An educational intervention study on mandatory reporting of intimate partner violence: changes in knowledge and attitudes among healthcare providers.

BACKGROUND: Intimate partner violence (IPV) is a major public health concern. Healthcare providers can play a crucial role in reporting cases of IPV or suspected IPV injuries to the police or the criminal justice system, commonly referred to as mandatory reporting. However, mandatory reporting of intimate partner violence (MR-IPV) is a debated topic that can pose complex challenges for healthcare providers. This underscores the importance of training programs to ensure that healthcare providers can fulfill their MR-IPV obligations. METHODS: We developed an educational intervention on MR-IPV and assessed its impact on healthcare providers' knowledge and attitudes. The study used a pre- and post-test design with three measurement points: baseline (T0), immediately after the intervention (T1), and six months later (T2). The intervention was conducted at a university college in Norway, with data collected between October 2022 and May 2023. The intervention was delivered to 37 healthcare providers who were currently part-time students in mental healthcare. Changes in knowledge and attitudes between T0 and T1, and T0 and T2 were analyzed through nonparametric tests on related samples using the Marginal homogeneity (Stuart-Maxwell) test. Risk differences (RD), along with their corresponding 95% confidence intervals (CI), were calculated for selected categories. RESULTS: The number of participants knowing the MR law increased from 2.9% at baseline to 62.9% at T1 (RD = 0.60, 95% CI: 0.41-0.79) and to 31.4% at T2 (RD = 0.29, 95% CI: 0.11-0.46). The number of participants reporting knowing relevant criteria increased from 0.0% at baseline to 68.6% at T1 (RD = 0.69, 95% CI: 0.50-0.87) and to 34.3% at T2 (RD = 0.34, 95% CI: 0.16-0.53). We observed several persistent changes in healthcare providers' attitudes towards MR, including finding MR to be a useful instrument and generally complying with MR requirements. CONCLUSIONS: The findings suggest that this educational intervention can have a positive impact on healthcare providers' attitudes and compliance with MR-IPV. Before the intervention, few participants reported knowing the MR law and its application criteria, demonstrating the importance of continuous learning and evidence-based training programs.

Part III - Navigating an Encounter with a Trafficked Person in the Dermatology Clinic.

Patients experiencing or having experienced trafficking frequently interact with the healthcare system, highlighting the need for healthcare providers to be equipped with the appropriate tools to serve these patients effectively. The third part of this series focuses on navigating encounters with trafficked persons within the dermatology clinic, emphasizing the importance of trauma-informed, patient-centered care. We review the barriers trafficked patients face and mechanisms to overcome these, the importance of comprehensive needs assessments, and the implementation of effective healthcare protocols. Additionally, we review the role of dermatologists in mandatory reporting and the use of appropriate ICD-10 codes for documenting a potential trafficking victim encounter in the electronic medical record. We conclude with recommendations for specialized training, emphasizing the critical role dermatologists play in identifying and supporting trafficked patients within the healthcare system.

The Role of Mandatory Reporting, Perpetrator and Violence Type, and Alcohol Consumption in Undergraduates' Likelihood of Disclosing Sexual Violence.

It remains unclear if mandatory reporting (MR) of sexual violence (SV) in universities impacts student reports of SV. MR may deter students from disclosing SV under certain circumstances (e.g., alcohol, perpetrator). This study evaluated students' likelihood of reporting SV under MR policy across perpetrators, violence, and alcohol use. Female students received instructional manipulations describing either confidential or mandatory reporting policies before reading four vignettes describing SV. They rated their likelihood of reporting each vignette. Significant differences arose across vignettes, conditions, and alcohol consumption. This indicates MR can significantly decrease reporting likelihood in some cases, while alcohol consumption may increase the likelihood.

