Head injury secondary to suspected child maltreatment: results of a prospective Canadian national surveillance program

Objective

We sought to determine the incidence, clinical features, and demographic profile of head injury secondary to suspected child maltreatment (abuse or neglect) in Canada to help inform the development and evaluation of prevention programs for abusive head injuries.

Methods

From March 1, 2005 to February 28, 2008, an average of 2,545 paediatricians and paediatric subspecialists were surveyed monthly through the established network of the Canadian Paediatric Surveillance Program. We calculated incidence rates using the number of confirmed cases over the product of the duration of the study (3 years) and population estimates by age group.

Results

There were 220 confirmed cases of head injury from suspected child maltreatment. The annual incidence rate was 14.1 per 100,000 for children less than 1 year of age and 1.4 per 100,000 for those less than 15 years. Seventy three percent (141) of cases involved infants less than 12 months of age and 52% (100) of cases involved infants less than 6 months of age. Seventy-five percent (165) of cases presented to the emergency room. With regard to outcome, 12% (27) of cases resulted in death and 45% (75) of survivors had neurological sequelae at discharge. Thirty percent (67) of all cases, as well as 30% (8) of deaths were previously known to child welfare authorities.

Conclusion

This study provides an estimate of the rate of head injury secondary to suspected child maltreatment in Canada. The young age and poor medical outcomes of those involved highlights the need for prevention efforts that are implemented early in life. Given that a significant percentage of injured infants and children were already known to child welfare authorities, the study also highlights the need to establish and evaluate additional preventive efforts for parents and caregivers already in the child welfare system.     

Surgeons as medical school educators: an untapped resource

Despite extensive experience teaching residents, surgeons are an untapped resource for educating medical students. We hypothesized that by involving surgeons as teachers earlier in the medical school curriculum, medical students' interest in surgery will increase and their opinions of surgeons will improve. Five programs designed to involve surgeons as educators in the medical school curriculum were implemented. The first program, started in 2008, introduced surgical faculty into the first-year medical student anatomy dissection laboratories. Other programs initiated in 2008 included: Surgical Clinical Correlates in Anatomy, which involved faculty teaching through cadaver surgery; Clinical Pathologic Conferences in Anatomy, a surgeon-led conference based on clinical cases; and a women's faculty-student mentorship program. Table Rounds, a surgeon-led anatomy review that used clinical scenarios to quiz students was begun in 2009. All five programs were successfully integrated into the medical school curriculum. While student opinion of surgeons as educators improved, there were no significant changes in student interest in surgery as a career nor change in performance on written examinations over the Anatomy content covered by the surgeons. Surgical faculty and trainees can be integrated into the medical school curriculum. Involving surgeons as educators earlier in the medical school curriculum may have longer term effects than could be observed in this study. At a minimum, the experience improved student opinion of surgeons as educators.     

Incorporating Library School Interns on Academic Library Subject Teams

This case study analyzes the use of library school interns on subject-based teams for the social sciences, humanities, and sciences in the San José State University Library. Interns worked closely with team librarians on reference, collection development/management, and instruction activities. In a structured focus group, interns reported that the internship enhanced their professional and career development, but they desired greater feedback and mentoring than they received. The library gained staff for its large instruction program and successfully recruited talented former interns for professional openings. This analysis will help other libraries and library science schools to improve their internships and field experiences.     

Integrated carbon fiber electrodes within hollow polymer microneedles for transdermal electrochemical sensing

In this study, carbon fiber electrodes were incorporated within a hollow microneedle array, which was fabricated using a digital micromirror device-based stereolithography instrument. Cell proliferation on the acrylate-based polymer used in microneedle fabrication was examined with human dermal fibroblasts and neonatal human epidermal keratinocytes. Studies involving full-thickness cadaveric porcine skin and trypan blue dye demonstrated that the hollow microneedles remained intact after puncturing the outermost layer of cadaveric porcine skin. The carbon fibers underwent chemical modification in order to enable detection of hydrogen peroxide and ascorbic acid; electrochemical measurements were demonstrated using integrated electrode-hollow microneedle devices.     

Home–School Literacy Bags for Twenty-first Century Preschoolers

Combining home–school literacy bags with preschool family literature circles provided a strong foundation for family involvement at home and school during this year-long Reading Partners project, and helped parents become essential partners in their children’s literacy development. Using home–school literacy bags, children and parents learned how to combine expressive arts and emergent literacy strategies including alphabet recognition, phonemic and phonological awareness, and oral language fluency. State-of-the-art activities designed for each of the multiple intelligences met the needs of diverse students with many different learning styles and interests. As families participated in fall and spring school-based Festivals in which they shared the literacy bags in small group family literature circles, they demonstrated children’s emerging literacy skills in a relaxed, yet highly engaging atmosphere.     

When Teaching Interferes With Learning: Balancing Accountability With the Unique Needs of Every Child

This article highlights the practices of administrators and master teachers who are trying to balance the needs for accountability, prescribed curriculum, and learning standards with a broader view of education that gives equal importance to skills not so easily quantified by standardized tests. The author makes a case for the use of careful observation of children, and documentation and analysis of project-based activities as a way to create a more complete picture of a child's skills while at the same time, supporting the innate desire to learn with which all children start life.     

A Spanish Soldier Becomes Mr Universe

A Spanish soldier has battled his way to the top of the beauty charts having been crowned Mr Universe. But Ruben Lopez vowed not to let the title of hottest man in the world go to his head, instead intending to stand by his troops and stay in military.