Reports Of Abuse Research Articles

Respectful maternity care and mistreatment: Women's experiences during induction of labor and childbirth in Ghana.

Most studies on respectful maternity care (RMC) and mistreatment of women have focused on intrapartum care with limited information on how women are treated during induction of labor (IOL), pre-labor phase of the maternity care continuum. Emerging multi-country evidence indicates that nearly 30% of women who undergo IOL do not consent to the procedure and constitutes a violation of their rights to optimal maternal health. This study explored women's lived experiences of respectful care and mistreatment during IOL in a tertiary setting in Ghana. This was a qualitative phenomenological study conducted between September 2021 to October 2021 in Ghana. The eligibility criteria comprised women, aged ≥ 18 years who underwent IOL with singleton gestations. Purposive sampling was employed in recruiting the study participants (n = 17). Data analysis was performed based on thematic content using the inductive qualitative analytic framework approach. Nearly all the participants (94.1%) were first-timers to IOL. In general, we determined mixed findings relating to the experiences of RMC (respectful versus disrespectful care). Some women experienced respectful care including effective communication, optimal counseling and appropriate professionalism resulting in adequate client satisfaction with care. Conversely, we determined that some mothers experienced mistreatment of different types during labor induction and birth including verbal abuse, lack of privacy, neglect, ineffective communication, inadequate pain relief, non-consented care and inadequate professional standards. There were no reports of physical abuse. Mixed responses (positive and negative) were heartily described concerning future utilization of the health facility considering the quality of care they received. Personalized recommendations to improve the quality of care during IOL were provided by the affected women and these summed up to RMC (e.g. effective communication, adequate analgesia, shared-decision making). Our study indicates that women experience varied forms of mistreatment during induction of labor and childbirth, and can be potentially traumatic psychologically considering their prolonged exposure to health facilities. Context specific strategies to expedite integration and adherence to RMC guidelines in maternity care are recommended to improve the quality of care during induction of labor and birth.

POLICY SERIES: TRENDS IN ELDER ABUSE AND INITIATIVES TO PREVENT ELDER ABUSE IN JAPAN DURING THE PAST 20 YEARS

Abstract This symposium begins by briefly introducing activities of Japan Academy for the Prevention of Elder Abuse, cerebrating 20 years, and features the Japanese Act on the Prevention of Elder Abuse. First, using data collected by the Ministry of Health, Labour, and Welfare (MHLW), research analyses present trends in elder abuse case reports substantiated as “elder abuse”, trends in reporters in both institutional and domestic settings, and introduce recent amendments of operational standards made by ministerial ordinance. Second, using data (N=171) on elder abuse from Matsudo-City collected in 2019, analysis examines relationships between trends in the increasing number of elder abuse reports made by the police (about 43% of all cases) and trends in the number of cases regally considered to be “elder abuse” (only 17.8% of those reported to the police were legally considered to be “elder abuse”). It examines possible reasons and propose necessary policy changes in definitions of elder abuse. Third, using longitudinal data collected by Matsudo-city and by the MHLW from 2006 through 2022, this analysis examines the impacts of COVID-19 on the occurrence of elder abuse. Analyses revealed that neither data set showed significant increase in frequencies of occurrence of elder abuse due to COVID-19. Rather, it showed a decrease for the MHLW data. This study examines possible reasons and make recommendations to further decrease frequencies of occurrence of elder abuse cases. Abuse, Neglect and Exploitation of Older Persons Interest Group Sponsored Symposium

The Orange Ribbon and the Pitiful Child: Investigating Child Abuse, Family Normativity and the Welfare State in Japan

ABSTRACTFor over 15 years the Japanese government has promoted a national campaign on child abuse awareness and tasked authorities with addressing rising child abuse reports. With an orange ribbon as its symbol, a key aspect of this campaign, alongside casework, is the creation and circulation of visual‐discursive representations of abused children. Drawing on 18 months of ethnographic fieldwork on child protection practice, this paper contextualises the social construction of child abuse by critiquing the cultural and technical logics of abuse and protection discourse. Appeals to vulnerability, rights and duty bridge public and expert fields and position an image of pity as a call to action that drives child abuse prevalence as well as enduring dispositions by the state towards intrafamily normativity and a minimalist welfare state.