Cumplimiento de las recomendaciones de la OMS para la notificación de COVID-19 en Argentina

Introducción : La Organización Mundial de la Salud (OMS) efectuó recomendaciones en relación con la recopilación y notificación de datos agregados semanales de COVID-19. Objetivo : Investigar el grado de cumplimiento de las recomendaciones elaboradas por la OMS para la notificación de casos y muertes de COVID-19 en la Argentina durante el año 2020 a 2022, y comparar la notificación de muertes con el número de defunciones por COVID-19 consolidadas en el registro de estadísticas vitales del país. Materiales y métodos : Estudio cuantitativo descriptivo, basado en revisión documental y en fuentes de datos secundarias. Se utilizó los reportes diarios de información epidemiológica y la base de datos Dataset, COVID-19 casos registrados en la República Argentina. Adicionalmente, para estimar la omisión en los registros epidemiológicos de fallecimientos por COVID-19 en los años 2020 y 2021, se cotejaron los resultados de las bases de datos Dataset COVID-19 con la base de las Estadísticas vitales de mortalidad por causa de defunción, proporcionadas por la Dirección de Estadísticas e Información en Salud (DEIS). Se analizaron las variables recomendadas por la OMS para la notificación de casos y muertes por COVID-19. En cuanto a las consideraciones éticas relacionadas con el uso de la información utilizada en este trabajo, las bases de datos cumplen con lo estipulado por la Ley Nacional N° 17.622 de Resguardo del Secreto Estadístico, garantizando que la información mantiene el carácter confidencial y reservado del informante. Resultados: Del análisis de los reportes diarios, durante 2020 se observó que, de los 13 indicadores recomendados, 9 presentan datos algunos meses y los 4 restantes no se relevaron; en 2021 solo 7 indicadores presentaron datos algunos meses, y en 2022 solo 3 indicadores se continuaron informando. Respecto al análisis de la base de datos Dataset COVID-19, la mayoría fueron captadas. Respecto a la comparación de los valores de las defunciones registradas por el sistema de vigilancia epidemiológica y por la DEIS para los años 2020 y 2021, las muertes registradas fueron superiores en el registro de la DEIS (9,6% y 14,2%). Conclusiones : El Estado argentino cumplió con gran parte de las recomendaciones que establece la OMS para la notificación de los casos de COVID-19. Estudios posteriores deberían analizar otros componentes de la calidad de los datos, así como la oportunidad de los registros de defunciones, característica necesaria para la toma de decisiones en salud pública.

Introduction : The World Health Organization (WHO) establishes recommendations regarding the collection and reporting of weekly aggregated data on COVID-19. Objective : To investigate the degree of compliance with the recommendations made by the WHO for the reporting of COVID-19 cases and deaths in Argentina during the years 2020 to 2022, and to compare death notifications with the number of COVID-19 deaths recorded in the country's vital statistics registry. Materials and methods : Descriptive quantitative study, based on a documentary review and secondary data sources. Daily reports of epidemiological information and the Dataset database containing registered COVID-19 cases in the Argentine Republic were used. Additionally, to estimate the omission in the epidemiological records of COVID-19 deaths in the years 2020 and 2021, the results of the Dataset COVID-19 databases were compared with the vital statistics death registry on cause of death, provided by the Directorate of Statistics and Health Information (DEIS, by its acronym in Spanish). The variables recommended by the WHO for the reporting of COVID-19 cases and deaths were analyzed. As for the ethical considerations related to the use of the information in this study, the databases comply with the provisions of National Law 17,622 on the Protection of Statistical Secrecy, ensuring that the information remains confidential and reserved for the informant. Results : From the analysis of daily reports, it was observed that in 2020, out of the 13 recommended indicators, 9 had data for some months, and the remaining 4 were not reported. In 2021 only 7 indicators had data for some months, and in 2022 only 3 indicators continued to be reported. Regarding the analysis of the Dataset COVID-19 database, most data were captured. In comparing the values of deaths recorded by the epidemiological surveillance system and by the DEIS for the years 2020 and 2021, the deaths recorded were higher in the DEIS registry (9.6% and 14.2%). Conclusions : The Argentine state largely complied with the recommendations established by the WHO for the reporting of COVID-19 cases. Subsequent studies should analyze other components of data quality, as well as the timeliness of death records, a necessary characteristic for public health decision-making.

