Child abuse & neglect
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In order to be reimbursed for the care they provide, hospitals in the United States are required to use a standard system to code all discharge diagnoses: the International Classification of Disease, 9th Revision, Clinical Modification (ICD-9). Although ICD-9 codes specific for child maltreatment exist, they do not identify all maltreatment-related hospital and emergency department discharges. To increase the usefulness of medical data for public health surveillance of child maltreatment, this project sought to identify ICD-9 codes that are suggestive of child maltreatment. ⋯ Use of these suggestive codes facilitates identifying conditions and injuries that are likely maltreatment-related in hospital discharge and ED visit data. When used in conjunction with ICD maltreatment-specific codes, these suggestive codes may enhance the use of medical data for monitoring child maltreatment trends.
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Child abuse & neglect · Jan 2011
Case ReportsVaginal lacerations from consensual intercourse in adolescents.
(1) To describe lacerations of the vaginal fornices, an injury known to be associated with consensual sexual intercourse, including known complications and treatment course, (2) to contrast these injuries with injuries sustained during sexual assault, and (3) to discuss the assessment of adolescent patients for sexual injuries. ⋯ Knowledge of the consensual sexual injuries that may occur in adolescent patients can guide diagnosis, treatment, and counseling for the patient and her family, preventing long-term medical complications and legal consequences.
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Child abuse & neglect · Oct 2010
Follow-up skeletal surveys for suspected non-accidental trauma: can a more limited survey be performed without compromising diagnostic information?
Follow-up skeletal surveys have been shown to improve the rate of fracture detection in suspected cases of non-accidental trauma (NAT). As these studies are performed in a particularly radiosensitive population, it is important to evaluate if all of the (approximately 20) radiographs obtained at repeat skeletal survey are clinically useful. Our goal was to evaluate if certain radiographs can be excluded at follow-up skeletal survey without compromising the clinical efficacy. ⋯ If no injury is detected or suspected in the pelvis, spine, hands, or skull at initial bone survey for suspected NAT, a limited follow-up skeletal survey which excludes the pelvis, lateral spine, hands, and skull should be considered to limit radiation exposure without limiting diagnostic information.
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Child abuse & neglect · Oct 2010
Risk and protective factors for bullying victimization among AIDS-affected and vulnerable children in South Africa.
To examine whether bullying is a risk factor for psychological distress among children in poor, urban South Africa. To determine risk and protective factors for bullying victimization. ⋯ Those working with children in Southern Africa should be alert to risk of bullying, especially among abused or AIDS-affected children. Interventions combating community violence and AIDS-related stigma may have additional positive impacts on bullying, and promotion of peer and sibling support may reduce bullying victimization among high-risk children.