Primary prevention of pediatric abusive head trauma: A cost audit and cost-utility analysis

ObjectivesTo obtain comprehensive, reliable data on the direct cost of pediatric abusive head trauma in New Zealand, and to use this data to evaluate the possible cost–benefit of a national primary prevention program.MethodsA 5 year cohort of infants with abusive head trauma admitted to hospital in Auckland, New Zealand was reviewed. We determined the direct costs of hospital care (from hospital and Ministry of Health financial records), community rehabilitation (from the Accident Compensation Corporation), special education (from the Ministry of Education), investigation and child protection (from the Police and Child Protective Services), criminal trials (from the Police, prosecution and defence), punishment of offenders (from the Department of Corrections) and life-time care for moderate or severe disability (from the Accident Compensation Corporation). Analysis of the possible cost-utility of a national primary prevention program was undertaken, using the costs established in our cohort, recent New Zealand national data on the incidence of pediatric abusive head trauma, international data on quality of life after head trauma, and published international literature on prevention programs.ResultsThere were 52 cases of abusive head trauma in the sample. Hospital costs totaled $NZ2,433,340, child protection $NZ1,560,123, police investigation $NZ1,842,237, criminal trials $NZ3,214,020, punishment of offenders $NZ4,411,852 and community rehabilitation $NZ2,895,848. Projected education costs for disabled survivors were $NZ2,452,148, and the cost of projected lifetime care was $NZ33,624,297. Total costs were $NZ52,433,864, averaging $NZ1,008,344 per child. Cost-utility analysis resulted in a strongly positive economic argument for primary prevention, with expected case scenarios showing lowered net costs with improved health outcomes.ConclusionsPediatric abusive head trauma is very expensive, and on a conservative estimate the costs of acute hospitalization represent no more than 4% of lifetime direct costs. If shaken baby prevention programs are effective, there is likely to be a strong economic argument for their implementation. This study also provides robust data for future cost–benefit analysis in the field of abusive head trauma prevention.     

A design-based research case study documenting a constructivist ID process and instructional solution for a cross-cultural workforce

As the need for instructing a globalized workforce increases, instructional designers must embrace the constraints and the opportunities these projects provide in order to move the field of cross-cultural instructional design (ID) forward. Cross-cultural projects offer multiple avenues for growth in ID practice, overcoming cultural barriers, and a venue to apply and test contemporary models, methodologies, and theories in ID. This design-based research case study employed a rapid prototyping methodology and the constructivist ID model, Layers of Negotiation, to collect critical cultural information for the design of this cross-cultural instruction. Instructional strategies deemed effective for instructing an unskilled workforce in Dubai, United Arab Emirates, included job aids, situated learning and apprenticeship principles consisting of modeling, coaching and scaffolding. Use of the constructivist ID model and instructional solution for a cross-cultural workforce for The Dubai Mall are presented. Evaluation results indicate the success of the instructional strategies varied dependent upon worker culture, and the sequential nature of the instructional strategies.     

A Study of Gender Differential Linguistic Interaction in the Adult Classroom

This article attempts to determine whether men dominate the language in the mixed‐gender adult classroom. Form‐based and activity‐based research methods were used with a group of adults on a training project at Cranford Community School in the London Borough of Hounslow. The findings were related to some of the relevant literature on the linguistic domination of boys in the school classroom and an attempt was made to establish whether men use the same devices to control the language in adult learning situations.     

Parents' Child Care Arrangements and their Ecological Correlates

Young children rely on their parents for making decisions about their child care experiences. Parents' child care arrangements are affected by the information they gather, their values and childrearing beliefs, their knowledge of child care quality, and the extent to which they are satisfied with their child care choices. Parents' decisions about child care are also influenced by ecological correlates, such as child age, maternal education and hours of employment, family ethnicity and income, and state and federal child care policies. This review addresses each of these elements and their role in parents' child care arrangements and concludes with recommendations for honoring parents' child care ideals through better child care quality information and higher professional standards for child care providers.     

