Children's Advocacy Center

EP1.4, e-Poster Terminal 1, September 4, 2025, 11:35 - 13:00AimsIn 2022 migrants comprised 48% of all new HIV diagnoses in the EU/EEA and only four countries provided data across the care continuum for migrants. We sought to implement a HIV screening strategy for migrants in 10 European countries.MethodsBetween April 2022 – March 2023, we conducted the Mi-Health HIV Partnership, a study of migrants in 10 European countries (Belgium, Cyprus, England, France, Germany, Greece, Italy, Netherlands, Portugal, Sweden). HIV infection was determined by combined antibody/antigen, point-of-care, rapid blood or rapid oral test. Additional study variables were collected through a survey of all participants.ResultsWe screened 2402 migrants and diagnosed 154 with HIV, a prevalence rate of 6.41%. Amongst the subset of migrants self-identifying as MSM (n = 413), 74 were diagnosed with HIV, a prevalence rate of 17.92%. Of the HIV-positive MSM, 64.86% identified as South/Central American, compared to 47.46% of all MSM sampled. Higher levels (90.54%) of HIV-positive MSM were linked into healthcare compared to all MSM (48.43%). Additionally, 10.82% of HIV-positive MSM reported no/limited access to healthcare as compared to 19.73% of all MSM with no/limited access. Substantially higher levels of HIV-positive MSM (47.30%) reported stigma/racism/discrimination as their primary barrier to healthcare access as compared to all MSM in our sample (34.14%). Markedly higher levels of HIV-positive MSM identified engaging in sex work or sex with a sex worker as their primary behavioural vulnerability as compared to all MSM (64.86% versus 35.59%, respectfully). Finally, HIV-positive MSM reported lower levels of both PrEP awareness (43.24%) and using PrEP at least once in the previous year (4.05%) as compared to all MSM (68.28% and 13.08%, respectfully).ConclusionsHIV infection rates are higher amongst key population migrants. There is a need to implement community-led, targeted, culturally-sensitive screening, engagement and treatment strategies to address the multilevel barriers faced by migrants.

Abstract The 2017 French Law on the Duty of Vigilance of Parent and Lead Companies has been hailed as a pioneering national legislation to hold corporations accountable for human rights and environmental abuses. Most lawsuits brought under this law have faced a plethora of admissibility objections, and so far, only one case has resulted in a decision on the merits. Initial formalistic court decisions on admissibility have now been mostly dismissed. However, critical questions around the role and powers entrusted to judges under the law remain contested.

Disparities exist in autism identification and service access in U.S. public schools. Over- or under-identification of autism may limit access to appropriate services. This study examined racial and ethnic differences in autism identification, general education inclusion, and service access in the California education system and examined trends in autism identification by race and ethnicity in special education from 2008 to 2018. Hispanic/Latino and Pacific Islander students were less likely to be identified with autism than other groups. Black autistic students were less likely to be included in general education settings. A narrowing gap in autism identification over the past decade between White and Hispanic/Latino students suggests some improvement in equitable identification practices, although continued disparities exist.

Functional tumor volume (FTV), measured from dynamic contrast-enhanced MRI, is an imaging biomarker that can predict treatment response in breast cancer patients undergoing neoadjuvant chemotherapy (NAC). The FTV-based predictive model, combined with core biopsy, informed treatment decisions of recommending patients with excellent responses to proceed to surgery early in a large NAC clinical trial. In this retrospective study, we constructed models using FTV measurements. We analyzed performance tradeoffs when a probability threshold was used to identify excellent responders through the prediction of pathology complete response (pCR). Individual models were developed within cohorts defined by the hormone receptor and human epidermal growth factor receptor 2 (HR/HER2) subtype. A total of 814 patients enrolled in the I-SPY 2 trial between 2010 and 2016 were included with a mean age of 49 years (range: 24 to 77). Among these patients, 289 (36%) achieved pCR. The area under the ROC curve (AUC) ranged from 0.68 to 0.74 for individual HR/HER2 subtypes. When probability thresholds were chosen based on minimum positive predictive value (PPV) levels of 50%, 70%, and 90%, the PPV-sensitivity tradeoff varied among subtypes. The highest sensitivities (100%, 87%, 45%) were found in the HR-/HER2+ sub-cohort for probability thresholds of 0, 0.62, and 0.72; followed by the triple-negative sub-cohort (98%, 52%, 4%) at thresholds of 0.13, 0.58, and 0.67; and HR+/HER2+ (78%, 16%, 8%) at thresholds of 0.34, 0.57, and 0.60. The lowest sensitivities (20%, 0%, 0%) occurred in the HR+/HER2- sub-cohort. Predictive models developed using imaging biomarkers, alongside clinically validated probability thresholds, can be incorporated into decision-making for precision oncology.

