Public perception of individuals who commit Child Sexual Abuse Material offences: Exploring the impact of demographic variables and cross-national differences.

BACKGROUND: Lay perceptions of persons who download and distribute Child Sexual Abuse Material (CSAM) is an underexplored subject. There is a need for understanding the factors that influence perceptions as the public perceptions have implications for endorsement of sex offender rehabilitation that in turn can influence the availability of treatment programs and stigma for help-seeking. OBJECTIVE: To explore public perceptions of individuals that commit child sexual abuse offences, to compare the results to those obtained in a large US sample, and to explore associations between demographic variables, general perceptions and endorsement of imprisonment and treatment for individuals that commit CSAM offences. PARTICIPANTS AND SETTING: An online survey were distributed in Norway in February 2023. 618 individuals responded, 76 % were female, mean age 34.99 (SD = 14.23), the majority (>70 %) had higher education, and 44 % had children. RESULTS: Consistent with prior research, the public perceptions overestimated the risk of future contact offences and recidivism. Women overestimated the percentage of risk of contact offences and pedophilic interest more than men. The overestimation was significantly less in this sample compared to the US sample (d = 0.39-0.96). Those working with online child abuse had perceptions of persons committing CSAM offences that were more aligned with empirical findings. Demographic variables were only marginally associated with endorsement for treatment and imprisonment, except for having children, which was associated with endorsement of imprisonment. Perceived risk of contact offences, pedophilic preference, and assumed childhood sexual victimization were associated with perceptions of individuals committing CSAM offences as different than those committing physical sexual abuse and both endorsement of treatment and imprisonment. CONCLUSIONS: The perceptions of those who commit CSAM offences showed a stronger association with endorsement for treatment and imprisonment than demographic variables.

Sensory Processing Assessment and Feedback in the Treatment of Complex Developmental Trauma.

This study explored the impact of a sensory processing assessment, recommendations and feedback process on the functioning at school and after-hours environments of children who had been traumatised by abuse. A mixed methods design (Schoonenboom & Johnson, 2017) was utilized incorporating pre (12 months prior) and post (four to eight months after the report) repeated child focused measure, alongside thematic analysis of participants qualitative survey feedback. The methodology included two stages: firstly, an occupational therapy assessment of young people referred by Own Organisation clinicians for a sensory processing assessment and secondly, an evaluation was conducted of the impact of occupational therapy on the young person's behaviour and their carers. The study found significant improvement in family life and relationships as well as a reduction in impairment as evidenced by decreases in HoNOSCA scores across problems with family life and relationships, non-accidental self-injury, problems with emotional and related symptoms, poor school attendance and on the social subscale. These findings were supported by clinician participant reports. A sensory processing assessment provided young people, their carers and teachers with information which contributed to environmental adaptations. These environmental adaptations were associated with improved functioning and behaviour of young people impacted by child abuse. It is recommended future research attempt to replicate and extend our understanding of how sensory processing assessments and interventions can increase children's wellbeing. Supplementary Information: The online version contains supplementary material available at 10.1007/s40653-023-00607-0.

The Risk for Readmission to Juvenile Detention: The Role of Trauma Exposure and Trauma-related Mental Health Disorders.

The purpose of this study was to examine the impact of childhood trauma exposure, posttraumatic stress disorder, and trauma-related comorbid diagnoses on the risk for readmission to juvenile detention among youth in a large metropolitan area (N = 1282). The following research questions were addressed: 1) Does a greater number of childhood traumas increase the risk for readmission to detention following release? 2) Does the risk for readmission differ by type of trauma? 3) Do PTSD and other co-morbid diagnoses increase the risk for readmission? and 4) What role do demographic factors play in the relationship between trauma-related variables and risk for readmission? This study utilized the screening results of 1282 youth who were voluntarily screened for PTSD, depressive symptoms and substance use during their initial intake to detention. More than half of the sample was readmitted during the three-year study period, with readmissions most likely to occur within one year of release. Returning to detention within one year was also associated with increased risk for multiple readmissions. Youth readmitted to detention were more likely to have a history of sexual abuse and problematic substance use. No other significant relationships were found between risk for readmission and trauma-related variables. Although trauma-related symptoms may be crucial targets for treatment, focusing solely on trauma exposure and traumatic stress symptoms without considering the impact of other risk factors may not be enough to decrease the likelihood of readmission for youth of color in a large urban environment.

