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Online child sexual abuse encompasses a range of offenses including the accessing, downloading, sharing and creating of images of child sexual abuse, often referred to as Child Sexual Abuse Material (CSAM). CSAM consumption has increased exponentially, and the lockdowns implemented as a response to COVID-19 have exacerbated this problem. CSAM offenders are more likely than other sex offenders to be married, to have children and to live with a partner and child(ren). Policy, practice and research has largely considered these families within the context of their protective properties, with little consideration for the individual and collective harms that they experience, and their unique support needs. Using data from 20 interviews with family members of those convicted of CSAM offenses in the UK, we propose seven key elements that characterize the impacts of CSAM offending on non-offending family members. We categorize these as: 1) Disenfranchised Grief; 2) Ambiguous Loss; 3) Ontological Assault; 4) Contamination by Causal Responsibility; 5) Wall of Silence; 6) No-Win Situation, and 7) Burden of Responsibility. We propose policy and practice responses to minimize these harms. [ABSTRACT FROM AUTHOR]

Background: The internet is used by many new rheumatology patients before visiting a health care provider, and is also used for health education, for recruiting study participants, administering surveys, conducting clinical trials, data entry and management of multicenter trials, and providing a forum for patients to share experiences in chat rooms. The internet has not been used for nor evaluated for public health applications., Objectives: We evaluated the internet for early detection and referral of individuals with "typical" early symptoms of undiagnosed rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE)., Methods: The websites and selected links identified by search terms of typical symptoms were evaluated for health information quality, readability, and whether or not the sites prioritized possibilities and suggested actions., Results: None of the websites examined were completely suitable for finding undiagnosed persons with early RA or SLE. Although the websites had accurate information, their reading levels were too high for the average reader, and were generally poor in terms of giving a differential diagnosis, prioritizing the possibilities and none provided an algorithm for action., Conclusions: Internet sites could be enhanced for early detection and referral. The internet has become an important factor in clinical practice and physicians are increasingly explaining or responding to the information that their patients find on the internet. Our study shows that the information available to individuals with undiagnosed RA and SLE is likely to be of little help to them and could delay their seeking appropriate attention.