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Increasing empirical attention has been given to the role of adverse childhood experiences (ACEs) in the development and maintenance of body dysmorphic disorder (BDD). Yet, current research has predominantly focused on adult and nonclinical BDD samples, and little is known about relevance of ACEs in adolescent BDD. The present study examined (a) the frequency of ACEs in adolescents with a primary diagnosis of BDD (n = 50) versus obsessive compulsive disorder (OCD) (n = 50) and (b) the clinical profile of ACE‐exposed youth with BDD. ACEs were ascertained through a systematic search of electronic patient records, as well as through a parent‐ and self‐report screening item for exposure to traumatic events. Results showed higher rate of peer victimisation (74% vs. 38%) and child maltreatment (44% vs. 24%) among BDD versus OCD youths; sexual abuse was the most common type of child maltreatment documented in the BDD group (28%) according to patient records. Parent‐reported exposure to traumatic events was also significantly higher in the BDD than the OCD group (40% vs. 18%, respectively). Clinical presentation and treatment outcomes did not differ between those with versus without a history of ACEs. The current study is the first to demonstrate that a range of ACEs are common in adolescent BDD. Our findings highlight the importance of screening for these experiences. Although further research is needed, our findings also indicate that adolescents with BDD who have a history of ACEs are broadly similar in their clinical presentation to those without, and benefit from BDD‐focused treatment. [ABSTRACT FROM AUTHOR]

Violence is recognised as a cause of health harm, but it is not consistently or adequately captured in healthcare data systems. While administrative health records could be valuable sources of information for measuring violence, they remain underutilised in violence-related research. The present research aims to examine the suitability of violence indicators in emergency care, primary care, and linked healthcare datasets. Descriptive analyses were conducted with the 2015/16 Hospital Episode Statistics Accident and Emergency (HES A&E) and the 2021/22 Emergency Care Data Set (ECDS). The potential of the Clinical Practice Research Datalink (CPRD) and the South Wales Violence Surveillance dataset (a police and emergency department (ED) dataset linked by Public Health Wales) were shown using available evidence. Among the discussed datasets, the South Wales Violence Surveillance dataset has the most detail about violent acts and their contexts, while the CPRD includes a more extensive range of socioeconomic factors about patients and extensive linkage with other datasets. Currently, detailed safeguarding information is routinely removed from the ECDS extracts provided to researchers, limiting its utility for violence research. In the HES A&E, only physical violence was consistently recorded. Addressing these issues has the potential to improve the use of health administrative data in research on violence. [ABSTRACT FROM AUTHOR]

There are growing levels of abuse toward match officials in sport as well as general problems of their recruitment and retention. Purpose: This study analyzes the role that physical and nonphysical abuse has on association football referees' intentions to quit and their personal well-being. Methods: Drawing on pooled survey data of association football referees from the UK and Canada, this paper employs probit, ordinary least squares, and treatment effects regression analyses to explore the casual relationship between the physical and nonphysical abuse faced by referees, their intention to quit and their well-being. Results: Although physical abuse is less common than nonphysical abuse both affect the intention to quit and well-being of officials. Moreover, those that do not contemplate quitting also face reductions in their well-being. Conclusion: The research recommends a zero-tolerance approach to all forms of abuse of officials in sport and identifies that organizations have a duty of care for the well-being of their officials. [ABSTRACT FROM AUTHOR]

The issue of Romanian commercial vessels during the Second World War has not been extensively presented in Romanian historiography, although it pertains to national security and defence. After great financial efforts, in 1939, Romania had a commercial fleet that ensured part of the transport needs of exported and imported goods. With the exception of the passenger ships sent to Istanbul, the other vessels, which were in ports in the Mediterranean, the USA and Great Britain, as well as those leased to Germany, were lost. Even if some shipowners managed to recover the vessels or their value, they did not sail under the Romanian flag. The mentioned situation was determined by the geopolitical and geostrategic evolution in Europe and worldwide. With regard to Romania, the proximity to Germany and, then, the "alliance" with the government in Berlin were catastrophic also from the perspective of the situation of the Romanian commercial fleet. The USA, Great Britain and the USSR acted in accordance with their interests both during the war and after its end, so that the Romanian state could not recover any vessel or the value of those lost. [ABSTRACT FROM AUTHOR]

This paper reports on the evaluation of an integrated violence and abuse prevention programme for children aged 5–11, focusing on children with special educational needs and disabilities (SEND). The Speak Out Stay Safe (SOSS) programme was delivered in mainstream primary schools across the UK. A small‐scale study of children with SEND nested within the larger evaluation captured their understandings of abuse and harm and readiness to seek help. A specially adapted survey was completed by 76 children with SEND (aged 6–7 and 9–10) at baseline (31 intervention; 45 comparison schools), 12 in intervention schools post‐programme and 37 (four intervention; 33 comparison schools) six months post‐baseline. Qualitative data was captured through 16 teacher interviews. Whilst this nested study was compromised by the COVID‐19 pandemic, it provides important evidence that with appropriate adaptations, a survey approach to investigating the learning of children with SEND can be effective. Findings indicate that awareness of abuse and help seeking strategies may improve over time, whilst interview data suggests that adapting the programme to be inclusive of those children may have a better effect. However, a much larger sample of children with SEND is required to confidently measure the effects of such programmes for this population. [ABSTRACT FROM AUTHOR]

This article investigates the hidden and under-researched phenomenon of child/adolescent-to-parent violence and abuse (CAPVA). Despite the attention given to spousal and child abuse, very little is known about why children abuse their parents or what can be done to prevent it. This article explores how this issue is explained, its effects on parents and carers and the different interventions that have emerged to tackle it. Based on in-depth focus groups with parents, grandparents and practitioners participating in a 'Who's in Charge' intervention in the United Kingdom, this article explores the complex intersection of parenting skills, intergenerational violence, gender, neurodiversity and the associated response (or lack thereof) from education and law enforcement. The article concludes with important new recommendations on 1) the need for better referral routes, 2) greater emphasis on neurodiversity, 3) very early intervention, and 4) the benefit of online platforms used during the COVID-19 lockdown for engaging parents and grandparents. [ABSTRACT FROM AUTHOR]

Purpose: Most abuse affecting older adults in the UK, as across Europe, takes place within caring relationships, where one person is disabled and needs care/support. This paper critically appraises two of the key theoretical explanations. First, feminist theories of "intimate partner abuse" tell us that it is mostly men who perpetrate abuse against women. Second, "carer strain": the stress caused by caring responsibilities, often with inadequate help from services. Neither fully reflects the complex dynamics of "dangerous care" leading to a lack of voice and choice in safeguarding responses. This paper aims to articulate the need for an overarching theoretical framework, informed by a deeper understanding of the intersectional risk factors that create and compound the diverse experiences of harm by disabled people and family carers over the life course. Design/methodology/approach: The critical synthesis of the theoretical approaches informing UK policy and practice presented here arises from a structured literature review and discussions held with three relevant third sector agencies during the development of a research proposal. Findings: No single theory fully explains dangerous care and there are significant gaps in policy, resources and practice across service sectors, highlighting the need for joint training, intersectional working and research across service sectors. Originality/value: Drawing both on existing literature and on discussions across contrasting policy and practice sectors, this paper raises awareness of some less well-acknowledged complexities of abuse and responses to abuse in later life. [ABSTRACT FROM AUTHOR]

