Injuries constitute a large share of childhood morbidity and mortality. This study examines whether adolescents with self-reported experiences of different types of child maltreatment more frequently reported unintentional injury events requiring health- or dental care during the last year and/or hospitalization at any time during childhood. Cross-sectional data from a Swedish national representative school survey (2016) including 4741 adolescents were used (78.5% response rate). Data were analyzed with univariate tests and multiple logistic regression. Statistically significant associations between reported experiences of physical, psychological and sexual abuse, neglect, and witnessing partner violence during childhood and reported unintentional injuries requiring health- or dental care during the last year were found (aOR:s between 1.39-1.77). The corresponding association for poly-victimization was aOR 1.91 (95% CI 1.39-2.62). Furthermore, a linear-by-linear association was seen for degree of victimization and number of episodes of unintentional injuries that required care in the last year (p = 0.000), as well as lifetime hospitalizations (p = 0.000). This study shows significant associations between child maltreatment and unintentional injuries requiring health- and/or dental care and hospitalization. To improve both injury and child maltreatment prevention, healthcare professionals need to pay particular attention to children and adolescents who repeatedly seek healthcare services due to injurious events.

Background: Psychosocial risk factors in the home may impair children’s health and development and increase the risk of maltreatment. The Safe Environment for Every Kid (SEEK) model was developed to provide pediatric primary care professionals with a structured way to identify common psychosocial problems. The SEEK model includes use of the Parent Screening Questionnaire (SEEK-PSQ) at routine preventive child health visits, discussion with parents about their responses and, when indicated, referral to relevant services. The SEEK-PSQ has not previously been available in Swedish. The aim of the present study was to evaluate the psychometric properties of an adapted Swedish version of the SEEK-PSQ (PSQ-S). Methods: This study is part of a cluster-randomised controlled trial of SEEK in the Swedish child health services. To validate the PSQ-S, parents (n = 852) with children 0–18 months of age were invited to complete a survey including the PSQ-S as well as evidence-based standardized instruments for the targeted psychosocial risk factors: economic worries, depressive symptoms, parental stress, alcohol misuse and intimate partner violence (IPV). Baseline data from 611 (72%) parents were analysed regarding sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for each risk factor. Results: As a whole, the PSQ-S had a sensitivity of 93%, specificity of 52%, PPV of 67% and NPV of 87%. For mothers and fathers combined, sensitivity was 80% for economic worries, 89% for depressive symptoms, 78% for parental stress, 47% for intimate partner violence (IPV) and 70% for alcohol misuse. Specificity was highest for IPV and alcohol misuse (91%) and lowest for depressive symptoms (64%). NPV values were high (81–99%) and PPV values were low to moderate (22–69%) for the targeted problems. Sensitivity was higher for mothers compared to fathers for economic worries, depressive symptoms and IPV. This difference was particularly evident for IPV (52% for mothers, 27% for fathers). Conclusion: The SEEK-PSQ-S demonstrated good psychometric properties for identifying economic worries, depressive symptoms, parental stress and alcohol misuse but low sensitivity for IPV. The PSQ-S as a whole showed high sensitivity and NPV, indicating that most parents with or without the targeted psychosocial risk factors were correctly identified.

Great need of improved training of paediatricians on children at risk of abuse

In 2009 the Swedish Paediatric Society carried out a national survey that examined the training of paediatric specialty registrars concerning child abuse and neglect. The survey was repeated in 2016. Both surveys highlighted considerable deficits. In 2020 a slightly revised version of the original survey was sent to training leads for paediatrics and paediatric surgery in Sweden. The results showed that most paediatric specialty registrars received their clinical training in social paediatrics with actual patients. Most of the clinics cooperated with a Children's Advocacy Centre (»Barnahus« in Swedish) and some were situated in an area with a Child Protection Team. Similar results were obtained for specialty registrars in paediatric surgery. Our survey shows that the training has partly improved and that university hospital clinics perform better than other paediatric clinics. Major educational investments are needed to obtain an equivalent education throughout the country.