The other side of the law: Discrimination and emergency powers

Emergency powers have always posed a threat to the rule of law, particularly standards of legality and respect for individual rights. Although system-wide impacts to legal norms and the rights of the general population continue to pose real dangers, we argue that the most egregious violations of the rule of law in liberal democratic societies in times of emergency now tend to be restricted to historically marginalized groups depicted as disorderly, dysfunctional, or pathological. As exemplified in official responses to Hurricane Katrina in New Orleans, reports of rampant child abuse in aboriginal communities in Australia’s Northern Territory, and high levels of homicide in Jamaica, emergency powers are often applied in discriminatory ways that reflect and reinforce existing disparities in race, gender, and class. Even when emergency measures are nominally adopted for the entire population, their application is often limited to highly specific geographical areas that place marginalized groups into “zones of otherness.” The result, we argue, is to establish a de facto system of legal pluralism that subjects subordinate groups to enhanced forms of regulation, surveillance, detention, and violence, but generally leaves established legal rules and protections intact for everyone else.

Research Review: Why do prospective and retrospective measures of maltreatment differ? A narrative review.

Childhood maltreatment contributes to a large mental health burden worldwide. Different measures of childhood maltreatment are not equivalent and may capture meaningful differences. In particular, prospective and retrospective measures of maltreatment identify different groups of individuals and are differentially associated with psychopathology. However, the reasons behind these discrepancies have not yet been comprehensively mapped. In this review, we draw on multi-disciplinary research and present an integrated framework to explain maltreatment measurement disagreement. We identified three interrelated domains. First, methodological issues related to measurement and data collection methods. Second, the role of memory in influencing retrospective reports of maltreatment. Finally, the motivations individuals may have to disclose, withhold, or fabricate information about maltreatment. A greater understanding of maltreatment measurement disagreement may point to new ways to conceptualise and assess maltreatment. Furthermore, it may help uncover mechanisms underlying maltreatment-related psychopathology and targets for novel interventions.

The Force Intervention Brigade in the drc, Civilian Security and Women Peace and Security

Abstract This article examines the UN Security Council (unsc) authorised Force Intervention Brigade (fib) in the Democratic Republic of the Congo (drc) and the component of the mandate that articulates civilian security as a rationale for justified force. In examining civilian protection (articulated as both civilian security and as the protection of civilians), we explore the parallels between the women, peace and security agenda and the image – versus the reality – of civilian vulnerability in the drc. In focusing on the narratives of civilian security we explore how the ten years of repeat authorisations for the fib replicate heteronormative and colonial tropes that have ultimately undermined security in the drc and, for international lawyers, undermine peacekeeping principles, authorisations of force, and understandings of consent. The contradictions between the Security Council’s commitments to addressing and preventing conflict-related sexual violence and the mobilisation of the fib are drawn on to demonstrate the ways in which gender simultaneously strengthens the Council’s legitimacy and yet produces few spaces of significant change from a feminist perspective. We conclude that not only is the legacy of the fib detrimental to women’s security in the drc given reports of sexual exploitation and abuse (sea) perpetrated by peacekeepers but that the fib has transformed peacekeeping away from peace, embedding militarised responses to a complex humanitarian crisis.

The Reliability and Validity of the Greek Version of the Child Abuse Report Intention Scale (CARIS) Questionnaire for Midwives, Along With Factors Associated With Their Intention to Report Child Abuse and Neglect.