Caracterização epidemiológica de violência sexual no sudeste da região norte do brasil / Epidemiological characterization of sexual violence in southeast of northern Brazil / Caracterización epidemiológica de la violencia sexual en el sureste del norte de Brasil

Introdução: A violência sexual é qualquer ato físico, coercivo, de intimidação com potencial psicológico contra outra pessoa, ocorrendo, especialmente,no sexo feminino, em qualquer faixa etária.Objetivo: Apresentar uma caracterização epidemiológica dos casos de violência sexual referente ao número de casos, faixa etária e gênero entre período de 2014 a 2019 no município de Tucuruí-Pará.Métodos:Trata-se de um estudo de caráter descritivo, comparativo e retrospectivo de corte transversal. A coleta dos dados foi realizada através de notificações em protocolos dos órgãos do governo estadual e do governo municipal, na cidade de Tucuruí-Pará.Para análise dos dados, foram utilizados o teste Exato de Fisher e teste de Mann Whitney.Resultados:A instituição com maior número de notificações foi pelo instrumento Estadual, com 771 casos notificados durante o período de 2014 a 2019, (∆%=631%; p<0,001) em relação ao instrumento municipal, que apresentou o total de 140 casos notificados. Quanto a diferença de gênero, as mulheres são as mais atingidas por este tipo de violência em ambos os órgãos analisados, assim como, com respeito a faixa etária mais acometida, a infância, adolescência e adultos jovens são os que mais sofrem com o problema da violência sexual, de acordo com os dados de ambos os órgãos.Conclusão: O perfil da violência sexual no município de Tucuruí é predominante entre mulheres, da faixa etária que vai desde a infância até a fase adulta. Os dados utilizados das duas instituições durante o período de estudo apresentaram diferenças estatísticas, sendo o instrumento de notificações Estadual o órgão com maior número de notificações em todas as comparações realizadas (AU).

Introduction: Sexual violence is any physical, coercive act of intimidation with psychological potential against another person, occurring especially among females, in any age group.Objective: Present an epidemiological characterization of cases of sexual violence regarding the number of cases, age group and gender between 2014 and 2019 in the municipality of Tucuruí-Pará.Methods: This is a descriptive, comparative and retrospective cross-sectional study. Data collection was carried out through notifications in protocols of state and municipal government agencies, in the city of Tucuruí-Pará.For data analysis, Fisher's exact test and Mann Whitney test were used.Results: The institution with the highest number of notifications was by the State instrument, with 771 cases notified during the period 2014 to 2019, (∆%=631%; p<0.001) compared to the municipal instrument, which presented a total of 140 cases notified. As for the gender difference, women are the most affected by this type of violence in both bodies analyzed, as well as, with respect to the most affected age group, childhood, adolescence and young adults are the ones who suffer most from the problem of sexual violence, according to data from both bodies. Conclusion: The profile of sexual violence in the city of Tucuruíis predominant among women, in the age group that goes from childhood to adulthood. The data used from the two institutions during the study period showed statistical differences, with the State notification instrument being the body with the highest number of notifications in all comparisons performed (AU).

