Social Pediatrics Unit: Interdisciplinary and intersectoral care model for patients who are victims of child abuse

Child abuse reporting laws: time for reform?

Research has consistently found rates of intimate partner violence (IPV) in nonheterosexual relationships to be comparable or higher than rates of IPV in heterosexual relationship. Less is understood about the relationship between child abuse, sexual orientation, and IPV victimization. The role of sexual orientation in the relationship between child abuse and IPV victimization is important to consider given research has found higher rates of childhood abuse among nonheterosexual individuals. In addition, the relationship between child abuse victimization and IPV victimization in adulthood has also been documented. This research extends the literature on IPV by comparing child abuse victimization as a predictor for IPV between heterosexual and nonheterosexual IPV victims. Using the National Violence Against Women Survey, this study used logistic regression models to find partial support for the hypothesis that nonheterosexuals who experience child abuse will be more likely to be IPV victims as adults than similarly situated heterosexuals.

The Supreme Court, Child Abuse, and the Role of the State

The purpose of this study was to identify whether experiences of childhood physical and/or sexual victimization would increase women's and men's risk for victimization in adulthood by different perpetrators (any perpetrator regardless of the relationship to the victim; intimate partner perpetrator; non-intimate perpetrator) using a nationally representative sample. Results of hierarchical logistic regression analyses indicated that childhood victimization increased the risk for adulthood victimization by any perpetrator for men and women, and by an intimate partner for women but not men. Female and male victims of physical and/or sexual child abuse are at higher risk for adult victimization by non-intimate perpetrators. These results suggest the appropriateness of interventions among adults or young adults who have been victims of child abuse, to prevent any future victimization in adulthood. To guide the development of such prevention programs, research is needed to identify factors that affect the probability of adulthood victimization among child abuse victims.

IntroductionEthiopia has made remarkable progress in expanding access to and provision of comprehensive abortion care. However, complications due to unsafe abortion persist. As efforts to increase quality of comprehensive abortion care continue, evaluating service quality is critical. Although “women-centered” abortion care is a central component of Ethiopia's technical guidelines for safe abortion, research has mostly focused on access to care, availability of services, and meeting clinical criteria, rather than examining service quality from abortion clients’ perspectives. This study assesses the quality of comprehensive abortion care (CAC) in public health facilities, from clients’ perspectives, in four regions of Ethiopia to examine how person-centered care differs based on facility and service characteristics.MethodsWe conducted 1,870 client exit surveys in 2018 using structured questionnaires with women who received induced abortion or postabortion care services from 76 public health facilities across four regions: Tigray, Amhara, Oromia, and Southern Nations, Nationalities, and People's. We operationalized person-centered care by mapping 30 indicators of quality to five of the six domains in the Person-Centered Care Framework for Reproductive Health Equity developed by Sudhinaraset and colleagues (2017): dignity & respect; autonomy; communication & supportive care; trust, privacy, and confidentiality; and health facility environment. We calculated descriptive, bivariate, and multivariable statistics to examine associations between service characteristics and person-centered care.ResultsCAC clients reported high levels of person-centered care, with exceptionally positive experiences for outcomes in the dignity and respect and trust, privacy, and confidentiality domains. However, there was notable room for improving client experiences across three domains: autonomy, communication and supportive care, and health facility environment. Client-reported quality outcomes differed significantly by diagnosis (induced or postabortion care), region, health facility type, and procedure type. Clients in Amhara, clients at tertiary and primary hospitals, and clients who received postabortion care reported lower levels of person-centered care.DiscussionThe positive experiences reported by comprehensive abortion care clients bolster evidence of the impact of the Ethiopian government's strategy to increase abortion access in the public health sector. However, notable disparities exist for key subgroups, particularly those seeking postabortion care and people visiting tertiary and primary hospitals. Quality improvement efforts should concentrate on improving abortion clients’ autonomy, communication and supportive care, and the health facility environment. The Ethiopian Ministry of Health and its partners must dedicate resources to improve postabortion care quality, integration of reproductive health services within CAC, and pain management for MA clients as vital interventions.

