Gardnerella vaginalis infection and sexual contact in female children

Gardnerella vaginalis (GV) infection has been reported as being acquired via sexual contact in adults and as an indicator of sexual contact in female children (DeJong, 1985). The purpose of this study was to determine if GV infection was more commonly found in 191 female children who gave a history of sexual contact and/or were infected with Neisseria gonorrhoeae (GC) or Chlamydia trachomatis (CT) (Group 1), compared with 144 female children evaluated for possible sexual abuse and found to have no such history or infection with GC or CT (Group 2), or 31 female children (friends of the authors) without such a history or GC or CT infection (Group 3). Vaginal GV was found in 5.3% of Group 1, 4.9% of Group 2 and 6.4% of Group 3 (p > .05). Also, vaginal GV infection was not related to the type of sexual contact or race, but did increase with age in white female children. Because vaginal GV infection is not more commonly found in children with a history of sexual contact than those without such a history, the finding of GV in a vaginal culture in an individual case would not be a reliable marker of sexual contact. Routine culturing for GV is not recommended as part of a sexual abuse workup.     

Ureaplasma urealyticum and large colony mycoplasma colonization in female children and its relationship to sexual contact, age, and race.

In order to determine if Ureaplasma urealyticum (Uu) or large colony mycoplasma (LCM) colonization was related to a history of sexual abuse, the type of sexual contact, an enlarged vaginal introitus transverse diameter (greater than 4 mm), age or race, 452 female children, ages 1-12 years, were evaluated by the Child Sexual Abuse Team at Wake Medical Center in Raleigh, NC. Thirty-six girls were deleted because of inadequate cultures. When controlled for race and age, Uu throat (T), vaginal (V), and rectal (R) colonization and LCM vaginal and rectal colonization were not related to any of the other variables listed above. The enlarged vaginal introital diameter was related to a history of sexual abuse (p less than .001). Uu and LCM vaginal colonization rates were increased in black girls as compared to white girls (p less than .05). Uu V, Uu R, LCM V, and LCM R colonization increased with age. In our study population, Uu and LCM colonization was not a useful marker of sexual contact.     

Promoting teachers’ instructional practices in alternative assessment through teacher collaboration

This paper reports the findings of a study which aims to examine the processes and effectiveness of the collaboration between teachers in their professional learning which some Singapore schools are currently engaged in. The learning process attempted to raise the profile of teacher professionalism in classroom alternative assessment through action research. A total of nine schools participated in this two-year study. Participants included teachers and school leaders. Guided by a university researcher and supported by a cluster superintendent and school leaders, the collaboration helped familiarise teachers with alternative ways of assessing student learning, connect theories with practice in their classroom assessment, and acquire the skills of doing research. Facilitated by a structure that supports the development of partnerships between teachers from different schools, the collaboration focused on teachers working on a common task. The data reveal how teachers took ownership of their own learning through this process and led their peers in their respective schools in curriculum customisation through alternative assessment practices. Such an education reform process, which has driven the effectiveness of the collaborative teacher learning in promoting teachers’ instructional practices, is analysed from four dimensions, namely, (a) macro level (systemic reform), (b) school level (school improvement plans), (c) teacher level (teacher community), and (d) micro level (classroom level). This paper concludes with a discussion of the challenges in sustaining teacher collaboration across schools in Singapore.     

Vaginal introital diameter in the evaluation of sexual abuse

Physical objective markers to aid in the diagnosis of sexual abuse are few. We therefore studied 242 females, ages 1 through 12 years, to determine if the vaginal introital diameter is useful in evaluating a child for sexual abuse. The children were divided into three groups: Group I, history of sexual contact and/or Neisseria gonorrhoeae; Group II, no history of sexual contact but at risk; and Group III, nonabused. A vaginal introital transverse diameter of greater than 4 mm was more prevalent among children in Group I (94%) than in Group II, (5%); or in Group III (0%) (chi 2, p less than .001). Eighty-eight percent of children who complained of penile-vaginal penetration had a vaginal introital diameter greater than 4 mm as compared to 18% of children with no penetration (chi 2, p less than .001). Forty-six percent of children who complained of fondling with penetration had a vaginal introital diameter of greater than 4 mm as compared to 14% in those without a history of penetration (chi 2, p less than .008). Fifty-eight percent of children with more than one encounter had a vaginal introital diameter greater than 4 mm as compared to 29% in those with one encounter (chi 2, p less than .006). In a logarithmic regression analysis, the greatest proportion of children with a vaginal introital diameter greater than 4 mm was observed in the penile-vaginal contact group (chi 2, p less than .00003). The test is not very sensitive but highly specific. The sensitivity drops precipitously at greater than 5 mm without losing the specificity. A vaginal introital diameter of greater than 4 mm is highly associated with sexual contact in children less than 13 years of age.