Introducción: La violencia sexual es cualquier acto físico y coercitivo de intimidación con potencial psicológico contra otra persona,que ocurre especialmente entre mujeres, en cualquier grupo de edad.Objetivo:Presentar una caracterización epidemiológica de los casos de violencia sexual en cuanto al número de casos, grupo etario y género entre 2014 y 2019 en el municipio de Tucuruí-Pará. Métodos:Se trata de un estudio transversal descriptivo, comparativo y retrospectivo. La recolección de datos se realizó a través de notificaciones en protocolos de organismos gubernamentales estatales y municipales, en la ciudad de Tucuruí-Pará. Parael análisis de los datos se utilizó la prueba exacta de Fisher y la prueba de Mann Whitney. Resultados:La institución con mayor número de notificaciones fue por el instrumento Estatal, con 771 casos notificados durante el período 2014 a 2019, (∆%=631%; p<0,001) frente al instrumento municipal, que presentó un total de 140 casos notificados. En cuanto a la diferencia de género, las mujeres son las más afectadas por este tipo de violencia en ambos cuerpos analizados, así como, respecto al grupo de edad más afectado, la infancia, la adolescencia y los adultos jóvenes son quienes más sufren el problema de la violencia sexual, según datos de ambos organismos. Conclusión:El perfil de violencia sexual en la ciudad de Tucuruí es predominante entre las mujeres, enel grupo etario que va desde la niñez hasta la edad adulta. Los datos utilizados de las dos instituciones durante el período de estudio mostraron diferencias estadísticas, siendo el instrumento de notificación del Estado el organismo con mayor número de notificaciones en todas las comparaciones realizadas (AU).

"Nothing Was Done": Experiences of continued sexual abuse after disclosing to a mandated reporter among youth in the United States.

BACKGROUND: Disclosing ongoing child sexual abuse (CSA) to a mandated reporter should facilitate youth safety. Unfortunately, youth may continue to experience abuse after disclosure, although little research has examined this phenomenon. OBJECTIVE: We aimed to understand when and why the child protection process fails after youth disclose to a mandated reporter. PARTICIPANTS AND SETTING: Hotline support specialists completed an online survey about 124 anonymous hotline chats with youth whose abuse continued after a prior disclosure to a mandated reporter. METHODS: We thematically analyzed support specialists' open-ended descriptions of information disclosed by the victim in their chat. RESULTS: In most cases (71 %), the abuse was seemingly not reported or not investigated. Mandated reporters' belief of the victim and minimization of abuse affected reporting decisions. Some mandated reporters tried to address the abuse directly with the perpetrators, endangering victims. Rarely, mandated reporters did not report to respect the victim's wishes. In 24 % of cases, the victim described an investigation that did not result in protection. Victims indicated that investigators "sided to the perpetrator" or said there was not enough evidence. Some victims recanted, often in fear. In 6 % of cases, formal actions were taken but did not provide long-term protection. Victims described temporary cessation of abuse that resumed because their guardian(s) allowed the perpetrator to access them. CONCLUSIONS: Disclosing to a mandated reporter can engender traumatic experiences without resulting in long-term safety. Professionals need additional training to increase their knowledge of CSA and respond in ways that prioritize physical and emotional safety.

Attitudes and responses of Victorian paediatric intensive care doctors to the detection and reporting of child maltreatment.

AIM: To determine the attitudes and responses of Victorian paediatric intensive care doctors to the detection and reporting of child maltreatment. METHODS: A prospective study conducted in a 30-bed paediatric intensive care unit of a university teaching hospital using data collected from a questionnaire completed by paediatric intensive care consultants and registrars. The questionnaire covered the following domains - doctors' knowledge of Victorian mandatory reporting legislation, doctors' history of reporting and doctors' current role in the detection and reporting of child maltreatment. RESULTS: The questionnaire was completed by 37 doctors. All but one doctor considered their role in the detection and reporting of all six forms of maltreatment (physical abuse, sexual abuse, emotional abuse, neglect, exposure to domestic violence and grooming to facilitate later sexual activity with a child) very important or somewhat important. Thirty-two percent of doctors did not feel adequately trained to detect child maltreatment while 51% did not feel adequately trained to report maltreatment. If a doctor wanted to make a report to Child Protection about the physical or sexual abuse of a child, only one would likely make Child Protection their first point of contact. CONCLUSIONS: Paediatric intensive care doctors show a strong intent to detect and report child maltreatment across a broad range of maltreatment types. Doctors are likely to contact one or more members of a child's care team and/or one or more relevant hospital/community services before making a report to Child Protection about the physical or sexual abuse of a child. Opportunities exist for the further education of doctors in regards to the detection and reporting of child maltreatment.

Experiences of Domestic Violence in Adult Patients with Brain Injury: A Select Overview of Screening, Reporting, and Next Steps.

