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Support provided to families experiencing the loss of an infant to sudden infant death syndrome has focused on the description of maternal bonding and the consequences to the mother. However fathers also develop significant relationships with their infants, and their responses to the unanticipated loss of their children may be different than those of mothers. In this study 28 fathers who lost infants to SIDS appeared to have identifiable patterns of behavior which were more peculiar to men: (1) the necessity to "keep busy" with increased work; (2) feelings of diminished self-worth; (3) self-blame because of lack of "care" involvement; and (4) a limited ability to ask for help. That men should be stoic and less emotional and that one need not be concerned with the reactions of fathers appears to be a reflection of societal attitudes. However, these paternal behaviors, which emerge at a time of crisis and which obstruct full expression of grief, may unwittingly be promoted by medical and health care providers who are anxious to help fathers fulfill societal expectations of masculine strength.

The institutions surveyed cared for many children suspected of abuse and neglect. Thirty-eight percent did >300 evaluations per year. In general, institutions with CPTs provided more comprehensive documentation and follow-up of children suspected of having been abused or neglected than institutions without CPTs. Whether this is associated with better outcomes for children suspected of abuse or neglect is unknown.

Three cases of inflicted hypopharyngeal perforation, an unusual manifestation of child physical abuse, are presented here. The extant literature on abusive pharyngeal injuries is reviewed with a discussion of the features that distinguish inflicted from unintentional etiologies. A glossary of medical terminology is provided at the end of the article.

This study examined the effects of sociodemographic, training, and attitudinal variables on the child maltreatment lifetime reporting proportion (LRP) of 382 randomly selected pediatricians, master's level social workers (MSWs), and physician assistants (PAs). Findings indicated a lifetime mean of 24 suspected cases of child maltreatment and an average of 16 reported cases with an LRP of 69%. Pediatricians reported the highest LRP (76%), followed by MSWs (63%) and PAs (60%); differences in LRP were partially reduced to nonsignificance after adjusting for the other independent variables. Multivariate analysis revealed that the strongest predictors of LRP were case-related attitudes, professional concerns, institutional setting, and the amount of training the professional received. These results demonstrate the importance of professional education and opinions of mandated reporters in reporting practices.