Physical abuse

身体虐待
  • 文章类型: Journal Article
    由于与之相关的重大社会健康影响,虐待儿童是一个非常重要的现象。该研究的目的是评估依从性虐待儿童的临床管理指南,并建议采取纠正措施,以避免假阴性或假阳性判断。数据来自儿科诊所住院的34例涉嫌虐待儿童受害者的医疗记录。我们通过分析儿科,皮肤病学,眼科(包括眼底检查),和妇科(仅在某些情况下)咨询,大脑和骨骼成像,实验室测试(参考止血研究),和医学法律咨询。在34名患者中,平均年龄23个月,从1个月到8年不等。20例患者的滥用判断为阳性,12例患者为阴性;在两种情况下,无法表达结论性判断。两名儿童因受伤而死亡。我们强调了临床诊断标准化方案的需要,验尸官在紧急情况下,短距离随访,社会工作者的支持。我们还建议以描述性的方式(使用通用且可重复的语言)客观化,并使用照片文档记录所有调查的结果,评估身体虐待和忽视的迹象。
    Child maltreatment is a phenomenon of great importance due to the significant socio-health implications related to it. Purpose of the study is assessing compliance child abuse clinical management with guidelines and suggest corrective actions to avoid false negative or false positive judgments. The data come from 34 medical records of child victims of suspected abuse hospitalized in a pediatric clinic. We examined diagnostic and medico-legal management through the analysis of pediatric, dermatological, ophthalmological (including fundus examination), and gynecological (only in some cases) consultations, brain and skeletal imaging, laboratory tests (with reference to the study of hemostasis), and medico-legal advice. Of 34 patients, the average age was 23 months, ranging from 1 month to 8 years. The judgment was positive for abuse for 20 patients and negative for 12 patients; in two cases it was not possible to express a conclusive judgment. Two children died because of the injuries sustained. We underline the need of clinical-diagnostic standardized protocols, coroner in emergency settings, short-distance follow-up, social worker support. We also suggest objectifying in a descriptive way (using a common and repeatable language) and with photographic documentation the results of all the investigations carried out, to evaluate signs of physical maltreatment and neglect.
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  • 未经评估:身体虐待是儿童长期发病和死亡的常见但可预防的原因。尽管索引儿童中的虐待与接触儿童中的虐待之间存在很强的联系,没有概述如何筛选后者的指导,更脆弱的群体,虐待伤害。因此,经常省略对接触儿童的放射学评估,或可变地执行,允许隐匿性损伤未被发现,并增加进一步滥用的风险。
    UNASSIGNED:报告一套基于证据和共识的最佳做法,用于在疑似儿童身体虐待的情况下对接触儿童进行放射筛查。
    UNASSIGNED:这一共识声明得到了对文献的系统回顾和国际公认的26名专家组的临床意见的支持。修改后的德尔菲共识进程包括2021年2月至6月间举行的关于可疑儿童身体虐待接触筛查国际共识小组的3次会议。
    未经评估:联系人被定义为无症状兄弟姐妹,同居的孩子,或与怀疑儿童身体虐待的索引儿童受到相同照顾的儿童。所有接触儿童应在成像前进行彻底的体检和病史。接触不到12个月的儿童应该有神经影像学检查,首选的模态是磁共振成像,和骨骼调查。12至24个月的接触儿童应进行骨骼检查。24个月以上的无症状儿童未进行常规影像学检查。如果演示时异常或模棱两可,应进行视野有限的后续骨骼调查。具有阳性结果的联系人应作为索引儿童进行调查。
    UNASSIGNED:本特别通讯报告了在涉嫌儿童身体虐待的情况下对接触儿童进行放射筛查的共识建议。为这些高危儿童的严格评估建立公认的基线,并为临床医生提供一个更有弹性的平台来倡导他们。
    Physical abuse is a common but preventable cause of long-term childhood morbidity and mortality. Despite the strong association between abuse in an index child and abuse in contact children, there is no guidance outlining how to screen the latter, significantly more vulnerable group, for abusive injuries. Consequently, the radiological assessment of contact children is often omitted, or variably performed, allowing occult injuries to go undetected and increasing the risk of further abuse.
    To report an evidence-based and consensus-derived set of best practices for the radiological screening of contact children in the context of suspected child physical abuse.
    This consensus statement is supported by a systematic review of the literature and the clinical opinion of an internationally recognized group of 26 experts. The modified Delphi consensus process comprised 3 meetings of the International Consensus Group on Contact Screening in Suspected Child Physical Abuse held between February and June 2021.