This select overview examines the important intersection of adult domestic violence, including intimate partner violence and elder abuse, with brain injury. Despite the high prevalence of domestic violence amongst brain injury patients, there is a notable gap in screening and management training for providers. To provide optimal patient care, brain injury medicine clinicians must screen, recognize, and treat patients who have experienced domestic violence. This select overview highlights barriers to screening, validated screening tools from other medical disciplines, and management considerations for the brain injury clinician. A suggested protocol for domestic violence screening and management, as well as recommended resources for providers and patients, is summarized.

Legal requirements for reporting clinical cases to the South African police or social services.

Medical confidentiality is the cornerstone for a trustful relationship between patients and the health professionals attending to them. However, when history or clinical findings suggest certain offenses, statutory laws (Children's Act, Older Persons Act, Mental Health Care Act, Sexual Offenses Act) establish a legal obligation for health professionals to report suspected instances of abuse to the police or alternatively, in some cases, to a designated social worker. Given the high rate of domestic violence and abuse in South Africa, health professionals are most likely to encounter such situations. Many clinicians are oblivious of the obligations, exposing themselves to possible liability and their patients to potential additional harm. This article aims to demonstrate the reporting requirements under the respective acts through case scenarios. Finally, the advantages and disadvantages of the existing legal setting are discussed briefly.

Consultation-Liaison Case Conference: Assessment and Management of a Physician With Thoughts of Suicide.

We present the case of a physician who engages with a peer response team and discloses suicidal ideation while himself seeing patients in the hospital. Top experts in consultation-liaison psychiatry provide guidance for this clinical case based on their experience and a review of the available literature. Key teaching topics include a general approach to suicide risk assessment, peer response programs for healthcare workers, and ethical and clinical considerations in treating colleagues. Consultation-liaison psychiatrists should be familiar with suicide risk management, take a pro-active approach to addressing modifiable risk factors, and keep in mind unique challenges of treating colleagues referred for care.

Case commentary: a 'merciful approach' to discipline for a New Zealand lawyer's misconduct.

A recent decision reveals how a New Zealand's disciplinary tribunal promoted justice for an unwell lawyer in a case of professional misconduct. In 2023, the Lawyers and Conveyancers Disciplinary Tribunal (LCDT) applied a 'merciful approach' when assessing the lawyer's misconduct and health issues. In Auckland Standards Committee 3 v Ms W [2023], the LCDT discussed the impacts of reproductive treatment in relation to the practitioner's conduct. This decision is the foundation to compare the disciplinary regime for legal and health practitioners in New Zealand. The article outlines New Zealand's framework for discipline of lawyers, noting the absence of a health pathway. The article discusses opportunities to resolve cases involving impaired lawyers outside the disciplinary system, including benefits and disadvantages of mandatory reporting. While focusing on the legal profession, the discussion is relevant to other professions and examines health-promoting regulatory strategies from other jurisdictions.

The new reporting obligation for Respiratory Syncytial Virus (RSV) in Germany - a critical view.

Background: In summer 2023, mandatory reporting of respiratory syncytial virus (RSV) by name was introduced in Germany. The stated objectives were: to improve the database to prevent overburdening of the healthcare system, to implement targeted, early investigation and action by local health authorities to prevent further spread, and to assess vaccines after the expected approval of RSV vaccination. Methods: These objectives are examined against the background of data from mandatory reporting of RSV in the German federal state of Saxony, which has been required since 2002, and the data from the ARE (acute respiratory diseases) survey in Germany, considering the basic legal requirements and options of the Infection Protection Act, the requirements of the EU Commission for the collection of data on infectious diseases and the recommendations by experts of the European Centre for Disease Prevention and Control (ECDC), the options for individual or general preventive measures by the health authorities and previous experience with the evaluation options of the reported data (especially regarding the effectiveness of vaccinations). Results and discussion: An extrapolation of the previously reported data from Saxony to the whole of Germany shows that over 100,000 reports per year must be expected (more than the reports of both rota and noroviruses together). Neither the requirements of the EU Commission nor the views of an expert group of the ECDC recommend mandatory RSV reporting. Mandatory reporting by name is also not appropriate from a legal perspective. A sentinel, which is also better suited to assessing vaccinations, would be more appropriate to avoid unnecessarily overburdening the health authorities. In addition, initial experience with wastewater sentinels for RSV has shown that they may be used to record local and regional RSV infections - albeit without information on the severity of the disease and thus the burden on the healthcare system.Against this background, mandatory reporting of RSV does not appear to be appropriate. Instead, the existing sentinels should be continued and further expanded, possibly supplemented by RSV wastewater monitoring.

