scholarly journals Trends in shaken baby syndrome diagnosis codes among young children hospitalized for abuse

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Aislinn Conrad ◽  
Brandon Butcher ◽  
Resmiye Oral ◽  
Megan Ronnenberg ◽  
Corinne Peek-Asa
Keyword(s):  
Child Abuse ◽  
Young Children ◽  
Low Income ◽  
Hospital Admissions ◽  
Head Injuries ◽  
Secondary Analysis ◽  
Shaken Baby Syndrome ◽  
Teaching Hospitals ◽  
Future Research ◽  
Diagnosis Codes

Abstract Objective To investigate national trends of SBS diagnosis codes and how trends varied among patient and hospital characteristics. Methods We examined possible SBS, confirmed SBS, and non-SBS abuse diagnosis codes among children age three and younger who were hospitalized for abuse between 1998 and 2014 using a secondary analysis of the National Inpatient Sample, the largest US all-payer inpatient care database (N = 66,854). A baseline category logit model was used based on a quasi-likelihood approach (QIC) with an independent working correlation structure. Results The rate (per 100,000 census population of children age 3 and younger) of confirmed and possible SBS diagnosis codes was 5.4 (± 0.3) between 1998 and 2014, whereas the rate of non-SBS abuse was 19.6 (± 1.0). The rate of confirmed SBS diagnosis codes increased from 3.8 (± 0.3) in 1998 to 5.1 (± 0.9) in 2005, and decreased to 1.3 (± 0.2) in 2014. Possible SBS diagnosis codes were 0.6 (± 0.2) in 1998, increasing to 2.4 (± 0.4) in 2014. Confirmed SBS diagnosis codes have declined since 2002, while possible SBS diagnosis codes have increased. All abuse types were more frequent among infants, males, children from low-income homes, and urban teaching hospitals. Conclusions We investigated seventeen-year trends of SBS diagnosis codes among young children hospitalized for abuse. The discrepancy between trends in possible and confirmed SBS diagnosis codes suggests differences in norms for utilizing SBS diagnosis codes, which has implications for which hospital admissions are coded as AHT. Future research should investigate processes for using SBS diagnosis codes and whether all codes associated with abusive head injuries in young children are classified as AHT. Our findings also highlight the relativity defining and applying SBS diagnosis codes to children admitted to the hospital for shaking injuries. Medical professionals find utility in using SBS diagnosis codes, though may be more apt to apply codes related to possible SBS diagnosis codes in children presenting with abusive head injuries. Clarifying norms for SBS diagnosis codes and refining definitions for AHT diagnosis will ensure that young children presenting with, and coded for, abusive head injuries are included in overall counts of AHT based on secondary data of diagnosis codes. This baseline data, an essential component of child abuse surveillance, will enable ongoing efforts to track, prevent, and reduce child abuse.

scholarly journals Trends in Shaken Baby Syndrome Diagnoses Among Young Children Hospitalized for Abuse

2020 ◽  
Author(s):  
Aislinn Conrad ◽  
Brandon Butcher ◽  
Resmiye Oral ◽  
Megan Ronnenberg ◽  
Corinne Peek-Asa
Keyword(s):  
Child Abuse ◽  
Young Children ◽  
Low Income ◽  
Head Injuries ◽  
Secondary Analysis ◽  
Shaken Baby Syndrome ◽  
Teaching Hospitals ◽  
Future Research ◽  
Working Correlation ◽  
National Trends

