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The online distribution of abusive images has risen dramatically over recent years and this raises many questions concerning the children within the images, particularly in relation to identification and provision of services. From October 2004 until September 2007, Innocence in Danger e.V. conducted an empirical study concerning the care and treatment of victims of child pornographic exploitation (CPE) in Germany by contacting all specialized institutions nationwide dealing with sexually abused children. This was achieved through questionnaires and interviews. A total of 245 cases of child pornographic exploitation (197 girls, 48 boys) and 280 suspected cases of child pornographic exploitation were identified. It was reported that cases of CPE were of a higher complexity than offline abuse, more demanding for professionals and raised many questions about professional involvement. Identified challenges included the issue of permanence once abusive images have been distributed online, and the coping strategies of children which might foster resilience. The study concludes that even though child pornographic exploitation is much talked about, there is still a lack of knowledge in how to identify, approach and help such children.

Introduction: Women with gestational diabetes mellitus (GDM) have a higher risk of developing type 2 diabetes mellitus compared with women who never had GDM. Consequently, the question of structured aftercare for GDM has emerged. In all probability, many women do not receive care according to the guidelines. In particular, the process and interaction between obstetrical, diabetic, gynaecological, paediatric and general practitioner care lacks clear definitions. Thus, our first goal is to analyse the current aftercare situation for women with GDM in Germany, for example, the participation rate in aftercare diabetes screening, as well as reasons and attitudes stated by healthcare providers to offer these services and by patients to participate (or not). Second, we want to develop an appropriate, effective and patient-centred care model., Methods and Analysis: This is a population-based mixed methods study using both quantitative and qualitative research approaches. In various working packages, we evaluate data of the GestDiab register, of the Association of Statutory Health Insurance Physicians of North Rhine and the participating insurance companies (AOK Rheinland/Hamburg, BARMER, DAK Gesundheit, IKK classic, pronova BKK). In addition, quantitative (postal surveys) and qualitative (interviews) surveys will be conducted with randomly selected healthcare providers (diabetologists, gynaecologists, paediatricians and midwives) and affected women, to be subsequently analysed. All results will then be jointly examined and evaluated., Ethics and Dissemination: The study was approved by the ethics committee of the Faculty of Medicine, Heinrich-Heine-University Düsseldorf (Ethics Committee No.: 2019-738). Participants of the postal surveys and interviews will be informed in detail about the study and the use of data as well as the underlying data protection regulations before voluntarily participating. The study results will be disseminated through peer-reviewed journals, conferences and public information., Trial Registration Number: DRKS00020283., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)