Child abuse is a widespread public health problem, potentially leading to long-term consequences for the exposed individuals and society. By learning more about the major risk factors, child abuse can be prevented. The objective of this study was to examine the pattern and severity of maltreatment in adolescents reporting parental alcohol and/or other drug problems. Cross-sectional data from a Swedish national school survey including 4,741 pupils (15- and 17-year-olds) conducted in 2016 were analysed using univariate tests (chi-squared) and binomial logistic regression models. Results showed that parental alcohol or other drug misuse, reported by the adolescents, was significantly associated with all types of child maltreatment. There was a particularly increased risk of severe child abuse, including witnessing recurrent physical intimate partner violence (adjusted odds ratio (adj. OR) 11.01; confidence interval (CI) 6.61-18.35) and poly-victimisation (adj. OR 7.82; CI 5.50-11.13), in families with parental alcohol and/or other drug problems compared to families without these problems. These results call for preventive measures, such as restrictive alcohol and drug policies, and early recognition of alcohol or other drug misuse among parents. In addition, professionals working with children and with substance-using parents need to identify and support these children.

As in most low-income countries, there is a lack of scientific information on the incidence and pattern of child maltreatment (CM) in Bangladesh. However, the role of the media to disclose CM and to develop public awareness in society is noteworthy. The present study assessed newspaper reports about CM by type and socio-demographics of victims and perpetrators in Bangladesh. In total, 790 news articles were collected retrospectively from four Bengali- and two English-language newspapers from October to December 2014. Among all reported incidents, almost half of the CM cases concerned alleged physical abuse (26%) and sexual abuse (22%). Neglect and emotional or psychological abuse received less coverage. Female children were to a high degree (90%) victims of sexual abuse. The main perpetrators were males, and they were often known to the victims. Approximately 32 per cent of the reported abuse cases resulted in death and were related to rape, family violence, administrative negligence, abduction and ransom demand. Some of these deaths were suicides. News stories concerning CM were often reported in an unethical way by identifying the victim and not respecting child rights. Further, the stories seldom discussed the individual or social consequences of CM, or how maltreatment could be prevented. 'The present study assessed newspaper reports about CM by type and socio-demographics of victims and perpetrators in Bangladesh' Key Practitioner Messages The main types of reported cases of CM in Bangladeshi print media are physical abuse and sexual abuse, and there is a high proportion of fatal consequences. The perpetrators are often known to the victims. The identity of the victim is frequently reported, potentially putting the child at risk and violating child rights. Bangladeshi print media seldom discusses individual or societal consequences of CM, or how it could be prevented.

Background Although child physical abuse (CPA) is considered as a major global public health problem, it has not yet been recognized as such in Bangladesh. Very few studies have assessed the prevalence and victims' characteristics of multiple forms of CPA. Objective This population-based study assessed the prevalence of CPA committed by adults in a rural area of Bangladesh and examined its association with demographic and socio-contextual factors. Methods Data were obtained using ISPCAN Child Abuse Screening Tool for Children (ICAST-C) in a random sample of 1416 children (49% girls, 51% boys) aged 11 to 17 years by face-to-face interviews during March-April 2017. The response rate was 91.5%. To estimate predictors of CPA, physical abuse was categorized into frequent and less frequent groups. Results The prevalence of at least one form (>= 1), two forms (>= 2) and three or more forms (>= 3) of CPA were estimated approximately to 99%, 95% and 83% in their lifetime and 93%, 79%, and 57% in the past year respectively. Hitting (except on buttocks), standing/kneeling and slapping were the most common physical abuse whereas given drugs or alcohol, pinched, burned or scalded, beaten-up and locked up were less reported. Female children were faced severe forms of CPA more than that of males. Male children, younger age groups, witnessing adults using weapons at home, bullied by siblings and low level of maternal education were found to be significant risk factors for both >= 1 form and >= 2 forms of frequent CPA whereas adding also adult shouting in a frightening way was found as a significant risk factor for >= 2 forms of frequent CPA. Conclusion Self-reported prevalence of CPA is extremely common in the Bangladeshi rural society. The prevalence was associated with demographic and socio-contextual characteristics of the children such as being younger, witnessing domestic violence and maternal low education. The findings provide evidence to support parents and policy-makers to take effective measures to implement policy and programme on alternative up-bringing methods and creating awareness of negative effects of CM which in turn help Bangladesh to line up with UN Convention on the Rights of the Child, which the country signed in 1990.