ABSTRACT. Failure to thrive is a common problem in infancy and childhood. It is most often multifactorial in origin. Inadequate nutrition and disturbed social interactions contribute to poor weight gain, delayed development, and abnormal behavior. The syndrome develops in a significant number of children as a consequence of child neglect. This clinical report is intended to focus the pediatrician on the consideration, evaluation, and
We explored the challenges and lived experiences of intimate partner violence (IPV) survivors during the COVID-19 pandemic by interviewing 53 U.S.-based IPV advocates between June and November 2020. Advocates described how the COVID-19 pandemic limited survivors’ abilities to meet their basic needs. The pandemic was also described as being used by abusive partners to perpetrate control and has created unique safety and harm reduction challenges. IPV survivors experienced compounding challenges due to structural inequities. IPV must be considered by local, state, and federal governments when developing disaster planning policies and practices, including in the context of pandemics.
Background The COVID-19 pandemic has impacted children and young people experiencing child abuse and neglect. Child Protective Services (CPS) has played an important role in supporting children and families during the COVID-19 pandemic. Few studies to-date have evaluated the impact of the pandemic on CPS caseworkers and administrators in the United States. Objectives We conducted interviews to explore CPS caseworkers' and administrators' experiences working and serving families during the pandemic. Methods Participants were U.S.-based CPS caseworkers and administrators. We conducted semi-structured virtual interviews with participants and used an inductive thematic analysis approach. Results We conducted 37 interviews. Participants discussed how the COVID-19 pandemic has changed the way they conduct investigations and provide services to families in the CPS system. Several services were adapted to occur virtually, providing challenges and unique opportunities. Participants also described the personal barriers they faced during the pandemic, including working remotely, experiencing burnout, and challenges obtaining personal protective equipment. Finally, participants shared creative solutions they engaged in to support children and families during the COVID-19 pandemic, including expanding collaborations with other community-based organizations. Discussion This study suggests the important role that CPS has played during the pandemic and challenges individual CPS workers felt, in terms of both experiencing burnout and difficulty obtaining personalized protective equipment. Inclusion of the CPS system in emergency preparedness planning for future pandemics or natural disasters will ensure continuation of these vital services.
A novel use of genograms in primary care practice is to identify processes and relationships among physicians and staff prior to implementing practice change. The authors hypothesized that the genogram would inform researchers and practice staff, participating in a child maltreatment prevention study, how practice members function in a practice. They describe the use of genograms and show how the genogram results are associated with intervention uptake. Researchers constructed genograms, collected baseline surveys, and conducted postintervention interviews with physicians. Data were analyzed to determine processes associated with intervention uptake. While survey results supported the relationships and conflicts observed in the genograms, the genogram provided more multilevel information that reflected practices' abilities to implement change. By providing a snapshot of the relationship and organizational dynamics within a practice, genograms can assess culture for practice change. Genograms describe organizational dynamics and are useful tools to use prior to initiating new programs.
At the Child Abuse Recognition, Research, and Education Translation (CARRET) Conference, national child abuse experts representing different disciplines discussed and developed new strategies that would address the barriers to reporting suspected child abuse and improve the protection of children. This article describes the experts' analysis of the barriers to and strategies for improving the outcome for abused children, in addition to the steps planned to facilitate continued action. Pediatrics 2008;122:S18-S20 A GENERATION AFTER the introduction of mandated reporting and the development of the child protection systems by the states, there are still major problems in effective communication and collaboration. These structural issues frustrated all of the conference participants: doctors, social workers, advocates, and families. As the articles and discussions presented in this journal supplement clearly illustrate, conference participants felt that improvements in these collaborations could save the lives of children and minimize the severe long-term consequences of maltreatment for many more children. METHODSTo translate these sentiments into action, conference participants, in facilitated small groups, discussed and debated the strategies presented by the speakers and panelists. Using a structured discussion format, they assessed feasibility and the potential impact of suggested systems changes and reforms. When the groups reconvened, key points were identified and prioritized.The final panel focused on ways to improve relationships between reporters and state child protective services (CPS). Using a consensus approach in which participants revisited each strategy and then ranked them, the participants then determined their final priorities stemming from the conference, which formed the core of an action plan. The participants then planned potential mechanisms for implementing these recommendations. Specifically, they considered the organizations responsible for implementation, their roles, the actions needed to implement the strategy, and the logistics and other needed information. Finally, the conference closed with discussion about immediate and medium-term action steps.In this manner, the various disparate groups were able to achieve agreement on high-impact priority areas for policy change and development, which are summarized below. RESULTSThe following 5 barriers to effective protection of children and the strategies for addressing them (Table 1) were prioritized for implementation:1. Barrier: Hospitals have varying interpretations of how the Health Insurance Portability and Accountability Act (HIPAA) applies in child abuse cases, which limits hospital-based personnel's ability to discuss cases with CPS. CPS regulations and practices vary according to locality, often preventing them from providing even the most basic feedback to mandated reporters concerning the outcome of their reports.Strategy: Clarify and expand confidentiality regulations to improve communication and collaboration between C...
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