This study focuses on understanding the experiences of family members of problem gamblers in the United Kingdom and the gambling consequences in their lives. Family members of problem gamblers, even though they suffer from gambling consequences, the impacts of gambling are under-researched. Qualitative research through in-depth interviews was employed. Thematic analysis was used to gain a deeper insight into gambling. Nine female participants were interviewed based on a semi-structured questionnaire. The results of this study indicated that close family members of problem gamblers had suffered not only financial devastation but also harsh psychological and mental health damages. Furthermore, family members suffer from gamblers' abusive and violent behaviors. Addiction was a key factor of gamblers' habit; fear, anxiety, and depression were some of the health issues derived from gambling. Overall, gambling addiction leads to further addiction, crime, and severe, family-relation sufferings. The study results suggest that the London Gambling Commission and regulating authority should change gambling policy, reduce gambling points, and limit gambling slot machines in food markets and community areas. More support is needed for family members affected by gamblers' addictive gambling behaviors. [ABSTRACT FROM AUTHOR]

Hannah Ellis, Emily Ellis and Peter Ellis discuss the legal legislation surrounding safeguarding and explore how it applies to kidney care specialists [ABSTRACT FROM AUTHOR]

Hussar Trooper John Flood, Private C. Niblett and Private Jamie Benjafield are three British soldiers who had similar bullying experiences during their service in the British Army. All three men were antagonised by a fellow serviceman, were punished by the institution they served and felt aggrieved at their treatment. The only particular difference between them is that they served separately between a 150-year span from the 1860s through 2017. Bullying is a complicated and contentious issue that is as important today as it was a century ago. Within the military, the act of bullying demands particular attention as coercive and humiliating tactics, common within cases of bullying, have been actively employed by and within the ranks of the British Military for various reasons ranging from training and indoctrination to hazing and targeted abuse. Using the experiences of the three men and many other accounts, this article considers in detail the role of bullying within the experience and transformation of British servicemen during World War I by examining core areas where this behaviour was evident. This research interweaves the commonly identified aspects of bullying behaviour with enthusiastic civilian encouragement for recruitment, overzealous training regimes, enforced military discipline and barrack-room horseplay that were all visible during World War I. This focus remains central to the argument as the article concludes how British men were targeted, abused and humiliated by their officers, their compatriots and the public as part and parcel of the military experience between 1914-1918. [ABSTRACT FROM AUTHOR]

Image-based sexual abuse (IBSA) is a form of technology-facilitated abuse in which intimate (nude or sexual) images of a person are taken, distributed, or threats are made to distribute the images, without a person's consent. It is an increasingly criminalized form of sexual abuse, and yet little is known about the perpetrators of these harms, including the extent, relational nature and correlates of perpetration. This article reports on the first multi-country survey study to comprehensively investigate IBSA perpetration. An online panel survey of the general community (aged 16–64 years) in the United Kingdom (UK), Australia, and New Zealand (NZ) (n = 6109) found that self-reported IBSA perpetration was relatively common, with one in six (17.5%, n = 1070) respondents engaging in at least one form of IBSA. Logistic regression analyses identified nine characteristics that significantly increased the odds of having engaged in IBSA perpetration during their lifetime, namely: residing in the NZ as opposed to the UK or Australia, being male, having disability/assistance needs, holding attitudes that minimize the harms and excuse the perpetrators of IBSA, engaging in online dating behaviors, engaging in sexual self-image behaviors, and experiencing IBSA victimization (images taken, images distributed, and images threatened). Policy and prevention implications of the findings, as well as directions for future research are discussed. [ABSTRACT FROM AUTHOR]

Psychoanalysis can advance our understanding of responses from the hierarchy of mainstream religious denominations to disclosures of abuse by clergy. This paper takes analytic insights to discuss how and why the Anglican institutional church has responded so callously to disclosures of child sexual abuse within the church. Inhumane responses have led to feelings of institutional betrayal in survivor groups. The subject is explored firstly in the context of organizational and group dynamics, and, secondly, by analysing defences that underly the interaction between the person who has been abused and the member of the church hierarchy who is hearing the disclosure. Defences and deceptions have been consciously and unconsciously used within the organization that have obstructed contact with reality, and so hindered it both in fulfilling its task in responding appropriately to what has taken place, and in adapting to changing circumstances. Churches have been active agents in re-traumatising individuals. Examples to illustrate are taken from hearings on the Anglican Church by the Independent Inquiry into Child Sexual Abuse in England, UK. The idea of organizational redemption is presented. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to explore the association between child maltreatment and hospital-treated infectious diseases in middle-aged and older adults., Methods: 145,151 participants aged 38-72 years from the UK Biobank between 2006 and 2010 were enrolled and interviewed. Child maltreatment included five types: physical abuse, physical neglect, emotional abuse, emotional neglect, and sexual abuse. Patterns of maltreatment were identified using latent class analysis (LCA). Cox regression was employed to estimate the associations between child maltreatment (number of types, individual types, and patterns) and infectious diseases. Further, we evaluated potential mediators using mediation analysis., Results: Over a median follow-up of 13.4 years, 22,688 participants (12.26 per 1000 person-years) were hospitalized for an infectious disease. Participants reporting any maltreatment had elevated infectious diseases risk (HR 1.18, 95 % CI: 1.15-1.21) than those without maltreatment. A dose-response relationship was observed between the number of maltreatment types and infectious disease (one, HR 1.09 [95 % CI 1.06-1.13]; two, HR 1.17 [95 % CI 1.12-1.23]; three to five, HR 1.48 [95 %CI 1.41-1.55]; P trend  < 0.001). Each type of maltreatment was associated with increased infectious diseases risk. LCA identified four patterns (low maltreatment, child neglect, child abuse, and poly-maltreatment), with those who experienced poly-maltreatment exhibiting the highest infectious diseases risk (HR 1.51, 95 % CI: 1.43-1.59). The association between child maltreatment and infectious diseases was mediated by C-reactive protein, phenotypic age acceleration, loneliness, psychiatric disorders, and unhealthy lifestyles., Conclusions: Child maltreatment may increase susceptibility to a broad spectrum of infectious diseases in adulthood, highlighting the need for early-life maltreatment prevention policies., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Inc.)

