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Sullivan KS, Richardson S, Ross A, Cederbaum JA, Pflieger J, Abramovitz L, Bukowinski A, Stander V. Pre- and Perinatal Risk Factors for Child Maltreatment in Military Families Across the First Two Years of Life. CHILD MALTREATMENT 2023; 28:209-220. [PMID: 35427204 DOI: 10.1177/10775595221088198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Military families are exposed to a unique constellation of risk factors, which may impact maltreatment outcomes. The present study examined prospective relationships between demographic, health, birth-related, and military-specific risk factors identified prior to a child's birth on their risk for maltreatment in the first two years of life. Data from the Millennium Cohort Study, Department of Defense (DoD) operational records and Family Advocacy Program data on met-criteria maltreatment, and Birth and Infant Health Research program data on suspected maltreatment were linked for 9076 service member parents. Discrete time survival analysis showed that preterm birth increased risk of maltreatment while parents' older age, physical health, and service in the Navy or Air Force decreased risk. Building on DoD's New Parent Support Program, findings suggest the need for universal and targeted prevention efforts, beginning during pregnancy, which limit or eliminate risk factors for maltreatment in military families.
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Affiliation(s)
| | - Sabrina Richardson
- Leidos, Inc., San Diego, CA, USA
- Center for Deployment Health Research, 115252Naval Health Research Center, San Diego, CA, USA
| | - Abigail Ross
- Graduate School of Social Service, 5923Fordham University, New York, NY, USA
| | - Julie A Cederbaum
- Suzanne Dworak-Peck School of Social Work, 5116University of Southern California, Los Angeles, CA, USA
| | - Jacqueline Pflieger
- Leidos, Inc., San Diego, CA, USA
- Center for Deployment Health Research, 115252Naval Health Research Center, San Diego, CA, USA
| | - Lisa Abramovitz
- Leidos, Inc., San Diego, CA, USA
- Center for Deployment Health Research, 115252Naval Health Research Center, San Diego, CA, USA
| | - Anna Bukowinski
- Leidos, Inc., San Diego, CA, USA
- Center for Deployment Health Research, 115252Naval Health Research Center, San Diego, CA, USA
| | - Valerie Stander
- Center for Deployment Health Research, 115252Naval Health Research Center, San Diego, CA, USA
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Negriff S. Incidence of child maltreatment diagnosis in electronic health records of a large integrated healthcare system: 2001-2018. J Child Health Care 2022:13674935221116485. [PMID: 35938633 DOI: 10.1177/13674935221116485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to identify the number of children (<18years old) with an International Classification of Disease (ICD) diagnosis code for child maltreatment each year from 2001-2018 and examine differences by age, gender, and race/ethnicity. Data were drawn from the electronic health records of children (birth to <18years old) who were members of a large integrated healthcare system in California. We calculated the incidence rate (1 per 1000 children) for each year from 2001-2018 separately by age groups, gender, and race/ethnicity. Adolescents (11-15years old) had the overall highest incidence of all ages groups. Females had nearly twice the rate of males for the past 5years. Lastly, for race/ethnicity Black children had the highest incidence and Asian children the lowest. The findings demonstrate that maltreatment diagnosis in medical settings may be underused. Understanding the trends of these ICD codes by demographic characteristics yields information that health care providers may use to both increase the identification and documentation of child maltreatment.
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Affiliation(s)
- Sonya Negriff
- Department of Research & Evaluation, 82579Kaiser Permanente Southern California, Pasadena, CA, USA
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Kerr PL, Bryant G. Use of ICD-10 Codes for Human Trafficking: Analysis of Data From a Large, Multisite Clinical Database in the United States. Public Health Rep 2022; 137:83S-90S. [PMID: 35775908 DOI: 10.1177/00333549221095631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES People experiencing trafficking often seek health care but are not identified. Although the Centers for Disease Control and Prevention added new International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) codes specific to human trafficking (hereinafter, HT ICD-10-CM codes) that could systematize the identification and documentation of human trafficking in US health care settings, the extent of their use is unknown. The objectives of this study were to investigate (1) the frequency of HT ICD-10-CM code use in US health care organizations (HCOs) and (2) demographic data associated with HT ICD-10-CM codes using a large clinical database. METHODS This retrospective study used deidentified data collected from October 1, 2018, through March 30, 2021, from a clinical database (N = 69 740 144 patients) network (TriNetX) of 48 collaborating US HCOs. Data included number of patients with ≥1 HT ICD-10-CM code, diagnoses, and demographic characteristics (age, sex, race, ethnicity, and region). RESULTS HT ICD-10-CM codes were associated with 298 patients in US HCOs, most of whom were young (mean [SD] age, 26 [16] y), White (53.0%; n = 158), and female (87.9%; n = 262). Thirty-seven of 48 (77.1%) participating HCOs used ≥1 HT ICD-10-CM code. The most frequently used HT ICD-10-CM codes were "forced sexual exploitation, suspected" (32.2%; n = 96) and "personal history of forced labor or sexual exploitation" (27.1%; n = 81). Labor trafficking codes were noted in approximately 3.7% of cases. CONCLUSIONS HT ICD-10-CM codes are being used by health care professionals, as confirmed by large databases. Further research is needed to understand variation in code use and risk factors associated with human trafficking.
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Affiliation(s)
- Patrick L Kerr
- Department of Behavioral Medicine and Psychiatry, West Virginia University School of Medicine-Charleston, Charleston, WV, USA
| | - Gavin Bryant
- Charleston Area Medical Center, Charleston, WV, USA
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Rebbe R, Mienko JA, Martinson ML. Reports and Removals of Child Maltreatment-Related Hospitalizations: A Population-Based Study. CHILD MALTREATMENT 2022; 27:235-245. [PMID: 33375836 DOI: 10.1177/1077559520984549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Despite U.S. child protective services (CPS) agencies relying on mandated reporters to refer concerns of child maltreatment to them, there is little data regarding which children mandated reporters decide to report and not to report. This study addresses this gap by utilizing a population-based linked administrative dataset to identify which children who are hospitalized for maltreatment-related reasons are reported to CPS and which are removed by CPS. The dataset was comprised of all children born in Washington State between 1999 and 2013 (N = 1,271,416), all hospitalizations for children under the age of three, and all CPS records. We identified maltreatment-related hospitalizations using standardized diagnostic codes. We examined the records for children with maltreatment-related hospitalizations to identify hospitalization-related CPS reports and if the child was removed from their parents. We tested for differences in these system responses using multinomial regression. About two-thirds of children identified as experiencing a child maltreatment-related hospitalization were not reported to CPS. We found differences in responses by maltreatment subtype and the type of diagnostic code. Children whose hospitalizations were related to abuse and associated with a specific maltreatment code had increased odds of being both reported to CPS and subsequently removed by CPS.
