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Pediatric Child Abuse

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https://www.readbyqxmd.com/read/29127017/the-educational-opportunities-provided-by-a-pediatric-orthopedic-urgent-case-review-conference-keep-score-to-provide-a-better-experience
#1
Eric D Shirley, Radu Gheorghe, Kevin M Neal, Gary Kiebzak, Steven L Frick
OBJECTIVE: To evaluate the distribution of conditions presented at a case conference to assess resident educational exposure to acute pediatric orthopedic conditions. DESIGN: Retrospective review of emergency department and inpatient consultations presented at a daily pediatric orthopedic case conference over a 3-year period. Consultations were divided into 3-month resident rotation blocks for analysis. SETTING: Tertiary children's hospital in the southern United States which host residents from 2 orthopedic surgery residency programs...
November 7, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/29122066/oral-and-dental-aspects-of-child-abuse-and-neglect
#2
Susan A Fisher-Owens, James L Lukefahr, Anupama Rao Tate
In all 50 states, health care providers (including dentists) are mandated 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 in children and the role of pediatric care providers and dental providers in evaluating such conditions. This report addresses the evaluation of bite marks as well as perioral and intraoral injuries, infections, and diseases that may raise suspicion for child abuse or neglect...
July 15, 2017: Pediatric Dentistry
https://www.readbyqxmd.com/read/29111300/ano-genital-findings-in-3569-pediatric-examinations-for-sexual-abuse-assault
#3
Tanya D Smith, Sudha R Raman, Sheri Madigan, Judy Waldman, Michelle Shouldice
OBJECTIVES: Accurate interpretation of ano-genital examination findings in the context of suspected child and adolescent sexual abuse/assault is essential, as misinterpretation has significant child protection and criminal justice implications. A consensus approach to the interpretation of ano-genital examination findings is widely utilized to support accurate diagnosis; however, a large-scale study using this standardized approach is lacking. The objectives of this study are to: 1) determine the proportion of ano-genital examinations for sexual abuse concerns with findings diagnostic of trauma and/or sexual contact; 2) determine whether frequency of diagnostic findings varies by age, gender, timing of examination; and 3) characterize diagnostic findings...
October 27, 2017: Journal of Pediatric and Adolescent Gynecology
https://www.readbyqxmd.com/read/29099352/evaluations-for-abuse-in-young-children-with-subdural-hemorrhages-findings-based-on-symptom-severity-and-benign-enlargement-of-the-subarachnoid-spaces
#4
Jennifer B Hansen, Terra Frazier, Mary Moffatt, Timothy Zinkus, James D Anderst
OBJECTIVE Children who have subdural hematomas (SDHs) with no or minimal neurological symptoms (SDH-mild symptoms) often present a forensic challenge. Nonabusive causes of SDH, including birth-related SDH, benign enlargement of the subarachnoid spaces (BESS), and other proposed causes have been offered as etiologies. These alternative causes do not provide explanations for concomitant suspicious injuries (CSIs). If SDH with mild symptoms in young children are frequently caused by these alternative causes, children with SDH-mild symptoms should be more likely to have no other CSIs than those who have SDH with severe symptoms (SDH-severe symptoms)...
November 3, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29068874/prevalence-of-nonaccidental-trauma-among-children-at-american-college-of-surgeons-verified-pediatric-trauma-centers
#5
David D A Bogumil, Natalie E Demeter, Karen Kay Imagawa, Jeffrey S Upperman, Rita V Burke
BACKGROUND: Child abuse remains a national epidemic that has detrimental effects if unnoticed in the clinical setting. Extreme cases of child abuse, or nonaccidental trauma (NAT), have large financial burdens associated with them due to treatment costs and long-term effects of abuse. Clinicians who have additional training and experience with pediatric trauma are better equipped to detect signs of NAT and have more experience reporting it. This additional training and experience can be measured by using the American College of Surgeons (ACS) Pediatric Trauma verification...
November 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29035141/usual-care-for-maltreatment-related-pediatric-posttraumatic-stress-disorder-in-germany
#6
Annika Münzer, Rita Rosner, Helene Gertrud Ganser, Alexander Naumann, Paul Lukas Plener, Andreas Witt, Lutz Goldbeck
Child maltreatment represents a major risk factor for the development of emotional and behavioral problems, especially posttraumatic stress disorder (PTSD). While effective trauma-focused treatments are available, little is known about the usual mental healthcare for abused youths in Germany. The present study compared the utilization of mental healthcare in abused youths who had developed a PTSD (N = 95) with a group presenting other mental disorders (N = 146). Semistructured interviews were used to assess maltreatment histories, current mental health, and healthcare utilization...