In recent decades, part of the UK fishing industry has become increasingly reliant on migrant crew, to fill local crew shortages. With restricted immigration status and invisibility on vessels out at sea, crews are vulnerable to both extreme and mundane forms of control and exploitation. Although the UK is legally addressing the potential for trafficking and forced labour across the fishing industry, more needs to be done to address the potential for micro-disciplinary, psychological, and verbal abuse of non-European Economic Area (non-EEA) crew which remains difficult to evidence. This requires recognition of how non-EEA migrant fishers are made vulnerable by the intersection of socio-cultural practices of fishing with a visa system that anchors immigration status to named vessels, limits movements, and makes changing employers or raising complaints difficult. Taking the 2020 prosecution of a Scottish skipper for abusing Filipino crew as a discursive starting point, we explore how differences in local interpretation of fishing relationships, by skippers and non-EEA crew, reveal limited agreement over what constitutes acceptable behaviour. Drawing on fieldwork in North East Scotland, we argue that the white noise of coarse language, 'alpha male' behaviours, and narratives of risk and responsibility that dominate local fishing practice, when combined with scant appreciation of how non-EEA migrant experiences differ from other crew, can serve to obscure migrant crew's experiences of maltreatment. Greater attention is consequently required to vernacularise migrant crew rights, by making them locally meaningful so that both skippers and crew adequately recognise their responsibility to safeguard non-EEA crew. [ABSTRACT FROM AUTHOR]

The term "apostate" describes the term used by the religious to describe individuals raised within religious families who once identified as religious, but who have ceased to believe in the existence of God, gods or follow their religious belief, and now identify as non-religious. Given the strong feelings families can have about the rejection of their shared faith, and the difficulty that police forces may have in identifying and understanding the complexities of violence toward the apostate, this study sought to examine the possibility that apostates represent a hidden population of abuse victims within religious households. We recruited 228 persons (102 males, 119 females) from an online survey with the support of "Faith to Faithless"—a service within Humanists UK, which supports people that leave their religious faith. Individuals were screened using a modified version of the Conflict Tactics Scale to quantify their experience of assault and negotiation. It was found that persons who identified as apostates experienced more assault (i.e., harmful violence) than non-religious persons. Within this sample, Muslim apostates were significantly more likely to be victimized than Christian apostates. Disclosure of being abused for identifying as an apostate within a religious household to law enforcement was extremely uncommon, thereby preventing detection or prosecution of abusive acts committed by family members and limiting public awareness of this issue. These results are discussed in the context of the broader culture of honor-based (izzat) violence, which occurs across the Eastern Mediterranean, Middle East, and North Africa, and is also seen in some Protestant Christian subcultures, and common to all Abrahamic religions, rather than Islam alone. This study highlights that within a multicultural society, there remain hidden populations of abuse victims who are vulnerable due to religious, cultural, and traditional constraints made by abusive family members. [ABSTRACT FROM AUTHOR]

Long-term poverty, precarious employment, low pay, the increased pension age and real-term reductions in welfare benefits, including bereavement allowances, have brought into focus the financial vulnerability of many older women aged 55 years and older in the United Kingdom. In this article, survey data were analysed alongside evidence from observations of debt support meetings and interviews with older women who were receiving debt advice from a support charity. The findings suggest that older women were more likely to have financial problems than older men, particularly those women who were living on low incomes and who were separated or divorced. Following the breakdown of a relationship, many older women were at increased risk of more debt and bankruptcy, particularly those aged between 55 and 64 years and those in routine and semi-routine occupations. Many women had kept their financial problems hidden due to fear and shame whilst bringing up their children and some had been subject to coercive control and economic abuse by their former husbands or partners. It is important that any pension reforms, changes to minimum wage rates, and new divorce and domestic abuse legislation and welfare policies take account of the circumstances of separated, divorced and widowed older women. More financial support and advice needs to be provided to older women facing financial difficulties. [ABSTRACT FROM AUTHOR]

This paper addresses mental health and wellbeing among security operatives in the UK using a mixed-methods approach of survey questionnaire and interviews. The survey questionnaires were designed using three hybrid surveys: Warwick-Edinburgh Mental Wellbeing Scale; The Post-Traumatic Stress Disorder (PTSD) Checklist-Civilian Version (PCL-C); and CAGE-AID as a screen for substance misuse. The survey questionnaires were distributed with the support of the Security Industry Authority and the GMB Union and 754 completed surveys were returned and 15 interviews conducted. Results from the completed survey questionnaires show that 39.3% of the respondents were showing symptoms of PTSD and that many of the security operatives suffered varying degrees of verbal abuse and threats of physical violence with a number reporting acts of violence to themselves and other security operatives during the course of their employment. A key finding was the lack of provision of mental health and wellbeing services provided by the security companies to their employees and managers in general unable or unwilling to accept that some employees were suffering from poor mental health and wellbeing. [ABSTRACT FROM AUTHOR]

Introduction: Child protection has become a very poignant subject in the UK. The Laming report into the death of Victoria Climbié led to the implementation of multidisciplinary safeguarding policies and training for healthcare professionals, social services staff and police. However, many dental practitioners, as well as other healthcare professionals, have little confidence when reporting their concerns and reducing the 'gap' between suspicion and reporting (Laming in The victoria climbie inquiry: report of an inquiry by Lord Laming, 2003. https://www.gov.uk/government/publications/the-victoria-climbie-inquiry-report-of-an-inquiry-by-lord-laming). Our audit aimed to identify and address the barriers of reporting safeguarding concerns amongst the hospital team. Materials and methods: Questionnaires were distributed to staff at Surrey and Sussex Healthcare National Health Service Trust with a valid Safeguarding Children Level 3 certificate in order to assess their knowledge of safeguarding children. Changes to traditional safeguarding training (Group 1) were implemented to include a broader range of speakers, each speaking for shorter times with more personal and focused presentations (Groups 2 and 3). Three cohorts of participants were assessed including healthcare assistants, nurses, dentists, and doctors. Results: Group 1 (n = 100) reported 64% experience of reporting compared with group 2 (n = 100) 43% and group 3 (n = 76) 51%. Confidence was higher in those with more experience in child protection. The most common barrier was the uncertainty of diagnosis. More barriers to reporting existed in the new style of training in groups 2 and 3. The scenarios were answered with appropriate concern and reporting by groups 1 and 2, however, less for group 3. Discussion: Experienced and trained practitioners are more likely to refer children to child protection teams when they have concerns of abuse or neglect. Personalising training was shown to be less effective and the focus should be more on diagnosis and local protocols. Early training from undergraduate level was a unanimous request. Conclusion: Focused training on diagnosis and local protocols, accompanied by bespoke teaching for specific specialties would be the most constructive tool for safeguarding children. Exploring modern methods such as simulation-based training could be effective. Structured forms and local policies that are familiar to clinicians prevent omissions and encourage professional awareness. [ABSTRACT FROM AUTHOR]