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Affiliation(s)
- Rebecca Rebbe
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Joseph A Mienko
- Center for Social Sector Analytics & Technology, School of Social Work, University of Washington, Seattle, WA, USA
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Negriff S, DiGangi MJ, Sharp AL, Wu J. Injuries Associated With Subsequent Child Maltreatment Diagnosis: By Age, Race, Gender, and Medicaid Status. CHILD MALTREATMENT 2022; 27:225-234. [PMID: 34315243 DOI: 10.1177/10775595211031385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This study examined injuries that may precede a child maltreatment (CM) diagnosis, by age, race/ethnicity, gender, and Medicaid status using a retrospective case-control design among child members of a large integrated healthcare system (N = 9152 participants, n = 4576 case). Injury categories based on diagnosis codes from medical visits were bruising, fractures, lacerations, head injury, burns, falls, and unspecified injury. Results showed that all injury categories were significant predictors of a subsequent CM diagnosis, but only for children < 3 years old. Specifically, fracture and head injury were the highest risk for a subsequent CM diagnosis. All injury types were significant predictors of maltreatment diagnosis for Hispanic children < 3 years, which was not the case for the other race/ethnicities. Overall, these findings suggest that all types of injury within these specific categories should have a more thorough assessment for possible abuse for children under 3 years. This work can inform the development of clinical decision support tools to aid healthcare providers in detecting abusive injuries.
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Affiliation(s)
- Sonya Negriff
- Department of Research & Evaluation, 166700Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Mercie J DiGangi
- Department of Pediatrics, 166700Kaiser Permanente Southern California, Bellflower, CA, USA
| | - Adam L Sharp
- Department of Research & Evaluation, 166700Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Jun Wu
- Department of Research & Evaluation, 166700Kaiser Permanente Southern California, Pasadena, CA, USA
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Maguire-Jack K, Jespersen B, Korbin JE, Spilsbury JC. Rural Child Maltreatment: A Scoping Literature Review. TRAUMA, VIOLENCE & ABUSE 2021; 22:1316-1325. [PMID: 32274967 DOI: 10.1177/1524838020915592] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
TOPIC OF REVIEW The current study sought to review the state of existing knowledge on rural maltreatment. METHOD OF REVIEW We conducted a scoping literature review to answer two research questions: (1) Is maltreatment higher in rural areas compared to urban areas? and 2) Are there unique correlates of maltreatment in rural areas? NUMBER OF RESEARCH STUDIES MEETING THE CRITERIA FOR REVIEW This review included studies that compared child maltreatment in rural and urban areas in the United States (9) and predictors of maltreatment in rural areas (7). CRITERIA FOR INCLUSION Studies that compared child maltreatment in rural and urban areas in the United States were included. For our second research question, related to understanding maltreatment in rural areas, we included those studies that exclusively examined rural areas, when maltreatment was the outcome variable. HOW RESEARCH STUDIES WERE IDENTIFIED Studies were reviewed from relevant databases (Annual Reviews, PsychINFO, PubMed, Web of Science) between 1975 and 2019. MAJOR FINDINGS Findings were mixed on whether rates of maltreatment were higher or lower in rural areas. While five studies reported higher rates of maltreatment in rural areas, four reported higher rates in urban areas. Overall, child maltreatment rates tended to be higher in urban areas among people of color and higher in rural areas among White people. One study found that community economic factors were not related to maltreatment in a rural area, in stark contrast to robust findings from urban areas.
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Santaularia NJ, Larson R, Uggen C. Criminal punishment and violent injury in Minnesota. Inj Epidemiol 2021; 8:11. [PMID: 33715637 PMCID: PMC7958430 DOI: 10.1186/s40621-021-00303-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 01/30/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Violence is one of the leading causes of injury and death in the United States. One-way society attempts to eliminate violence is through criminal punishment. Yet, in many contexts, punishment fails to reduce violence and may cause other harms. Current research on violence often suffers from same-source bias which can produce spurious associations. This study assesses the associations of different forms of criminal punishment (monetary sanctions, incarceration, and probation) with violent injuries in two unique datasets. METHODS This study examines a unique combination of hospital discharge data and court administrative data, two Minnesota county-level data sources. First, we assess the spatial distribution of the three criminal punishment variables and two violent injury variables, violent injury overall and violent injury in children by county from 2010 to 2014, using Moran's I statistic and Local Indicators of Spatial Autocorrelation. Then we assess the association of criminal punishment on violent injury and child abuse injury using a two-way fixed effects panel models. RESULTS Child abuse injuries are relatively rare in our data but are significantly concentrated geographically, unlike violent injuries which are more dispersed throughout Minnesota. Incarceration and probation are significantly geographically concentrated in similar regions while monetary sanctions are not geographically concentrated. We find a link between probation loads and violent injury, specifically, with a 1 day increase in per capita probation supervision associated with a 0.044 increase in violent injury incidence per 1000 people. In contrast, monetary sanctions and incarceration loads have little association with either violent injury or child abuse injury incidence. CONCLUSIONS Criminal punishment is intended to reduce harm in society, but many argue that it may bring unintended consequences such as violence. This study finds that county-level probation has a modest positive association with county-level violent injury rates, but monetary sanctions and incarceration are less associated with violence injury rates. No measure of criminal punishment was associated with a reduction in violence. This study addresses a gap in previous literature by examining the association of punishment and violence in two unrelated datasets. High rates of criminal punishment and violent injury are both urgent public health emergencies. Further individual-level investigation is needed to assess potential links.