October 16, 2017: Zeitschrift Für Kinder- und Jugendpsychiatrie und Psychotherapie
https://www.readbyqxmd.com/read/28977323/degradation-of-parental-bonding-and-violence-against-children-the-use-of-family-genogram-in-the-pediatric-clinic
#7
Égle Thomaz Leoncio, Sonia Regina Pereira de Souza, José Lúcio Martins Machado
OBJECTIVE: To demonstrate the importance of using the family genogram in pediatric consultation, as an analysis tool to evaluate the degradation of parental bonding and also violence against children. METHODS: A qualitative study was conducted in 2011 wherein 63 children, aged between 2 and 6 years, enrolled in a slum nursery, was studied. In order to construct the genogram, data were collected in four stages: pediatric evaluation at nursery; interview with caregivers; interview with teachers; and interview with the nursery coordinator...
April 2017: Revista Paulista de Pediatria: Orgão Oficial da Sociedade de Pediatria de São Paulo
https://www.readbyqxmd.com/read/28942263/child-protection-and-the-development-of-child-abuse-pediatrics-in-new-york-city
#8
Vincent J Palusci
The history of child abuse pediatrics reflects the development of medicine as a profession influenced by social movements reacting to poverty, economic exploitation, and child maltreatment. As physicians began to specialize in caring for children, egregious cases led them to recognize children were affected by special medical problems and diseases which were compounded by poor conditions and abuse and neglect. They developed the fields of pediatrics and child abuse pediatrics to advocate for their needs in courts and communities...
September 14, 2017: Journal of Forensic and Legal Medicine
https://www.readbyqxmd.com/read/28921014/-legal-medicine-specialists-within-the-framework-of-acute-care-analysis-of-legal-medicine-consultations-in-relation-to-the-victims-statistics-of-the-state-office-of-criminal-investigation-in-saxony-anhalt
#9
G Pliske, S Heide, B Lucas, K Brandstädter, F Walcher, S Kropf, R Lessig, S Piatek
BACKGROUND: In acute medical care, there are patients who have been injured by the influence of others. The aim of this study was to analyze all cases which were presented to the Institute for Legal Medicine of the University Halle (Saale). The cases where analyzed in relation to the victims' statistics of the state office of criminal investigation in Saxony-Anhalt. MATERIALS AND METHODS: The consultations of the Institute for Legal Medicine Halle-Wittenberg for 2012-2015 were evaluated with regard to the age and gender distribution, the reasons for the consultation and time until the request for consultations...
September 18, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28865661/methods-to-assess-adverse-childhood-experiences-of-children-and-families-toward-approaches-to-promote-child-well-being-in-policy-and-practice
#10
Christina D Bethell, Adam Carle, James Hudziak, Narangerel Gombojav, Kathleen Powers, Roy Wade, Paula Braveman
BACKGROUND: Advances in human development sciences point to tremendous possibilities to promote healthy child development and well-being across life by proactively supporting safe, stable and nurturing family relationships (SSNRs), teaching resilience, and intervening early to promote healing the trauma and stress associated with disruptions in SSNRs. Assessing potential disruptions in SSNRs, such as adverse childhood experiences (ACEs), can contribute to assessing risk for trauma and chronic and toxic stress...
September 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28858895/current-review-of-prepubertal-vaginal-bleeding
#11
Maggie Dwiggins, Veronica Gomez-Lobo
PURPOSE OF REVIEW: Prepubertal vaginal bleeding raises many concerns and evaluation and diagnosis may prove difficult for many providers. We aim to provide a comprehensive review and recent updates for those practitioners who care for these patients. RECENT FINDINGS: Prompt management in the case of prepubertal vaginal bleeding is indicated, especially to rule out malignancy or abuse. If a child is reluctant to undergo examination, or if the extent of injury or source of bleeding cannot be determined, examination under anesthesia and vaginoscopy is recommended...
October 2017: Current Opinion in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28844430/child-maltreatment-screening-and-anticipatory-guidance-a%C3%A2-description-of-pediatric-nurse-practitioner-practice-behaviors
#12
Gail Hornor, Deborah Bretl, Evelyn Chapman, Pamela Herendeen, Nancy Mitchel, Barbara Mulvaney, Saribel Garcia Quinones, Brigit VanGraafeiland
INTRODUCTION: Given the number of children affected by child maltreatment and the dire consequences that can develop, prompt identification of child maltreatment is crucial. The purpose of this study was to describe pediatric nurse practitioner (PNP) practice behaviors related to screening and providing anticipatory guidance for child maltreatment and its psychosocial risk factors. METHOD: The Risk Assessment Survey was developed for this study by 12 PNPs, all of whom were members of NAPNAP's Child Maltreatment Special Interest Group to ensure face validity; all 12 PNPs were content experts in child maltreatment...
