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PURPOSE: To integrate a parenting assessment into primary care and assess pediatric providers' time needed to review it and their perceptions of the process. DESCRIPTION: The Quick Parenting Assessment (QPA) is a validated, 13 item parent support tool that assesses for healthy and unhealthy parenting practices. Higher QPAs indicate more unhealthy parenting being used. In a clinic serving low-income parents, the QPA was integrated into the 15 month, 30 month, 5 year, and 8 year well child visits. After each well child visit in which the QPA was administered, providers were invited to complete a one-page survey-315 surveys were included in the analysis. ASSESSMENT: Most QPAs (78.7%) were low risk (QPA < = 2), 14.6% were medium risk (QPA = 3-4), and 6.7% were high risk (QPA > 4). The median time was 15-30 s to review low risk QPAs and 30 s to 1 min to review high risk QPAs. For most QPA reviews, health care providers reported that the QPA increased their objectivity in determining the level of support needed (68%), facilitated communication about parenting (77%), and increased the value of the visit (68%). CONCLUSION: A validated parenting assessment tool, integrated into pediatric primary care, appears to work for pediatric health care providers. These findings have implications for supporting parents in pediatrics, value-based care, and disease prevention.

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BACKGROUND: Childhood trauma adversely impacts adolescents, and consequently, they develop behavioural problems. Understanding the distribution of childhood traumas and their association with behavioural problems among adolescents is paramount for the preventive efforts. AIM/OBJECTIVE: The present research aimed to investigate this association among adolescents. METHODS: This association was investigated among adolescents (N = 200) between 12 and 18 years. Childhood Trauma Questionnaire and Strength and Difficulty Questionnaire was used to assess the distribution of trauma and internalizing and externalizing behavioural problems among adolescents through purposive and convenience sampling technique. RESULTS: The findings across trauma distribution indicated higher distribution of childhood abuse and neglect across males as compared to females. Males further significantly scored higher on sexual abuse and emotional neglect. Apparently, a large number of adolescents experienced all five sub types of childhood traumas (sexual abuse, emotional abuse, physical abuse, emotional and physical neglect). Additionally, across the severity continuum of childhood traumas, male scored higher on the severe to extreme continuum for all subtypes except physical abuse, where females scored higher. Lastly, logistic regression analysis indicated higher peer problems among those adolescents who have experienced all types of childhood traumas. CONCLUSION: These findings could be beneficial for intervention-based programs and policies to help trauma-exposed adolescents cope with their lives.

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The prevalence of interpersonal violence has been reported at higher levels among Indigenous than non-Indigenous populations worldwide, but has not been thoroughly investigated among the Sámi population in Sweden. The aims of this study were to investigate: (1) the prevalence of emotional, physical, and sexual violence and violence by intimate partners, family members, acquaintances, and strangers among participants identifying as Sámi or Swedish, (2) whether reporting experiences of historical losses and discrimination mediated the anticipated association between identifying as Sámi and reporting experiences of violence, and (3) whether background characteristics were associated with reporting experiences of violence. Cross-sectional questionnaire data collected in 2021 for the "Health and Living conditions in Sápmi" study were used. All adults in an arctic region in Sweden were invited to participate (response rate: 41%). Respondents self-identifying as Sámi (n = 375; 24.7%) or Swedish (n = 1,144; 75.3%) were included in this study. Sámi respondents of both sexes more often reported violence by an acquaintance or stranger. Likewise, more Sámi than Swedish women reported family violence (16.4% vs. 9.2%), but there was no difference concerning intimate partner violence (13.3% vs. 15.4%). Mediation analyses revealed strong positive indirect effects of historical losses and discrimination on the different types of violence. Being female was the strongest predictor of reporting intimate partner violence, and younger age was associated with violence by all perpetrators except family members. In conclusion, interpersonal violence was more often reported by Sámi respondents, but the association was explained in full by experiences of historical losses and discrimination. The results underline the importance of a life-course and even intergenerational and historical perspectives when investigating interpersonal violence.