Lesbian, gay, bisexual and trans (LGBT) inclusive sex and relationships education (SRE) is of growing interest. However, there is a lack of clarity about what LGBT inclusive SRE should/does look like in practice. This article addresses that uncertainty by examining original research findings on innovative youth work based SRE provided within an arts-based project run by a third sector organisation in the North East of England. The research is set within the context of three broad rationales for LGBT inclusive SRE: to support the mental health of LGBT+ young people; to tackle sexual health issues, and to address concerns about sexual encounters and intimate relationships. The article sets out research findings within four main themes concerning: young people's experiences of formal SRE; young people's attempts to acquire SRE informally; young people's experiences of youth work based SRE; practitioners' experiences of delivering youth work based SRE. It then draws on this data to make the case for dedicated youth work for LGBT+ young people, outlining its potential alongside school-based SRE. [ABSTRACT FROM AUTHOR]

This study explored patterns of abuse, self-harm and thoughts of suicide/self-harm in the UK during the first month of the COVID-19 pandemic using data from the COVID-19 Social Study (n=44 775), a non-probability sample weighted to population proportions. The reported frequency of abuse, self-harm and thoughts of suicide/self-harm was higher among women, Black, Asian and minority ethnic (BAME) groups and people experiencing socioeconomic disadvantage, unemployment, disability, chronic physical illnesses, mental disorders and COVID-19 diagnosis. Psychiatric medications were the most common type of support being used, but fewer than half of those affected were accessing formal or informal support. [ABSTRACT FROM AUTHOR]

Purpose: People with an intellectual disability are much more likely to be sexually violated and the violation is less likely to be reported. Despite this being high-lighted at least 3 decades ago and improvements in both safeguarding and national reporting processes, under-reporting remains a problem. This paper explored under-reporting alongside prevention possibilities using safeguarding alerts raised in a Community Learning Disability Team within a UK NHS trust. Design/methodology/approach: Using a combination of authentic but anonymised case vignettes and descriptive data drawn from the safeguarding team, under-reporting was examined through the lens of an ecological model. Safeguarding alerts raised in a particular year were compared with the number expected if all (estimated) cases of abuse were disclosed and reported. Findings: Only 4.4 per cent of expected abuse cases were reported to the team, which is lower than the reporting level the authors had expected from the literature. There is evidence in the literature of the under-reporting of sexual assault for all kinds of people. Arguably, the implications of under-reporting for PwID are even more traumatic. Research limitations/implications: Constraints included the lack of standardisation in data collection within the statutory services that report to the Birmingham Safeguarding Adults Board. One key recommendation is that the national provider of data for the NHS in the UK requires more complex and standardised audit information that would allow each local authority to benchmark their practice against a higher protection standard. Another recommendation is that compliance to quality standards sits within a comprehensive strategy. Originality/value: This paper explored the extent to which the previously documented under-reporting concern remains an issue. Certainly eye-balling safeguarding compliance data in the NHS organisation we worked in led us to a concern that reporting might be even lower than implied in the literature. This together with a renewed spot-light on sexual violence (e.g, NHS England, 2018) led us to decide that it was timely to re-examine the problem. [ABSTRACT FROM AUTHOR]

Novel psychoactive substances (NPS) are new drugs of abuse. Over the last 10 years 50–100 new NPS have been detected for the first time each year. This has led to numerous deaths and challenges to healthcare providers and law‐makers worldwide. We review preclinical studies of NPS and discuss how these studies have influenced legislative decisions. We focus on the UK legal system but include experiences from Europe. We reviewed manuscripts from 2008–2019 and have summarised the in vitro and in vivo data on NPS, highlighting how these studies define pharmacological mechanisms and how they might predict harm in humans. We found that only a small percentage of NPS have been examined in preclinical studies. Most preclinical studies of NPS focus on basic pharmacological mechanisms (46% of studies reviewed) and/or addictive liability (32%) rather than toxicity and harm (24%). Very few preclinical studies into NPS include data from chronic dosing schedules (9%) or female rodents (4%). We conclude that preclinical studies can predict harm to humans, but most of the predictions are based on basic pharmacology rather than demonstrated toxicity. Some of these studies have been used to make changes to the law in the UK and Europe and perhaps, because of the paucity of toxicology data, most NPS have been placed in the highly dangerous schedule 1 or Class A category in the UK. We suggest that in silico studies and high throughput toxicology screens might be the most economical way forward to rapidly screen the health harms of NPS. [ABSTRACT FROM AUTHOR]

There has been growing public attention around the abuse of MPs online including criminal convictions for violent threats, regular coverage of racist and misogynistic language directed at representatives. Yet, the extent of the problem and patterns of abuse remain relatively under-researched. So far, much of coverage of the problem is anecdotal or based on self-reporting from MPs. This research sets out to provide a more rigorous benchmark measure of abuse. It also examines targets and triggers for social media abuse – how far is abuse connected to contentious debates such as Brexit or targeted at specific groups of MPs (e.g. female representatives)? Our results indicate that whilst the overall volume of abuse appears low, social media abuse has become ubiquitous and is highly public. Furthermore, whilst some abuse is undoubtedly targeted and gendered, the biggest proportion of abuse follows a reactive response to political discussions and public interventions of MPs. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to discuss the relevance and importance of developing and making use of robust theory to explain and counter the tenacious social anomaly of the abuse of older people who live in care homes. Design/methodology/approach: The activities of theorising and conducting research to gain revised theoretical comprehension of why abuse occurs in care homes, along with the enduring over reliance of those with an interest in safeguarding on existing theories borrowed from other fields to guide their activities are considered and discussed. Findings: There is a pressing need for theory based understandings of the continuing abuse of older people and it is apparent that the development of such theory will be more productive if theorising and theory development are specific to certain types of abuse perpetrated in delineated settings. Practical implications: The paper offers the opportunity for the reader to consider the significance of theorising and developing new theory in order to improve of the protection of potentially vulnerable adults by virtue of the guidance it can provide to the activities of policy makers, managers and practitioners. Originality/value: This is a conceptual paper from which future theorising and research may arise to better understand the most fundamental causes of the abuse of older people in care homes (and elsewhere) in order to develop feasible and effective measures to overcome it. [ABSTRACT FROM AUTHOR]