Systematic Review and Meta-Analysis of Policies and Interventions that Improve Health, Psychosocial, and Economic Outcomes for Young People Leaving the Out-of-Home Care System.

Young people who transition to adulthood from out-of-home care (OOHC) are more likely to experience a range of poorer outcomes relative to their same-age peers in the community. This systematic review assessed the effectiveness of policies or interventions (hereafter "interventions") aimed at improving housing, health, education, economic, and psychosocial outcomes for youth leaving OOHC (hereafter "care leavers"). Eleven databases of published literature were reviewed along with gray literature. Eligible studies used randomized or quasi-experimental designs and assessed interventions that provided support to care leavers prior to, during, or after they left OOHC. Primary outcomes were housing and homelessness, health and well-being, education, economic and employment, criminal and delinquent behavior, and risky behavior, while secondary outcomes were supportive relationships and life skills. Where possible, results were pooled in a meta-analysis. Certainty of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation. Fourteen studies published in 27 reports were identified that examined independent living programs (ILPs) (n = 5), intensive support services (n = 2), coaching and peer support (C&PSP) (n = 2), transitional housing (n = 1), health information or coaching (n = 2), and extended care (n = 2). All but one study was conducted in the United States. Twenty small meta-analyses were undertaken encompassing ILPs and C&PSP, with two showing results that favored the intervention with certainty. The level of confidence in each meta-analysis was considered very low. A significant risk of bias was identified in each of the included studies. While some interventions showed promise, particularly extended care, the scope and strength of included evidence is insufficient to recommend any included approach.

Atypical localized Mongolian spots in dark pigmented skin - a challenge for forensic medical examination.

The assessment of skin changes in the context of possible child abuse is an important task in forensic medicine. This requires knowledge of pigmentation variants and pigmentation disorders such as congenital dermal melanocytosis, which includes Mongolian spots. Particularly in the case of atypical localization and dark pigmented skin, the differentiation from hematomas can be challenging. A case of two Nigerian siblings with extensive and atypically localized Mongolian spots is reported. The 1.5-year-old girl showed Mongolian spots on her back and the right side of her trunk. The 8-year-old boy showed Mongolian spots only on the back of his thighs. The authors are not aware of any case in which so called Mongolian spots were present exclusively on the back of the thighs and this case is all the more noteworthy as the back of the thigh is a common localization of blunt force trauma.

Prevalence of childhood trauma in patients with psychiatric disorders and its association with perceived social support and suicide attempts: A cross-sectional observational study in a tertiary hospital in South India.

Background: Adverse childhood experiences include exposure of children to physical abuse, physical neglect, emotional neglect, emotional abuse, and sexual abuse. Children exposed to severe maltreatment and trauma during their early childhood are at a higher risk of early onset of psychiatric disorders. Aim: To find the prevalence of childhood adverse experiences in psychiatric patients and its association with perceived social support and suicidal attempts. Materials and Methods: A cross-sectional observational study was conducted in the psychiatry outpatient department at a tertiary care hospital in Kerala. Patients with a diagnosis of substance use disorders, psychotic disorders, mood disorders, and neurotic disorders according to ICD-10 (F10-F45) and in remission were included in the study. Institutional Ethical Committee approval and informed consent from the participants were obtained. Socio-demographic and clinical details were obtained. Childhood Trauma Questionnaire-Short Form and Multidimensional scale of Perceived Social Support were administered. Descriptive statistics and Chi-square test were employed for data analysis. Results: Eighty-five per cent of the subjects had a history of at least one type of childhood trauma. Emotional abuse was the most commonly reported type of trauma. Among patients with childhood trauma, 47.2% reported high levels of perceived social support, whereas 18.5% individuals reported a history of at least one suicide attempt. Conclusions: A significant proportion of patients with psychiatric disorders in an Indian setting have experienced childhood trauma. Childhood trauma in psychiatric disorders is associated with a higher risk of attempting suicide.