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In Asia, rates of interpersonal violence are increasing, with significant regional disparities. However, long-term, continental-scale research considering regional differences across the Asia regions is limited. Guided by the ecological model, we examined five ecological risk factors (low life satisfaction/happiness, economic hardship, neighborhood disadvantage, patriarchal values, and religiosity) associated with perceptions of justification of interpersonal violence (i.e., intimate partner violence [IPV] against wife, child physical abuse, and violence against others) in five regions in Asia (i.e., East, West, Central, South, and Southeast). Using the World Values Survey (n = 32,307), a multigroup multiple regression model was used with robust maximum likelihood estimation using Mplus ver. 8. In the entire Asia sample model, perceptions of justifiability of IPV against wife were positively associated with low life satisfaction/happiness; economic hardship; neighborhood disadvantage; and patriarchal values, while they were negatively associated with religiosity. Perceptions of justifiability of child abuse were positively associated with low life satisfaction/happiness; neighborhood disadvantage; and patriarchal values, while they were negatively associated with economic hardship and religiosity. Perceptions of justifiability of violence against others were positively associated with economic hardship and neighborhood disadvantage, while they were negatively associated with religiosity. Each region presented unique risk factor associations. Considering the high rates of interpersonal violence in Asia, understanding the risk factors associated with perceptions of justifying specific types of interpersonal violence can provide an initial insight into preventing violence in Asia. Further, as many Asians dwelling outside Asian regions are still influenced by their culture, religion, language, and norms of the region of origin, the study findings may shed light on future studies to consider in the interpersonal violence literature.

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This review explored how the phenomenon of coerced "self-produced" child sexual exploitation material (CSEM) has been constructed in the literature using Critical Interpretative Synthesis. Selected keywords were systematically searched on relevant databases. Types of papers included were: peer-reviewed research articles; conceptual papers; commentary papers; theses; book chapters; systematic reviews; and government reports. Papers published in English between January 2005 and November 2022 were included. The initial search revealed 1,021 papers, after two reviewers applied the inclusion and exclusion criteria, 38 papers were selected for the final sample. Findings indicated five forms of coerced "self-produced" CSEM: Solicitation; Peer Sexting; Viral Challenge; Sextortion; and Financial Coercion. The forms are described and critically analyzed through an "Accountability Lens." This Lens was developed to be victim-centered including identifying the coercive actions of the person responsible for the exploitation. The review found an absence of a consistent victim-centered approach to how the phenomena of coerced "self-produced" CSEM is understood that would ensure children are not held responsible for being exploited.

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BACKGROUND: Seizures occur frequently in pediatric patients with traumatic brain injury (TBI), particularly abusive head trauma (AHT). There are limited data on the effectiveness of fosphenytoin and levetiracetam to prevent posttraumatic seizures. METHODS: We performed a retrospective single center cohort study of children < 3 years old admitted with mild [Glasgow Coma Scale (GCS) score 13-15], moderate (GCS 9-12), and severe (GCS 3-8) TBI at a level I trauma center from 2011 to 2021. Antiseizure medications were used at the discretion of the treating physicians. Nonparametric tests were used to compare antiseizure medication prophylaxis and TBI etiology. RESULTS: A total of 717 patients (263 with AHT, 454 with accidental TBI) were included, of whom 135 (19%) received fosphenytoin, 152 (21%) received levetiracetam, and 430 (60%) did not receive any seizure prophylaxis. Over the study period, the use of fosphenytoin prophylaxis decreased (R2 = 0.67, p = 0.004), whereas the use of levetiracetam increased (R2 = 0.51, p = 0.008). Additionally, the occurrence of early posttraumatic seizures decreased (R2 = 0.58, p = 0.006). Children with AHT were more likely to receive any seizure prophylaxis than those with accidental TBI (52% vs. 27%; p < 0.001) and were more likely to have ≥ 1 seizure during hospitalization (22% vs. 4%; p < 0.001). Among children who received seizure prophylaxis, those who received fosphenytoin had a higher occurrence of seizures than those who received levetiracetam (33% vs.18%; p = 0.004). After controlling for age, admission year, TBI mechanism, and severity of injury, we observed no differences in seizure occurrence between groups. CONCLUSIONS: In children < 3 years old with TBI, no differences were observed in occurrence of seizures between patients who received fosphenytoin and patients who received levetiracetam prophylaxis after controlling for patient factors including severity of injury. Levetiracetam may be an equally effective alternative to fosphenytoin for seizure prophylaxis for early posttraumatic seizure prevention in this age group.