Aims: Investigate awareness in the multidisciplinary orthopaedic trauma team regarding intimate partner violence (IPV), willingness to ask patients and knowledge of available support.Methods: Orthopaedic staff in several UK centres completed an anonymous online validated questionnaire reflecting their opinions on IPV in orthopaedics. Respondents from orthopaedic surgery, nursing, and physiotherapy participated.Results: There were 121 respondents with a mean 10 years' experience. 52% of respondents had previously had a disclosure of IPV from at least one orthopaedic patient. Doctors and nurses were equally likely to have cared for IPV patients (50% versus 56%), but doctors thought abuse was less common (57% doctors compared to 15% nurses thought IPV affected less than 1% of trauma patients, p < 0.05). 74% of respondents reported asking patients about abuse (77/104 answered) but only 24% (29/121) knew about the support currently available. Staff who did not know about available support were less likely to ask about possible abuse (46% versus 22% respectively, p < 0.05). 74% of respondents felt it was important/very important to ask about IPV.Conclusions: This is the first study investigating IPV in UK orthopaedics. Although three quarters of the staff interviewed thought that it was important to ask trauma patients about IPV, only 2% routinely ask patients presenting with musculoskeletal injuries about IPV. Orthopaedic staff are well placed to identify vulnerable patients. This study highlights the need for training staff on how to identify IPV and manage disclosures of abuse given that the incidence of IPV is on the increase. [ABSTRACT FROM AUTHOR]

Qualitative researchers are often advised to use their emotional responses to data, and participants' experiences are understood through those of researchers', how this process unfolds is less clear. This article is about the role of feelings for the qualitative researcher at different stages of the process and offers strategies for working through, 'using' and 'feeling together with' participants' reflections on lived experiences. I interviewed nine African and Caribbean heritage British women about their experiences of violence and abuse where one described feeling 'like a minority... a pathology'. This article describes my responses to experiences of racialised and gendered intrusion in interviews, later reflection and analytic work. The article brings recognition to a stigmatised and hidden process within qualitative interviews and data interpretation. This serves to amplify the impact of injustice and adverse experiences for participants, and researchers, and to a wider audience, and to validate its existence and emotional burden as a legitimate and crucial stage of qualitative data analysis. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to present findings from face-to-face interviews with three former care staff who were proven to have abused some of the older people living in the care and nursing homes in which they had once worked. The research sought to explore the intra-personal dynamics, personal characteristics and work experiences that led these staff to perpetrate abuse. Design/methodology/approach: Semi-structured interviews were undertaken with three former care and nursing home staff who had committed abusive acts and the data secured subjected to thematic narrative analysis. Findings: None of the three people interviewed had intended to become care staff and reported that the interview and induction processes they experienced did little to establish their suitability for the work they would be undertaking or to prepare them for its demands. Participants expressed their generally negative perceptions of older people, particularly those living with dementia, and told of how they also felt that they were under pressure to conform with the often abusive care home regimes that they had entered. They also recounted some specific abusive practices developed to allow them to manage the constant tension between the time available to complete all of the tasks required when "caring" for older people, and revealed their perceptions of external scrutiny of care home conduct and the behaviours developed to deflect the effectiveness of this oversight. Two interview participants also revealed their unfavourable attitudes to some of the people they were employed to care for that were based upon perceptions of ethnic differences, and of how this had contributed to the abuse they perpetrated. Research limitations/implications: Though the research draws upon the experiences of only three former care staff, the data reveal some of the intra-personal dimensions of individual staff who have engaged in abusive acts, and illuminates how the care home environment with which they interact can engender conditions under which abuse is more likely to occur. Originality/value: Unusually, the paper explores the characteristics, perceptions and experiences of care staff who have actually committed abusive acts against those entrusted to their care. [ABSTRACT FROM AUTHOR]

Although domestic abuse of women by men has received significant media, police, and research attention, domestic violence directed toward men has been marginalized across the board and is still rarely treated seriously. The purpose of this research, then, is to examine and compare different anti-domestic violence messages in which the abuser's gender is not always clear. In Study 1, 200 U.K. participants (100 females and 100 males, aged 18-67, M = 28.98, SD = 9.613) evaluated posters that varied across three levels; in that the subject (male or female) was depicted as being silenced, bruised, or experiencing live abuse. The results showed that the posters featuring female victims were all rated as more effective than posters showing male victims. In Study 2, 140 different U.K. participants (95 females; 45 males) aged 18 to 59 (M = 27.27, SD = 10.662) evaluated the cartoon facial images of Disney characters who had been altered to look like victims of violence and real-life corresponding photos of human models. The results showed that the realistic posters were found to be more believable, emotional, and effective than the cartoons. The implications of such perceptions are discussed. [ABSTRACT FROM AUTHOR]

Background: Little research has compared the mental health and victimization experiences of non-binary youth depending on their sex assigned at birth (SAAB), or compared these two groups with binary transgender youth. Aims: To compare mental health, self-harm and suicidality, substance use and victimization experiences between non-binary and binary transgender young adults, both male assigned at birth (MAAB) and female assigned at birth (FAAB). Methods: Online survey data from 677 participants from the "Youth Chances" community study of 16 to 25 year olds in the United Kingdom was analyzed, comparing across binary participants (transgender females (n = 105) and transgender males (n = 210)) and non-binary participants (MAAB (n = 93) and FAAB (n = 269)). Results: Female SAAB participants (binary and non-binary) were more likely to report a current mental health condition and history of self-harm than male SAAB participants (binary and non-binary). Similarly, female SAAB participants (binary and non-binary) were more likely to report childhood sexual abuse than male SAAB participants (binary and non-binary); the reverse pattern was found for lifetime physical assault relating to being LGBTQ. Non-binary MAAB participants were less likely than the other groups to report past suicide attempts and previous help-seeking for depression/anxiety. Binary participants reported lower life satisfaction than non-binary participants. For all four groups, mental health problems, self-harm, suicidality, alcohol use and victimization experiences were generally higher than that of youth in general population studies. Conclusions: These findings highlight the importance of considering both non-binary versus binary gender identity and SAAB in relation to mental health problems, self-harm, suicidality and substance use in transgender youth. The roles of sexual abuse, other abuse and discrimination in contributing to increased rates of mental illness and self-harm in non-binary and binary transgender individuals, particularly those who were assigned female at birth, relative to those assigned male, require investigation. [ABSTRACT FROM AUTHOR]

