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BACKGROUND: An important element of reducing the sexual abuse and exploitation of children is to understand the behaviors of individuals who consume child sexual abuse material (CSAM), including the predictors of continued use. OBJECTIVE: To investigate predictors of 'ever viewing' CSAM and subsequent intentional use among individuals in the community. METHOD: This study used multivariate logistic regression analysis to identify significant predictors of ever viewing CSAM (n = 742) in an anonymous survey of 5512 Internet users in the community, and of subsequent intentional CSAM use among a subset of 459 CSAM viewers. RESULTS: The characteristics of respondents that were significantly associated with ever viewing CSAM were being male, older in age (25-34 and 55+ years cf. 18-24 years), residing in Australia, New Zealand, or Canada (cf. the United Kingdom), earlier exposure to adult pornography (<14 years), experiencing childhood physical abuse or neglect, viewing bestiality pornography featuring adults, viewing bondage/S&M (BDSM) pornography featuring adults, being likely (self-reported) to have sexual contact with a child, and visiting pedophilic chat forums online. In the subset sample, almost half (218, 47.5 %) viewed CSAM again intentionally after first exposure. Predictors of subsequent intentional viewing of CSAM after adjusting for age and country of residence were being male, ever experiencing loneliness, searching for CSAM intentionally at first exposure, being likely (self-reported) to have sexual contact with a child, and visiting pedophilic chat forums online. CONCLUSIONS: The findings have strong implications for prevention of first exposure to CSAM, and of continued CSAM use after exposure does occur.

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Live streaming of child sexual abuse (CSA) involves the procurement and viewing of sexual abuse of children across the internet in real time, in exchange for money. These offenses leave little tangible evidence of the offense beyond a financial transaction, and metadata relating to the live-streaming session. This research analyzed the demographic, criminal history, and financial transaction characteristics of 209 individuals who live streamed child sexual abuse. A machine learning clustering technique was implemented to consider whether there were sub-groups present among these offenders, and in particular the prevalence of contact sexual offending among any detected sub-groups. Findings revealed that offenders tend to engage in live streaming around the same age, before making regular transactions with facilitators at brief intervals, with the majority of offenders featuring limited criminal history. This analysis identified a notable sub-group of live-streaming offenders that also engaged in contact sexual offending. This is the first study to empirically demonstrate an intersection between live streaming of CSA, and contact sexual offenses against children and adults. This research highlighted the importance of financial transactions data in detecting, and disrupting this crime type. Further, the identification of an intersection between live-streaming CSA offenders, and contact sexual offenders suggests that these individuals may pose a risk to both local and international communities.

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BACKGROUND: Orlistat is an anti-obesity drug licensed in the United Kingdom for 7 years. We present a case of a patient who developed pancreatitis four days after commencing orlistat. CASE PRESENTATION: A 36 year old man presented to hospital with acute severe pancreatitis four days after starting a course of Orlistat, a lipase inhibitor used in the treatment of obesity. A diagnosis of drug related pancreatitis was made by exclusion of other causes of pancreatitis; he was a teetotaller, had a normal serum calcium, had no family history of pancreatitis or hyperlipidaemia, no history of trauma and had no evidence of gallstones on Computerised Tomography scan (CT). CONCLUSION: Orlistat was the only drug that had been started recently and has been associated with pancreatitis previously. We found no case reports of similar cases, however 99 cases of orlistat related pancreatitis have been reported to the Food and Drug Administration (FDA), but no causative link has been found in clinical trials by the drug company. It is therefore not on the list of possible complications or side effects of the drug.

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