Screening for Child Abuse in the Emergency Department of Academic Hospital Paramaribo in Suriname.

Background. Child abuse in Suriname has a prevalence between 58.2% and 68.8%. This prospective observational study evaluates the implementation of screening for child abuse at the Emergency Department (ED) of the Academic Hospital Paramaribo (AZP). Methods. Children (0-16 years) presenting with injury from 01-02-2018 until 31-08-2018 were eligible. Case-record-forms were completed. Multidisciplinary meetings were used to evaluate positive screened and admitted patients. Diagnostic accuracy was calculated and results were compared to retrospective data from 2016. Results. 3253 Children attended the ED. In 1190 (36.6%) children, the screening was completed. The screening was positive in 148 (12%); in 71 (6%) cases child abuse was confirmed. The sensitivity and specificity were 0.88 and 0.92 respectively, PPV 0.43, NPV 0.99. There was a significant increase of detected child abuse cases; 4.4% in 2016 versus 6% in 2018 (P = .04). Conclusion. Implementation of screening at the ED in the AZP increased detection of child abuse. To improve screening's accuracy, more education for healthcare professionals is pivotal.

Systematic review of the impacts of US Social Safety Nets on child maltreatment.

INTRODUCTION: Children living in poverty are at an increased risk for maltreatment. Social safety net (SSN) programs with anti-poverty objectives may reduce child maltreatment through pathways such as reduced food insecurity, lessened caregiver stress, and improved caregiving behaviors and ability to meet children's basic needs. The objective of this study is to conduct a systematic review of evidence on the ability of SSN programs to reduce child maltreatment in the United States (US). METHODS: This systematic review was conducted using PRISMA protocol. Among studies published between 1996-2022, the initial search returned 1,873 articles, and 27 papers were included in the final analysis. Abstracts were identified primarily on June 24th, 2022, and extraction and synthesis of data was conducted in 2022-2023. RESULTS: Of the 27 papers assessed, 16 studies found that SSN programs were protective against child maltreatment. Three of the reviewed studies found no effect of safety net programs, four studies presented mixed findings, and four studies found adverse impacts in terms of child maltreatment outcomes. When restricting to high-quality studies only, 10 out of 12 found protective impacts and none found adverse impacts on child maltreatment. DISCUSSION: SSNs are associated with protective effects against child maltreatment. Expansion of SSN programs would likely have positive benefits beyond poverty-related objectives, including reducing incidence of child maltreatment.

The effectiveness of parenting interventions in reducing violence against children in humanitarian settings in low- and middle-income countries: A systematic review and meta-analysis.

BACKGROUND: Violence against children is a global phenomenon, yet children living in humanitarian settings are at elevated risk of experiencing violent parenting. Parenting interventions are a recommended prevention strategy. OBJECTIVE: To conduct a systematic review and meta-analysis on the effectiveness of parenting interventions in preventing violence against children and related parent and child outcomes. PARTICIPANTS AND SETTING: Primary caregivers in humanitarian settings in low- and middle-income countries (LMICs). METHODS: A highly sensitive multi-language systematic search in electronic and grey-literature database. Studies were appraised for risk of bias, summary effects by certainty of effect, and effect estimates pooled using robust variance estimation. RESULTS: Twenty-three randomized trials were meta-analyzed finding a small effect on physical and psychological violence (n = 14, k = 21, d = -0.36, 95 % CI [-0.69, -0.04]), positive parenting (n = 16, k = 43, d = 0.48, 95 % CI [0.29, 0.67]), negative parenting (n = 17, k = 37, d = -0.42, 95 % CI [-0.67, -0.16]), parental poor mental health (n = 9, k = 15, d = -0.34, 95 % CI [-0.66, -0.02]), and internalizing behaviors (n = 11, k = 29, d = -0.38, 95 % CI [-0.70, -0.05]); a non-significant effect on externalizing child behaviors (n = 9, k = 17, d = -0.12, 95 % CI [-0.50, 0.27]). Too few studies reported intimate partner violence, sexual violence, and parenting stress outcomes. CONCLUSIONS: Our findings suggest that parenting interventions in humanitarian settings in LMICs may be an effective strategy to reduce physical and psychological violence, and numerous related parent and child outcomes. However, findings need to be interpreted in light of the limited number of available studies and imprecise statistical significance for selected outcomes.