November 2017: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/28814554/crawford-jakubiak-je-alderman-em-leventhal-jm-aap-committee-on-child-abuse-and-neglect-aap-committee-on-adolescence-care-of-the-adolescent-after-an-acute-sexual-assault-pediatrics-2017-139-3-e20164243
#13
https://www.readbyqxmd.com/read/28807480/opportunities-and-challenges-in-screening-for-childhood-sexual-abuse
#14
Deepa L Sekhar, Jennifer L Kraschnewski, Heather L Stuckey, Pamela D Witt, Erica B Francis, Ginger A Moore, Paul L Morgan, Jennie G Noll
Retrospective studies suggest 1 in 4 girls and 1 in 6 boys will experience sexual abuse before 18 years of age, resulting in future morbidity. Successful interventions exist, however, victims are reluctant to disclose. Screening for childhood sexual abuse (CSA) may provide an opportunity to overcome this barrier, yet no current model for universal CSA screening exists. We sought to understand the perspective of key stakeholders on CSA screening through qualitative research. Eight focus groups of 7-10 participants each (n=62) were conducted from April-September 2016...
August 11, 2017: Child Abuse & Neglect
https://www.readbyqxmd.com/read/28802910/inter-rater-reliability-of-physical-abuse-determinations-in-young-children-with-fractures
#15
Katherine E Buesser, John M Leventhal, Julie R Gaither, Victoria Tate, Daniel R Cooperman, Rebecca L Moles, Cicero T Silva, Lauren J Ehrlich, Melinda S Sharkey
As there is no "gold standard" in determining whether a fracture is caused by accident or abuse, agreement among medical providers is paramount. Using abstracted medical record data from 551 children <36months of age presenting to a pediatric emergency department, we examined the extent of agreement between specialists who evaluate children with fractures for suspected abuse. To simulate clinical scenarios, two pediatric orthopaedists and two child abuse pediatricians (CAPs) reviewed the full abstraction and imaging, whereas the two pediatric radiologists reviewed a brief history and imaging...
October 2017: Child Abuse & Neglect
https://www.readbyqxmd.com/read/28771417/oral-and-dental-aspects-of-child-abuse-and-neglect
#16
Susan A Fisher-Owens, James L Lukefahr, Anupama Rao Tate
In all 50 states, health care providers (including dentists) are mandated 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 in children and the role of pediatric care providers and dental providers in evaluating such conditions. This report addresses the evaluation of bite marks as well as perioral and intraoral injuries, infections, and diseases that may raise suspicion for child abuse or neglect...
August 2017: Pediatrics
https://www.readbyqxmd.com/read/28770443/how-to-proceed-with-examination-of-a-child
#17
REVIEW
Sonia Makhija, Poornima Tiwari
The assessment of a child is quite different from that of adults and requires knowledge of normal variations in anatomy and physiology with growth and development. An important part of initial assessment includes triage and recognizing children with emergency signs so that they can be managed at the earliest to prevent death and referred timely to the specialist. After ruling out emergency signs, the children with priority signs require prompt assessment, management and referral to the specialist. In addition to normal history as in adults, prenatal and birth history, developmental history, immunization history, feeding history and social history are important for complete assessment of the child...
August 3, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28760315/parental-opioid-abuse-barriers-to-care-policy-and-implications-for-primary-care-pediatric-providers
#18
Michelle K Spehr, Jennifer Coddington, Azza H Ahmed, Elizabeth Jones
Parental opioid use is affecting the physical, developmental, and mental health of the pediatric population nationwide and raises questions of safety when these children remain in the care of opioid-addicted parents. Pediatric providers face many barriers to identifying and caring for children beyond the neonatal period who have been affected by parental opioid abuse both in utero and in the home. These barriers include communication between providers and services, identification of intrauterine exposure, parental opioid abuse screening, and knowledge of child protective services involvement...
November 2017: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/28742308/nonaccidental-injury-in-pediatric-patients-detection-evaluation-and-treatment-digest
#19
Gunjan Tiyyagura, Meghan Beucher, Kirsten Bechtel, Kathryn H Pade
Emergency clinicians are likely to encounter physical abuse in children, and they must be prepared to recognize its many manifestations and take swift action. Pediatric nonaccidental injury causes considerable morbidity and mortality that can often be prevented by early recognition. Nonaccidental injuries present with a wide array of symptoms that may appear to be medically inconsequential (such as bruising in a premobile infant), but are actually sentinel injuries indicative of child abuse. This issue provides guidance regarding factors that contribute to abuse in children, key findings on history and physical examination that should trigger an evaluation for physical abuse, and laboratory and radiologic tests to perform when child abuse is suspected...
July 21, 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28692318/misconceptions-and-malpractices-toward-antibiotic-use-in-childhood-upper-respiratory-tract-infections-among-a-cohort-of-lebanese-parents
#20
Ghada El Khoury, Elsy Ramia, Pascale Salameh
Antimicrobial resistance is an emerging global health threat. Misuse and abuse of antibiotics are of particular concern in the pediatric population. Since management of childhood illnesses depends considerably on parents' perceptions, the objectives of this study were to report parents' perspectives and assess their practices toward antibiotics used for upper respiratory tract infections (URTIs) in children. Using a cross-sectional design, anonymous structured questionnaires were completed by 1,037 parents in public and private schools across Lebanon's largest governorate...
January 1, 2017: Evaluation & the Health Professions
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