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INTRODUCTION: Child abuse and neglect (CAN) are social and public health problems. Access to oral health care for abused and neglected children is a challenge. The aim of this study was to assess the attitudes and knowledge of dental students from Bosnia and Herzegovina towards CAN. MATERIALS AND METHODS: A cross-sectional survey was conducted among 263 dental students from two public universities in Bosnia and Herzegovina. The students answered 31 questions about the topic of CAN. The study population was categorised by year of study into six groups. Pearson's chi-squared test was used to analyse differences among participants regarding the year of study. The level of significance was set at p < 0.05. RESULTS: The results show that 10.26% of total participants had experienced some knowledge about the topic of CAN during their studies, 17.87% had read about it in professional dental literature and 8.74% had some form of education and training on the topic. Over 50% of participants answered all of the questions about social indicators of CAN correctly. The knowledge of the study participants was found to be deficient concerning some physical signs of CAN found in the orofacial region. For a significant number of questions 'I don't know' was a frequent answer. CONCLUSION: The level of knowledge of dental students from Bosnia and Herzegovina regarding the challenge of CAN is insufficient. An important strategy this to improve this is to increase the education and training of child abuse and neglect in dental curriculums.

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Introduction: This study investigates the cumulative effects of adverse childhood experiences (ACEs) on adult depression, anxiety, and stress in Abu Dhabi, controlling for demographic factors, lifestyle, and known health and mental health diagnoses. Methods: Utilizing a cross-sectional design and self-report measures, the research aims to fill a critical gap in understanding the specific impacts of ACEs in the UAE. Based on a multi-site, cross-sectional community sample of 697 residents of Abu Dhabi. Results: The findings reveal significant variances in current screening values for depression, anxiety, and stress attributable to ACEs after controlling for demographic factors, lifestyle risk factors, and adult diagnoses of health and mental health conditions. Discussion: The results underline the lifelong impact of ACEs and reinforce the importance of early identification and intervention. In particular, the implications for policy and practice in understanding and mitigating ACEs long-term effects on mental health are considered.

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Introduction of evidence relating to the now-discredited behavioural-science syndrome known as 'child sexual abuse accommodation syndrome' in R v Ellis demonstrates the danger of syndrome reasoning in judicial fact finding. Comparable syndrome evidence is still used in the Family Court in the form of 'parental alienation syndrome'. Ellis should sound the death knell for all forensic applications of unreliable syndrome reasoning in the courts.

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Introduction: With thousands of children abducted and abused each year, efforts are needed to keep children safe from predators. Revved Up Kids (RUK) is an intervention that gives elementary-aged children the necessary tools to recognize and avoid dangerous people and situations. The purposes of this study were to describe the RUK intervention components and document its effectiveness. Methods: This evaluation utilized a quasi-experimental design to determine the effectiveness of RUK. The single-session intervention was offered in two formats: one-hour (n = 119 youth) and three-hour (n = 28 youth) workshops. RUK workshop effectiveness was compared to a comparison group (n = 211 youth) that did not receive an intervention. Data were collected at baseline, immediate-post, and 1-month follow-up from second to fourth grade participants. A series of linear mixed models were fitted. Results: Compared to the comparison group, participants in both RUK workshops showed significant improvements across the three time points. More specifically, participants in the one-hour and three-hour RUK workshops significantly increased their safety knowledge measured by the Recognize Score (p < 0.01), Avoid Score (p < 0.01), and Escape Score (p < 0.01), respectively. Discussion: These effective single-session workshops can be easily introduced into schools and community-based settings to complement existing efforts to prevent child abduction and abuse.

