Bakgrund Barnmisshandel är ett globalt hälsoproblem med både svåra direkta och långtgående konsekvenser. I tidigare forskning ses var femte barn uppge sig blivit utsatt för någon typ av barnmisshandel. Vuxna som blivit utsatta för barnmisshandel har en ökad risk för psykisk- och fysisk ohälsa. Sjuksköterskan har en viktig del i att följa barnets utveckling och att arbeta för en trygg uppväxt där förebygga och upptäcka barnmisshandel ingår. Syfte Att undersöka vilka hinder som finns att en orosanmälan inte utförs i en situation där ett barn misstänks utsättas för eller vid kännedom utsätts för barnmisshandel. Vidare är syftet också att undersöka vilken kunskap och stöd som behövs för att öka möjligheterna att dessa barn upptäcks i mötet med sjuksköterskan och att åtgärder verkställs. Metod En litteraturgranskning av kvalitativa studier med Evans metod för dataanalys och resultatet presenterades i en beskrivande syntes. Resultat Hinder som försvårar upptäck och anmälan gällande barnmisshandel identifierades, så som organisation, brist på kompetens, personliga barriärer samt svåra möten. Behov av utbildning och stöd gällande upptäckt och anmäla kring barnmisshandel sågs. Slutsats Barns rätt att inte fara illa kan förbättras genom att eliminera hinder. Förbättringar inom organisationen som kontinuerligt stöd och utbildning främjar upptäckt och ökar orosanmälningar vid misstanke om barnmisshandel. Sjuksköterskans insikt gällande skyldigheter är viktigt att fokusera på, att våga ge stöd till barn som uttrycker utsatthet och våga möta känslor av rädsla och obehag ökar möjligheterna att hitta barn som utsätts för barnmisshandel. / Background Child abuse is a global health issue that causes severe consequences in early life development and adulthood. Every fifth child are exposed to child abuse. Adults who have experienced child abuse have a higher risk for mental and physical illness. Monitoring the child’s progress and making sure they have a safe home environment is important. Purpose To explore what obstacle there is for nurses not to report child abuse in a situation where it is suspected or confirmed. It was also to explore what kind of knowledge and support the nurses need to increase their chances of identifying these children and to provide intervention. Method A review of qualitative studies were conducted with the method of Evans for the descriptive analysis. Results Several risks for not detecting or reporting child abuse were identified; organization, lack of skills, personal barriers and tough encounters. A focused need for education and support to detect and report child abuse were expressed. Conclusion The children’s right not to be harmed can be improved by eliminating barriers. Improvements within the organization, support and education promote detection and reports of concern in suspected child abuse and will reduce the potential for child harm. The nurse's understanding of responsibilities is a critical part to focus on. If nurses dare to provide support to children who express vulnerability and face their own feelings of fear and discomfort it would increase the opportunity to find children who are subjected to child abuse.

The classic metaphyseal lesion (CML) is considered to be a strong indicator of physical abuse in infants. These fractures extend through the metaphysis of a long bone near the growth plate, disrupting the trabecular bone structure. The mechanism(s) behind this fracture type are not entirely understood. The present study investigated experimentally the possible loading conditions required to generate CMLs in pig models. Fifty hindlegs from stillborn pigs were tested in torsion using a mechanical testing machine and a digital torque wrench. Fractures to the metaphysis that resemble CMLs were produced during a combined loading event which applied torsion to the knee joint (distal femur, proximal tibia, and proximal fibula). A visual assessment of the physeal surface of each specimen was performed after testing, and classic metaphyseal lesions were identified by comparison with findings from Love et al. (2011). The only fractures seen in both the femora and tibiae were CMLs, with both bone types having 60% (30 of 50) total fractures. The frequency of total fractures on fibulae was less, with 42% (21 of 50). The frequency of CMLs in the fibulae, however, is lower than the frequency of total fractures (38%, n=50), as physeal fractures also presented in some of those bones. Thus, the CML was the most common type of fracture produced due to the torque applied to the bones during testing. When assessing the number of CMLs that occurred on each limb, nine limbs had only one CML present, while 28 limbs had one or more CMLs. Additionally, complete CMLs made up 51.9% (41 of 79) of the total number, while partial made up 48.1% (38 of 79). Out of the 150 bones tested, 79 (52.7%) showed fractures resembling CMLs in human infants. A fracture was 35% more likely to occur in a femur or a tibia than in a fibula, and multiple CMLs per specimen were more common than single CMLs. The physeal surfaces of the specimens recorded as having CMLs showed damage to the trabecular bone. Three physeal fractures were noted; one Type IV physeal fracture on a proximal tibia and one on a proximal fibula, and a Type II physeal fracture on a proximal fibula. No diaphyseal fractures of any kind were produced. Further investigation of these conditions is encouraged to gain more insight into the injury mechanism.

Considering the institution of the Convention on the rights of the Child as Swedish law (Regeringskansliet, 2020), now, more than ever, the importance for children to exist and strivein safe environments is highlighted in society. In light of reports on lacking implementation of child rights policies in sport context, this study aimed to contribute with knowledge of schools and sport clubs’ child protection work, to discover how the organizations manage situations where children get hurt. From interviewing physical education teachers from four elementary schools and administrative personnel, board members and sports directors from three sport clubs, a thematic analysis was conducted. The results consisted of three themes of managing: conversing, reporting, and acting. I discuss implications for schools and sport clubs and offer some recommendations based on the current results. I also make suggestions for future research.