Meta-analysis of studies assessing interpersonal dependency in child abuse perpetrators (N of studies = 7) and victims (N of studies = 9) indicated that perpetrators have higher dependency levels than nonabusing controls (d = 0.43), and child abuse victims have higher dependency levels in early adulthood than people who were not abused as children (d = 0.47). An array of other personality traits and disorders showed comparable associations with abuse suggesting that in both populations increased dependency reflects a generalized increase in pathology and distress. Theoretical implications of these results are discussed, and suggestions for future research on dependency and abuse are offered.

Background Child Abuse & Neglect is a worldwide social and public health problem, which has a multitude of short- and long-term effects on children. Objective Pediatric dentists are often the ones who, after a pediatrician, come to identify a child abuse victim, so this article addresses the importance of the pediatric dentist in identifying the oral health issues that can be associated with child abuse victims. Data sources Web of Science, PubMed, Google Scholar were databases researched for peer review articles in indexed journals. Method Literature search was conducted and articles were selected according to the data provided regarding child abuse and neglect and the relevant data were summarized. Result Some medical providers may receive less education pertaining to oral health and dental injury that are related to abuse or neglect as readily as they detect those involving other areas of the body. Conclusion Pediatric dentists are encouraged to collaborate with pediatricians to increase the prevention and detection of child abuse and neglect in children.

Background: This article discusses reasons why child abuse victims and witness may not disclose child maltreatment. Methods: For primary data collection of this article, a sample of church pastors, community members and social workers from Mashonaland West in Zimbabwe were interviewed. Primary data from a qualitative research methodology was used to explore why child abuse victims and witnesses do not always report child abuse when they come across it. Aim: The purpose for this article is to promote awareness of what hinders people from reporting child abuse so that childcare professionals and families can work together in removing barriers that hinders the revelation of horrid secret such as child abuse. Results: Inefficient systems for reporting child abuse can hinder victims and witness from disclosing child abuse cases. Conclusion: To prevent and reduce child abuse, there is a need to have effective procedures of protecting and encouraging child abuse victims and witnesses to disclose suspected child abuse cases.

APA Files Another Amicus Brief in Ongoing Texas Case on Banning Trans Care for Youth

Sexual abuse is a major health problem and trauma if encountered in childhood. This study was conducted about the Effectiveness, Forgiveness skill on worry and hopelessness in Women Victims of sexual abuse in childhood.
 This is a semi-experimental study with pretest-posttest as well as control and test groups. 30 depressed women who reported a sexual abuse by relative and referred to several psychological clinics in Tehran in 2017 were studied. Studied sample consisted of 30 women who were selected randomly (how the author has used random sampling) (the author should have used purposive sampling rather than random) and signed into two 15-member experimental and control groups. Sample members of test group were under intervention individually within 12 sessions with forgiveness approach and control group members were remained in waiting list. Both of groups filled out worry and hopelessness scale in baseline and after intervention. The data were analyzed using covariance analysis through IBM SPSS 22.0 software.
 Results obtained from study indicate difference between worry and hopelessness level of women victims of sexual abuse in control and experimental groups after forgiveness training.
 Forgiveness skill is effective in reducing worry and hopelessness in women victims of sexual abuse in childhood.

Reproductive Injustice at the Southern Border and Beyond: An Analysis of Current Events and Hope for the Future.

Organ transplantation has become a valuable and accepted treatment for many patients with organ failure. A major limitation to transplantation is the shortage of organ donors. Due to lack of willingness by medical examiners to release child abuse cases for organ donation, child abuse victims are a greatly underutilized pool of potential donors. This paper presents a model to facilitate organ recovery in the child abuse victim. This protocol has been in consistent use in San Diego County since midyear 1991. In all cases of child abuse where the victim was brain dead and the family consented to organ donation, the medical examiner's office released the body for organ donation. Since institution of the model described in this paper, organ donation among child abuse victims has risen dramatically in San Diego County. If similar protocols are established at other pediatric centers, the disparity between supply and demand in pediatric organ donation will diminish.