    Contacts are defined as the asymptomatic siblings, cohabiting children, or children under the same care as an index child with suspected child physical abuse. All contact children should undergo a thorough physical examination and a history elicited prior to imaging. Contact children younger than 12 months should have neuroimaging, the preferred modality for which is magnetic resonance imaging, and skeletal survey. Contact children aged 12 to 24 months should undergo skeletal survey. No routine imaging is indicated in asymptomatic children older than 24 months. Follow-up skeletal survey with limited views should be performed if abnormal or equivocal at presentation. Contacts with positive findings should be investigated as an index child.
    This Special Communication reports consensus recommendations for the radiological screening of contact children in the context of suspected child physical abuse, establishing a recognized baseline for the stringent evaluation of these at-risk children and providing clinicians with a more resilient platform from which to advocate for them.
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  • 文章类型: Journal Article
    基于性别的暴力影响到全球三分之一的妇女,死亡是反复暴力之后的最终后果。政府干预势在必行。本文重点介绍意大利最近的立法,该立法提供了一个框架,以协助意大利急诊室的暴力受害者。
    Gender-based violence affects one third of women globally with death the ultimate consequence after repeated violence. Government intervention is imperative. This article focuses on recent Italian legislation that provides a framework to assist victims of violence in Italian Emergency Rooms.
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  • 文章类型: Journal Article
    暂无摘要。
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    文章类型: Journal Article
    In all 50 states, physicians and dentists are required to report suspected cases of abuse and neglect to social service or law enforcement agencies. The purpose of this report is to review the oral and dental aspects of physical and sexual abuse and dental neglect and the role of physicians and dentists in evaluating such conditions. This report addresses the evaluation of bite marks as well as perioral and intraoral injuries, infections, and diseases that may be suspicious for child abuse or neglect. Physicians receive minimal training in oral health and dental injury and disease and, thus, may not detect dental aspects of abuse or neglect as readily as they do child abuse and neglect involving other areas of the body. Therefore, physicians and dentists are encouraged to collaborate to increase the prevention, detection, and treatment of these conditions.
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  • 文章类型: Consensus Development Conference
    Despite the well-recognised benefits of sport, there are also negative influences on athlete health, well-being and integrity caused by non-accidental violence through harassment and abuse. All athletes have a right to engage in \'safe sport\', defined as an athletic environment that is respectful, equitable and free from all forms of non-accidental violence to athletes. Yet, these issues represent a blind spot for many sport organisations through fear of reputational damage, ignorance, silence or collusion. This consensus statement extends the 2007 IOC Consensus Statement on Sexual Harassment and Abuse in Sport, presenting additional evidence of several other types of harassment and abuse-psychological, physical and neglect. All ages and types of athletes are susceptible to these problems but science confirms that elite, disabled, child and lesbian/gay/bisexual/trans-sexual (LGBT) athletes are at highest risk, that psychological abuse is at the core of all other forms and that athletes can also be perpetrators. Harassment and abuse arise from prejudices expressed through power differences. Perpetrators use a range of interpersonal mechanisms including contact, non-contact/verbal, cyber-based, negligence, bullying and hazing. Attention is paid to the particular risks facing child athletes, athletes with a disability and LGBT athletes. Impacts on the individual athlete and the organisation are discussed. Sport stakeholders are encouraged to consider the wider social parameters of these issues, including cultures of secrecy and deference that too often facilitate abuse, rather than focusing simply on psychopathological causes. The promotion of safe sport is an urgent task and part of the broader international imperative for good governance in sport. A systematic multiagency approach to prevention is most effective, involving athletes, entourage members, sport managers, medical and therapeutic practitioners, educators and criminal justice agencies. Structural and cultural remedies, as well as practical recommendations, are suggested for sport organisations, athletes, sports medicine and allied disciplines, sport scientists and researchers. The successful prevention and eradication of abuse and harassment against athletes rests on the effectiveness of leadership by the major international and national sport organisations.
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  • 文章类型: Consensus Development Conference, NIH
    The health, fitness and other advantages of youth sports participation are well recognised. However, there are considerable challenges for all stakeholders involved-especially youth athletes-in trying to maintain inclusive, sustainable and enjoyable participation and success for all levels of individual athletic achievement. In an effort to advance a more unified, evidence-informed approach to youth athlete development, the IOC critically evaluated the current state of science and practice of youth athlete development and presented recommendations for developing healthy, resilient and capable youth athletes, while providing opportunities for all levels of sport participation and success. The IOC further challenges all youth and other sport governing bodies to embrace and implement these recommended guiding principles.
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