Abstract Objective To investigate national trends of SBS diagnosis codes and how trends varied among patient and hospital characteristics. Methods We examined possible SBS, confirmed SBS, total SBS, and non-SBS abuse diagnoses among children age three and younger who were hospitalized for abuse between 1998 and 2014 using a secondary analysis of the National Inpatient Sample, the largest US all-payer inpatient care database (N = 66,854). A baseline category logit model was used based on a quasi-likelihood approach (QIC) with an independent working correlation structure. Results The rate (per 100,000 census population) of total SBS diagnoses was 5.4 (± 0.3) between 1998 and 2014, whereas the rate of non-SBS abuse was 19.6 (± 1.0).The rate of confirmed SBS diagnoses increased from 3.8 (± 0.3) in 1998 to 5.1 (± 0.9) in 2005, and decreased to 1.3 (± 0.2) in 2014. Possible SBS diagnoses were 0.6 (± 0.2) in 1998, increasing to 2.4 (± 0.4) in 2014. Confirmed SBS diagnoses have declined since 2002, while possible SBS diagnoses have increased. All abuse types were more frequent among infants, males, children from low-income homes, and urban teaching hospitals. Conclusions We investigated seventeen-year trends of SBS diagnoses among young children hospitalized for abuse. The discrepancy between trends in possible and confirmed SBS suggests differences in norms for diagnosing SBS, which has implications for which cases are considered AHT. Future research should investigate diagnostic processes for SBS and whether all codes associated with abusive head injuries in young children are classified as AHT. Our findings also highlight the relativity defining and diagnosing SBS. Medical professionals find utility in diagnosing SBS, though may be more apt to apply possible SBS diagnoses to abusive head injuries in children. Clarifying norms for SBS diagnosis and refining definitions for AHT will ensure that young children presenting with abusive head injuries are included in overall counts of AHT. This baseline data, an essential component of child abuse surveillance, will enable ongoing efforts to track, prevent, and reduce child abuse.

scholarly journals Trends in Shaken Baby Syndrome Diagnoses Among Young Children Hospitalized for Abuse

2020 ◽  
Author(s):  
Aislinn Conrad ◽  
Brandon Butcher ◽  
Resmiye Oral ◽  
Megan Ronnenberg ◽  
Corinne Peek-Asa
Keyword(s):  
Young Children ◽  
Secondary Analysis ◽  
Shaken Baby Syndrome ◽  
Teaching Hospitals ◽  
Medical Providers ◽  
Diagnosis Codes ◽  
Likelihood Approach ◽  
Working Correlation ◽  
National Trends ◽  
Baseline Category

Abstract Objective To investigate national trends of SBS diagnosis codes and how trends varied among patient and hospital characteristics. Methods We examined possible and confirmed SBS diagnoses among children age three and younger who were hospitalized for abuse between 1998 and 2014 using a secondary analysis of the National Inpatient Sample, the largest US all-payer inpatient care database ( N = 52,562). A baseline category logit model was used based on a quasi-likelihood approach (QIC) with an independent working correlation structure. Results The rate of confirmed SBS diagnoses increased from 3.8 (± 0.3) in 1998 to 5.1 (± 0.9) in 2005, and decreased to 1.3 (± 0.2) in 2014. Possible SBS diagnoses were 0.6 (± 0.2) in 1998, and increased to 2.4 (± 0.4) in 2014. Confirmed SBS diagnoses have declined since 2002, while possible SBS diagnoses have increased. Possible SBS diagnoses were more common among urban teaching hospitals and small to medium hospitals than for other hospital types. Conclusions We investigated seventeen-year trends of SBS diagnoses among young children hospitalized for abuse. The discrepancy between trends in possible and confirmed SBS suggests differences in diagnostic norms for SBS and related conditions. Researchers should examine diagnostic processes for SBS and investigate why cases are diagnosed as SBS or a related diagnosis. We propose that researchers and pediatric medical providers agree to a standardized definition and diagnostic guidelines for SBS, much like the AHT guidelines proposed by CDC, which may help reduce discrepancies in diagnosis and improve options for surveillance.

scholarly journals Perceived Stress Can Mediate the Associations between a Lifestyle Intervention and Fat and Fast Food Intakes

Nutrients ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3606
Author(s):  
Mei-Wei Chang ◽  
Roger Brown ◽  
Duane T. Wegener
Keyword(s):  
Young Children ◽  
Lifestyle Intervention ◽  
Perceived Stress ◽  
Low Income ◽  
Fast Food ◽  
Structural Equation ◽  
Dietary Intervention ◽  
Secondary Analysis ◽  
Equation Modeling ◽  
Mediation Effects