Agreement between retrospective and prospective assessments of childhood abuse revisited.

A recent meta-analytic review demonstrated that retrospective assessments of childhood abuse acquired during adulthood - typically via self-report - demonstrate weak agreement with assessments of maltreatment gathered prospectively. The current report builds on prior findings by investigating the agreement of prospectively documented abuse from birth to age 17.5 years in the Minnesota Longitudinal Study of Risk and Adaptation with retrospective, Adult Attachment Interview-based assessments of childhood abuse administered at ages 19 and 26 years. In this sample, an agreement between prospective and retrospective assessments of childhood abuse was considerably stronger (κ = .56) than was observed meta-analytically. Retrospective assessments identified prospectively documented sexual abuse somewhat better than physical abuse, and the retrospective approach taken here was more sensitive to identifying abuse perpetrated by primary caregivers compared to non-caregivers based on prospective records.

Knowledge, Awareness, and Attitude of Physicians Toward Child Abuse: A Cross-Sectional Study.

INTRODUCTION: Child abuse refers to any type of mistreatment of a child, perpetrated by a parent, caregiver, or another individual in a custodial capacity, which may lead to instances of physical, sexual, or emotional abuse. Physicians play a crucial role in identifying and managing this phenomenon in the healthcare setting, as the number of unreported cases increases globally. METHODS: A questionnaire-based cross-sectional study was conducted between 2022 and 2023 among physicians practicing in Saudi Arabia to assess their knowledge, awareness, and attitude toward child abuse. The data were analyzed using IBM SPSS Statistics for Windows, Version 26 (Released 2019; IBM Corp., Armonk, New York, United States). RESULTS: A total of 153 physicians were involved in this study, in which 65 participants (42.5%) indicated poor awareness of child abuse, while 79 participants (51.6%) indicated moderate knowledge of child abuse. Additionally, lack of knowledge was the most common barrier to reporting child abuse in 87 participants (56.9%). A positive significant correlation was identified between awareness and knowledge and between knowledge and attitude. Also, it was found that a higher attitude score was more associated with being male, having less experience, practicing in the emergency medicine department, and working in a governmental hospital. CONCLUSION: These results highlight the significance of implementing specialized training programs and workshops focused on identifying and reporting child abuse, as well as providing guidelines for recognizing signs of abuse and taking appropriate intervention measures.

The mediating role of nurses' attitude towards reporting child abuse and neglect.

PURPOSE: Attitudes towards reporting child abuse and neglect play a significant role in determining the tendency to report abuse and neglect. In addition, Cognitive Response Theory (Shen, 2020) suggests that individuals actively process messages by producing pro and/or counter arguments referred to as "Gain - loss thoughts". However, literature positioning the variable, attitudes towards reporting, as a mediator, as well as its importance, are limited. The purpose of the study was to investigate the mediating effect of pediatric nurses' attitudes between "gain-loss thoughts" and the tendency to report child abuse and neglect. DESIGN AND METHODS: A cross-sectional study examined 124 pediatric nurses working in central Israel's hospital departments concerning nurses' tendency to report (tendency to report = TTR), attitudes towards reporting, and "gain-loss thoughts" (positive and negative consequences for the child). RESULTS: Most of the nurses had professional experience of 11 years or more (n = 75; 62.5%). According to the findings, nurses' attitudes towards reporting mediate the effect of gain-loss on the TTR child abuse and neglect. CONCLUSIONS: Findings from this study contributed to our understanding of the importance of pediatric nurses' attitudes in determining the TTR abuse and neglect. Only nurses' positive attitudes towards reporting child abuse had a mediating effect on TTR. PRACTICE IMPLICATIONS: Understanding the importance of attitudes and gain-loss thoughts can serve as a strategy for training programs and in the assimilation of reporting obligations by health professionals in general and nurses in particular.

