Fifteen-minute consultation: Apparent vaginal bleeding in the pre-pubertal girl

2020 ◽  
pp. edpract-2018-316218
Author(s):  
Julie-Ann Collins ◽  
Julie-Ann Maney ◽  
Alison Livingstone
Keyword(s):  
Emergency Department ◽  
Sexual Abuse ◽  
Urinary Tract ◽  
Child Sexual Abuse ◽  
Genital Tract ◽  
Vaginal Bleeding ◽  
Systematic Approach ◽  
Medical Examiner ◽  
Normal Female ◽  
Sexual Offences

A parent or carer’s observation of blood in a child’s nappy or underwear can be quite alarming for both parent and child and may indicate vaginal bleeding. At first glance, it may be difficult to ascertain whether the bleeding is from the skin, genital tract, urinary tract or anus. Confirmed vaginal bleeding in a pre-pubertal girl is rare but always abnormal and requires comprehensive assessment to determine the cause. Recognition of normal female pre-pubertal anatomy is essential to detect any abnormalities. Appropriate action should be taken according to findings on initial inspection of the ano-genital area. The possibility of child sexual abuse and the need for specialist paediatric sexual offences medicine examination by an FME (Forensic Medical Examiner) or specialist paediatrician should always be considered. This article offers a systematic approach to assessment in pre-pubertal girls with apparent vaginal bleeding which will benefit general paediatricians, emergency department practitioners and GPs.

Preventing child sexual abuse and the use of child abuse images: the Prevention Project Dunkelfeld as an international perspective

2019 ◽  
Vol 1 (1) ◽  
pp. 61-66 ◽  
Author(s):  
Klaus M. Beier
Keyword(s):  
Sexual Abuse ◽  
Child Sexual Abuse ◽  
Sex Offenders ◽  
Mental Health Professionals ◽  
Child Pornography ◽  
Sexual Exploitation ◽  
International Perspective ◽  
The Body ◽  
World Health ◽  
Sexual Offences

Paedophilia—a sexual preference for the body scheme of pre-pubescent children—is defined as a disorder within the International Classification of Diseases (ICD) of the World Health Organization as well as within the Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Association. Contrary to popular belief, not all sex offenders who target children are paedophiles, and not all paedophiles commit sexual offences. But quite obviously paedophilia is an emotionally charged and controversial topic, which might be an explanation for putting it out of focus within the healthcare system. Mental health professionals are mainly (and worldwide) not well trained in terms of assessment methods and intervention techniques available to develop and implement effective policies and practices. This presents an obstacle for prevention, in that proactive strategies to protect children from child sexual abuse and sexual exploitation by online offences, such as the consumption or distribution of child abusive images (so-called child pornography), which emphasises the internationally relevant dimension of the issue. The article will address key concerns and questions in dealing with this clinically relevant population, offer insights into a primary prevention approach developed in Germany, and discuss the situation on a European level.

Right to Protection against Sexual Abuse and Exploitation

2017 ◽  
Author(s):  
Asha Bajpai
Keyword(s):  
Sexual Abuse ◽  
Child Sexual Abuse ◽  
Sexual Exploitation ◽  
Commercial Sexual Exploitation ◽  
Child Victims ◽  
Sexual Offences ◽  
Minor Children ◽  
Marriage Laws ◽  
Education Act ◽  
International Instruments

Child sexual abuse and exploitation covers the sexual maltreatment of both children and young people. Part A deals with child sexual abuse (CSA) in India, its magnitude, and child sexual abuse in institutions. It deals with the national legal regime relating to CSA including the constitutional provisions, Juvenile Justice Act, 2015 and Protection of Children from Sexual Offences Act, 2012 (POCSO). Law reform relating to some provisions in POCSO, child marriage laws, Right to Education Act and, and child victims and witnesses is recommended. Part B deals with commercial sexual exploitation and trafficking of minor children in the context of organized exploitation for commercial gain. The Indian laws dealing with commercial sexual exploitation and pornography are included. Important judgements and international instruments dealing with child sexual abuse and exploitation and the important role played by NGOs and government in dealing with cases of CSA and exploitation are included.

scholarly journals A review of child sexual abuse cases presenting to a paediatric emergency department

2021 ◽  
Vol 50 (7) ◽  
pp. 527-535
Author(s):  
Magdalene HM Lee ◽  
Sashikumar Ganapathy ◽  
Soo Mei Low ◽  
Christine LQ Chua ◽  
Shu-Ling Chong ◽  
...  
Keyword(s):  
Emergency Department ◽  
Sexual Abuse ◽  
Child Sexual Abuse ◽  
Secondary Analysis ◽  
Well Being ◽  
Abuse Child ◽  
Vulnerable Children ◽  
Paediatric Emergency Department ◽  
Paediatric Emergency ◽  
Biological Parents

Introduction: Child sexual abuse (CSA) adversely affects a child’s growth and well-being. This study aimed to describe the profile of children presenting to a tertiary paediatric emergency department (ED) with CSA. Methods: Children 0–16 years old presenting to KK Women’s and Children’s Hospital ED from June 2016 to August 2020 with sexual abuse were retrospectively reviewed. We performed a secondary analysis on girls and stratified them by age <13 and ≥13 years o ld. Results: There were 790 patients who made 833 visits for CSA. Victims were predominantly girls (747, 94.8%) and perpetrators were predominantly men (763, 96.6%). The abuse first occurred before the age of 13 years in 315 victims (39.9%). For 468 (59.2%), more than one incident occurred before presentation. Compared to girls ≥13 years old, girls <13 years old were more frequently abused by a family member (47.7% versus 8.0%, P<0.001) and abused in their own home (55.7% vs 21.0%, P<0.001). Among all children, parental divorce and the absence of one or both biological parents in the household were prevalent, with 287/783 (36.7%) having divorced parents, and only 374/784 (47.8%) residing with both biological parents. Conclusion: The findings highlight common characteristics of CSA cases, and can aid the future identification and protection of vulnerable children. The fact that most children presented after more than one incident suggests the need to more closely monitor and protect potentially at-risk children. Keywords: Child abuse, child sexual abuse, child welfare, sexual abuse

Predicting prolific live streaming of child sexual abuse

2021 ◽  
Author(s):  
Timothy Cubitt ◽  
Sarah Napier
Keyword(s):  
Sexual Abuse ◽  
Child Sexual Abuse ◽  
High Volume ◽  
The Philippines ◽  
Live Streaming ◽  
Learning Approach ◽  
Sexual Offences ◽  
Crime Type ◽  
Machine Learning Approach ◽  
Crime Types

Technologically enabled crime has proliferated in recent years. One such crime type is the live streaming of child sexual abuse (CSA). This study employs a machine learning approach to better understand the characteristics of Australians who engaged with known facilitators of CSA live streaming in the Philippines. This model demonstrated notable success in identifying the individuals who would engage in a high number of transactions with known facilitators. Individuals engaged in high-volume live streaming typically spent small amounts (under $55) at intervals of less than 20 days. Where prolific offenders had a criminal record, it was unlikely to consist of high-harm crime types, such as violent or sexual offences.

scholarly journals Emergency Department Admissions for Child Sexual Abuse in the United States From 2010 to 2016

2020 ◽  
Vol 174 (1) ◽  
pp. 89
Author(s):  
Jesse J. Helton ◽  
Jason T. Carbone ◽  
Michael G. Vaughn ◽  
Theodore P. Cross
Keyword(s):  
United States ◽  
Emergency Department ◽  
Sexual Abuse ◽  
Child Sexual Abuse ◽  
The United States
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