Barriers and facilitators of the reporting by family doctors of cases of domestic violence - a qualitative study across Portugal.

BACKGROUND: Domestic violence (DV) is a serious and prevalent public health problem with devastating consequences for the victims and their families. Whilst the number of cases reported to the authorities has risen in recent years, many victims still chose not to present a complaint. In Portugal, to address this, DV became a public crime. As victims of DV present multiple health problems and frequently seek professional help, family doctors are in a privileged position to detect and report cases of DV to the authorities. However, little is known about what motivates these professionals to report or not the DV cases they encounter in their practice to the authorities. METHODS: We conducted semi-structured interviews with family doctors from all regional health administrations of continental Portugal. Interviews occurred between July 2020 and September 2022, were conducted in person or remotely, audio recorded, transcribed, and analysed using thematic analysis. Content analysis was conducted to assess the agreement or disagreement regarding mandatory reporting in each of the themes and subthemes. RESULTS: Fifty-four family doctors took part in this study (n = 39 women, n = 15 men). The main themes that arose from the analysis were: "Barriers related to the physician's activity," "Barriers related to the victim or aggressor," "Facilitators related to the physician's activity," "Facilitators related to the victim or aggressor." Although different barriers were described, most doctors agreed with the mandatory reporting of DV cases. CONCLUSIONS: Family doctors encounter multiple barriers and facilitators when considering reporting a DV case to the authorities. The results of this study can help develop new interventions to address the barriers described by the doctors, increasing their compliance with mandatory reporting, the protection of victims and the just persecution of the aggressor.

Disclosure of sexual abuse by adolescents treated in a psychiatry department.

OBJECTIVES: The aim of the study is to describe the population of adolescents who have disclosed sexual abuse to a health professional during their care in a psychiatric department. We also want to discuss the circumstances that enable adolescents to make this disclosure. METHODS: This single-center retrospective observational study is based on the mandatory reports (n=139) sent by a Paris adolescent psychiatry department between 2005 and 2021 after patients disclosed previous sexual abuse. R® (3.6.1) and RStudio® (1.2.5001) software were used for statistical analysis. RESULTS: Girls accounted for almost all the adolescents who disclosed (95.7%). First abuse occurred around the age of 12 years and was first disclosed to a health professional a mean of 3.5 years later; 66 (47.5%) patients were admitted for inpatient care during their follow-up. The most common diagnoses were depression, eating disorders, posttraumatic stress disorders, and other anxiety disorders. Before disclosing to a health professional, most of these adolescents had already talked about it, mainly to a family member (69.8%) or peers (24.7%). CONCLUSION: This is the first study in France on the reporting of sexual abuse after its disclosure by adolescents being treated in a psychiatry unit. Our results show that child sexual abuse is rarely reported and that health care professionals are far from being the first recipients of these disclosures. We recommend routine screening for sexual abuse in adolescent psychiatry units, improved training for staff receiving these disclosures, and consideration of how best to coordinate medical, social, and legal services for these adolescents.

[Mandatory Reporting as the Basis of Epidemiological Statistics: The Impact of the Reporting Practice and Usage of Paper Technologies on the Informative Content of Morbidity Statistics 1886-1921]. / Die Meldepflicht als Grundlage der epidemiologischen Statistik: Die Auswirkungen der Meldepraxis und der Verwendung von paper technologies auf den Informationsgehalt von Morbiditätsstatistiken 1886­1921.