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AIM: To determine the attitudes and responses of Victorian paediatric intensive care doctors to the detection and reporting of child maltreatment. METHODS: A prospective study conducted in a 30-bed paediatric intensive care unit of a university teaching hospital using data collected from a questionnaire completed by paediatric intensive care consultants and registrars. The questionnaire covered the following domains - doctors' knowledge of Victorian mandatory reporting legislation, doctors' history of reporting and doctors' current role in the detection and reporting of child maltreatment. RESULTS: The questionnaire was completed by 37 doctors. All but one doctor considered their role in the detection and reporting of all six forms of maltreatment (physical abuse, sexual abuse, emotional abuse, neglect, exposure to domestic violence and grooming to facilitate later sexual activity with a child) very important or somewhat important. Thirty-two percent of doctors did not feel adequately trained to detect child maltreatment while 51% did not feel adequately trained to report maltreatment. If a doctor wanted to make a report to Child Protection about the physical or sexual abuse of a child, only one would likely make Child Protection their first point of contact. CONCLUSIONS: Paediatric intensive care doctors show a strong intent to detect and report child maltreatment across a broad range of maltreatment types. Doctors are likely to contact one or more members of a child's care team and/or one or more relevant hospital/community services before making a report to Child Protection about the physical or sexual abuse of a child. Opportunities exist for the further education of doctors in regards to the detection and reporting of child maltreatment.

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In cases of alleged child sexual abuse, information about the timing of events is often needed. However, published developmental laboratory research has demonstrated that children struggle to provide accurate and reliable testimony about time and there is currently a lack of field research examining how attorneys actually question child witnesses about time in court. The current study analyzed 130 trial transcripts from cases of alleged child sexual abuse containing a child witness between the ages of 5-17 years old to determine the frequency, style, and content of attorneys' questions and child responses about time. We found that attorneys primarily ask closed-ended temporal location questions (i.e., asking when an event took place using a temporal construct such as day, month, and year) to child witnesses. Additionally, children, of all ages, rarely said "I don't know" or expressed uncertainty in response to temporal questions. These findings are concerning as researchers find that children tend to struggle with temporally locating past events.

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While sexual harm has been studied across a range of contexts, it has not yet been considered within the video game, streaming, and esports community. This study aimed to explore the landscape of sexual harm in this community, specifically, where it has been committed by esports professionals and video game live streamers. Fifty-five victim statements were extracted from online sources (such as Twitter/X and Reddit) and coded into variables relating to offender and victim demographics, offense characteristics, the offense process, and platform(s) used. Descriptive statistics were generated for each variable and Fisher's exact tests were conducted to examine the differences between adult-on-adult and adult-on-child cases. The findings reveal diverse offense outcomes across the sample, ranging from rape to sexual communication with a child. Some offense patterns can be seen in wider sexual offending literature, such as pre-offense alcohol consumption, offending against incapacitated victims (e.g., sleeping), and offending within an established romantic relationship. However, several offense process characteristics unique to the video gaming community were identified. These included offenders using their position of fame within the community to access victims and bypass the need for other coercive behaviors. Online offenses were more common with children and offenders demonstrated a preference for "live" methods, such as voice chat and video calling, rather than instant messaging or sharing images of themselves. This limits the digital evidence left behind and indicates the offenders' greater technological literacy. The study's findings shed light on the sexual harm that exists within this previously unexplored context and highlight areas where esports organizations, live-streaming platforms, and educational providers can do more to safeguard players, fans, and viewers in this community.