Child maltreatment is a serious public health issue with unquestionable short- and long-term consequences. The midwives' role in the prevention, identification, and reporting of child abuse and neglect (CAN) is crucial for children's well-being. The Child Abuse Report Intention Scale (CARIS) questionnaire was designed to measure factors influencing Taiwanese nurses to report child abuse and has been used in many studies worldwide. The purposes of this study were to test the reliability and validity of the Greek version of the CARIS questionnaire and to determine factors associated with the Greek midwives' intention to report suspected CAN. A convenience sample of 70 registered midwives participated in the study from February to June 2023. After forward and backward translation, the participants completed the CARIS questionnaire twice, with a one-week interval, to determine test-retest reliability. Cronbach's alpha was used to assess the internal consistency of the questionnaire. Concerning the internal consistency, reliability, and repeatability of the Greek version of the CARIS questionnaire, our results were consistent, stable, and highly reproducible. For the CARIS, Cronbach's alpha ranged from 0.549 to 0.810 depending on the subscale, Pearson's statistic ranged from 0.649 to 0.797, while all the paired samples t-tests apart from one were nonsignificant. Concerningthe subscale "Intended Practice Behaviors: Vignettes questions and Respond Options," Cronbach's alpha ranged from 0.527 to 0.890 depending on the subscale, Pearson's statistic ranged from 0.803 to 0.850, while all the paired samples t-tests apart from two were nonsignificant. Sixty-six participants (94.2%)had received no CAN training while in midwifery school. Only seven participants (10%) had ever reported suspected CAN, while 12 out of 70 (17%) did not report although they suspected CAN. Thirty-six midwives (51.4%) stated that they did not know how to report CAN cases, and 35 (50.7%) did not have the appropriate resources. Participants had overwhelmingly negative attitudes about child harsh discipline (34.34 of 36), low tolerance towardperpetrators (25.10 of 30), positive attitudes toward the responsibility of reporting suspected CAN (32.60 of 42), moderate knowledge of CAN (6.63 of 13), and increased engagement in reporting severe cases of CAN (32.37 of 40). Attitude, subjective norm, and perceived behavioral control were significantly related to the midwives' intention to report CAN. The Greek version of the CARIS is a valid and reliable instrument that can be used to determine reasons influencing midwives' intention to report CAN. One of our key findings was the lack of adequate and appropriate training in dealing with CAN cases, both at the undergraduate and postgraduate levels, that needs to be addressed by health policy makers.

An exploratory analysis of repeat victimisation of domestic violence disclosure scheme applicants

ABSTRACT This study explores the impact of the Domestic Violence Disclosure Scheme (DVDS) on repeat victimisation among applicants. By analysing all ‘Right to Ask’ applications to Avon & Somerset Constabulary in 2021, the study investigates the extent of prior domestic abuse victimisation and the influence of disclosure decisions on subsequent reports. The findings reveal that 80% of applicants had prior victimisation records, and disclosures were made in 53% of the cases. The probability of subsequent abuse reports increased significantly for those with prior victimisation when disclosures were made, highlighting the need for robust support mechanisms post-disclosure. The study complements debate around the theoretical tension between empowerment and responsibilisation within DVDS and calls for enhanced support systems and rigorous outcome evaluations. These results suggest that while DVDS aims to protect victims, its effectiveness in reducing victimisation requires further empirical validation and comprehensive support strategies.

Factors associated with perception of harassment in interns, trainees and residents of Veracruz