This article examines the impact of the reporting practice and paper technologies like forms on reports that were later used for national morbidity statistics by studying the Swiss reporting system for infectious diseases between 1886 and 1921. Analysing the production processes of notifications shows the difficulties and solutions in the implementation of the statutory reporting process. Two disease outbreaks-a smallpox outbreak in Schaffhausen and a typhoid outbreak in the canton of Lucerne-serve as case studies. It is shown that reports are not only objective representations of diseases, but also symbolize the medico-social interactions that produce them, timed by administrative tools like reporting forms and the act of reporting. This destabilises historical statistics and illustrates the complexity of the historical source material, as these interactions and their impact on reporting must be considered. These findings are further supported by examining the Swiss reporting system during the Spanish flu of 1918 and its failure to record influenza cases.

REPORT-SCS: minimum reporting standards for spinal cord stimulation studies in spinal cord injury.

Objective.Electrical spinal cord stimulation (SCS) has emerged as a promising therapy for recovery of motor and autonomic dysfunctions following spinal cord injury (SCI). Despite the rise in studies using SCS for SCI complications, there are no standard guidelines for reporting SCS parameters in research publications, making it challenging to compare, interpret or reproduce reported effects across experimental studies.Approach.To develop guidelines for minimum reporting standards for SCS parameters in pre-clinical and clinical SCI research, we gathered an international panel of expert clinicians and scientists. Using a Delphi approach, we developed guideline items and surveyed the panel on their level of agreement for each item.Main results.There was strong agreement on 26 of the 29 items identified for establishing minimum reporting standards for SCS studies. The guidelines encompass three major SCS categories: hardware, configuration and current parameters, and the intervention.Significance.Standardized reporting of stimulation parameters will ensure that SCS studies can be easily analyzed, replicated, and interpreted by the scientific community, thereby expanding the SCS knowledge base and fostering transparency in reporting.

Managing reports of trouble: designated officials' responses to reports of mistreatments initiated by service users and relatives.

Mandatory reporting of elder abuse aims to detect and prevent mistreatment and improve services. Service users and their relatives can raise concerns, but only staff can file mandatory reports. This article examines how the concerns of service users and relatives were managed by designated officials in reports of mistreatments in care for older adults in Sweden. We lean on sociological theories of "interpersonal trouble" and organizational "disputes domains." The thematic analysis is based on 28 incident reports initiated by service users or their relatives. The analysis shows that the reports were managed in one of three ways: asymmetrically, by 1) dismissing or 2) supporting the complainant's position, or symmetrically, by 3) treating complainants' accounts as credible but minimizing their seriousness. There were differences between reports initiated by service users and relatives. Dismissing concerns about abuse, mainly those made by relatives, risks support for service users failing.

Elderly women's leading role in reporting violence: a grounded theory / El papel protagónico de las mujeres mayores en la denuncia de violencia: una teoría fundamentada / O protagonismo de mulheres idosas na denúncia da violência: uma teoria fundamentada

ABSTRACT Objective: to interpret the experience of empowering elderly women to report domestic violence and develop a theoretical model that explains it. Method: a qualitative study, carried out using Grounded Theory. Between February 2018 and January 2020, semi-structured interviews were conducted with 21 elderly women who filed police reports. Also, nine professionals working at the Women's Defense Station of the Civil Police of the State of São Paulo, Brazil, located in a medium-sized city in the countryside of São Paulo, were interviewed. Results: the phenomenon identified as "Taking the lead in coping with violence", based on the categories, revealed that elderly women experience multiple conditions of vulnerability resulting from the situation of dependency, conflicts in relationships and unfavorable living conditions. Even so, the impacts of this violence generate the need to take action against it and to be empowered to report it. After reporting it, they experience the complexity of it and find ways to deal with the situation. Conclusion: violence reporting by elderly women derives from the individual empowerment process, driven by the decision to stop the abuse, even with possible consequences, thus awakening critical awareness based on self-perception of the context of life.