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OBJECTIVE: The purpose of this systematic review and meta-analysis is to examine the relationship between childhood maltreatment as a variable of exposure and eating disorders as an outcome. METHODS: PubMed, Web of Science, and Google Scholar were searched to find manuscripts related to the current research. The search was conducted up until October 2023 and limited to the English language. An odds ratio (OR) based on the random effects method was used to combine studies. One subgroup analysis was performed based on the type of eating disorder and another based on the type of childhood maltreatment. RESULTS: Thirty eligible studies were recognized for this research. Childhood maltreatment was associated with a rate of eating disorders of more than double: OR 2.37 with 95% confidence interval (CI) 1.84-3.06 (P < 0.001; I2 = 92.6%). Childhood maltreatment was associated with anorexia nervosa (OR 1.89, 95% CI 1.47-2.42; Z = 5.03; P < 0.001; I2 = 0%), bulimia nervosa (OR 2.64, 95% CI 1.34-5.17; Z = 2.82; P = 0.005; I2 = 93.1%), and binge eating disorder (OR 1.76, 95% CI 1.38-2.26; Z = 4.52; P < 0.001; I2 = 80.2%). CONCLUSION: The findings of this research showed that childhood maltreatment significantly increases the risk of eating disorders. Therefore, in understanding the mechanisms related to eating disorders, it is necessary to pay attention to the issue of the childhood living environment and the traumatic experiences of that time.

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Introduction: Child abuse pediatrics is an underrepresented area of medical education. To date, the available teaching materials about child abuse in MedEdPORTAL do not address burn injury, and the available materials about burn injury do not address child abuse. We created an interactive, case-based module on abusive pediatric burns to fill this educational gap. Methods: The abusive pediatric burns module was presented to a hybrid audience at a 45-minute emergency medicine grand rounds at Mayo Clinic. Participants completed a pre- and postmodule assessment to measure their confidence and knowledge pertaining to abusive pediatric burns. Results: Fifty-six attendees, from an audience primarily composed of emergency medicine physicians but also including some multidisciplinary individuals, participated in the module. The median confidence level in assessing pediatric burns for abuse showed a modest increase from 4 (interquartile range [IQR]: 2-6) to 6 (IQR: 5-8), and the proportion of participants answering knowledge questions correctly increased for every question: 18% versus 45%, 41% versus 100%, 59% versus 84%, and 72% versus 100%. Qualitative feedback from the audience was favorable. Discussion: This interactive, case-based module about abusive pediatric burns was successfully administered to an audience at emergency medicine grand rounds. Increases in confidence and knowledge were observed, and positive qualitative feedback was received.

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INTRODUCTION: Homicide is a leading cause of death for American children. We hypothesized demographics and homicide circumstances would differ by victim age. METHODS: We performed a retrospective analysis of the 2003-2020 National Violent Death Reporting System. The National Violent Death Reporting System collects data from nearly all 50 states, the District of Columbia, and Puerto Rico. Demographics (age, sex, race, and ethnicity), homicide year, and weapon type were abstracted. Inclusion criteria were pediatric victims (age < 18). Two groups: 0-4 y old (young cohort [YC]) and 13-17 y old (teen cohort [TC]) were compared. Chi-squared tests, p-test, and t-tests with significance P < 0.05 were used to determine the association between victim demographics, cohort, and homicide mechanism. RESULTS: 10,569 pediatric (male: 70.2% [n = 7424], median age: 12 y old [interquartile range 1-16], black: 52.7% [n = 5573]) homicides met inclusion. Homicides demonstrated a bimodal age distribution (YC: 40.9% [n = 4320] versus TC: 48.9% [n = 5164]). Gender and race were both associated with homicide victimhood (P < 0.001). TC homicides were more likely to be male (YC: 57.8% [n = 2496] versus TC: 83.7% [n = 4320], P < 0.001) and black (YC: 40.1% [n = 1730] versus TC: 65.0% [n = 3357], P < 0.001). Pediatric homicides increased from 2018 (n = 1049) to 2020 (n = 1597), with only TC demonstrating a significant increase (2018: n = 522 versus 2020: n = 971, P < 0.001). Homicide mechanism was significantly associated with age (Blunt: YC: 57.5% [n = 2484] versus TC: 2.9% [n = 148], P < 0.001; Penetrating: YC: 7.9% [n = 340] versus TC: 92.8% [n = 4794], P < 0.001). CONCLUSIONS: Pediatric homicides demonstrate distinct demographic characteristics and homicide mechanisms between two at risk age cohorts. Age-based education and intervention strategies may increase injury prevention programs' efficacy.