Abstract Background Harassment among resident physicians remains prevalent, with reports of abuse at 20% in Mexico, potentially creating a hostile learning environment that does not foster comprehensive learning for students. Objectives To determine the factors associated with harassment among interns, medical interns, and residents in Veracruz. Methods This is a prospective cross-sectional study, including interns, social service interns, and residents in the state of Veracruz, excluding those diagnosed with oppositional defiant disorder or mythomania. Workplace harassment was assessed using the Cisneros scale (Cronbach’s alpha 0.98), in addition to perceptions of workplace, psychological, and sexual harassment. Within the statistical analysis, the association was determined using chi-square test, odds ratio, and 95% confidence interval (OR/CI95%). Results A total of 81 participants were included, with a perception of workplace harassment in 42% and sexual harassment in 51.9%; the Cisneros scale shows 2.5% of subjects free from any harassment behavior. Female gender showed association with workplace harassment (0.7/0.01-0.2); meanwhile, attending a public university (OR: 0.22 / CI: 0.07-0.6) and being a pregraduate intern (OR:2.6/CI:1.03-6.6) were associated with perception of psychological harassment. Furthermore, being female (OR:9.28/CI:3.3-25.4), bisexual (OR:11.8/CI:1.4-97.8), a pregraduate intern (OR:3.44/CI:1.32-8.97), an R1 resident (OR:0.09/CI:0.01-0.79), and being affiliated with Veracruz (OR:2.6/CI:1.05-6.58) or Xalapa (OR:0.1-CI:0.05-0.7) were identified with association for experiencing sexual harassment (p < 0.05). Conclusions Gender and level of education are the main factors associated with harassment, while the type of university of origin plays an important role in psychological harassment, warranting further study of these interactions while considering the limitations of this research. Key messages • The results of this research show that the roles of violence within hospital medical education are still maintained despite the social evolution with respect to gender roles and equality. • It is necessary to promote the culture of denunciation and offer courses to eliminate abuse and promote equality and respect among hospital staff.

Divergent interpretations of child abuse in legal judgments: perspectives from clinicians and forensic experts

BackgroundChild abuse in Taiwan is a major societal concern that severely affects the well-being of children. Despite the complexity in detecting abuse, reports of child abuse are increasing, evidenced by a rise in cases and heightened awareness. This study utilizes judicial judgments as a lens to understand the varied interpretations of child abuse by clinical and forensic experts and explores the broader epidemiological trends of such abuse within the declining youth population of Taiwan.MethodsWe conducted a retrospective study by analyzing official court judgments on child abuse allegations judged from 2008 to 2022 from the online database of Judicial Yuan. Furthermore, the study analyzed demographic factors, injury patterns, and opinions from various experts.ResultsThe results reveal that severe criminal cases of child abuse predominantly involve biological fathers as the primary offenders and physical abuse as the most common form of maltreatment. Victims are typically aged less than 5 years, which frequently leads to an unfavorable prognosis. Analysis also highlights the TEN-4-FACESp acronym as a highly predictive indicator of child abuse and underscores the prevalence of abusive head trauma (AHT). Moreover, the findings emphasize ongoing disparities in opinions between forensic medical examiners and clinical physicians, especially in AHT cases, which potentially influences judicial decisions.ConclusionsIn summary, the study reveals ongoing disagreements between forensic medical examiners and clinical physicians, especially in cases of AHT, which may impact judicial decisions. Promoting consensus through interdisciplinary collaboration and improved communication can aid in revealing the truth in child abuse cases.

Childhood Maltreatment and Electrodermal Reactivity to Stress Among Pregnant Women.

There are competing theoretical hypotheses regarding the consequences of early adversity, such as childhood maltreatment, for individuals' autonomic nervous system activity. Research examining potential implications of child maltreatment for sympathetic nervous system activity, specifically, is scarce. In this preregistered study, we examined whether childhood maltreatment history is associated with pregnant adults' sympathetic responses to different stressors. This population is particularly relevant, given potential intergenerational consequences of pregnant individuals' physiological responses to stress. Pregnant women's (N=162) electrodermal levels were recorded while completing the Trier Social Stress Test (TSST), which elicits social-evaluative threat, and while watching a video of an unfamiliar infant crying, which was intended to activate the attachment system. Pregnant women's retrospective reports of childhood maltreatment were negatively associated with their electrodermal reactivity to the TSST and to the video of the infant crying. Follow-up analyses indicated that these associations were specific to reported experiences of childhood abuse and not childhood neglect. Altogether, these findings indicate that self-reported childhood maltreatment experiences, and childhood abuse in particular, may result in blunted activity of the sympathetic nervous system in response to multiple types of stressors.