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Affiliation(s)
- N Jeanie Santaularia
- Division of Epidemiology and Community Health, 1300 2nd Street S, Minneapolis, MN, 55454, USA. .,Minnesota Population Center, University of Minnesota, 225 19th Ave S #50th, Minneapolis, MN, 55455, USA.
| | - Ryan Larson
- Department of Sociology, University of Minnesota, 909 Social Sciences Building, 267 19th Ave S, Minneapolis, MN, 55455, USA
| | - Christopher Uggen
- Department of Sociology, University of Minnesota, 909 Social Sciences Building, 267 19th Ave S, Minneapolis, MN, 55455, USA
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George J, Häsler B, Komba E, Sindato C, Rweyemamu M, Mlangwa J. Towards an integrated animal health surveillance system in Tanzania: making better use of existing and potential data sources for early warning surveillance. BMC Vet Res 2021; 17:109. [PMID: 33676498 PMCID: PMC7936506 DOI: 10.1186/s12917-021-02789-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 02/03/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Effective animal health surveillance systems require reliable, high-quality, and timely data for decision making. In Tanzania, the animal health surveillance system has been relying on a few data sources, which suffer from delays in reporting, underreporting, and high cost of data collection and transmission. The integration of data from multiple sources can enhance early detection and response to animal diseases and facilitate the early control of outbreaks. This study aimed to identify and assess existing and potential data sources for the animal health surveillance system in Tanzania and how they can be better used for early warning surveillance. The study used a mixed-method design to identify and assess data sources. Data were collected through document reviews, internet search, cross-sectional survey, key informant interviews, site visits, and non-participant observation. The assessment was done using pre-defined criteria. RESULTS A total of 13 data sources were identified and assessed. Most surveillance data came from livestock farmers, slaughter facilities, and livestock markets; while animal dip sites were the least used sources. Commercial farms and veterinary shops, electronic surveillance tools like AfyaData and Event Mobile Application (EMA-i) and information systems such as the Tanzania National Livestock Identification and Traceability System (TANLITS) and Agricultural Routine Data System (ARDS) show potential to generate relevant data for the national animal health surveillance system. The common variables found across most sources were: the name of the place (12/13), animal type/species (12/13), syndromes (10/13) and number of affected animals (8/13). The majority of the sources had good surveillance data contents and were accessible with medium to maximum spatial coverage. However, there was significant variation in terms of data frequency, accuracy and cost. There were limited integration and coordination of data flow from the identified sources with minimum to non-existing automated data entry and transmission. CONCLUSION The study demonstrated how the available data sources have great potential for early warning surveillance in Tanzania. Both existing and potential data sources had complementary strengths and weaknesses; a multi-source surveillance system would be best placed to harness these different strengths.
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Affiliation(s)
- Janeth George
- Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, P.O. Box 3021, Morogoro, Tanzania.
- SACIDS Foundation for One Health, Sokoine University of Agriculture, P.O. Box 3297, Morogoro, Tanzania.
| | - Barbara Häsler
- Department of Pathobiology and Population Sciences, Veterinary Epidemiology, Economics, and Public Health Group, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, AL9 7TA, UK
| | - Erick Komba
- Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, P.O. Box 3021, Morogoro, Tanzania
| | - Calvin Sindato
- SACIDS Foundation for One Health, Sokoine University of Agriculture, P.O. Box 3297, Morogoro, Tanzania
- National Institute for Medical Research, Tabora Research Centre, Tabora, Tanzania
| | - Mark Rweyemamu
- SACIDS Foundation for One Health, Sokoine University of Agriculture, P.O. Box 3297, Morogoro, Tanzania
| | - James Mlangwa
- Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, P.O. Box 3021, Morogoro, Tanzania
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Syed S, Ashwick R, Schlosser M, Gonzalez-Izquierdo A, Li L, Gilbert R. Predictive value of indicators for identifying child maltreatment and intimate partner violence in coded electronic health records: a systematic review and meta-analysis. Arch Dis Child 2021; 106:44-53. [PMID: 32788201 PMCID: PMC7788194 DOI: 10.1136/archdischild-2020-319027] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 06/15/2020] [Accepted: 06/16/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Electronic health records (EHRs) are routinely used to identify family violence, yet reliable evidence of their validity remains limited. We conducted a systematic review and meta-analysis to evaluate the positive predictive values (PPVs) of coded indicators in EHRs for identifying intimate partner violence (IPV) and child maltreatment (CM), including prenatal neglect. METHODS We searched 18 electronic databases between January 1980 and May 2020 for studies comparing any coded indicator of IPV or CM including prenatal neglect defined as neonatal abstinence syndrome (NAS) or fetal alcohol syndrome (FAS), against an independent reference standard. We pooled PPVs for each indicator using random effects meta-analyses. RESULTS We included 88 studies (3 875 183 individuals) involving 15 indicators for identifying CM in the prenatal period and childhood (0-18 years) and five indicators for IPV among women of reproductive age (12-50 years). Based on the International Classification of Disease system, the pooled PPV was over 80% for NAS (16 studies) but lower for FAS (<40%; seven studies). For young children, primary diagnoses of CM, specific injury presentations (eg, rib fractures and retinal haemorrhages) and assaults showed a high PPV for CM (pooled PPVs: 55.9%-87.8%). Indicators of IPV in women had a high PPV, with primary diagnoses correctly identifying IPV in >85% of cases. CONCLUSIONS Coded indicators in EHRs have a high likelihood of correctly classifying types of CM and IPV across the life course, providing a useful tool for assessment, support and monitoring of high-risk groups in health services and research.
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Affiliation(s)
- Shabeer Syed
- UCL Great Ormond Street Institute of Child Health, Population, Policy and Practice, University College London, London, UK
- Oxford Institute of Clinical Psychology Training and Research, University of Oxford, Oxford, UK
| | - Rachel Ashwick
- Oxford Institute of Clinical Psychology Training and Research, University of Oxford, Oxford, UK
| | - Marco Schlosser
- Division of Psychiatry, University College London, London, UK
| | | | - Leah Li
- UCL Great Ormond Street Institute of Child Health, Population, Policy and Practice, University College London, London, UK
| | - Ruth Gilbert
- UCL Great Ormond Street Institute of Child Health, Population, Policy and Practice, University College London, London, UK
- Institute of Health Informatics and Health Data Research UK, University College London, London, UK
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Muldoon K, Smith G, Talarico R, Heimerl M, McLean C, Sampsel K, Manuel D. A 15-Year Population-Based Investigation of Sexual Assault Cases Across the Province of Ontario, Canada, 2002-2016. Am J Public Health 2019; 109:1280-1287. [PMID: 31318596 DOI: 10.2105/ajph.2019.305179] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives. To estimate the population-level frequencies and standardized rates of sexual assault cases in the province of Ontario, Canada.Methods. We conducted a 15-year retrospective analysis (2002-2016) of sexual assault cases by linking 5 provincial administrative health databases. We defined sexual assault by an algorithm of 23 International Classification of Diseases, 10th Revision, and physician billing codes. We calculated age- and sex-stratified standardized rates per 100 000 census population, and we used age- and sex-stratified Poisson regressions to determine annual rate ratios.Results. Between 2002 and 2016, there were 52 780 incident cases of sexual assault in Ontario at a rate of 27.38 per 100 000 population. The highest rates were found among females aged 15 to 19 years (187 per 100 000) and 20 to 24 years (127 per 100 000). Among males, the highest rates were observed among children aged 0 to 4 years (41 per 100 000) and 5 to 9 years (29 per 10 000). Among males and females, the annual rate ratio increased among those aged 15 years and older and decreased among those aged 14 years and younger.Conclusions. Sexual assault was documented across all age groups and sexes, from children to elders, with high standardized rates among adolescents and children.
