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BACKGROUND: Immediate medical assessment has been recommended for children after sexual abuse to identify physical injuries, secure forensic evidence, and provide for the safety of the child. However, it is unclear whether young children seen urgently within 72 hours of reported sexual contact would have higher frequencies of interview or examination findings as compared to those seen non-urgently or whether forensic findings would be affected by child characteristics, type of reported contact, or later events. DESIGN/SETTING: We evaluated 190 consecutive cases of children under 13 years of age urgently referred during a 5-year period in 1998-2003 to a community child advocacy center and compared them to those non-urgently referred with regard to their physical examination findings, any sexually transmitted infections or forensic evidence, gender, pubertal development, type of contact, reported ejaculation, later bathing or changing clothes, time to examination, and gender, age and relationship of alleged perpetrator. RESULTS: Children seen urgently were younger and had less frequent CPS involvement, more disclosures, and more positive physical examinations, and had more contact with older perpetrators than those seen non-urgently. Overall, most children were female and had normal or non-specific physical examinations. Certain case characteristics were predictive of evidence isolation in the 9% who had positive forensic evidence identified. Semen or sperm was identified from body swabs only from non-bathed, female children older than 10 years of age or on clothing or objects. CONCLUSIONS: Female children over 10 years old who report ejaculation or genital contact without bathing have the highest likelihood of positive examinations or forensic evidence. While there are other potential benefits of early examination, physicians seeking to identify forensic evidence should consider the needs of the child and other factors when determining the timing of medical assessment after sexual abuse. 相似文献
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Eugene R. Declercq Carol Sakala Maureen P. Corry Sandra Applebaum Ariel Herrlich 《The Journal of perinatal education》2014,23(1):9-16
To understand the experiences and views of childbearing women in the United States and trends over time, Childbirth Connection carried out the third national Listening to Mothers survey among 2,400 women who gave birth in U.S. hospitals to a single baby from mid-2011 to mid-2012 and could participate in English. Harris Interactive conducted the survey using a validated methodology that includes data weighting to ensure that results closely reflect the target population. Results of the initial survey describe experiences from before pregnancy through the early postpartum period, and were reported in Listening to Mothers III: Pregnancy and Birth. A follow-up survey directed to the same participants explored postpartum experiences, attitudes about maternity care, and some additional pregnancy and birth items. 相似文献
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Jonhendro Goh Bee Ching Rohazna Wahab Wang Meei Leng Jimmy Tan Lip Aun Eugene Yeoh Oon Hock W. K. Koo 《The Internet and Higher Education》2001,4(3-4)
The democratization of education has brought forth an unprecedented demand for education by the masses, especially at the tertiary level. However, the availability of education is hampered by limited resources to provide pervasive and effective teacher–student interaction, changing lifestyle patterns, changing expectations of the students, and the problems associated with the great urban–rural divide and nonuniform access. The problem of availability of education is compounded by the tide of globalization and the Internet that demands not only high efficiency but also competitive delivery of services and goods in all sectors of our economy, including education. Education is not immune to these current trends. It is imperative that education institutions rise up to the challenge in meeting the demand of a more discerning, discriminating, mobile, and selective student population. It is imperative that education institutions reconsider the necessary ingredients to make learning effective, relevant, and fun for the students. Our company, Kolej Damansara Utama (KDU), has embarked on an education experiment begun almost 3 years ago to implement a student-centered, teacher-facilitated, Information and Communications Technology (ICT)-enabled and knowledge-based initiative. The goal of this experiment has been to create an active learning environment, and to promote learning for our students. The knowledge ecosystem, comprising students, teachers, administrators, parents, partner institutions, employers, and the community at large, forms the KDU e-Community Network (KCN). The KCN enables passive, interactive, collaborative, and constructive learning to take place as long as the stakeholder has a connection to the Internet. 相似文献
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With permission from Childbirth Connection, the concise version of the Listening to Mothers II "Survey Methodology" is reprinted here. Harris Interactive(R) conducted Listening to Mothers II: Report of the Second National U.S. Survey of Women's Childbearing Experiences on behalf of Childbirth Connection. The survey consisted of 1,373 online interviews and 200 telephone interviews with women who had given birth in U.S. hospitals in 2005, with weighting of data to reflect the target population. Interviews were conducted from January 20 through February 21, 2006. The methods used to conduct the survey and analyze the data collected are described. 相似文献
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