Typology and correlates of sexual abuse in children and youth: multivariate analyses in a prevalence study in Geneva.

OBJECTIVE: Child sexual abuse (CSA) encompasses a variety of distinct situations, which should be differentiated. There is a need for a working classification, taking into account various parameters. METHODS: The Geneva CSA prevalence study was based on 1116 randomly selected adolescents aged 14 to 16. Secondary analyses of the 252 reported cases of abuse was carried out using a multivariate approach combining multiple correspondence analysis and automatic classification, leading to descriptive analyses and to a new classification of CSA. RESULTS: Global prevalence of CSA, using a broad definition, was 10.9% for boys, and 33.8% for girls. Classification of cases of abuse differentiated 5 classes: (A) exhibitionism or other abuse without contact, by an adult (proportion of cases in boys: 22%; girls: 32%); (B) abuse of an adolescent boy by a peer without contact (62%); (C) abuse of an adolescent girl by a peer with physical contact (38%); (D) abuse inside the family, repeated (boys: 10%, girls: 16%); (E) child abuse with genital penetration, lasting 2 years or more (boys: 7%; girls: 14%). CONCLUSIONS: CSA is a complex and heterogeneous problem. Reported abuse situations can be classified into five classes, with different degrees of severity, causes, and consequences. Classification is essential in clinical research as well as in the design and conception of prevention programs.

Prevalence of child sexual abuse among adolescents in Geneva: results of a cross sectional survey.

OBJECTIVE: To measure the cumulative prevalence of child sexual abuse in a representative sample of the adolescent population of Geneva. DESIGN: Cross sectional survey with an anonymous self administered questionnaire centred on a factual description of sexual activities. SETTING: 68 classes (17 schools) randomly selected from the 201 ninth grade classes of the public school system in Geneva. SUBJECTS: 1193 adolescents aged 13-17 years, of whom 1116 (93.5%; 568 girls, 548 boys) consented to the study and returned completed questionnaires. RESULTS: 192 (33.8%) girls and 60 (10.9%) boys reported having experienced at least one sexually abusive event. The prevalence of abuse involving physical contact was 20.4% (116 cases) among girls and 3.3% (18) among boys. The prevalence of abuse involving some form of penetration was 5.6% (32 cases) among girls and 1.1% (six) among boys. One third of the abused adolescents had experienced more than one abusive event and 46.5% (92/198) had experienced the first event before age 12. Abuse by a family member was reported by 20.5% (36/176) of abused girls and 6.3% (3/48) of abused boys. Abusers were known to victims in two thirds of cases. Ninety per cent of abusers were male and 35.3% (71/201) came from the victim's peer group. Over 80% of participants found the questionnaire interesting, clearly formulated, and useful. CONCLUSIONS: Child sexual abuse is a universal social phenomenon. Adolescents themselves can contribute to research and so help in the search for more efficient prevention and intervention strategies.

[Health education: prevention of smoking]. / Education pour la santé: prévention du tabagisme.

With the aim of primary prevention, the Health Education Service of Geneva organizes in all schools since 1970, an information campaign against the dangers of smoking! The objectives of this preventive action are to render the pupils conscient of the dangers of smoking, to draw their attention on the lures of advertisement and to permit them to make a personal opinion on the subject. This information is given in primary and secondary schools by the teachers who receive the necessary audio-visual equipment from the Health Education Service. In the higher degrees, this information is integrated in a regular health teaching program. All future teachers also receive an "anti-smoking" information given by doctors of our Department. We hope that this form of objective and scientific instruction in schools will minimise the effects of publicity, making the young people aware of the risks they encounter.

PIP: The Health Education Service of Geneva has organized in all primary and secondary schools a campaign of information against the dangers of smoking. Goals of the program, which was implemented in 1970, are first prevention, and then to draw the attention of the students on the misrepresentation of the pleasures of smoking given by advertising, and on the possible risks a smoker may encounter. The Health Education Service provides teachers with the necessary audio-visual equipment and with other teaching materials. In higher degrees the information is conveyed through the regular health program in the curriculum. Future teachers receive instruction from doctors of the Health Department.

[A clinical and cytogenetic investigation carried out in a special institution for mentally retarded patients: preliminary results concerning 82 cases of oligophrenia (author's transl)]. / Investigation clinique et cytogénétique d'une institution medico-educative: resultats preliminaires portant sur 82 oligophrenes

A clinical and cytogenetic investigation carried out in a special institution for mentally retarded patients revealed 82 cases of oligophrenia, amongst whom were found 56 normal karyotypes (68.3%). Out of 25 karyotypes with chromosome anomalies or variants there were 18 cases of trisomy 21 and 7 others: one case of mosaicism with balanced translocation, 46,XX/46,XX,6p+,17q-; one case of partial trisomy, 46,XX,11q+; one case of pericentric inversion, 46,XY,inv(1) (p13,q21); one case with 8% chromosome breaks; three cases of marker chromosomes, of which one was of karyotype 46,XX,1qh+, and two (oligophrenic sisters) 46,XX,21p+. Moreover, there was an interesting case of testicular feminisation in a 9-year-old girl with karyotype 46,XY. The authors' results corroborate those obtained in several important previous studies based on much larger numbers of patients. Amongst the 56 cases where the karyotype was shown to be normal, there were 15 for whom a probably exogenic cause of the oligophrenia could be established, occurring mainly during the perinatal period. The authors were also able to confirm that the genetic factor plays an important role in the incidence of mental retardation, since in 22 examined patients, i.e. 26.8% of all cases, the condition was of familial type. Some interesting observations of idiopathic oligophrenia are reported, as well as several cases with well-known syndromes (Crouzon's and Cornelia de Lange's syndromes, hypothyroidism). Two cases of incest between father and daughter, which had produced children with serious oligophrenia associated, in one case, with deaf-mutism, microphthalmia, microcephaly and sclerocornea, are also discussed. The data show that mental retardation can frequently have a genetic cause, either of mendelian, chromosomal or multifactorial origin.

[A case of Goldenhar syndrome: acute vitamin A intoxication in the mother during pregnancy]. / A propos d'un das de syndrome de Goldenhar: intox;cation aiguë à la vitamine A chez la mère pendant la grossesse

The authors describe the case of a boy aged 2 1/2, who showed at birth a bilateral epibulbar dermoid, preauricular appendices on the left side and other malformations suggesting Goldenhar's syndrome. The history disclosed that in the second month of pregnancy the mother had accidentally swallowed 10 ml of an oily solution of Vitamin A during a laboratory manipulation. In their discussion, the autonrs analyse the teratogenic action of Vitamin A during embryonic development and review the aetiologies found in cases of Goldenhar's syndrome.