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Affiliation(s)
- Katherine Muldoon
- Katherine Muldoon, Glenys Smith, Robert Talarico, and Douglas Manuel are with ICES and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada. Kari Sampsel and Cheynne McLean are with Faculty of Medicine, The Ottawa Hospital and University of Ottawa, Ottawa. Melissa Heimerl is with Ottawa Victim Services and the Victimology Program at Algonquin College, Ottawa
| | - Glenys Smith
- Katherine Muldoon, Glenys Smith, Robert Talarico, and Douglas Manuel are with ICES and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada. Kari Sampsel and Cheynne McLean are with Faculty of Medicine, The Ottawa Hospital and University of Ottawa, Ottawa. Melissa Heimerl is with Ottawa Victim Services and the Victimology Program at Algonquin College, Ottawa
| | - Robert Talarico
- Katherine Muldoon, Glenys Smith, Robert Talarico, and Douglas Manuel are with ICES and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada. Kari Sampsel and Cheynne McLean are with Faculty of Medicine, The Ottawa Hospital and University of Ottawa, Ottawa. Melissa Heimerl is with Ottawa Victim Services and the Victimology Program at Algonquin College, Ottawa
| | - Melissa Heimerl
- Katherine Muldoon, Glenys Smith, Robert Talarico, and Douglas Manuel are with ICES and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada. Kari Sampsel and Cheynne McLean are with Faculty of Medicine, The Ottawa Hospital and University of Ottawa, Ottawa. Melissa Heimerl is with Ottawa Victim Services and the Victimology Program at Algonquin College, Ottawa
| | - Cheynne McLean
- Katherine Muldoon, Glenys Smith, Robert Talarico, and Douglas Manuel are with ICES and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada. Kari Sampsel and Cheynne McLean are with Faculty of Medicine, The Ottawa Hospital and University of Ottawa, Ottawa. Melissa Heimerl is with Ottawa Victim Services and the Victimology Program at Algonquin College, Ottawa
| | - Kari Sampsel
- Katherine Muldoon, Glenys Smith, Robert Talarico, and Douglas Manuel are with ICES and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada. Kari Sampsel and Cheynne McLean are with Faculty of Medicine, The Ottawa Hospital and University of Ottawa, Ottawa. Melissa Heimerl is with Ottawa Victim Services and the Victimology Program at Algonquin College, Ottawa
| | - Douglas Manuel
- Katherine Muldoon, Glenys Smith, Robert Talarico, and Douglas Manuel are with ICES and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada. Kari Sampsel and Cheynne McLean are with Faculty of Medicine, The Ottawa Hospital and University of Ottawa, Ottawa. Melissa Heimerl is with Ottawa Victim Services and the Victimology Program at Algonquin College, Ottawa
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Dougall N, Savinc J, Maxwell M, Karatzias T, O'Connor RC, Williams B, Grandison G, John A, Cheyne H, Fyvie C, Bisson JI, Hibberd C, Abbott-Smith S, Nolan L. Childhood adversity, mental health and suicide (CHASE): a methods protocol for a longitudinal case-control linked data study. Int J Popul Data Sci 2019; 5:1338. [PMID: 34232970 PMCID: PMC7473285 DOI: 10.23889/ijpds.v5i1.1338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Introduction Suicide is a tragic outcome with devastating consequences. In 2018, Scotland experienced a 15% increase in suicide from 680 to 784 deaths. This was marked among young people, with an increase of 53% in those aged 15-24, the highest since 2007. Early intervention in those most at risk is key, but identification of individuals at risk is complex, and efforts remain largely targeted towards universal suicide prevention strategies with little evidence of effectiveness. Recent evidence suggests childhood adversity is a predictor of subsequent poor social and health outcomes, including suicide. This protocol reports on methodology for harmonising lifespan hospital contacts for childhood adversity, mental health, and suicidal behaviour. This will inform where to 1) focus interventions, 2) prioritise trauma-informed approaches, and 3) adapt support avenues earlier in life for those most at risk. Methods This study will follow a case-control design. Scottish hospital data (physical health SMR01; mental health SMR04; maternity/birth record SMR02; mother’s linked data SMR01, SMR04, death records) from 1981 to as recent as available will be extracted for people who died by suicide aged 10-34, and linked on Community Health Index unique identifier. A randomly selected control population matched on age and geography at death will be extracted in a 1:10 ratio. International Classification of Disease (ICD) codes will be harmonised between ICD9-CM, ICD9, ICD10-CM and ICD10 for childhood adversity, mental health, and suicidal behaviour. Results ICD codes for childhood adversity from four key studies are reported in two categories, 1) Maltreatment or violence-related codes, and 2) Codes suggestive of maltreatment. ‘Clinical Classifications Software’ ICD codes to operationalise mental health codes are also reported. Harmonised lifespan ICD categories were achieved semi-automatically, but required labour-intensive supplementary manual coding. Cross-mapped codes are reported. Conclusion There is a dearth of evidence about touchpoints prior to suicide. This study reports methods and harmonised ICD codes along the lifespan to understand hospital contact patterns for childhood adversity, which come to the attention of hospital practitioners. Key words Childhood Adversity, Adverse Childhood Experiences, Mental Health, Self-harm, Suicide, Suicidality, Violence, Hospital episodes, Routine Data, Data Linkage, Study Protocol
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Affiliation(s)
- N Dougall
- School of Health & Social Care, Edinburgh Napier University, Edinburgh, EH11 4BN, UK
| | - J Savinc
- School of Health & Social Care, Edinburgh Napier University, Edinburgh, EH11 4BN, UK
| | - M Maxwell
- Nursing, Midwifery and Allied Health Professions Research Unit, Scion House, University of Stirling, Stirling, FK9 4LA, UK
| | - T Karatzias
- School of Health & Social Care, Edinburgh Napier University, Edinburgh, EH11 4BN, UK
| | - R C O'Connor
- Institute of Health & Wellbeing, University of Glasgow, Glasgow, G12 8RZ, UK
| | - B Williams
- School of Health & Social Care, Edinburgh Napier University, Edinburgh, EH11 4BN, UK
| | - G Grandison
- School of Health & Social Care, Edinburgh Napier University, Edinburgh, EH11 4BN, UK
| | - A John
- Swansea University Medical School, Swansea University, Swansea, SA2 8PP, UK
| | - H Cheyne
- Nursing, Midwifery and Allied Health Professions Research Unit, Scion House, University of Stirling, Stirling, FK9 4LA, UK
| | - C Fyvie
- The Rivers Centre, NHS Lothian, Edinburgh, EH11 1BG, UK
| | - J I Bisson
- Cardiff University School of Medicine, Cardiff University, Cardiff, CF24 4HQ, UK
| | - C Hibberd
- Faculty of Health Sciences & Sport, University of Stirling, Stirling, FK9 4LA, UK
| | - S Abbott-Smith
- Child and Adolescent Mental Health Service (CAMHS), NHS Lothian, Edinburgh, EH10 5HF, UK
| | - L Nolan
- Aberlour, Scotland's children's charity (SC007991), Stirling, FK8 2JR, UK