Coping strategies and psychological resilience of parents with children victimized of sexual abuse: A cross-sectional descriptive study.

AIM: The aim of this study is to assess the coping strategies and psychological resilience of parents of children who are victims of sexual abuse. METHODS: The study's sample was compiled from parents of sexually abused children admitted to the Child Advocacy Centre for forensic interviews in a Northern Turkish province (N = 75). Data were collected from May to September 2022. A cross-sectional design was used to assess psychological resilience and coping skills. The Introductory Information Questionnaire, the Strategies for Coping with Family Stressors Scale, and the Psychological Resilience Scale for Adults were administered verbally during individual interviews. The study was approved by the institutional ethics committee. RESULTS: According to the results, the psychological resilience and coping skills of parents played a significant role, particularly concerning touch-based abuse, a single occurrence of abuse, and the absence of family violence. Moreover, there was a positive correlation between coping skills with stressors and psychological resilience (p < 0.05). CONCLUSION: In conclusion, empowering parents of children exposed to abuse proves crucial for reducing the traumatic impact on the victimized child. Further research, identifying risk factors for both the child and the family, and strategizing follow-up, educational, and counseling initiatives can enhance the provision of holistic health services in this context. IMPLICATIONS TO PRACTICE: This study emphasizes the need to restructure issues of not only trauma in children who are victims of sexual abuse but also coping skills and psychological resilience in parents within nursing approaches aimed at children who are victims of sexual abuse.

Characteristics of children aged 5 and under presenting with ingestion: An analysis of cases from a tertiary child protection unit.

AIM: This study aimed to determine what proportion of children presenting to a tertiary children's hospital with ingestion were referred for child protection assessment, and to describe the characteristics of the referred group. METHODS: This is a retrospective case series study of children who presented to a tertiary children's hospital between 1 January 2016 and 31 December 2020 with ingestion (poisoning). Demographic and clinical data were collected from the electronic medical record and patients who underwent child protection assessment were identified. The child protection group was compared to the whole cohort. The child protection group had psychosocial data gathered and descriptively analysed. RESULTS: Two hundred and three patients were included. The most common substances ingested were over-the-counter medications (45%) followed by prescription medications (41%). Most patients were discharged from the emergency department (70%). Of the 203 patients, 24 (11.8%, 95% CI 7.72-17.08) were referred to the child protection unit. A significant proportion of these patients had a history of parental depression (64%) and other mental health conditions (41%), parent separation (77%) and domestic violence in the home (64%). CONCLUSION: The patients assessed by the child protection team had high prevalence of psychosocial risk factors that also place the patients at risk of child abuse and neglect. Most of the other patients did not have a psychosocial history documented in the medical record, and this group likely contains a high proportion of vulnerable children. By screening patients presenting with ingestion we may be able to identify children at risk and provide opportunities for protective intervention.

Violence outcomes in later adolescence with the Good School Toolkit-Primary: a nonrandomized controlled trial in Uganda.