Developing An Online Course To Increase Staff Awareness And Responses To Unwanted And Illegal Sexual Behaviour Perpetrated Against Older People

Abstract Background The idea that older people can be victims of unwanted sexual behaviour or sexual assault in health and social care settings is relatively recent. In the Irish context, 165 reports of sexual abuse of older people were made to the HSE National Safeguarding and Protection teams in 2022. The prevalence of sexual abuse against older people in health and social care settings is poorly understood and there is an acknowledgement that hospital staff require additional training to understand and manage incidents. Methods In response to the need for training and support for staff, an online awareness-raising course based on a pre-developed course from Australia ‘Preventing unwanted sexual behaviour against older people in health and social care settings’ will be adapted, trialled and tested in a large acute teaching hospital. This course sets out to support acute care staff to identify and manage incidents of sexualised behaviour, to seek expert help and to ensure that older people are protected from unwanted and at times, what may constitute illegal sexual behaviour. Results The adapted course ‘Understanding and Responding to Unwanted or Illegal Sexual Behaviour Perpetrated against Older People in Health and Social Care Settings’ utilises a trauma-informed lens and key themes covered include defining unwanted sexual behaviours, understanding older people and sexual behaviour, risk factors for sexual abuse, barriers to recognising and reporting abuse and managing incidents. Conclusion The ‘trial and test’ will involve a feedback survey (N=50 respondents) and focus groups with participating healthcare professionals from the hospital site informing further refinement of the course content in preparation for wider rollout and implementation across Ireland's health and social care settings.

Unlocking data to inform public health policy and practice: A pilot study on utilising police data for linked population data research

ObjectiveThe UK Government increasingly emphasises a comprehensive, multi-agency approach to tackling crime. This pilot study explores the feasibility of integrating police data with routine health data to develop a holistic understanding of the predictors of domestic abuse (DA). ApproachThe study encompasses three work-packages a) coding the narrative data from Domestic Abuse, Stalking and Harassment (DASH) risk assessment report from Public Protection Notifications (PPNs), which are information-sharing documents recording safeguarding concerns and shared with partner agencies b) exploring to identify what works to harmonise different software systems within police data-sharing approach, c) constructing a case study by linking PPN DASH data with routine health and administrative records. These efforts illustrate the potential of national data-sharing initiatives. Results a) Text mining methods successfully identified and coded (with over 95% accuracy) 17 refereed/involved agencies from the PPN DASH data. b) Barriers to data sharing were attributed to a lack of clarity and consensus regarding appropriate information sharing, rather than technical obstacles. This barrier can be overcome by an unambiguous framework, endorsed at an elevated level, highlighting which data should be shared. c) The data-linkage study revealed that victims of DA had prior interactions with healthcare services before their initial PPN, and younger pregnant victims had higher risk of future healthcare emergency visits. Conclusion and ImplicationPolice and health data integration enhances evidence-based prevention and early identification of vulnerable individuals by both law enforcement and public health services.

Revisiting dezocine for opioid use disorder: A narrative review of its potential abuse liability.