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Mason SM, Schnitzer PG, Danilack VA, Elston B, Savitz DA. Risk factors for maltreatment-related infant hospitalizations in New York City, 1995-2004. Ann Epidemiol 2018; 28:590-596. [PMID: 30153909 PMCID: PMC6117827 DOI: 10.1016/j.annepidem.2018.05.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 05/17/2018] [Accepted: 05/24/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND Child maltreatment is a major public health problem, but population-based surveillance and research is hindered by limitations of official child welfare data. The present study used a promising complementary data source, hospital discharge data, to investigate risk factors for infant injuries suggestive of maltreatment. METHODS Discharge data from all hospital births to New York City residents from 1995 to 2004 were linked to birth certificates and to subsequent infant hospitalizations within 12 months after delivery. Probable maltreatment of infants was identified with 33 injury diagnosis codes highly correlated with maltreatment. Modified Poisson regression estimated the association of sociodemographic factors and pregnancy/birth characteristics with subsequent infant admission for probable maltreatment. RESULTS Risk factors for maltreatment included neonatal intensive care unit stays of more than 11 days (adjusted risk ratio [aRR] = 1.8; 95% confidence interval [CI]: 1.1-2.8), preterm birth (aRR = 1.6; 95% CI: 1.2-2.1), maternal age less than 20 years (aRR = 1.5; 95% CI: 1.2-1.9), and public insurance (aRR = 1.5; 95% CI: 1.2-1.9). Factors associated with reduced maltreatment risk included mother born outside the United States (aRR = 0.7; 95% CI: 0.6-0.8) and female infant (aRR = 0.7; 95% CI: 0.6-0.9). CONCLUSIONS Sociodemographic factors and challenges at birth (preterm, neonatal intensive care unit stays) are important risk factors for subsequent maltreatment-related hospitalization, with potential implications for prevention targeting.
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Affiliation(s)
- Susan M Mason
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis.
| | | | - Valery A Danilack
- Department of Epidemiology, Brown University School of Public Health, Providence, RI; Division of Research, Women & Infants Hospital, Providence, RI; Department of Obstetrics and Gynecology, Brown University Alpert Medical School, Providence, RI
| | - Beth Elston
- Department of Epidemiology, Brown University School of Public Health, Providence, RI
| | - David A Savitz
- Department of Epidemiology, Brown University School of Public Health, Providence, RI; Department of Obstetrics and Gynecology, Brown University Alpert Medical School, Providence, RI
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Karatekin C, Almy B, Mason SM, Borowsky I, Barnes A. Documentation of Child Maltreatment in Electronic Health Records. Clin Pediatr (Phila) 2018; 57:1041-1052. [PMID: 29168394 DOI: 10.1177/0009922817743571] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
International Classification of Diseases codes for child maltreatment can aid surveillance and research, but the extent to which they are used is not well established. We documented prevalence of the use of maltreatment-related codes, examined demographic characteristics of youth assigned these codes, and compared results with previous studies. Data were extracted from electronic health records of 0- to 21-year-olds assigned 1 of 15 maltreatment-related International Classification of Diseases, Ninth Revision, codes who had encounters in a large medical system over a 4-year period. Only 0.02% of approximately 2.5 million youth had a maltreatment-related code, replicating other studies. Results provide a dramatic contrast to much higher rates based on self-report or informant-report and referrals to Child Protective Services. Lack of documentation of maltreatment in electronic health records can lead to missed chances at early intervention, inadequate coordination of health care, insufficient allocation of resources to addressing problems related to maltreatment, and flawed public health data.
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Parrish JW, Shanahan ME, Schnitzer PG, Lanier P, Daniels JL, Marshall SW. Quantifying sources of bias in longitudinal data linkage studies of child abuse and neglect: measuring impact of outcome specification, linkage error, and partial cohort follow-up. Inj Epidemiol 2017; 4:23. [PMID: 28762156 PMCID: PMC5545181 DOI: 10.1186/s40621-017-0119-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Accepted: 06/28/2017] [Indexed: 11/10/2022] Open
Abstract
Background Health informatics projects combining statewide birth populations with child welfare records have emerged as a valuable approach to conducting longitudinal research of child maltreatment. The potential bias resulting from linkage misspecification, partial cohort follow-up, and outcome misclassification in these studies has been largely unexplored. This study integrated epidemiological survey and novel administrative data sources to establish the Alaska Longitudinal Child Abuse and Neglect Linkage (ALCANLink) project. Using these data we evaluated and quantified the impact of non-linkage misspecification and single source maltreatment ascertainment use on reported maltreatment risk and effect estimates. Methods The ALCANLink project integrates the 2009–2011 Alaska Pregnancy Risk Assessment Monitoring System (PRAMS) sample with multiple administrative databases through 2014, including one novel administrative source to track out-of-state emigration. For this project we limited our analysis to the 2009 PRAMS sample. We report on the impact of linkage quality, cohort follow-up, and multisource outcome ascertainment on the incidence proportion of reported maltreatment before age 6 and hazard ratios of selected characteristics that are often available in birth cohort linkage studies of maltreatment. Results Failure to account for out-of-state emigration biased the incidence proportion by 12% (from 28.3%w to 25.2%w), and the hazard ratio (HR) by as much as 33% for some risk factors. Overly restrictive linkage parameters biased the incidence proportion downwards by 43% and the HR by as much as 27% for some factors. Multi-source linkages, on the other hand, were of little benefit for improving reported maltreatment ascertainment. Conclusion Using the ALCANLink data which included a novel administrative data source, we were able to observe and quantify bias to both the incidence proportion and HR in a birth cohort linkage study of reported child maltreatment. Failure to account for out-of-state emigration and low-quality linkage methods may induce bias in longitudinal data linkage studies of child maltreatment which other researchers should be aware of. In this study multi-agency linkage did not lead to substantial increased detection of reported maltreatment. The ALCANLink methodology may be a practical approach for other states interested in developing longitudinal birth cohort linkage studies of maltreatment that requires limited resources to implement, provides comprehensive data elements, and can facilitate comparability between studies. Electronic supplementary material The online version of this article (doi:10.1186/s40621-017-0119-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jared W Parrish
- Alaska Division of Public Health, Section of Women's, Children's, and Family Health, 3601 C St., Suite 358, Anchorage, AK, 99503, USA. .,The University of North Carolina at Chapel Hill, Injury Prevention Research Center, 137 East Franklin St, CB# 7505, Chapel Hill, NC, 27599, USA.