Although evidence-based treatments (EBTs) for youth trauma have been developed, trauma-informed EBTs are rarely used in community settings. Clinician concerns about evidence-based trauma treatment may be a barrier to adoption and delivery. However, few instruments to assess clinician beliefs about specific EBTs, such as trauma-focused cognitive behavior therapy (TF-CBT) are available. This study evaluated an instrument of clinician concerns about TF-CBT, the TF-CBT Therapist Stuck Points questionnaire, in a sample of community mental health clinicians training in a year-long TF-CBT community-based learning collaborative. The 26 items in the instruments, which aim to assess clinician views on child trauma treatment and TF-CBT, indicate preliminary psychometric support (i.e., item-total correlations, internal consistency, negative correlations with measures of attitudes towards evidence-based practice). Scores on the TF-CBT Therapist Stuck Points questionnaire revealed that, on average, clinicians expressed concerns about having children talk about their trauma in session, the effectiveness of certain TF-CBT components, and whether to involve caregivers in treatment. Clinician doubts could be targeted during a TF-CBT implementation effort and clinical supervision to facilitate treatment delivery. Implications for assessing TF-CBT specific beliefs during implementation are discussed.

Numerous efforts are underway to train clinicians in evidence-based practices. Unfortunately, the field has few practical measures of therapist adherence and skill with which to judge the success of these training and implementation efforts. One possible assessment method is using behavioral rehearsal, or role-play, as an analogue for therapist in-session behavior. The current study describes aspects of reliability, validity and utility of a behavioral role-play assessment developed to evaluate therapist adherence and skill in implementing Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT). TF-CBT role-play assessments were conducted with a sample of 43 therapists as part of a larger training study. The TF-CBT role-play assessments were independently coded for TF-CBT adherence and skill by a certified TF-CBT trainer and three clinical psychology doctoral students. Findings indicated good interrater reliability for the individual items (ICC: M = .71, SD = .15). Regarding utility, 67.19% (n = 43/64) of contacted therapists completed the role-play assessment, which took an average of 30min (M = 31.42, SD = 5.65) to complete and 60min (M = 62.84, SD = 11.31) to code. Therapists with a master's degree were more likely to complete the role-play assessment than those with other degrees but no other differences in demographic variables, practice characteristics, or TF-CBT knowledge or training were found between participants and nonparticipants. Role-play assessments may offer an alternative to observational coding for assessing therapist adherence and skill, particularly in contexts where session recordings are not feasible.

Our current educational system places the onus on individual professions to create large-scale change within the field of child maltreatment. Historically, each profession has expended significant time and resources to personally create and traverse their own pathway in addressing the prevention and treatment of child abuse and neglect. The siloed structure of our current educational system inherently limits our collective vision and impact toward a safer future for children. Our greatest collective failing has been the failure to effectively shift the focus across professional disciplines from post-maltreatment intervention to that of primary prevention. Our vision for breaking down educational silos begins at the undergraduate level, continues throughout the graduate and post-graduate progression, and culminates in professional leadership training and mentorship. We are convinced that this multi-tiered educational approach will create the necessary foundation to support a collaborative approach to the design, dissemination, and implementation of a new era of within- and cross-systems best practices in child abuse prevention. Our paper will focus on the creation of the EndCAN Academy to serve as the unifying leader in this vision.

Clinical norms were developed for two screening tools recently developed by Briere and published by Psychological Assessment Resources. The screening measures were derived from the most predictive items of the Trauma Symptom Checklist for Children (TSCC) and the Trauma Symptom Checklist for Young Children (TSCYC). Both screening measures (TSCC-Screening Form and TSCYC-Screening Form) have a total of 20 items measuring general trauma (12 items) and sexual concerns (8 items). Briere and Wherry report on the reliability and validity of the instrument when used with a normative group of children who are not identified as abused. This clinical sample of abused children seeking services from a child advocacy center was comprised of 86.1% females and 55.4% Hispanic children. Data were collected for 177 TSCYCs and 261 TSCCs. Internal consistencies ranged from an α of .74 to .85, and correlation coefficients indicating validity with the longer scales ranging from an r = .563 to .807. T score norms were calculated for this clinical sample. The measure has promise as a tool for screening multiple domains with child and caregiver informants; and in addition to its psychometric properties, it assesses sexualized behavior, suicidal thoughts, and trauma.