Violence against children can have extensive, long-term, and far-reaching adverse impacts on survivors and society. There is currently little consensus in the United Kingdom around the prevalence of violence against children: maltreatment, intimate partner violence, sexual violence, bullying, and community violence, and most existing studies focus on only a single or a few forms of violence. This study aims to produce data to highlight the current magnitude of the problem in the UK, to inform policy, drive action and allow for monitoring of progress over time. To produce weighted prevalence estimates by violence type, as well as gender and age sub-categories, to give as full a picture as possible of the current prevalence of violence against children in the UK. The prevalence of violence against children from 23 self-report studies conducted in the United Kingdom was gathered through a systematic review. Databases were searched from inception to 24th June 2022. Studies were reviewed systematically for appropriate data and meta-analyses were conducted to give pooled prevalence data based on a quality effects model. The most prevalent self-reported experience of childhood violence was community violence at 27.33 % (95 % CI [9.84, 48.97]). Prevalence of bullying was also high at 22.75 % (95 % CI [13.25, 33.86]). The most prevalent forms of child maltreatment were domestic violence exposure at 11.9 % (95 % CI [6.34, 18.84]) and emotional maltreatment at 11.84 % (95 % CI [5.58, 19.89]). National child maltreatment surveys are needed in the UK, using a comprehensive and conceptually robust approach, and valid and reliable instruments, to provide data for researchers and policymakers on the prevalence of all types of violence against children including exposure to multiple types. This allows monitoring of trends over time, can inform strategies for prevention, and can enable monitoring of future progress in reducing violence against children and its associated health and economic burden. [ABSTRACT FROM AUTHOR]

Objective: To examine the prevalence of traumatic brain injury (TBI) and past abuse experienced by adult female offenders. Methods: Twenty-nine female offenders from a UK women's prison and twenty-nine age and gender matched university controls were recruited. In addition to demographic data, the Brain Injury Screening Index was utilized alongside the Childhood Trauma Questionnaire and the Abusive Behaviour Inventory. Results: Approximately 79% (n = 21) of female offenders reported a history of TBI, with 38% (n = 8) reporting six or more injuries. However, only 28.5% of female offenders reporting injury (n = 6) believed they had sustained a brain injury. Prevalence of both childhood (n = 15, 51.7%), and partner (n = 19, 65.5%) abuse was also high among offenders. TBI Index scores correlated with past childhood and past partner physical abuse. Past mental illness, partner physical abuse, and number of convictions were predictive of greater TBI severity. Conclusion: This is the first European study to examine combined TBI and abuse among an exclusively female offender population. It suggests that TBI is as prevalent among incarcerated females as it is among males. The unique presentation of female offenders must be acknowledged if effective rehabilitation programs are to be implemented. [ABSTRACT FROM AUTHOR]

This article explores the nature of power and control under the New Poor Law to better engage with the Victorian approach to discipline and punishment in 'closed' institutions, such as workhouses. Through the mechanism of an empirical case study it will illustrate that, far from being static, approaches to punishment evolved considerably over time. The article employs sophisticated record linkage work, at the local and national level, to analyse a complex case of power, control, abuse and neglect involving women and children inmates. The study will hence challenge the theoretical constructs of punishment and discipline promoted by Foucault by focusing on the actual lived experience of female inmates in mid-nineteenth century Bedfordshire. It provides new evidence that the reality of law and order for paupers could be far removed from a strict disciplinary regime, underpinned by rigid rules and regulations and augmented by clearly defined and executed roles. For these women and children, the actual experience was far more complex and subtly expressed. It is, therefore, as much a refined case study analysis about abuse and neglect as it is a micro study about punishment. It is a story about the exploitation of power to control the workhouse population; the impact of the absence of power and the considerable and sophisticated agency employed by one of the female inmates at the centre of the events. [ABSTRACT FROM AUTHOR]

This article explored the experiences of 89 rugby league referees in England who undertook a mixed methods online survey from the January 9 to March 31, 2017. The results of the survey produced rich data from the open responses, and the quantitative measures are used to support these open responses. Findings identified an established culture of abuse towards referees, a refereeing workforce requiring greater support, better communication with the governing body and, therefore, revisions to existing policy and training. Conclusions identified specific recommendations and policy implications to improve the operational environment and working conditions and increased support for referees. [ABSTRACT FROM AUTHOR]

Purpose A previous publication in this journal reported the findings of a 2013 survey into people’s experiences of membership of a Christian church in the UK (author citation removed for the purposes of review). A major finding of this survey was that many people said they had been “harmed” by their experience with some labelling it as “Spiritual Abuse” (SA). Respondents in the 2013 study also stressed the importance of developing safeguarding policy and practice in this area. The purpose of this paper is to explore the findings of a more extensive survey conducted in 2017 which aims to identify people’s understanding of SA some four years after the initial work and within a context of some discussion and uncertainty around the term itself. The study also aims to assess the current status of safeguarding policy and practice in SA perpetrated against individuals in the Christian church in the UK. A secondary aim of the study is to ascertain how far understandings, policy and practice have developed since the initial survey was conducted. It is emphasised that the authors do not assert that SA is perpetrated solely in the Christian church. However, as this is their personal religious background it is the focus of this work.Design/methodology/approach A mixed methods online survey of Christians, Church attendees and members of Christian organisations was conducted in 2017. Data were analysed using descriptive statistics, inductive thematic and content analysis.Findings A clear definition of SA is required. There is an ongoing need to develop policy and practice in the area of SA in order to respond effectively to those who have these harmful experiences.Research limitations/implications This work has been conducted within the Christian faith community and thus, represents only this faith context. Accordingly, it is research with a specific group. The work would usefully be expanded to other faith contexts.Practical implications People are still being harmed by experiences in the Christian church. Safeguarding policy and practice in the area of spiritual abuse needs to be developed in the immediate future.Social implications Those working in statutory agencies, faith and community contexts need to develop an understanding of SA.Originality/value This is the largest survey conducted on the topic of SA in the Christian faith to date in the UK. [ABSTRACT FROM AUTHOR]

Early life experiences leave a mark on a child’s emotional, social and cognitive development. It is well established that children adopted from psychosocially depriving institutions have difficulties in executive functioning and social communication ability, but this type of research has not been replicated in children adopted from foster care. In this study, 30 primary school aged UK adoptees without a history of institutionalisation completed an assessment of their intellectual, executive functioning and social communication abilities. Compared to children of a similar age in the general population, the adopted group showed elevated emotional and behavioural difficulties on a parental report measure (Strengths and Difficulties Questionnaire, SDQ). They performed statistically poorer on two of three computerised executive functioning tests (CANTAB Intra-Extra Dimensional Shift and Spatial Working Memory) and elevated scores were observed on a parental report measure of executive functioning (Behavior Rating Inventory of Executive Functioning, BRIEF). A strong negative correlation was found between age of adoption and BRIEF scores controlling for ADHD symptoms; no other pre- or post-adoption variables strongly correlated with executive functioning. Although all participants scored below cut-off on an autism screening measure (Social Communication Questionnaire, SCQ), a moderate positive correlation was observed with age of adoption. The identified elevation in emotional, behavioural and executive functioning difficulties is in line with previous research examining children adopted from institutions; however, the observed negative correlation between BRIEF scores and age of adoption is contrary to previous evidence. Limitations and implications for future research are discussed. [ABSTRACT FROM AUTHOR]