There are many aspects of child abuse, among them the most common forms are physical and sexual abuse, emotional or physical neglect and Munchausen by proxy syndrome. However, all aspects of intentional or unintentional malnutrition and hunger in childhood on the one side, as well as excess of everything possible on the other should be included in the list of child abuse. In this chapter we refer primarily to the symptoms, clinical signs, diagnostic procedures in children suspicious for physical or sexual child abuse and for the Munchausen by proxy syndrome. The real incidence of child abuse is diffi cult to estimate due to the rather high number of unreported cases, especially when sexual abuse occurs. UNICEF has estimated that maltreatment leads to 3,500 death/year, and more than 800 are infants aged 0–11 months—resulting in an annual mortality rate of 6.1/100,000. The total number of cases of maltreatment is estimated to be 150–2,000 times higher than the number of deaths. A study of the US Department Health and Human Services estimated 903,000 children as victims of child abuse. Fifty-seven percent were neglected, 19% were physically abused, 10% were sexually abused, 7% were psychologically maltreated, and 2% experienced medical neglect. Parents were the perpetrators in 77% of child fatalities. The study showed that in 2001 approximately 1,300 death were attributed to child neglect or abuse. Of these deaths, 41% occurred in children under 1 year of age, and 85% occurred in children under 6 years of age. Factors which are typically associated with maltreatment are low socioeconomic status, violence in the family, breakdown of families, child morbidity, parental mental ill-health, and parents who were abused during their own childhood. 21

Previous research has shown that youth consider school-based child abuse prevention programs as one of the most important strategies for preventing child abuse and neglect. This study asked young child abuse survivors how school-based child abuse prevention programs should be shaped and what program components they perceive as essential. Semi-structured interviews were conducted with 13 Dutch young adults that were a victim of child abuse or neglect. A literature review that resulted in 12 potential program components was used to guide the interviews. All young adults agreed that school-based child abuse prevention programs are important and have positive effects on children’s awareness of child abuse. Teaching children that they are never to blame for child abuse occurrences was considered one of the most important components of school-based programs, next to teaching children how to escape from threatening situations and to find help, increasing children’s social–emotional skills, promoting child abuse related knowledge, recognizing risky situations, and increasing children’s self-esteem. Further, the participants found it important to provide children with aftercare when a school program has ended. Overall, young child abuse survivors have a strong view on what should be addressed in school-based child abuse prevention programs to effectively prevent child abuse.

The global COVID-19 pandemic prompted governments to impose unprecedented sanitary measures, such as social distancing, curfews, and lockdowns. In France and other countries, the first COVID-19 lockdown raised concerns about an increased risk of child abuse. Abusive head trauma (AHT) is one of the most serious forms of child abuse in children aged 0–24 months and constitutes the leading cause of death in children under 2 years of age. Subdural hemorrhage (SDH) is present in 89% of cases of AHT and constitutes one of the most specific, objective clinical presentations in the diagnosis of child abuse. In a French nationwide study, we sought to evaluate the potential impact of the first year of the COVID-19 pandemic on the incidence of hospital admissions for child abuse with SDH, relative to the two previous years. We conducted a nationwide, retrospective study of data in the French national hospital discharge summary database by applying the International Classification of Diseases (10th Revision) codes for SDH and for child abuse. After including children aged up to 24 months with a diagnosis of child abuse and/or SDH following hospital admission anywhere in France between January 1, 2018, and December 31, 2020, we compared the incidence of child abuse, the incidence of SDH + child abuse, and the demographic data for 2020 with the corresponding values for 2018 and 2019. There were no significant differences in the number of hospital admissions due to child abuse or SDH + child abuse between 2020 and the 2018/2019 control years. The incidence of SDH + child abuse was higher among boys than among girls. There were significantly fewer hospital admissions in May 2020 (p = 0.01) and significantly more in December 2020 (p = 0.03), relative to the same months in the two preceding years. There was a nonsignificant trend toward a lower incidence of hospital admission for child abuse in 2020, relative to 2019 (decrease: 6.4%) and 2018 (decrease: 7.6%).Conclusion: When considering children under the age of 24 months in France, the incidence of hospital admission for SDH in the context of child abuse was not significantly higher in 2020 than in the two previous years.What is Known:• The impact of COVID-19 lockdown on child abuse and more specifically on subdural hemorrhage remains unknown.What is New:• There was no increase in hospitalizations for child abuse and AHT.• We found that boys are more often victims of child abuse and subdural hemorrhage among children aged less than 12 months.Supplementary informationThe online version contains supplementary material available at 10.1007/s00431-022-04387-x.