Opioid use disorder (OUD) remains a serious public health problem. Opioid maintenance treatment is effective but under-utilized, hard to access under existing federal regulations, and, once patients achieve OUD stability, challenging to discontinue. Fewer than 2% of persons with OUD stop using opioids completely. There have been calls from public advocacy groups, governmental agencies, and public health officials for new treatments for OUD. Dezocine, a non-scheduled opioid previously used in the United States and currently widely prescribed in China for pain management, could be a candidate for a novel OUD treatment medication in the U.S. Nonetheless, to date, there have been no reviews of the clinical and preclinical literature detailing dezocine's abuse potential, a key consideration in assessing its clinical utility. There are no English language reports of human abuse, dependence, or overdose of dezocine, despite years of extensive clinical use. There are a few case reports of dezocine abuse in the Chinese literature, but there are no reports of overdose deaths. Dezocine is perceived as an opioid and is "liked" by opioid-experienced human and non-human primates, properties that are not dose-dependent and are mitigated by ceiling effects-higher doses do not result in more "liking." There is little withdrawal, spontaneous or precipitated, in humans, monkeys, rats, or mice treated chronically with dezocine alone. However, at some doses, dezocine can precipitate withdrawal in humans and monkeys dependent on other opioids. In rodents, dezocine reduces the severity of morphine withdrawal and the rewarding properties of other opioids. Although dezocine is reinforcing in humans and monkeys with prior or concurrent opioid use within a restricted dose range, there are only a few anecdotal reports of dezocine abuse despite of the long history of use in humans. Given the evidence of dezocine's limited abuse potential, it could be useful both as a treatment for OUD. However, in-depth studies would be required for dezocine to be re-considered for clinical use.

Objective and subjective experiences of childhood maltreatment and their relationships with cognitive deficits: a cohort study in the USA

Cognitive deficits might contribute to the elevated risk of life-course psychopathology observed in maltreated children. Leading theories about the links between childhood maltreatment and cognitive deficits focus on documented exposures (objective experience), but empirical research has largely relied on retrospective self-reports of these experiences (subjective experience), and the two measures identify largely non-overlapping groups. We aimed to test the associations of objective and subjective measures of maltreatment with cognitive abilities within the same individuals. We studied a cohort of individuals from the US Midwest with both objective, court-documented evidence of childhood maltreatment and subjective self-reports of individuals' histories at age 29 years. Between the ages of 29 years and 41 years, participants were assessed with a comprehensive set of cognitive tests, including tests of general verbal intelligence (Quick Test and Wide Range Achievement Test-Revised [WRAT]), non-verbal intelligence (Matrix Reasoning Test [MRT]), executive function (Stroop Test and Trail Making Test Part B [TMT-B]), and processing speed (Trail Making Test Part A [TMT-A]). Participants were also assessed for psychopathology (Center for Epidemiologic Studies Depression Scale and Beck Anxiety Inventory). We tested the associations between objective or subjective measures of childhood maltreatment with cognitive functions using ordinary least squares regression. To test whether cognitive deficits could explain previously described associations between different measures of maltreatment and subsequent psychopathology, we re-ran the analyses accounting for group differences in the Quick Test. People with lived experience were not involved in the research or writing process. The cohort included 1196 individuals (582 [48·7%] female, 614 [51·3%] male; 752 [62·9%] White, 417 [34·9%] Black, 36 [3·8%] Hispanic) who were assessed between 1989 and 2005. Of the 1179 participants with available data, 173 had objective-only measures of childhood maltreatment, 492 had objective and subjective measures, 252 had subjective-only measures, and 262 had no measures of childhood maltreatment. Participants with objective measures of childhood maltreatment showed pervasive cognitive deficits compared with those without objective measures (Quick Test: β=-7·97 [95% CI -9·63 to -6·30]; WRAT: β=-7·41 [-9·09 to -5·74]; MRT: β=-3·86 [-5·86 to -1·87]; Stroop Test: β=-1·69 [-3·57 to 0·20]; TMT-B: β=3·66 [1·67 to 5·66]; TMT-A: β=2·92 [0·86 to 4·98]). The associations with cognitive deficits were specific to objective measures of neglect. In contrast, participants with subjective measures of childhood maltreatment did not differ from those without subjective measures (Quick Test: β=1·73 [95% CI -0·05 to 3·50]; WRAT: β=1·62 [-0·17 to 3·40]; MRT: β=0·19 [-1·87 to 2·24]; Stroop Test: β=-1·41 [-3·35 to 0·52]; TMT-B: β=-0·57 [-2·69 to 1·55]; TMT-A: β=-0·36 [-2·38 to 1·67]). Furthermore, cognitive deficits did not explain associations between different measures of maltreatment and subsequent psychopathology. Previous studies based on retrospective reports of childhood maltreatment have probably grossly underestimated the extent of cognitive deficits in individuals with documented experiences of childhood maltreatment, particularly neglect. Psychopathology associated with maltreatment is unlikely to emerge because of cognitive deficits, but might instead be driven by individual appraisals, autobiographical memories, and associated schemas. National Institute of Justice, National Institute of Mental Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institute on Aging, Doris Duke Charitable Foundation, and National Institute for Health and Care Research.