The longitudinal study described in this article evaluated long-term counselling provided at a women’s health centre in the UK for service users on low incomes. The article focuses on the qualitative aspect of the study in which 59 women were interviewed individually before and/or after their counselling. The interviews explored how women make sense of long-term counselling in the context of their gendered experiences and complex needs. The data were analysed using thematic analysis informed by a feminist orientation and attachment theory. Four main themes emerged: “violence and loss in the context of female oppression”, “a sanctuary for women”, “non-medicalised long-term counselling in a safe setting”, and “benefits of the long view”. Participants attributed various benefits to receiving long-term counselling in a women-only environment. These included gaining employment; reduced suicidal ideation, anxiety and depression; improved physical health, improved confidence and being able to make positive changes in their relationships. The women interviewed post-counselling valued long-term counselling in this context, in contrast to short-term therapy in a medicalised environment. Wider implications with regard to clinical practice and research are discussed. [ABSTRACT FROM AUTHOR]

The risk of child sexual exploitation is a growing concern, both within community and child care settings. Within community services working with vulnerable young people, the risks of exploitation are pervasive and present a constant management problem for professionals. This makes the need for focused educational interventions within such settings all the more vital. This case study aims to describe the assessment, formulation, intervention, and outcomes of a young female considered to be at risk of sexual exploitation. It was hypothesised that, after completion of a psychoeducational group designed to enhance knowledge and skills around child sexual exploitation, positive outcomes would be seen in psychometric assessment, risk-taking behavior, and risk awareness. Results demonstrated no clinically significant change for measures of impulsivity, resourcefulness, or self-reported difficulties. A significant increase was seen for self-reported self-esteem, and all outcomes revealed a positive direction of change. Observational accounts of behavioral and attitudinal change produced more positive results, revealing an increase in prosocial behaviors and a reduction in risk-taking behaviors. Outcomes are discussed in relation to the individual’s history and the residential care environment. Implications for future research and practice are outlined, and the study limitations are considered. [ABSTRACT FROM PUBLISHER]

This interdisciplinary article revisits and re-evaluates an element of conceptual theory devised by Wolf Wolfensberger (1934-2011), one of the founding fathers of disability studies. Wolfensberger devised a typology which sought to historically position the ways in which disabled people, particularly those with intellectual impairments, have been viewed, perceived, stigmatised and (mis)used by wider society. Given that the academic, professional and practical landscape of disability studies has changed markedly over the last several decades, it is useful to revisit and reinterpret past ideas to test their ability to inform our current understandings. Using two recent examples from the United Kingdom of when care provision for people with intellectual impairments and complex needs has gone wrong, this article re-evaluates Wolfensberger's typology and concludes that it remains of relevance and should continue to inform our thinking. [ABSTRACT FROM AUTHOR]

Despite evidence of short-term effectiveness of ECT (electroconvulsive therapy), both positive and negative patient reports are common. However, research examining these polarized accounts has not adequately elucidated why such divergences occur. We thus sought to examine opposing patient narratives to better understand underlying meanings. Eighteen interviews were conducted with U.K.-based people who had experienced the treatment. Our analysis revealed that the quality of relations with staff, ECT artifacts (e.g., the ECT suite), and perceived outcomes all play a role in divergent accounts. Positive reflections on ECT emerged alongside narratives of trust in staff, comfort with ECT, and perception of sufficient personal control. Conversely, where negative evaluations of ECT predominated, there was anger associated with a lack of control, a belief that ECT made little sense, and was linked to past abuses and/or the unacceptability of side effects. We discuss the implications of our findings for professionals. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to argue for the need to move away from a sole focus on assessing and dealing with individualised risk factors in order to more fully engage with and understand the social determinants of many of the harms that are manifest in families.Design/methodology/approach It draws from a number of research studies being conducted by the authors and a literature on psycho-social approaches to social suffering.Findings It highlights the evidence on the contribution of poverty and inequality to many of the problems encountered within families. It explores how hurt, shame and loss are experienced by those who are marginalised and struggling to live well and care safely for themselves and others.Practical implications It highlights the practice implications of adopting an approach that engages with both the social and the psychological and understands their inter-relationship. It offers some thoughts on how the social in psycho-social might receive the attention it deserves, a situation which does not pertain currently.Originality/value It offers an original contribution to thinking in the area of child protection where the focus is primarily on individualised risk factors. It highlights the importance of understanding the social determinants of many of the harms experienced in families and offers some pointers towards thinking and practising differently. [ABSTRACT FROM AUTHOR]

An estimated one in nine children will run away from home or substitute care before their 16th birthday in the UK. This paper explores the safeguarding concerns and responses for children and young people who run away or go missing from home. The majority of children and young people run away from home due to family relationship problems. Running away or being physically absent from home may be due to abuse and neglect. One in 11 children reported being hurt or harmed whilst running away. For some young people, 'running to' a person or situation can present many risks and can be part of a coercive and exploitative relationship. Despite these multiple indicators of risk, there has been little focus on safeguarding policies and practice for children and young people who run away from home. Drawing on a case example of a third-sector service using Return Interview Assessments, this paper argues that professionals must ensure that all children and young people who run away or go missing from home are given meaningful opportunities to be listened to, and taken seriously, in order to ensure that a wide range of safeguarding concerns can be addressed. Copyright © 2014 John Wiley & Sons, Ltd. Key Practitioner Messages: When a child runs away from home, something may be wrong in that child's life., Some children run away or are absent from home due to abuse or neglect., Some children are 'running to' a place or person, which can place them at even more risk of harm., All children who run away need to have an opportunity to talk about what is happening in their life without feeling judged. [ABSTRACT FROM AUTHOR]

This study represents the first investigation into incidents of safeguarding concern in sport within the UK. Questionnaires were completed by 41 lead welfare officers from national governing bodies. A total of 652 cases were reported by a range of key stakeholders, covering a variety of different forms of abuse. Physical and sexual abuse were found to be the most frequently alleged forms of abuse. The majority of alleged perpetrators and victims were males. The need for a standardised form for collecting case data as part of normal practice is highlighted along with the necessity for training and support to manage safeguarding cases both internally and externally to sport organisations. [ABSTRACT FROM AUTHOR]

Evidently, various types of sexual, psychological and physical violence inflicts excruciating pain onthe female gender in epidemic proportions globally. Such abusive behaviours against women existing in any economic or social class is also a gross violation of the victim's human rights. This is further made worse by the patchy responses and inadequate support services of the criminal justice system of different countries in tackling abuse onwomen and young girls within their respective societal context. This review focuses on the problems of violence against the female gender with particular reference to the United Kingdom and assesses the responses of the British criminal justice system in dealing with these violent crimes. This review ends by making recommendations on how the justice systems in the UK can promptly and sufficiently deal with this social menace that is a major concern to all and sundry. [ABSTRACT FROM AUTHOR]