This secondary analysis study addressed a gap of knowledge: whether perceived stress reduction created by a lifestyle intervention might serve as a mediator for reducing fat and fast food intakes in low-income overweight or obese mothers of young children. This analysis included 338 low-income overweight or obese mothers of young children who completed a phone interview immediately after the 16-week lifestyle intervention. Valid surveys were used to assess perceived stress and fat and fast food intakes. Composite indicator structural equation modeling was performed to test the mediation effects. The overall effect of the intervention was not significant for fat intake but was significant for fast food intake (B = −0.53, p < 0.05). When assessing the potential role of perceived stress as a mediator, the indirect effects of the intervention on fat (B = −0.39, p < 0.01) and fast food (B = −0.27, p < 0.01) intakes were both significant. Future dietary intervention studies aimed to reduce fat and fast food intakes in low-income overweight or obese mothers of young children might consider including practical strategies aimed at reducing perceived stress.

scholarly journals The Circumstances of Children with and without Disabilities or Significant Cognitive Delay Living in Ordinary Households in 30 Middle- and Low-Income Countries

Disabilities ◽  
2021 ◽  
Vol 1 (3) ◽  
pp. 174-186
Author(s):  
Eric Emerson ◽  
Gwynnyth Llewellyn
Keyword(s):  
Young Children ◽  
Low Income ◽  
Rural Areas ◽  
Partner Violence ◽  
Children With Disabilities ◽  
Secondary Analysis ◽  
Low Income Countries ◽  
Developmental Potential ◽  
Home Based ◽  
Cognitive Delay

Home-based early intervention is a key component of strategic approaches to preventing the loss of developmental potential among young children in middle- and low-income countries. We undertook secondary analysis of nationally representative data collected in 30 middle- and low-income countries during Round 6 (2017-) of UNICEF’s Multiple Indicator Cluster Surveys. Our analyses, involving over 100,000 children with/without disabilities or significant cognitive delay, indicated that children with disabilities and/or significant cognitive delay were more likely than their peers to: be living in relative household poverty and in rural areas; have a mother with only primary level education; live in households where intimate partner violence was considered acceptable by the child’s mother; be less likely to be receiving any pre-school education; have a mother with disabilities; receive low levels of parental stimulation; be exposed to violent parental discipline. For many of these indicators of poorer home circumstances, the level of risk was notably higher for children with significant cognitive delay than for children with disabilities. Our study findings suggest the need to consider tailored, evidence-based approaches to reduce and (potentially) overcome the increased risks that young children with disabilities and young children with significant cognitive delay experience in middle- and low-income countries.

Nobody’s Perfect: Making sense of a parenting skills workshop through ethnographic research in a low-income neighbourhood in Santiago de Chile

2021 ◽  
pp. 026101832098398
Author(s):  
Marjorie Murray ◽  
Daniela Tapia
Keyword(s):  
Child Development ◽  
Young Children ◽  
Low Income ◽  
Ethnographic Research ◽  
Parenting Skills ◽  
Daily Lives ◽  
Making Sense ◽  
Santiago De Chile ◽  
One Year ◽  
Everyday Problems

Nadie es Perfecto (Nobody’s Perfect, or NEP) is a parenting skills workshop aimed at ‘sharing experiences and receiving guidance on everyday problems to strengthen child development’. This article explores this workshop in terms of its relationship with the daily lives of participants, based on one year of fieldwork focused on families with young children in a low-income neighbourhood in Santiago. While caregivers frame their parenting efforts as aiming to ‘hacer lo mejor posible’ (do their best) under difficult circumstances, our study found that facilitators take an anachronistic and homogenizing view of participants. Embracing a universalistic perspective of child development, they discourage participation and debate, focusing instead on providing concrete advice that limits the potential of the workshops. This article argues that by ignoring the different living situations of families in this socioeconomic context, NEP reproduces a prejudiced view of poor subjects that sees them as deficient and incapable of change.

scholarly journals Socioeconomic Disparities in Foods/Beverages and Nutrients Consumed by U.S. Adolescents When Snacking: National Health and Nutrition Examination Survey 2005–2018

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2530
Author(s):  
Navika Gangrade ◽  
Janet Figueroa ◽  
Tashara M. Leak
Keyword(s):  
National Health ◽  
Low Socioeconomic Status ◽  
Low Income ◽  
High Income ◽  
Future Research ◽  
Nutrition Examination Survey ◽  
Middle Income ◽  
Low Socioeconomic ◽  
Health And Nutrition ◽  
Income Ratio