(161) THE 30-DAY WAITING PERIOD FOR ELECTIVE STERILIZATION IN NEW YORK STATE

Abstract Introduction Current studies have shown that men who elect to undergo vasectomies do so willingly and with their eyes wide open: regret following vasectomy is quite rare, even in childless men. In the current era of patient autonomy, all that is required ethically for an adult male to undergo elective sterilization is capacity and a proper and complete informed consent discussion from a vasectomist skilled in the procedure. Why, then, must Medicaid covered men here in New York State and nationally wait 30 days following a consultation to have a vasectomy? Objective The purpose of the present study is to review the history of the 30-day-wait period for elective sterilization and to point out its inequities and dangers. Methods Public data search of primary source data: PubMed, Nexus/Lexus, NYTimes, NYUS DOH. Results In the 1970s, reports of sterilization abuse resulted in a movement to combat coercion in the form of regulations on publicly funded sterilization. The Department of Health, Education, and Welfare enacted regulations including a 72-hour waiting period before sterilization and prohibition of sterilization of those younger than 21 years old. In 1978 the waiting period was extended to 30 days. The New York State Sterilization Consent Form contains a policy length of 10 or more pages and exceeds the minimum reading levels required for patient education material and informed consent documents. The New York form requires a witness to certify that they were present while the counselor read and explained the consent to the patient, and that the witness saw the patient sign the consent form with his/her own handwriting. Conclusions Delays in access to reproductive care can, have and will continue to result in unwanted pregnancies. In the present post-Dobbs era, unwanted pregnancies have already caused morbidity and mortality in women and will only continue to so. Moreover, placing barriers to reproductive care for both men and women increases the woman’s reproductive burden and serves to promulgate generational poverty. Though mandatory wait period regulations came in response to public outcry related to improper sterilizations performed on vulnerable populations but in its current form, mandatory 30-day wait periods serve no one: not society nor the poor the policies claim to protect. Mandatory 30-day wait periods reek of inequity and must be abolished. This fight starts at the level of county and state medical societies. Disclosure No.

Examining School Nurses' Knowledge and Confidence Related to Their Intention to Screen for and Report Child Sexual Abuse: A Descriptive Cross-Sectional Study.

Child sexual abuse (CSA) is a preventable national public health problem that results in adverse health consequences. Research suggests youth experiencing CSA are often of school age. Screening for early detection of health issues is integral to school nurse (SN) practice. Still, there is little evidence that routine screening when CSA is suspected is occurring in schools, despite recommendations that it should be. Lack of confidence and knowledge related to screening and reporting for CSA contribute to a SN's missed opportunity for early intervention. The aim of this study was to describe SNs' knowledge and self-efficacy associated with screening for and reporting suspected CSA in school settings. A descriptive cross-sectional survey design was employed. The Child Abuse Report Intention Scale was sent to over 2,000 members of the National Association of School Nurses. Among SN respondents (N = 123), the main findings showed almost half reported being concerned a youth was experiencing CSA but may have missed identifying it. Self-efficacy and professional responsibility were predictors of SNs' intention to screen as well as knowledge about obvious and serious signs of abuse were predictors of SNs' intention to report in this sample. An educational partnership between forensic nurse examiners and SNs can facilitate improving SNs' knowledge about nonspecific physical and behavioral indicators of abuse that are not overtly obvious. The development of a screening tool specific for use by SNs can empower their confidence to screen by providing a resource for them to use as a guide when they are uncertain about the evidence.