| | - Meghan E Shanahan
- The University of North Carolina at Chapel Hill, School of Public Health, 2101 McGavran-Greenberg Hall, CB# 7435, Chapel Hill, NC, 27599, USA.,The University of North Carolina at Chapel Hill, Injury Prevention Research Center, 137 East Franklin St, CB# 7505, Chapel Hill, NC, 27599, USA
| | - Patricia G Schnitzer
- The National Center for the Review & Prevention of Child Deaths, c/o Michigan Public Health Institute, 1115 Massachusetts Ave. NW, Washington, DC, 20005, USA
| | - Paul Lanier
- The University of North Carolina at Chapel Hill, School of Social Work, 325 Pittsboro St. #3550, Chapel Hill, NC, 27516, USA
| | - Julie L Daniels
- The University of North Carolina at Chapel Hill, School of Public Health, 2101 McGavran-Greenberg Hall, CB# 7435, Chapel Hill, NC, 27599, USA
| | - Stephen W Marshall
- The University of North Carolina at Chapel Hill, School of Public Health, 2101 McGavran-Greenberg Hall, CB# 7435, Chapel Hill, NC, 27599, USA.,The University of North Carolina at Chapel Hill, Injury Prevention Research Center, 137 East Franklin St, CB# 7505, Chapel Hill, NC, 27599, USA
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15
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Wolf JP, Ponicki WR, Kepple NJ, Gaidus A. Are community level prescription opioid overdoses associated with child harm? A spatial analysis of California zip codes, 2001-2011. Drug Alcohol Depend 2016; 166:202-8. [PMID: 27496625 PMCID: PMC4987103 DOI: 10.1016/j.drugalcdep.2016.07.014] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 06/08/2016] [Accepted: 07/13/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND Non-medical prescription opioid use is increasing globally within high-income countries, particularly the United States. However, little is known about whether it is associated with negative outcomes for children. In this study, we use prescription opioid overdose as a proxy measure for non-medical prescription opioid use and ask the following: Do California communities with greater rates of non-medical prescription opioid use also have higher rates of child maltreatment and unintentional child injury? METHODS We used longitudinal population data to examine ecological associations between hospital discharges involving overdose of prescription opioids and those for child maltreatment or child injury in California zip codes between 2001 and 2011 (n=18,517 zip-code year units) using Bayesian space-time misalignment models. RESULTS The percentage of hospital discharges involving prescription opioid overdose was positively associated with the number of hospital discharges for child maltreatment (relative rate=1.089, 95% credible interval (1.004, 1.165)) and child injury (relative rate=1.055, 95% credible interval (1.012, 1.096)) over the ten-year period, controlling for other substance use and environmental factors. CONCLUSIONS Increases in community level prescription opioid overdoses between 2001 and 2011 are associated with a 2.06% increase in child maltreatment discharges and a 1.27% increase in discharges for child injury. Communities with higher rates of non-medical prescription opioid use may experience greater levels of child harms.
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Affiliation(s)
- Jennifer Price Wolf
- Division of Social Work, California State University, Sacramento 600 J Street, Sacramento, CA 95812, United States; Pacific Institute for Research and Evaluation, Prevention Research Center, 180 Grand Avenue, Oakland, CA 94612, United States.
| | - William R Ponicki
- Pacific Institute for Research and Evaluation, Prevention Research Center, 180 Grand Avenue, Oakland, CA 94612, United States
| | - Nancy J Kepple
- School of Social Welfare, University of Kansas, 1545 Lilac Ln., Lawrence, KS 66045, United States
| | - Andrew Gaidus
- Pacific Institute for Research and Evaluation, Prevention Research Center, 180 Grand Avenue, Oakland, CA 94612, United States
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King AJ, Farst KJ, Jaeger MW, Onukwube JI, Robbins JM. Maltreatment-Related Emergency Department Visits Among Children 0 to 3 Years Old in the United States. CHILD MALTREATMENT 2015; 20:151-161. [PMID: 25631298 PMCID: PMC9254131 DOI: 10.1177/1077559514567176] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The emergency department (ED) is a vital entry point in the health care system for children who experience maltreatment. This study fills a gap in the maltreatment literature by presenting systematic, national estimates of maltreatment-related ED visits in the United States by children ≤3 years old, from 2006 to 2011, using the Nationwide Emergency Department Sample (NEDS). Children who experienced and likely experienced maltreatment were identified via International Classification of Diseases, Ninth Revision, Clinical Modification diagnostic codes. Maltreatment was classified as physical or sexual abuse, neglect, or poly-victimization. The clinical and demographic profiles of children who experienced maltreatment were described. Approximately 10,095 children who experienced maltreatment (0.1% of total ED visits) and 129,807 children who likely experienced maltreatment (1.2% of total ED visits) were documented each year. Maltreatment was associated with significantly greater risk of injury, hospitalization, and death in the ED setting. Physical abuse was the most common explicit maltreatment diagnosis (33 ED visits per 100,000 children ≤3 years old) and neglect was the most common likely maltreatment diagnosis (436 ED visits per 100,000 children ≤3 years old). This study established the NEDS as a valuable complement to existing surveillance efforts of child maltreatment from a public health perspective.
