Journal."

Discusses the recognition of woman abuse as a serious public health problem and the need for clinicians to find ways to identify and help their abused female patients. Key elements that must be considered before advising physicians to screen routinely for woman abuse; Programs that are being recommended to reduce violence against women; Details on routine universal screening and diagnostic assessment of all women.

Editorial. Commends Muhajarine and D'Arcy for their study, published in the April 6, 1999 issue of the `Canadian Medical Association Journal,' which focuses on physical abuse during pregnancy in Saskatoon, Saskatchewan. How the findings should alert health care professionals to the problem; Assertion the prevalence rates and corresponding population estimates may be underestimates of the extent of physical abuse; Need for a population-based longitudinal study.

Editorial. Examines findings from 1997 reporting on child abuse among Ontario families. What is and is not considered child abuse; Why the findings tell us little about the scope and burden of the problem; Why few data are available; The long-term effectiveness of home visits by nurses; Studies to date, as of May, 1998.

Background: Nationally representative Canadian data on the prevalence of child abuse and its relation with mental disorders are lacking. We used contemporary, nationally representative data to examine the prevalence of 3 types of child abuse (physical abuse, sexual abuse and exposure to intimate partner violence) and their association with 14 mental conditions, including suicidal ideation and suicide attempts. Methods: We obtained data from the 2012 Canadian Community Health Survey: Mental Health, collected from the 10 provinces. Respondents aged 18 years and older were asked about child abuse and were selected for the study sample (n = 23 395). The survey had a multistage stratified cluster design (household response rate 79.8%). Results: The prevalence of any child abuse was 32% (individual types ranged from 8% to 26%). All types of child abuse were associated with all mental conditions, including suicidal ideation and suicide attempts, after adjustment for sociodemographic variables (adjusted odds ratios ranged from 1.4 to 7.9). We found a dose-response relation, with increasing number of abuse types experienced corresponding with greater odds of mental conditions. Associations between child abuse and attention deficit disorder, suicidal ideation and suicide attempts showed stronger effects for women than men. Interpretation: We found robust associations between child abuse and mental conditions. Health care providers, especially those assessing patients with mental health problems, need to be aware of the relation between specific types of child abuse and certain mental conditions. Success in preventing child abuse could lead to reductions in the prevalence of mental disorders, suicidal ideation and suicide attempts. [ABSTRACT FROM AUTHOR]

Contexte: On dispose de trop peu de données canadiennes nationales représentatives sur la prévalence de la violence envers les enfants et son lien avec les problèmes de santé mentale. Nous avons utilisé de récentes données nationales représentatives pour mesurer la prévalence de 3 types de violence envers les enfants (violence physique, violence sexuelle et exposition à la violence entre partenaires intimes) et leurs liens avec 14 problèmes de santé mentale, dont idées et tentatives suicidaires. Méthodes: Nous avons consulté les données de l'Enquête sur la santé dans les collectivités canadiennes 2012 : Santé mentale, recueillies dans les 10 provinces. Des participants âgés de 18 ans et plus ont été interrogés au sujet de la violence et ont été sélectionnés pour l'échantillon de l'étude (n = 23 395). L'enquête suivait un modèle en grappes stratifié à plusieurs degrés (taux de réponse des ménages 79,8 %). Résultats: La prévalence de tout type de violence envers les enfants était de 32 % (les types individuels variaient de 8 % à 26 %). Tous les types de violence envers les enfants ont été associés à tous les troubles de santé mentale, y compris idées et tentatives suicidaires, après ajustement pour tenir compte des variables sociodémographiques (rapports des cotes ajustés allant de 1,4 à 7,9). Nous avons observé un lien dose-réponse proportionnel entre le nombre de types différents de violence subis et le risque de souffrir de problèmes de santé mentale. Les liens entre la violence subie durant l'enfance et le trouble déficitaire de l'attention et les idées et tentatives suicidaires ont semblé plus étroits chez les femmes que chez les hommes. Interprétation: Nous avons noté des liens solides entre la violence subie durant l'enfance et les troubles de santé mentale. Les professionnels de la santé, surtout ceux qui évaluent des patients qui souffrent de problèmes de santé mentale, doivent être au courant du lien entre les types spécifiques de violence envers les enfants et certains problèmes de santé mentale. Prévenir efficacement la violence envers les enfants pourrait amener une réduction de la prévalence des problèmes de santé mentale, des idées et des tentatives suicidaires. [ABSTRACT FROM AUTHOR]

Reports on the use of audio computer-assisted self-interviewing (audio-CASI) in the gathering of survey answers. How it increases a person's privacy when answering; How the data is more accurately recorded; Problems with the technology.