The present study addresses two major issues . First, the need for children to develop the skills necessary t o prevent themselves fro m being molested. Second, the need for hearing impaired children to receive the same information, coping s kills, and defense strategies as their hearing counterparts. The "Safety with Strangers slide series was presented in classrooms of hearing impaired students at both the middle school level and elementary school level. Program trainers gave students information regarding stranger approaches, demonstrated the safe, appropriate (role-modeling) and gave the children opportunities to practice these safe, appropriate behaviors (behavioral rehearsal). This program was extremely effective with the middle school students, while there was no treatment effect with the younger children.

Many crisis intervention programs have been developed for child abuse but very few primary prevention programs exist. Teaching prospective parents to cope with aversive child behaviors might prevent the occurrence of child abuse later. The purpose of this study was to compare the effectiveness of using peer (high school students) and college students as trainers in a preventative approach to child abuse for high school students. It was proposed that peers would be better trainers because the trainees would be more likely to model their behavior and more at ease when asking the trainers questions. One hundred and thirty-four high school seniors were randomly assigned to one of three groups: control, college trained, or peer trained. These students rated their responses to potentially aversive child behavior situations and also role played their responses in these situations. Results indicated that there were no significant effects of training or types of trainers but the author concluded that more work should be done on the type of peer trainers used.

The purpose of the study is to higlight the social services' perception of the scope for action a which a social secretary has based on the legislation and the use of child's attachment in assessments of possible family home placement, relocation or granting of voluntary contributions due to violence in close relationships. The study is of qualitative character and based on a hermeneutical approach, together with attachment and action space theory. Empirical data were obtained through semi-structured interviews. The results show that the child's attachment is important in work with abused children and that investigators and therapists need to take the child's connection into account in order to create security for the child. This security creates better conditions for the child to be able to assimilate treatment efforts. Furthet, the results show that social workers feel that they have both large and small room for maneuver, particularly in relation to legislation and within the framework of the exercise of authority. While the social services need to comply with the legislation, there is also an opportunity for carrying out motivational work, not least within the framework of social work, in order to increase the possibility to meet childrens need for security, protection and safety. The results indicate that efforts are primarily directed at the parents, both the biological and foster parents. The reason for this is that parents need to understand their own attachment pattern in order to understand the attachment pattern och the child. In order for the child to be able to assimilate efforts without guilt and loyalty conflict arising towards the parents, there is a need for creating security and stability in the home environment. The child needs the support of his parents to be able to dare to talk about his feelings and experiences at the same time as the parents need to gain more knowledge about the child's development and the consequences which the parents' actions can have for the child in adulthood. Certainly, tje work with violence in close relationships is constantly evolving,Yet the field of social services still requires more knowledge about this type of violence and its consequences. There is also a need for more knowledge about the work of social services and other social actors in general, as much as of the opportunities for support, almed for families where violence occurs.

Victims of child sex trafficking in prostitution in the United States are often overlooked, misidentified, and among the most underserved type of child victim of crime. The majority of previous research on child sex trafficking has been conducted without a theoretical framework or reliable sampling methods. In this study, a schematic composed of a series of stepping-stones from childhood abuse to prostitution, which has been described by gendered pathways researchers, served as a sensitizing template for the study's development of a strain-reactive pathway into child sex trafficking. Agnew's general strain theory provided the primary theoretical basis for the proposed pathway, supplying both explanations of the generative factors of the pathway and the mechanisms operating within the life trajectory terminating in child sex trafficking in prostitution. Based on this theoretical framework, this study utilized structural equation modeling to examine the pathway by investigating the effects of caregiver strain, child maltreatment, and risk-inflating responses to strain on vulnerability to victimization in child sex trafficking in prostitution. Four structural equation models, incorporating different forms of child maltreatment, were assessed using data from a matched sample of 174 minority females who were residents of one U.S. city and participated in a longitudinal study on the effects of child sexual abuse. Findings show that the occurrence of child maltreatment including child neglect, child physical abuse, and juvenile sexual victimization increased with caregiver strain. Consequentially, neglected and abused children were more likely to have engaged in the risk-inflating responses of running away and earlier initiation of drug or alcohol use, and they also reported higher levels of relational shame. Both running away and early initiation of substance use impacted vulnerability to victimization in child sex trafficking in prostitution. Lastly, implications of the findings related to protection and intervention strategies that are projected to obstruct the progression of minors along the analytically identified pathway into child sex trafficking in prostitution are presented for criminal justice professionals, child protection investigators, and social service providers.

This study compared the social cognition and object relations of 39 physically abused children to a clinical group of 39 children with no recorded history of abuse.

This Master’s project aims to explore the challenges and possibilities the social services encounter when investigating honor related violence in childcare investigations. Furthermore, the project is investigating social workers’ perceptions and experiences of honor related violence (HRV) and if that aspect of violence makes any difference to the investigation of child abuse. A qualitative approach has been used, where interviews were held with ten social workers. The project’s result and analysis has been divided into three themes: Social workers knowledge regarding HRV, working methods used when investigating child abuse with elements of HRV   and the impact of the child perspective on different assessments concerning children in the same families.  The results show that the social worker's knowledge has a significant role in how a case is handled by the social services. The lack of in-depth knowledge among social workers regarding HRV can have consequences for the work in various ways. The study also shows that there is a need for social services to develop treatments that are adapted to honor-related violence. Finally, the conclusion of this study shows that the current legislation in Sweden could be further developed.

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