Child Welfare Outcomes After Attachment and Biobehavioral Catch-Up Intervention Participation: A Quasi-Experimental Study.

Limited research is available examining distal child welfare outcomes after participation in evidence-based parenting interventions. To address this gap, this study employed a multi-tiered analytic approach to examine child welfare outcomes after participation in Attachment and Biobehavioral Catch-up (ABC). Using propensity score analytic techniques to establish a matched comparison group, logistic regressions examined subsequent maltreatment reports and substantiation, and survival analyses observed time to and likelihood of reunification for children who received one of three ABC curriculums compared to comparison group children (child welfare services as usual). In total, 205 children were included in the impact analysis (n = 66 treatment; n = 139 comparison); the majority of the children were White (53.7%), non-Hispanic (84.4%), males (59.5%) with an average age of 6 months (M [SD] = .50 [1.0]). Over half (56.1%) of the study sample was in out-of-home placement; 23.5% of the removed children experienced reunification. No statistically significant group differences were observed on the likelihood of subsequent or substantiated maltreatment reports. All three ABC curriculums were associated with a statistically significant increased likelihood of reunification, when compared to their matched counterpart. Additional research is warranted, though results indicate ABC may be a promising intervention to help enhance the likelihood of reunification.

Contributions of Public Primary School Teachers Socio-Demographic Variables to Child Abuse Reporting Practices in Nigeria

The study analyzed the contributions of public primary school teachers’ socio-demographic variables to child abuse reporting practices in Alimosho Local Government Area of Lagos State, Nigeria. These were to examine the contributions of the socio-demographic variables of public primary school teachers to child abuse reporting practices and determine the type of association existing between teachers’ socio-demographic characteristics and child abuse reporting practices in the study area. This research is quantitative and utilizes a cross-sectional research design. The population for the study was all the 1,105 public primary school teachers in Alimosho, Local Government Area of Lagos State, Nigeria. The study sample consisted of 314 public primary school teachers in the study area, using a multi-stage sampling technique in four stages. Data collection techniques using questionnaires. The data collected was analyzed using descriptive and inferential statistical analysis. Results showed that the mean age of respondents was 35.89 ± 7.95 years; 72(24.8%) of the respondents were primary five teachers; males were 51.7%; 50% of the respondents were Christians; 49.7% of the respondents had 5-9 years of teaching experience. Also, results showed that religion (X2 = 0.47, p = 0.007), years of teaching experience (X2 = 13.38; p = 0.001), and level of qualification (X2 = 11.21, p = 0.02) varied significantly with respondents’ child reporting practices while respondents age (X2 = 6.99, p = 0.13), gender (X2 = 0.001, p = 0.97), and primary school teachers’ class (X2 = 15.59, p = 0.79) were not significant to child abuse reporting practices.

Developing a model for providing feedback to reporters of elder abuse

ABSTRACT Lack of feedback about reports made to Adult Protective Services (APS) is an important barrier to elder mistreatment reporting. To better understand barriers and facilitators to APS-reporter communication, we conducted an environmental scan of state policies and practices. We gathered publicly available information from 52 states and territories on APS administrative structure, reporting, intake, investigation, and feedback processes; performed a secondary analysis of focus groups with Emergency Medical Services providers and APS staff; and interviewed 44 APS leaders in 24 states/territories. Results revealed variation in information-sharing with reporters. Qualitative analyses revealed three overarching themes related to whether, when, and how information is shared. Results were used to develop a model illustrating factors influencing APS decisions on sharing information. This model incorporates the type of reporter (professional or nonprofessional), their relationship with the APS client (brief or ongoing), and the potential risks and benefits of sharing information with the reporter.