Snacking contributes a significant portion of adolescents’ daily energy intake and is associated with poor overall diet and increased body mass index. Adolescents from low socioeconomic status (SES) households have poorer snacking behaviors than their higher-SES counterparts. However, it is unclear if the types of food/beverages and nutrients consumed during snacking differ by SES among adolescents. Therefore, this study examines SES disparities in the aforementioned snacking characteristics by analyzing the data of 7132 adolescents (12–19 years) from the National Health and Nutrition Examination Survey 2005–2018. Results reveal that adolescents from low-income households (poverty-to-income ratio (PIR) ≤ 1.3) have lower odds of consuming the food/beverage categories “Milk and Dairy” (aOR: 0.74; 95% CI: 0.58-0.95; p = 0.007) and “Fruits” (aOR: 0.62, 95% CI: 0.50–0.78; p = 0.001) as snacks and higher odds of consuming “Beverages” (aOR: 1.45; 95% CI: 1.19-1.76; p = 0.001) compared to those from high-income households (PIR > 3.5). Additionally, adolescents from low- and middle-income (PIR > 1.3–3.5) households consume more added sugar (7.98 and 7.78 g vs. 6.66 g; p = 0.012, p = 0.026) and less fiber (0.78 and 0.77 g vs. 0.84 g; p = 0.044, p = 0.019) from snacks compared to their high-income counterparts. Future research is necessary to understand factors that influence snacking among adolescents, and interventions are needed, especially for adolescents from low-SES communities.

scholarly journals Are Nanobiosensors an Improved Solution for Diagnosis of Leishmania?

Pharmaceutics ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 491
Author(s):  
Sona Jain ◽  
Wanessa Santana ◽  
Silvio S. Dolabella ◽  
André L. S. Santos ◽  
Eliana B. Souto ◽  
...  
Keyword(s):  
Low Income ◽  
Neglected Tropical Diseases ◽  
Diagnostic Techniques ◽  
Cross Reactivity ◽  
Low Income Countries ◽  
Future Research ◽  
Immunological Tests ◽  
Diagnostic Approaches ◽  
Signal Improvement ◽  
Adequate Management

Leishmaniasis is one of the deadliest neglected tropical diseases affecting 12–15 million people worldwide, especially in middle- and low-income countries. Rapid and accurate diagnosis of the disease is important for its adequate management and treatment. Several techniques are available for the diagnosis of leishmaniasis. Among these, parasitological and immunological tests are most widely used. However, in most cases, the utilized diagnostic techniques are not good enough, showing cross-reactivity and reduced accuracy. In recent years, many new methods have been reported with potential for improved diagnosis. This review focuses on the diagnosis of Leishmania exploring the biosensors and nanotechnology-based options for their detection. New developments including the use of nanomaterials as fluorophores, fluorescence quenchers as reducing agents and as dendrimers for signal improvement and amplification, together with the use of aptamers to replace antibodies are described. Future research opportunities to overcome the current limitations on the available diagnostic approaches are also discussed.

Sub-Ethnicity and Survivorship Experience: Asian American Breast Cancer Survivors

2021 ◽  
pp. 019394592110319
Author(s):  
Wonshik Chee ◽  
Eun-Ok Im
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Asian American ◽  
Breast Cancer Survivors ◽  
Short Form ◽  
Secondary Analysis ◽  
Future Research ◽  
Japanese American ◽  
Personal Resource ◽  
Cancer Data

The purpose of the study was to explore the associations of sub-ethnicity to the survivorship experience of Asian American breast cancer survivors and identify the multiple factors that influenced their survivorship experience. This was a secondary analysis of the data among 94 Asian American breast cancer survivors from a larger ongoing study. Instruments included: questions on background characteristics, the perceived isolation scale, the Personal Resource Questionnaire, the Memorial Symptom Assessment Scale-Short Form, and the Functional Assessment of Cancer Therapy-Breast Cancer. Data were analyzed using hierarchical logistic and multiple regression analyses. After controlling for other factors, being a Japanese American (ref. = being a Chinese American) was significantly associated with pain scores (odds ratio [OR] = −0.32, p < .01), symptom distress scores ( β = −0.27, p < .01), and the quality of life scores ( β = 0.22, p = .03). Sub-ethnic variations in cultural attitudes, values, and beliefs need to be considered in future research/practice with Asian American breast cancer survivors.

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