RESUMEN Objetivo: interpretar la experiencia de empoderamiento de mujeres mayores para denunciar la violencia intrafamiliar y desarrollar un modelo teórico que la explique. Método: estudio cualitativo, realizado utilizando la Teoría Fundamentada. Entre los meses de febrero de 2018 y enero de 2020 se realizaron entrevistas semiestructuradas a 21 ancianas que registraron denuncias policiales. También fueron entrevistados nueve profesionales que trabajan en la Estación de Defensa de la Mujer de la Policía Civil del Estado de São Paulo, Brasil, ubicada en un municipio mediano del interior de São Paulo. Resultados: el fenómeno identificado "Iniciando la lucha contra la violencia", a partir de las categorías, reveló que las mujeres adultas mayores viven múltiples condiciones de vulnerabilidad derivadas de la situación de dependencia, conflictos en las relaciones de pareja y condiciones de vida desfavorables, aun así, los impactos de esta violencia generan la necesidad de tomar acciones frente a ella y empoderarse para denunciarla. Después de la denuncia, experimentan su complejidad y encuentran formas de afrontar la situación. Conclusión: la denuncia de la violencia por parte de mujeres mayores deriva del proceso de empoderamiento individual, impulsado por la decisión de detener el abuso, incluso con posibles consecuencias, despertando así una conciencia crítica basada en la autopercepción del contexto de vida.

RESUMO Objetivo: interpretar a vivência do empoderamento de idosas para realização da denúncia de violência intrafamiliar e desenvolver modelo teórico que o explicite. Método: estudo qualitativo, realizado por meio da Teoria Fundamentada nos Dados. Entre os meses de fevereiro de 2018 e janeiro de 2020, realizaram-se entrevistas semiestruturada com 21 idosas que registraram Boletins de Ocorrência. Também, entrevistaram-se nove profissionais atuantes em Delegacia de Defesa da Mulher da Polícia Civil do Estado de São Paulo, Brasil, localizada em município de médio porte do interior paulista. Resultados: o fenômeno identificado "Protagonizando o enfrentamento da violência", a partir das categorias, revelou que as mulheres idosas vivenciam múltiplas condições de vulnerabilidade decorrentes da situação de dependência, conflitos nas relações e condições de vida desfavoráveis, mesmo assim, os impactos dessa violência geram a necessidade de tomada de atitude frente a ela e ao empoderamento para a denúncia. Após a denúncia, vivenciam a complexidade da mesma e encontram formas para lidar com a situação. Conclusão: a realização da denúncia de violência por mulheres idosas deriva do processo de empoderamento individual, impulsionado pela decisão em interromper os abusos, mesmo com possíveis consequências, despertando, assim, consciência crítica a partir da autopercepção do contexto de vida.

Differences Among Types of Sexual Misconduct Incidents Reported to Title IX Coordinators and Institutional Stability in Incidents Over Time.

Sexual misconduct incidents reported to Title IX coordinators and stability in incident characteristics within institutions of higher education (IHEs) over time were examined. Data included two waves of reported incidents in 2016-2018 (n = 2,598) and 2018-2020 (n = 2,778) across Maryland IHEs (N = 40). Findings showed most reported incidents were for Other Sexual Misconduct (e.g., sexual harassment) versus Sexual Assault I (i.e., rape) or Sexual Assault II (e.g., unwanted sexual touching). Types of sexual misconduct differed regarding reporting by responsible employees, nonstudent perpetrators, and the range of accommodations accessed; institutional-level profiles of sexual misconduct were stable across waves. Implications and future research are discussed.

Stopping Criminalization at the Bedside.

Low-income women and, disproportionately low-income women of color seeking reproductive and pregnancy care are increasingly subject to what this article terms carceral care - care compromised by its' proximity to punishment systems. This article identifies the legal and health care practice mechanisms leading to carceral care and proposes solutions designed to stop criminalization at the bedside.