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Affiliation(s)
- Andrew J King
- Center for Health Decision Science, Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Karen J Farst
- Center for Children at Risk, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Matthew W Jaeger
- Pediatric Emergency Medicine, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Jennifer I Onukwube
- Center for Applied Research and Evaluation, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - James M Robbins
- Center for Applied Research and Evaluation, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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17
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Gonzalez-Izquierdo A, Cortina-Borja M, Woodman J, Mok J, McGhee J, Taylor J, Parkin C, Gilbert R. Maltreatment or violence-related injury in children and adolescents admitted to the NHS: comparison of trends in England and Scotland between 2005 and 2011. BMJ Open 2014; 4:e004474. [PMID: 24755210 PMCID: PMC4010840 DOI: 10.1136/bmjopen-2013-004474] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Legislation to safeguard children from maltreatment by carers or violence by others was advanced in England and Scotland around 2004-2005 and resulted in different policies and services. We examined whether subsequent trends in injury admissions to hospital related to maltreatment or violence varied between the two countries. SETTING AND PARTICIPANTS We analysed rates of all unplanned injury admission to National Health Service (NHS) hospitals in England and Scotland between 2005 and 2011 for children and adolescents aged less than 19 years. OUTCOMES We compared incidence trends for maltreatment or violence-related (MVR) injury and adjusted rate differences between 2005 and 2011 using Poisson or negative binomial regression models to adjust for seasonal effects and secular trends in non-MVR injury. Infants, children 1-10 years and adolescents 11-18 years were analysed separately. RESULTS In 2005, MVR rates were similar in England and Scotland for infants and 1-10-year-olds, but almost twice as high in Scotland for 11-18-year-olds. MVR rates for infants increased by similar amounts in both countries, in line with rising non-MVR rates in England but contrary to declines in Scotland. Among 1-10-year-olds, MVR rates increased in England and declined in Scotland, in line with increasing non-MVR rates in England and declining rates in Scotland. Among 11-18-year-olds, MVR rates declined more steeply in Scotland than in England along with declines in non-MVR trends. CONCLUSIONS Diverging trends in England and Scotland may reflect true changes in the occurrence of MVR injury or differences in the way services recognise and respond to these children, record such injuries or a combination of these factors. Further linkage of data from surveys and services for child maltreatment and violence could help distinguish the impact of policies.
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Affiliation(s)
| | - Mario Cortina-Borja
- Centre of Paediatric Epidemiology and Biostatistics, UCL Institute of Child Health, London, UK
| | - Jenny Woodman
- Centre of Paediatric Epidemiology and Biostatistics, UCL Institute of Child Health, London, UK
| | - Jacqueline Mok
- NHS Lothian University Hospitals Division, Edinburgh, UK
| | - Janice McGhee
- School of Social and Political Science, the Chrystal Macmillan Building, Edinburgh, UK
| | - Julie Taylor
- Child Protection Research Centre, University of Edinburgh, St Leonard's Land, Edinburgh, UK
| | - Chloe Parkin
- Centre of Paediatric Epidemiology and Biostatistics, UCL Institute of Child Health, London, UK
| | - Ruth Gilbert
- Centre of Paediatric Epidemiology and Biostatistics, UCL Institute of Child Health, London, UK
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18
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O’Neill DG, Church DB, McGreevy PD, Thomson PC, Brodbelt DC. Approaches to canine health surveillance. Canine Genet Epidemiol 2014; 1:2. [PMID: 26401319 PMCID: PMC4574389 DOI: 10.1186/2052-6687-1-2] [Citation(s) in RCA: 98] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Accepted: 01/14/2014] [Indexed: 01/21/2023] Open
Abstract
Effective canine health surveillance systems can be used to monitor disease in the general population, prioritise disorders for strategic control and focus clinical research, and to evaluate the success of these measures. The key attributes for optimal data collection systems that support canine disease surveillance are representativeness of the general population, validity of disorder data and sustainability. Limitations in these areas present as selection bias, misclassification bias and discontinuation of the system respectively. Canine health data sources are reviewed to identify their strengths and weaknesses for supporting effective canine health surveillance. Insurance data benefit from large and well-defined denominator populations but are limited by selection bias relating to the clinical events claimed and animals covered. Veterinary referral clinical data offer good reliability for diagnoses but are limited by referral bias for the disorders and animals included. Primary-care practice data have the advantage of excellent representation of the general dog population and recording at the point of care by veterinary professionals but may encounter misclassification problems and technical difficulties related to management and analysis of large datasets. Questionnaire surveys offer speed and low cost but may suffer from low response rates, poor data validation, recall bias and ill-defined denominator population information. Canine health scheme data benefit from well-characterised disorder and animal data but reflect selection bias during the voluntary submissions process. Formal UK passive surveillance systems are limited by chronic under-reporting and selection bias. It is concluded that active collection systems using secondary health data provide the optimal resource for canine health surveillance.
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Affiliation(s)
- Dan G O’Neill
- />Veterinary Epidemiology, Economics and Public Health, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Herts, AL9 7T UK
| | - David B Church
- />Small Animal Medicine and Surgery Group, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Herts, AL9 7TA UK
| | - Paul D McGreevy
- />Faculty of Veterinary Science, The University of Sydney, R.M.C. Gunn Building (B19), Sydney, NSW 2006 Australia
| | - Peter C Thomson
- />Faculty of Veterinary Science, The University of Sydney, R.M.C. Gunn Building (B19), Sydney, NSW 2006 Australia
| | - Dave C Brodbelt
- />Veterinary Epidemiology, Economics and Public Health, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Herts, AL9 7T UK
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19
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Parrish J, Baldwin-Johnson C, Volz M, Goldsmith Y. Abusive head trauma among children in Alaska: a population-based assessment. Int J Circumpolar Health 2013; 72:21216. [PMID: 23986886 PMCID: PMC3754493 DOI: 10.3402/ijch.v72i0.21216] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Serious physical abuse resulting in a traumatic brain injury (TBI) has been implicated as an underreported cause of infant mortality. Nearly 80% of all abusive head trauma (AHT) occurs among children <2 years of age, with infants experiencing an incidence nearly 8 times that of 2-year olds. OBJECTIVE This study describes the validation of the CDC Pediatric Abusive Head Trauma (PAHT) definitions when applied to a multi-source database at the state level and provides a robust annual incidence estimate of AHT among children <2 years of age in Alaska. DESIGN AHT cases among children residing in Alaska during 2005-2010 were identified by applying the PAHT coding schema to a multi-source database which included vital death records, the Violent Death Reporting System (AK-VDRS), the Maternal Infant Mortality Review - Child Death Review (MIMR-CDR), the Alaska Trauma Registry (ATR), the inpatient Hospital Discharge Database (HDD) and Medicaid claims. Using these data, we calculated statewide AHT annual incidence rates. RESULTS The databases with the highest case capture rates were the ATR and Medicaid systems, both at 51%, followed by HDD at 38%. Combined, the ATR, HDD and Medicaid systems captured 91% of all AHT cases. The linkage and use of the PAHT definitions yielded an estimated sensitivity of 91% and specificity of 98%. During the study period, we detected an annual average incidence of 34.4 cases per 100,000 children aged <2 years (95% CI 25.1, 46.1) and a case fatality proportion of 22% (10/45). Among the AHT cases, 82% were infants. Significant differences (p < 0.05) in AHT were noted by age and race, but not by sex. CONCLUSIONS In Alaska, applying the CDC PAHT definition to the multi-source database enabled us to capture 49% more AHT cases than any of the individual database used in this analysis alone.