BACKGROUND: We sought to determine whether the Good School Toolkit-Primary violence prevention intervention was associated with reduced victimisation and perpetration of peer and intimate partner violence four years later, and if any associations were moderated by sex and early adolescent: family connectedness, socio-economic status, and experience of violence outside of school. METHODS: Drawing on schools involved in a randomised controlled trial of the intervention, we used a quasi-experimental design to compare violence outcomes between those who received the intervention during our trial (n = 1388), and those who did not receive the intervention during or after the trial (n = 522). Data were collected in 2014 (mean age 13.4, SD 1.5 years) from participants in 42 schools in Luwero District, Uganda, and 2018/19 from the same participants both in and out of school (mean age 18, SD: 1.77 years). We compared children who received the Good School Toolkit-Primary, a whole school violence prevention intervention, during a randomised controlled trial, to those who did not receive the intervention during or after the trial. Outcomes were measured using items adapted from the International Society for the Prevention of Child Abuse and Neglect Child Abuse Screening Tool-Child Institutional. We used mixed-effect multivariable logistic regression, with school fitted as a random-effect to account for clustering. RESULTS: 1910 adolescents aged about 16-19 years old were included in our analysis. We found no evidence of an average long-term intervention effect on our primary outcome, peer violence victimization at follow-up (aOR = 0.81, 95%CI = 0.59-1.11); or for any secondary outcome. However, exposure to the intervention was associated with: later reductions in peer violence, for adolescents with high family connectedness (aOR = 0.70, 95% CI 0.49 to 0.99), but not for those with low family connectedness (aOR = 1.07, 95% CI 0.69 to 1.6; p-interaction = 0.06); and reduced later intimate partner violence perpetration among males with high socio-economic status (aOR = 0.32, 95%CI 0.11 to 0.90), but not low socio-economic status (aOR = 1.01 95%CI 0.37 to 2.76, p-interaction = 0.05). CONCLUSIONS: Young adolescents in connected families and with higher socio-economic status may be better equipped to transfer violence prevention skills from primary school to new relationships as they get older. TRIAL REGISTRATION: Clinicaltrials.gov, NCT01678846, registration date 24 August 2012. Protocol for this paper:  https://www.researchprotocols.org/2020/12/e20940 .

Female genital mutilation and cutting: a survey of child abuse pediatricians.

BACKGROUND: As global immigration from countries with a high prevalence of female genital mutilation and cutting (FGM/C) has grown in the United States (US), there is need for pediatricians to have adequate training to care for these patients. The objective of this study is to determine the level of knowledge and attitudes of child abuse pediatricians (CAPs) towards FGM/C in the US. METHODS: This cross-sectional study distributed a peer-reviewed survey to US CAPs-members of the Helfer Society-to assess their attitudes, knowledge, clinical practice, and education about FGM/C. Data was analyzed using descriptive statistics, Kruskal-Wallis tests, and Fisher's exact test. RESULTS: Most of the 65 respondents were aware that FGM/C is illegal (92%) and agreed that it violated human rights (99%). Individuals reporting previous training related to FGM/C were significantly more likely to correctly identify World Health Organization types of FGM/C (p < 0.05) and report confidence in doing so (p < 0.05). Only 21% of respondents felt comfortable discussing FGM/C with parents from countries with a high prevalence of FGM/C. Sixty-three percent were not aware of the federal law, and 74% were not aware of their own state's laws about FGM/C. CONCLUSIONS: US CAPs have high rates of training related to FGM/C; however, they need additional training to increase confidence and ability to identify FGM/C. FGM/C remains a topic that CAPs find difficult to discuss with families. With culturally sensitive training, CAPs have the opportunity to help manage and prevent the practice by serving as educators and experts for general pediatricians.

More Than What You Eat: A Review on the Association Between Childhood Maltreatment and Elevated Adult BMI.

