暂无摘要。

In all 50 states, the District of Columbia, and the Commonwealth of Puerto Rico, pediatricians, dental professionals, and other physicians are mandated to report suspected cases of abuse and neglect to social service or law enforcement agencies. The purpose of this clinical report is to review the oral aspects of abuse and dental neglect in children and the role of pediatricians, dental professionals, and other physicians in evaluating such conditions. This clinical report addresses recommendations on the evaluation of bite marks, as well as perioral and intraoral injuries, infections, and diseases that may raise suspicion for child abuse or neglect. Some physicians may have received less education pertaining to oral health, dental injury, and oral disease. These physicians may not detect the mouth and gum findings possibly related to abuse or neglect as readily as abuse injuries involving other areas of the body. Therefore, pediatricians, dental professionals, and other physicians are encouraged to collaborate to increase the prevention, detection, and treatment of these conditions in children.

BACKGROUND: As rates of substance use during pregnancy persist, the health and optimal development of infants with prenatal substance exposure remain a key priority. Nurses are tasked with identifying and reporting suspected cases of child maltreatment, including abuse and neglect, which is often assumed to be synonymous with substance use during pregnancy. While policies aimed at protecting infants from child abuse and neglect are well intentioned, literature regarding the short- and long-term social and legal implications of mandatory reporting policies is emerging.
OBJECTIVE: In this article, we explore the intersections between the condition of substance use in pregnancy and policies related to mandatory reporting.
METHODS: We provide an overview of historical and current trends in mandatory reporting policies for nurses related to substance use in pregnancy and related ethical and social implications for mother-infant dyads.
RESULTS: Nurses often function at the intersection of healthcare and social services, underscoring the important role they play in advocating for ethical and equitable care for both members of the mother-infant dyad affected by substance use.
CONCLUSIONS: We offer recommendations for practice including the integration of respectful care and family-centered support for the mother-infant dyad affected by substance use. Cross-sectoral collaborations, inclusive of the family, are important to the advancement of evidence-based and equity-focused research, advocacy, and policy initiatives to support familial preservation and reduce mother-infant separation.

BACKGROUND: Tuberculosis (TB) burden and the underreporting of TB remain major health challenges in Indonesia. Interest in the internet is growing extensively, and the introduction of the TB mandatory electronic notification system in 2017 engaged the public\'s interest to leverage digital traces regarding TB information in Indonesia.
OBJECTIVE: To quantify the correlation between Google Trends data and Indonesian TB surveillance data before and after the implementation of a mandatory TB notification system.
METHODS: Google Trends searches on TB information were used. We used two sets of time series data, including before and after the launch of the TB notification system. Pearson\'s correlation was used to measure the correlation between TB search terms and official TB reports.
RESULTS: The moving average graph showed a linear pattern of TB information with TB reports after 2017. Pearson\'s correlation estimated a high correlation for TB definition, TB symptoms, and official TB reports with an R-value range of 0.97 to -1.00 (p ≤ 0.05) and showed an increasing trend in TB information searching after 2016.
CONCLUSIONS: Google Trends data can depict public interest in the TB epidemic. Validation of information-searching behavior is required to advocate the implementation of Google Trends for TB digital surveillance in Indonesia.

OBJECTIVE: 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.

BACKGROUND: Disclosing ongoing child sexual abuse (CSA) to a mandated reporter should facilitate youth safety. Unfortunately, youth may continue to experience abuse after disclosure, although little research has examined this phenomenon.
OBJECTIVE: We aimed to understand when and why the child protection process fails after youth disclose to a mandated reporter.
METHODS: Hotline support specialists completed an online survey about 124 anonymous hotline chats with youth whose abuse continued after a prior disclosure to a mandated reporter.
METHODS: We thematically analyzed support specialists\' open-ended descriptions of information disclosed by the victim in their chat.
RESULTS: In most cases (71 %), the abuse was seemingly not reported or not investigated. Mandated reporters\' belief of the victim and minimization of abuse affected reporting decisions. Some mandated reporters tried to address the abuse directly with the perpetrators, endangering victims. Rarely, mandated reporters did not report to respect the victim\'s wishes. In 24 % of cases, the victim described an investigation that did not result in protection. Victims indicated that investigators \"sided to the perpetrator\" or said there was not enough evidence. Some victims recanted, often in fear. In 6 % of cases, formal actions were taken but did not provide long-term protection. Victims described temporary cessation of abuse that resumed because their guardian(s) allowed the perpetrator to access them.
CONCLUSIONS: Disclosing to a mandated reporter can engender traumatic experiences without resulting in long-term safety. Professionals need additional training to increase their knowledge of CSA and respond in ways that prioritize physical and emotional safety.

This select overview examines the important intersection of adult domestic violence, including intimate partner violence and elder abuse, with brain injury. Despite the high prevalence of domestic violence amongst brain injury patients, there is a notable gap in screening and management training for providers. To provide optimal patient care, brain injury medicine clinicians must screen, recognize, and treat patients who have experienced domestic violence. This select overview highlights barriers to screening, validated screening tools from other medical disciplines, and management considerations for the brain injury clinician. A suggested protocol for domestic violence screening and management, as well as recommended resources for providers and patients, is summarized.

BACKGROUND: In the U.S., the opioid epidemic has revitalized national attention to newborns with prenatal substance exposure (PSE). These newborns and their caregivers have specific health and treatment needs and frequently interact with multiple systems, including child protection systems (CPS).
METHODS: This study calculated rates of newborns (less than 15 days old) reported to CPS per 1,000 births due to PSE by state and year using data from the National Child Abuse and Neglect Data System (NCANDS). Given the lack of a clear definition of PSE reports in the data, we calculated rates using three different definitions. To examine the relationship between different state laws regarding the mandated reporting of PSE and PSE reports rates, we used panel data analysis.
RESULTS: Rates of newborn reports more than doubled between 2011 and 2019. There was extensive state variability of rates including some states that were consistently more than 100 % greater than and others consistently more than 150 % less than the annual national mean. Reporting rates were not associated with state requirements to report PSE, but were positively associated with rates of diagnosed neonatal abstinence syndrome.
CONCLUSIONS: State-level inconsistencies in identification, reporting, and CPS responses prevent a clear understanding of the scope of the affected population and service needs.

暂无摘要。

Medical confidentiality is the cornerstone for a trustful relationship between patients and the health professionals attending to them. However, when history or clinical findings suggest certain offenses, statutory laws (Children\'s Act, Older Persons Act, Mental Health Care Act, Sexual Offenses Act) establish a legal obligation for health professionals to report suspected instances of abuse to the police or alternatively, in some cases, to a designated social worker. Given the high rate of domestic violence and abuse in South Africa, health professionals are most likely to encounter such situations. Many clinicians are oblivious of the obligations, exposing themselves to possible liability and their patients to potential additional harm. This article aims to demonstrate the reporting requirements under the respective acts through case scenarios. Finally, the advantages and disadvantages of the existing legal setting are discussed briefly.