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Affiliation(s)
- Jared Parrish
- MCH-Epidemiology Unit, Alaska Division of Public Health, Anchorage, AK, USA.
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20
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Putnam-Hornstein E. Preventable injury deaths: a population-based proxy of child maltreatment risk in California. Public Health Rep 2012; 127:163-72. [PMID: 22379216 PMCID: PMC3268801 DOI: 10.1177/003335491212700205] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE This study used group variations in child injury fatality rates to assess racial bias in the population of children identified as victims of maltreatment. METHODS Injury fatality and maltreatment data from California were compiled for the years 1998-2007. Death and maltreatment risk ratios (RRs) and 95% confidence intervals (CIs) were computed by race and age. Rates of excess child injury mortality by race were derived from three different baseline rates of death. Substantiations per excess injury death were calculated. RESULTS compared with white children, black children faced a risk of substantiated maltreatment that was more than twice as great (black RR: 2.39, 95% CI 2.37, 2.42) and were fatally injured at nearly twice the rate (black RR: 1.89, 95% CI 1.68, 2.12). Per excess death, however, black children had rates of substantiated maltreatment allegations that were equivalent to or lower than the rates for white children. CONCLUSIONS These data support claims that, at least in California, black-white racial disparities observed in maltreatment rates reflect real group differences in risk. These data provide no evidence of systematic racial bias in the child protective services' substantiation process.
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Affiliation(s)
- Emily Putnam-Hornstein
- University of Southern California, School of Social Work, Los Angeles, CA 90089-0411, USA.
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21
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McKenzie K, Scott DA. Using routinely collected hospital data for child maltreatment surveillance: issues, methods and patterns. BMC Public Health 2011; 11:7. [PMID: 21208410 PMCID: PMC3091540 DOI: 10.1186/1471-2458-11-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2010] [Accepted: 01/05/2011] [Indexed: 11/15/2022] Open
Abstract
Background International data on child maltreatment are largely derived from child protection agencies, and predominantly report only substantiated cases of child maltreatment. This approach underestimates the incidence of maltreatment and makes inter-jurisdictional comparisons difficult. There has been a growing recognition of the importance of health professionals in identifying, documenting and reporting suspected child maltreatment. This study aimed to describe the issues around case identification using coded morbidity data, outline methods for selecting and grouping relevant codes, and illustrate patterns of maltreatment identified. Methods A comprehensive review of the ICD-10-AM classification system was undertaken, including review of index terms, a free text search of tabular volumes, and a review of coding standards pertaining to child maltreatment coding. Identified codes were further categorised into maltreatment types including physical abuse, sexual abuse, emotional or psychological abuse, and neglect. Using these code groupings, one year of Australian hospitalisation data for children under 18 years of age was examined to quantify the proportion of patients identified and to explore the characteristics of cases assigned maltreatment-related codes. Results Less than 0.5% of children hospitalised in Australia between 2005 and 2006 had a maltreatment code assigned, almost 4% of children with a principal diagnosis of a mental and behavioural disorder and over 1% of children with an injury or poisoning as the principal diagnosis had a maltreatment code assigned. The patterns of children assigned with definitive T74 codes varied by sex and age group. For males selected as having a maltreatment-related presentation, physical abuse was most commonly coded (62.6% of maltreatment cases) while for females selected as having a maltreatment-related presentation, sexual abuse was the most commonly assigned form of maltreatment (52.9% of maltreatment cases). Conclusion This study has demonstrated that hospital data could provide valuable information for routine monitoring and surveillance of child maltreatment, even in the absence of population-based linked data sources. With national and international calls for a public health response to child maltreatment, better understanding of, investment in and utilisation of our core national routinely collected data sources will enhance the evidence-base needed to support an appropriate response to children at risk.
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Affiliation(s)
- Kirsten McKenzie
- National Centre for Health Information Research and Training, School of Public Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, QLD 4059, Australia.
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22
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Swahn MH, Whitaker DJ, Pippen CB, Leeb RT, Teplin LA, Abram KM, McClelland GM. Concordance between self-reported maltreatment and court records of abuse or neglect among high-risk youths. Am J Public Health 2006; 96:1849-53. [PMID: 17008582 PMCID: PMC1586157 DOI: 10.2105/ajph.2004.058230] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined the concordance between measures of self-reported maltreatment and court records of abuse or neglect in a sample of detained youths. METHODS Data were collected by the Northwestern Juvenile Project and include interviews from 1829 youths aged 10-18 years. Participants were newly detained youths in the Cook County Juvenile Temporary Detention Center in Illinois between 1995 and 1998. Self-reported cases of child maltreatment were compared with court records of abuse or neglect in the Cook County judicial system. RESULTS We found that among detained youths, 16.6% of those who reported any maltreatment, 22.2% of those who reported the highest level of maltreatment, and 25.1% of those who reported that they required medical treatment as a result of maltreatment had a court record of abuse or neglect. Among those with any self-reported maltreatment, girls (vs boys) and African Americans (vs Whites) were more likely to have a court record (adjusted odds ratio [AOR]=2.18; 95% confidence interval [CI]=1.53, 3.09; and AOR=2.12; 95% CI=1.23, 3.63, respectively). CONCLUSIONS Official records seriously underestimate the prevalence of maltreatment, which indicates that multiple data sources are needed to document the true prevalence of maltreatment.
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Affiliation(s)
- Monica H Swahn
- Office on Smoking and Health, Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Ga 30341-3724, USA.
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