Academic Life and Motherhood: Variations by Institutional Type

This paper explores the interface between work and family at different types of institutions from the perspective of women faculty who are on the tenure track and who are mothers of young children. Such a perspective provides insight into institutional variation on academic life in general, and for new faculty as mothers in particular. A macro view of the findings points to two major concerns: time (and lack thereof) and its impact on the “ideal worker” norms that shape what it means to be a good mother and good professor at different institutional types; and, the idea of “choice” as an illusion.     

An Analysis of Anatomy Education Before and During Covid-19: May–August 2020

Coronavirus disease 2019 (Covid-19) created unparalleled challenges to anatomy education. Gross anatomy education has been particularly impacted given the traditional in-person format of didactic instruction and/or laboratory component(s). To assess the changes in gross anatomy lecture and laboratory instruction, assessment, and teaching resources utilized as a result of Covid-19, a survey was distributed to gross anatomy educators through professional associations and listservs. Of the 67 survey responses received for the May–August 2020 academic period, 84% were from United States (US) institutions, while 16% were internationally based. Respondents indicated that in-person lecture decreased during Covid-19 (before: 76%, during: 8%, P < 0.001) and use of cadaver materials declined (before: 76 ± 33%, during: 34 ± 43%, P < 0.001). The use of cadaver materials in laboratories decreased during Covid-19 across academic programs, stand-alone and integrated anatomy courses, and private and public institutions (P ≤ 0.004). Before Covid-19, cadaveric materials used in laboratories were greater among professional health programs relative to medical and undergraduate programs (P ≤ 0.03) and among stand-alone relative to integrated anatomy courses (P ≤ 0.03). Furthermore, computer-based assessment increased (P < 0.001) and assessment materials changed from cadaveric material to images (P < 0.03) during Covid-19, even though assessment structure was not different (P > 0.05). The use of digital teaching resources increased during Covid-19 (P < 0.001), with reports of increased use of in-house created content, BlueLink, and Complete Anatomy software (P < 0.05). While primarily representing US institutions, this study provided evidence of how anatomy educators adapted their courses, largely through virtual mediums, and modified laboratory protocols during the initial emergence of the Covid-19 pandemic.     

Into the Unknown: Examining Neural Representations of Parent–Adolescent Interactions

The parent–adolescent relationship is important for adolescents’ emotion regulation (ER), yet little is known regarding the neural patterns of dyadic ER that occur during parent–adolescent interactions. A novel measure that can be used to examine such patterns is cross-brain connectivity (CBC)—concurrent and time-lagged connectivity between two individuals’ brain regions. This study sought to provide evidence of CBC and explore associations between CBC, parenting, and adolescent internalizing symptoms. Thirty-five adolescents (mean age = 15 years, 69% female, 72% Non-Hispanic White, 17% Black, 11% Hispanic or Latino) and one biological parent (94% female) completed an fMRI hyperscanning conflict discussion task. Results revealed CBC between emotion-related brain regions. Exploratory analyses indicated CBC is associated with parenting and adolescent depressive symptoms.     

Graphing as a Means to Improve Middle School Science Learning and Mathematics-Related Affective Domains

Research in Science Education - This study evaluated the effectiveness of the Mathematics Infusion into Science Project (MiSP), which integrated science and mathematics in an engaging middle school...     

Extracurricular Activities,Screen Media Activity,and Sleep May Be Modifiable Factors Related to Children’s Cognitive Functioning: Evidence From the ABCD Study®

This study used a machine learning framework in conjunction with a large battery of measures from 9,718 school-age children (ages 9–11) from the Adolescent Brain Cognitive Development^SM (ABCD) Study to identify factors associated with fluid cognitive functioning (FCF), or the capacity to learn, solve problems, and adapt to novel situations. The identified algorithm explained 14.74% of the variance in FCF, replicating previously reported socioeconomic and mental health contributors to FCF, and adding novel and potentially modifiable contributors, including extracurricular involvement, screen media activity, and sleep duration. Pragmatic interventions targeting these contributors may enhance cognitive performance and protect against their negative impact on FCF in children.