PURPOSE OF REVIEW: Obesity is an overwhelmingly common medical entity seen in the adult population. A growing body of research demonstrates that there is a significant relationship between child maltreatment and adult obesity. RECENT FINDINGS: Emerging research demonstrates a potential dose-response relationship between various types of child abuse and adulthood BMI. Recent work also explores the potential role of the hypothalamic-pituitary-adrenal (HPA) axis, and other hormonal mediators such as sex-hormone binding globulin and leptin. There are also studies that suggest factors such as depression and socioeconomic and environmental influences mediate this relationship. Comorbidities that have been reported include cardiovascular and metabolic disease, diabetes, and insulin resistance. Preliminary work also demonstrates potential gender and racial disparities in the effect of abuse on adulthood obesity. In this narrative review, we summarize the existing work describing the different child maltreatment types (physical, sexual, emotional, verbal, and child neglect) and their relation to adult obesity, what is known about a potential dose-response relationship, potential mediators and pathophysiology, comorbidities, and preliminary work on gender and racial/ethnic disparities. We review the limited data on interventions that have been studied, and close with a discussion of implications and suggestions for clinicians who treat adult obesity, as well as potential future research directions.

Hair-Thread Tourniquet Syndrome: A Comprehensive Review.

Hair-thread tourniquet syndrome (HTTS) is an uncommon but preventable disorder in which a body appendage becomes constricted after becoming firmly wrapped by a hair or substance that resembles hair. The genitalia, fingers, and toes are typically affected. Prompt diagnosis and treatment by complete removal of the constricting agent are crucial for the preservation of the affected appendage. This narrative review article revisits HTTS in the context of the recent literature with the aim of raising healthcare professionals' awareness of this surgical emergency so that the condition can be prevented, correctly diagnosed, and treated early.

Emergency Department Presentations for Injuries Following Agency-Notified Child Maltreatment: Results From the Childhood Adversity and Lifetime Morbidity (CALM) Study.

Child maltreatment (CM) is associated with negative health outcomes in adulthood, including deliberate self-harm (DSH), suicidal behaviours, and victimisation. It is unknown if associations extend to emergency department (ED) presentations for non-DSH related injuries. Birth cohort study data was linked to administrative health data, including ED presentations for non DSH related injuries and agency-reported and substantiated notifications for CM. Adjusted analyses (n = 6087) showed that any type of agency-reported notification for CM was significantly associated with increased odds of ED presentation for injuries (aOR = 1.57; 95% CI 1.32-1.87). In moderation analyses, women yielded significantly higher odds of notified and substantiated physical abuse, substantiated emotional abuse, and being subject to more than one type of substantiated abuse than males. ED presentations for injuries could be a proxy for risky behaviours, disguised DSH/suicidal behaviours, or physical abuse. The consistent findings in women may point to victimisation via interpersonal violence.

Pediatric Hospital Admissions with Concern for Neglect: Correlations Between Neglect Types and Other Clinical and Environmental Risk Factors.

OBJECTIVE: Child neglect is a public health concern with negative consequences that impact children, families, and society. While neglect is involved with many pediatric hospitalizations, few studies explore characteristics associated with neglect types, social needs, and post-discharge care. METHODS: Data on neglect type, sociodemographics, social needs, inpatient consultations, and post-discharge care were collected from the electronic medical record for children aged 0-5 years who were hospitalized with concern for neglect during 2016-2020. Frequencies and percentages were calculated to determine sample characteristics. The Chi-square Test for Independence was used to evaluate associations between neglect type and other variables. RESULTS: The most common neglect types were inadequate nutrition (40%), inability to provide basic care (37%), intrauterine substance exposure (25%), combined types (23%), and inadequate medical care (10%). Common characteristics among neglect types included age less than 1 year, male sex, Hispanic ethnicity, public insurance, past involvement with Child Protective Services, and inpatient consultation services (social work, physical therapy, and occupational therapy), and post-discharge recommendations (primary care, physical therapy, and regional center). Neglect type groups varied by child medical history, social needs, and discharge recommendations. Statistically significant associations supported differences per neglect type. CONCLUSIONS: Our findings highlight five specific types of neglect seen in an impoverished and ethnically diverse geographic region. Post-discharge care needs should focus on removing social barriers and optimizing resources, in particular mental health, to mitigate the risk of continued neglect. Future studies should focus on prevention strategies, tailored interventions, and improved resource allocations per neglect type and discharge location.