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BackgroundThere have been no previous studies on the adequacy of combined evaluation of possible abusive head trauma cases by frontline medical personnel, hospital-based child protection teams, and child protective services in loc...
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BackgroundThere have been no previous studies on the adequacy of combined evaluation of possible abusive head trauma cases by frontline medical personnel, hospital-based child protection teams, and child protective services in local districts of Japan.
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Objective The aim of this paper is to describe characteristics associated with maltreatment types in children referred to the child protection team at the University Children’s Hospital Zürich. Since 2003, the child protection t...
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Objective The aim of this paper is to describe characteristics associated with maltreatment types in children referred to the child protection team at the University Children’s Hospital Zürich. Since 2003, the child protection team has registered data on each case in a standardized form.
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Objective: The aim of this study was to develop a reliable and valid self-evaluation tool for use by child protection team (CPT) members. Methods: An online survey was administered to members of 10 CPTs. The survey included the fo...
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Objective: The aim of this study was to develop a reliable and valid self-evaluation tool for use by child protection team (CPT) members. Methods: An online survey was administered to members of 10 CPTs. The survey included the following 3 sections: 1) initial conditions (eg, team composition, resources), 2) enabling conditions (eg, team effort, strategy), and 3) team effectiveness (eg, team cohesion, meeting performance standards). Each section contained multiple subscales. Internal consistency was calculated using Cronbach α. To evaluate construct validity, the subscale scores of the most advanced teams who qualified as centers of excellence (n = 3) were compared with the subscale scores of the other teams (n = 7) to determine whether the tool could distinguish between the two. Results: Of 116 team members, 83 (72%) completed the survey. The subscales exhibited good internal consistency (α =.71-.97). The 3 centers of excellence had significantly higher mean scores than the other 7 CPTs on the following subscales: incentives (in the initial conditions section, 61.46 vs 38.89; P =.003), effort (in the enabling conditions section, 79.31 vs 67.70; P =.003), and professional growth (in the team effectiveness section, 83.89 vs 80.40; P =.004). Conclusions: This novel survey demonstrates satisfactory test characteristics and can be used to assess CPT performance and identify areas for improvement.
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Background: Cooperation between different institutions in cases of child abuse is essential for the children and their families. The aim of this study is to evaluate the cooperation between the Child Protection Team (CPT) and the ...
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Background: Cooperation between different institutions in cases of child abuse is essential for the children and their families. The aim of this study is to evaluate the cooperation between the Child Protection Team (CPT) and the Youth Welfare Agency (YWF) in an academic teaching hospital. Issues: Is the child or the family already be known to the YWF? Was the suspicion of child abuse confirmed by the CPT? What impact did the CPT's report to the YWF have on the situation of the children, their families, and the members of the YWF? Methods: Between 1999 and 2009 196 cases were investigated by the CPT; 80 of them had been reported to the YWF. In 45 of the 80 cases, structured interviews were completed by the YWF social workers. In the remaining 35, the questionnaires were not fully completed (n=15), the responsible social workers not present (n=6), or data were not available due to change of residence (n=14). Results: Maltreatment was suspected in 21/45 (47%), child abuse in 7 (16%), child neglect in 12 (26%), and a combination of the above in 5 (11%) children. Of the children, 26/45 (58%) were already known to the YWF before being contacted by the CPT, and in 34/45 (75%) children either institutions reported the case to the criminal prosecution authorities. Positive changes were seen in 35/45 (78%) children and in 19/45 (42%) families and the CPT's report was considered helpful for the social workers in 41/45 (91%) children. Conclusions: A CPT is able to correctly identify new cases of child abuse. The activity of the CPT has a positive influence on the situation of affected children, their families, and the respective staff members of the YWF.
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To follow up on child protection children after their discharge from hospital in order to assess efficiency of our child protection team (CPT) and collaboration of family and of Youth Welfare Agencies (YWA) with the clinical CPT.
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BACKGROUND: Medical child abuse occurs when a child receives unnecessary and harmful, or potentially harmful, medical care at the instigation of a caretaker through exaggeration, falsification, or induction of symptoms of illness ...
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BACKGROUND: Medical child abuse occurs when a child receives unnecessary and harmful, or potentially harmful, medical care at the instigation of a caretaker through exaggeration, falsification, or induction of symptoms of illness in a child. Neurological manifestations are common with this type of maltreatment. OBJECTIVES: We sought to review common reported neurological manifestations that may alert the clinician to consider medical child abuse. In addition, the possible sequelae of this form of child maltreatment is discussed, as well as practice recommendations for establishing the diagnosis and stopping the abuse once it is identified. METHODS: A review of the medical literature was conducted regarding the reported neurological presentations of this entity. RESULTS: Neurological manifestations of medical child abuse include false reports of apparent life-threatening events and seizures and reports of induction of symptoms from poisoning. Failure to correlate objective findings with subjective complaints may lead to unnecessary and potentially harmful testing or treatment. This form of child maltreatment puts a child at significant risk of long-term morbidity and mortality. CONCLUSIONS: A wide variety of neurological manifestations have been reported in cases of medical child abuse. It is important for the practicing neurologist to include medical child abuse on the differential diagnosis.
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Caregiver-fabricated illness in a child is a form of child maltreatment caused by a caregiver who falsifies and/or induces a child's illness, leading to unnecessary and potentially harmful medical investigations and/or treatment. ...
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Caregiver-fabricated illness in a child is a form of child maltreatment caused by a caregiver who falsifies and/or induces a child's illness, leading to unnecessary and potentially harmful medical investigations and/or treatment. This condition can result in significant morbidity and mortality. Although caregiver-fabricated illness in a child has been widely known as Munchausen syndrome by proxy, there is ongoing discussion about alternative names, including pediatric condition falsification, factitious disorder (illness) by proxy, child abuse in the medical setting, and medical child abuse. Because it is a relatively uncommon form of maltreatment, pediatricians need to have a high index of suspicion when faced with a persistent or recurrent illness that cannot be explained and that results in multiple medical procedures or when there are discrepancies between the history, physical examination, and health of a child. This report updates the previous clinical report "Beyond Munchausen Syndrome by Proxy: Identification and Treatment of Child Abuse in the Medical Setting." The authors discuss the need to agree on appropriate terminology, provide an update on published reports of new manifestations of fabricated medical conditions, and discuss approaches to assessment, diagnosis, and management, including how best to protect the child from further harm.
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A scientific paradigm typically embraces research norms and values, such as truth-seeking, critical thinking, disinterestedness, and good scientific practice. These values should prevent a paradigm from introducing defective assum...
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A scientific paradigm typically embraces research norms and values, such as truth-seeking, critical thinking, disinterestedness, and good scientific practice. These values should prevent a paradigm from introducing defective assumptions. But sometimes, scientists who are also physicians develop clinical norms that are in conflict with the scientific enterprise. As an example of such a conflict, we have analyzed the genesis and development of the shaken baby syndrome (SBS) paradigm. The point of departure of the analysis is a recently conducted systematic literature review, which concluded that there is very low scientific evidence for the basic assumption held by Child Protection Teams: when certain signs are present (and no other acceptable explanations are provided) the infant has been violently shaken. We suggest that such teams have developed more value-based than scientific-based criteria when classifying SBS cases. Further, we suggest that the teams are victims of groupthink, aggravating the difficulties in considering critics' questioning the criteria established by the teams.
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