The aim of this study was to explore the nature and extent of sexual exploitation in a university student sample, while being clear that sexual exploitation is sexual abuse. Overall, 47% of participants (96 out of 204) reported having been approached by an adult in a sexual manner when they were under the age of 16. The study predicted that a number of individual characteristics would increase a young person’s vulnerability for sexual exploitation. These included low self-esteem, external locus of control, social loneliness, and insecure attachment. Results indicated lower levels of self-esteem among those who had been approached sexually, although it is not clear in terms of causality. There were no differences in scores for locus of control or loneliness. Relationship anxiety was significantly linked with children having engaged in sexual behaviors with an adult. The implications of these findings are discussed in terms of emerging individual characteristics relating to a risk of sexual exploitation. [ABSTRACT FROM PUBLISHER]

The issue of domestic violence is becoming increasingly prevalent in contemporary society and is no longer a hidden phenomenon kept behind closed doors and out of the public eye (Harne & Radford, 2008). Children living in violent homes are beginning to be seen as recognised 'victims' and there has been an increase in research literature regarding how the lives of these children are affected as a consequence of experiencing domestic violence (Cunningham & Baker, 2004). This article aims to investigate the types of behaviours primary school educational staff observed in children (4-11 years) known or suspected to experience domestic violence at home. The current research adopted a survey-based method in the form of a self-completion, postal questionnaire and utilised a non-probability convenience sample of 25 educational staff from three different schools. Children experiencing domestic violence were often found to be irritable, frustrated and angry, displaying both internal and external aggression - although inward acts of aggression were observed to be significantly more prevalent. The children were often recognised 'underachievers' and rarely reached their full academic potential. Four key themes emerged from the qualitative section of the questionnaires; children living in violent homes often have a poor self-image, the importance of early identification and improved staff training, the need for opportunities for children to disclose sensitive information to staff and the importance of information sharing. The findings from this study provide a basis for further, more extensive research into which behaviours may be evident in children experiencing domestic violence and therefore help educational staff identify these children earlier and provide their families with support and guidance. [ABSTRACT FROM AUTHOR]

Background Evidence suggests that consumers potentially put themselves at risk when purchasing medicines on-line. Whilst logos provided by regulators may provide some level of reassurance there may be other indicators which could be used by consumers to identify those websites which may be safely used. Objectives Identify characteristics of on-line pharmacies which are related to whether websites are regulated or non-regulated and those characteristics which could be used by patients to increase the likelihood of accessing regulated sites. Setting Online pharmacies which supply diazepam, fluoxetine and simvastatin. Methods Using piloted search terms via Google and Yahoo search engines, identified websites were screened for regulatory status, adherence to regulatory standards, administrative requirements, clinical assessment requirements and additional details deemed to be of relevance to a user. Characteristics of regulated and non-regulated (defined as those with an absence of a correctly linked regulatory logo) websites were compared to identify differences which could be used to improve patient safety. Main outcome measure Regulatory status, adherence to regulatory standards, quality of information provision, barriers to medicines access. Results 113 websites sold diazepam, fluoxetine and simvastatin; were identified within the first 100 results. Less than quarter were found to be regulated online pharmacies. 80 websites were willing to sell the medication without a prescription. The unregulated internet pharmacy websites (defined as those with an absence of a correctly linked regulatory logo) were found to adhere more closely to the clinical criteria, were less significantly likely to disclose a contact name and address, telephone number of the pharmacy or demand a prescription prior to sale ( P < 0.05, Fisher's Exact). Conclusions The three prescription-only medicines which are liable to abuse, have potentially serious interactions and require counselling to ensure patient safety are readily available via the internet. When purchasing medicines via this route UK consumers should be made aware of the importance of regulatory logos and additionally should ensure that the seller can be meaningfully contacted by the contact details provided. The provision of clinical information should not be used alone as an indication of the seller's provenance. [ABSTRACT FROM AUTHOR]

Purpose - People with a learning disability remain at increased risk of abuse and neglect due to a number of factors associated with learning disability per se and the culture in which they live. Understanding the prevalence of abuse within this population allows for appropriate planning and service development. Understanding more about the type and frequency of abuse (and the perpetrators) facilitates prevention of abuse. The paper aims to discuss these issues. Design/methodology/approach - All clients allocated to a psychologist between 2009 and 2011 were included in this survey. The psychologist reported whether the client had experienced any abuse over their lifetime. Information regarding the type of abuse experienced, the relationship to the abuser, and the number of different episodes of abuse was recorded. Findings - Of the 695 clients in the survey 25 per cent had experienced abuse. Of this 25 per cent, 46 per cent were men and 54 per cent were women. In all, 23 per cent of the group who had experienced abuse were referred to the service as a direct result of abuse, whilst 77 per cent were referred for another reason. The most prevalent types of abuse were emotional (27 per cent), sexual (24 per cent), physical (20 per cent), and neglect (12 per cent). Originality/value - Prevalence rates within this study are broadly in line with the existing literature. However, differences included high levels of emotional abuse, and high frequency of abuse perpetrated by women, and by family members. Psychology services should routinely screen for abuse experiences and be alert to the possibility of abuse from female caregivers. [ABSTRACT FROM AUTHOR]

This article focuses on a group whose voice is rarely heard: adopted adults who have been abused or neglected within their adoptive family. The findings are drawn from a larger study of post-adoption services and suggest that the abuse and neglect of children by adoptive family members may be more common historically than has been hitherto acknowledged. The article considers this finding in the context of the changes that have occurred in adoption legislation, policy and practice since these adults were placed. It highlights barriers to effective support for abused adopted adults and discusses their support needs. By looking at one aspect of what can go wrong in adoptions – abuse and neglect perpetrated by adoptive family members – it is argued that appropriate support will not be forthcoming unless we are truly hearing what people want. Suggestions are made regarding the development of support services for abused adopted adults and their birth parents and opportunities for adopted children to disclose maltreatment. [ABSTRACT FROM PUBLISHER]

This article examines the evidence on maltreatment in foster care, drawing on a critical review of research published in the USA, the UK and Australia. Few studies have reported on the extent of maltreatment in this setting and the evidence that does exist is inconclusive. The limited available evidence suggests that maltreatment may be reported for up to two per cent of children in foster care in any one year, but much depends on the definitions used and on local variation in thresholds for investigation. The article discusses the perpetrators and nature of this maltreatment and problems with substantiation, and highlights important gaps in the existing research. Copyright © 2013 John Wiley & Sons, Ltd. Key Practitioner Messages: It is important to distinguish allegations of maltreatment from those concerning poor standards of care. However, the boundary between the two may sometimes be unclear., Poor assessment and supervision of foster carers may increase the risk of maltreatment., Precipitate responses to allegations of poor standards of care, without a proper assessment of the balance of risks, may themselves be harmful to children's emotional wellbeing. [ABSTRACT FROM AUTHOR]