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BACKGROUND: Domestic, family and sexual violence is a prevalent health and social issue. Nurses may be exposed to higher rates of this violence in their personal lives compared to the community, but little is known about their polyvictimisation experiences or health and well-being impacts. METHODS: An online descriptive, cross-sectional survey of women nurses, midwives and carer members of the Australian Nursing and Midwifery Federation (ANMF) (Victorian Branch) (response rate: 15.2% of nurses sent an invitation email/28.4% opened the email). Violence survey measures included: intimate partner violence (Composite Abuse Scale); child abuse and sexual violence (Australian Bureau of Statistics Personal Safety Survey items). Health measures included: Short Form-12; Fast Alcohol Screening Test; Patient Health Questionnaire-4; Short Screening for DSM-IV Posttraumatic Stress Disorder; well-being measures included: Connor-Davidson Resilience Scale, social support, and financial stress. Proportions were used to describe the prevalence of violence by sociodemographic characteristics and health and well-being issues; logistic regression predicted the odds of experiencing overlapping types of violence and of experiencing health and well-being outcomes. RESULTS: 5,982 participants (from a parent study of 10,674 nurses, midwives and carers) had experienced at least one type of lifetime violence; half (50.1%) had experienced two or three types (polyvictimisation). Survivors of child abuse were three times more likely to experience both intimate partner violence and non-partner adult sexual assault. Any violence was associated with poorer health and well-being, and the proportion of affected participants increased as the types of violence they had experienced increased. Violence in the last 12-months was associated with the poorest health and well-being. CONCLUSIONS: Findings suggest a cumulative, temporal and injurious life course effect of domestic, family and sexual violence. The polyvictimisation experiences and health and well-being associations reported by survivor nurses, midwives and carers underscores the need for more accessible and effective workplace interventions to prevent and mitigate psychosocial ill health, especially in the recent aftermath of violence.

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Contact burns in children are not uncommon and are often due to accidental contact. Medico-legal assessment is of paramount importance in these contexts to identify cases of abuse. In three cases of burns caused by contact with radiators or a portable heater -two accidental and one deliberate- thorough medico-legal assessment, combined with on-site event reconstruction, enabled accurate diagnoses. Accidental burns displayed a 'pattern' compatible with the incandescent instrument but were more irregular, with different depths and in different parts of the body. In contrast, intentional burns were uniform in depth, distribution and localisation, inconsistent with accidental events. In this context, the on-site inspection and direct evaluation of the objects involved were crucial in the medico-legal assessment. These are indispensable elements for a thorough analysis and abuse recognition.

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Child maltreatment (CM) poses significant risks to victims, resulting in enduring physical, psychological, and developmental consequences. Adult survivors of CM seem especially vulnerable to perinatal complications. However, existing research on perinatal outcomes presents mixed results and relies heavily on self-reported data, which may not align with official medical data. Hence, a systematic review using official health data may provide clarity on this association; it may orient future research and the provision of perinatal services. This scoping review aimed to synthesize and evaluate the quality of the literature that utilizes official health data to explore associations between CM and perinatal complications. Following Arksey and O'Malley's model, searches across four databases (PsycINFO, MEDLINE, Scopus, and ProQuest Dissertations/Thesis) produced 8,870 articles. After screening, 23 articles met the inclusion criteria (e.g., recorded perinatal complications using official health data, and peer-reviewed studies or dissertation). Evidence indicates CM survivors have less prenatal care visits, more fetal loss and preterm births, lower gestational age, and increases in emergency cesarean sections. Adults had more cervical insufficiency, lower episiotomies and sphincter ruptures, and overall pregnancy and postpartum complications while adolescents had lower Apgar scores. No associations were observed on other outcomes (e.g., vaginal bleeding, group B streptococcus, and fetal distress). Mixed findings emerged for other perinatal and maternal health concerns such as birth weight and blood pressure. CM survivors may face an increased risk of experiencing perinatal complications. Findings point to the relevance of leveraging health data for CM research and adopting trauma-informed practices in perinatal services.