Age-related incidence curve of hospitalized Shaken Baby Syndrome cases: convergent evidence for crying as a trigger to shaking

OBJECTIVE: To determine whether there is an age-specific incidence of hospitalized cases of Shaken Baby Syndrome (SBS) that has similar properties to the previously reported "normal crying curve," as a form of indirect evidence that crying is an important stimulus for SBS. DESIGN AND SETTING: The study analyzed cases of Shaken Baby Syndrome by age at hospitalization from hospital discharge data for California hospitals from October 1996 through December 2000. PATIENTS: All cases of children less than 18 months (78 weeks) of age for whom the diagnostic code for Shaken Baby Syndrome (995.55) in the International Classification of Disease, Ninth Edition, Clinical Modification was assigned. RESULTS: There were 273 hospitalizations for SBS. Like the "normal crying curve," the curve of age-specific incidence starts at 2-3 weeks, has a clear peak, and declines to baseline by about 36 weeks of age. In contrast to the normal crying curve that peaks at 5-6 weeks, the peak of SBS hospitalizations occurs at 10-13 weeks. CONCLUSIONS: The age-specific incidence curve of hospitalized SBS cases has a similar starting point and shape to the previously reported normal crying curve but the peak occurs about 4-6 weeks later. Of the likely predisposing causes, this pattern is only consistent with the properties of early crying. There are numerous explanations for the lag in the peaks between crying and SBS hospitalizations, including the possibility of repeat shakings prior to hospitalization. The importance of crying as a stimulus to SBS may provide an opportunity for preventive intervention.     

Characteristics of child abuse in immigrant Korean families and correlates of placement decisions

OBJECTIVE: This study examined the characteristics and patterns of child abuse among immigrant Korean families in Los Angeles and critical variables that contribute to the type of placement made by the child protective services (CPS) system. METHOD: Data were obtained from reviewing and analyzing 170 active Korean case files maintained by the Asian Pacific Unit (APU) of the Los Angeles County Department of Children and Family Services (LAC-DCFS) during July through September, 2001. Logistic regression analysis was employed to examine the odds of children being kept in or removed from the home. RESULTS: Some of the major findings from this study include: (1) immigrant Korean families are more likely to be charged with physical abuse (49.4%) and less likely to be charged with neglect (20.6%) in comparison with all other groups in Los Angeles (13.2% and 27.1%, respectively); (2) the circumstance under which physical abuse occurred most frequently was corporal punishment used by Korean parents with an intention to discipline their children; and (3) the context under which emotional abuse occurred among the Korean families was likely to be children's witnessing domestic violence. In addition, the logistic regression showed that response status, referral source, living arrangement, victim's relationship to perpetrator, and chronicity of abuse were significant in predicting out-of-home placement. CONCLUSIONS: An analysis of Korean child abuse cases reported to child protective service revealed that culture and child rearing practices shaped the patterns of child maltreatment. A culturally sensitive approach is strongly suggested for effective child abuse prevention and intervention services with this group by CPS agencies.     

EDITORIAL

Novice nurses encounter numerous factors that impact on their learning in the complex healthcare workplace. Registered nurses often work one‐on‐one with novices as preceptors to facilitate the development of novices’ clinical skills and socialisation into the profession. This paper explores the concept of preceptorship from novice nurses’ and preceptors’ perspective, drawing upon data from a project between a large healthcare organisation and a university in Melbourne, Australia. The study, framed in ethnomethodology, included fieldwork observation, interviews and student surveys; this paper focuses on data collected over a series of individual interviews with nursing students (n = 28) and preceptors (n = 25). Thematic analysis yielded six key themes: workplace socialisation, empathy, individuality, willingness to engage, changing support and a realisation [by novices about the preceptor role]. Findings highlight the complexity of workplace learning that is influenced by the idiosyncrasies of the individuals involved and the social milieu in which the learning takes place.     

Roles,Risks, and Benefits of Peer Mentoring Relationships in Higher Education

Successful peer mentoring in university settings is the result of relationships among students, mentors, and instructors. Findings from this study indicate that even in programs where training is ongoing and established, assumptions cannot be made about the understanding of the roles, risks, and benefits involved in such relationships. This study demonstrates that students, instructors, and mentors all have different perspectives about a mentor’s role and how that role should be enacted. Connecting link, peer leader, learning coach, student advocate, and trusted friend were identified as predominant roles enacted by mentors. Also described are risks and benefits for being or having a peer mentor.     

Annual Index Volume 8

The objective of this paper is to report the development and use of an observation checklist to identify typically developing children with behavioural manifestations associated with inattention, hyperactivity and impulsivity. This measure is termed the Scope Classroom Observation Checklist (SCOC). The SCOC was developed, assessed for reliability using an independent observer and teacher ratings, and administered to a sample of 157 mainstream schoolchildren. The SCOC revealed a normal distribution of scores on the checklist, and the top and bottom quartiles of this distribution were found, as would be expected, to differ significantly on SCOC score. The SCOC had good inter‐observer reliability and a high rate of concordance with teacher ratings of attentional difficulties. The SCOC has emerged as a reliable measure that could prove to be a useful tool in a battery of screening measures to identify mainstream schoolchildren with difficulties characterised by inattention and hyperactivity‐impulsivity.     

Do emotional and behavioural difficulties in primary school predict adolescent victimisation trajectories?

Chronic victimisation in adolescence is a traumatic experience with potential negative long-term health consequences. Given that victimisation has been shown to increase over the transition from primary to secondary school, longitudinal data from 1810 students transitioning from primary to secondary school were used to identify victimisation trajectory groups; classified as low-increasing, low-stable, medium-stable and not-bullied. Males with emotional and behavioural difficulties (both internalising and externalising behaviours) and females with externalising behaviours were more likely to be in the increasing and stable victimised groups than the not-bullied group. The results of this study suggest whole-school bullying intervention programmes need to occur before students reach secondary school, and that transition programmes need to emphasise and support social interaction between peers to reduce victimisation and the harms caused by long-term exposure to bullying.     

Improving sexual health for young people: making sexuality education a priority

How well do young people understand their developing sexuality and what this means? This paper reports on findings from the Our Lives: Culture, Context and Risk project, which investigated sexual behaviour and decision-making in the context of the everyday life experience and aspirations of Indigenous and non-Indigenous young people (16–25 years) in the Northern Territory, Western Australia and in South Australia. Using qualitative data, this paper focuses on what participating young people thought was necessary to improve the quality of sexuality education. Participants suggest that current forms of sexuality education are too clinical, didactic and unengaging, and are missing in relevant content. Young people requested more information on relationships, first sexual experiences and negotiating condom use. These requests indicate that young people realise that they need more knowledge in order to have healthy relationships, which conflicts with the popular belief that providing young people with open, honest information around sex will encourage them to have sex or increase sexual risk taking. Making sexuality education more of a priority and listening to the needs of young people could be a positive step towards improving sexual health and well-being.     

Best Practices for English Language Learners in Massachusetts: Five Years After The Question 2 Mandate

Educating English language learners (ELLs) presents a challenge for teachers and policy makers; the population of ELLs increases, yet their achievement trails that of their native English-speaking peers. In November 2002, Massachusetts voters supported a law that mandated Sheltered English Immersion (SEI) as the primary means of instruction for ELLs, effectively ending transitional bilingual education. This report examines key considerations in educating ELLs, and in implementing SEI in Massachusetts schools. It also presents case studies of three schools making significant strides with ELLs through innovative programming built around SEI methods yet maintaining important bilingual education practices that promote educational equity. Cross-case analysis identified themes about strategic data use, staff recruitment, and supports for students and families.