Reliability of routinely collected hospital data for child maltreatment surveillance

Background: Internationally, research on child maltreatment-related injuries has been hampered by a lack of available routinely collected health data to identify cases, examine causes, identify risk factors and explore health outcomes. Routinely collected hospital separation data coded using the International Classification of Diseases and Related Health Problems (ICD) system provide an internationally standardised data source for classifying and aggregating diseases, injuries, causes of injuries and related health conditions for statistical purposes. However, there has been limited research to examine the reliability of these data for child maltreatment surveillance purposes. This study examined the reliability of coding of child maltreatment in Queensland, Australia. Methods: A retrospective medical record review and recoding methodology was used to assess the reliability of coding of child maltreatment. A stratified sample of hospitals across Queensland was selected for this study, and a stratified random sample of cases was selected from within those hospitals. Results: In 3.6% of cases the coders disagreed on whether any maltreatment code could be assigned (definite or possible) versus no maltreatment being assigned (unintentional injury), giving a sensitivity of 0.982 and specificity of 0.948. The review of these cases where discrepancies existed revealed that all cases had some indications of risk documented in the records. 15.5% of cases originally assigned a definite or possible maltreatment code, were recoded to a more or less definite strata. In terms of the number and type of maltreatment codes assigned, the auditor assigned a greater number of maltreatment types based on the medical documentation than the original coder assigned (22% of the auditor coded cases had more than one maltreatment type assigned compared to only 6% of the original coded data). The maltreatment types which were the most ‘under-coded’ by the original coder were psychological abuse and neglect. Cases coded with a sexual abuse code showed the highest level of reliability. Conclusion: Given the increasing international attention being given to improving the uniformity of reporting of child-maltreatment related injuries and the emphasis on the better utilisation of routinely collected health data, this study provides an estimate of the reliability of maltreatment-specific ICD-10-AM codes assigned in an inpatient setting.

Processing load and the use of concrete representations and strategies for solving linear equations

This paper is a report of students' responses to instruction which was based on the use of concrete representations to solve linear equations. The sample consisted of 21 Grade 8 students from a middle-class suburban state secondary school with a reputation for high academic standards and innovative mathematics teaching. The students were interviewed before and after instruction. Interviews and classroom interactions were observed and videotaped. A qualitative analysis of the responses revealed that students did not use the materials in solving problems. The increased processing load caused by concrete representations is hypothesised as a reason.

Monitoring energy performance of air conditioners in classrooms

Air quality and temperatures in classrooms are important factors influencing the student learning process. To improve the thermal comfort of classrooms for Queensland State Schools, Queensland Government initiated the "Cooler Schools Program". One of the key objectives under this program was to develop low energy cooling systems as an alternative to high energy demand conventioanl split system of air conditioning (AC) systems. In order to compare and evaluate the energy performance of different types of air conditioners installed in classrooms, monitoring systems were installed in a state primary school located in the greater outer urban area of Brisbane, Australia. It was found that the installation of monitoring systems could have a significant impact on the accuracy of the data being collected. By comparing the estimated energy efficiency ratio (EER)for four qualified air conditioners included in this study, it was also found that AC6, a hybrid air conditioner newly developed by the Queensland Department of Public Works (DPW), had the best energy performance, although the current data were not able to show the full advantages of the system.

Gate 38

Airports are a place of transition, empty halls of fleeting comings, goings and waitings. 'Gate 38' follows the experience of four groups of young people trapped at this point of departure. As contact with the outside world is cut off, the focus is placed squarely on what they’re doing, and where they’re going. A non-traditional musical set at the end of the world. Commissioned by MacGregor State High School's Centre of Artistic Development, script development included workshops with the CAD class of 2007. No musical score required.

Feasibility of using health data sources to inform product safety surveillance in Queensland : a report for the Queensland Injury Prevention Council

This report provides an evaluation of the current available evidence-base for identification and surveillance of product-related injuries in children in Queensland. While the focal population was children in Queensland, the identification of information needs and data sources for product safety surveillance has applicability nationally for all age groups. The report firstly summarises the data needs of product safety regulators regarding product-related injury in children, describing the current sources of information informing product safety policy and practice, and documenting the priority product surveillance areas affecting children which have been a focus over recent years in Queensland. Health data sources in Queensland which have the potential to inform product safety surveillance initiatives were evaluated in terms of their ability to address the information needs of product safety regulators. Patterns in product-related injuries in children were analysed using routinely available health data to identify areas for future intervention, and the patterns in product-related injuries in children identified in health data were compared to those identified by product safety regulators. Recommendations were made for information system improvements and improved access to and utilisation of health data for more proactive approaches to product safety surveillance in the future.

An accessible method for teaching doctors about death certification

The World Health Organization recommends that data on mortality in its member countries are collected utilising the Medical Certificate of Cause of Death published in the instruction volume of the ICD-10. However, investment in health information processes necessary to promote the use of this certificate and improve mortality information is lacking in many countries. An appeal for support to make improvements has been launched through the Health Metrics Network’s MOVE-IT strategy (Monitoring of Vital Events – Information Technology) [World Health Organization, 2011]. Despite this international spotlight on the need for capture of mortality data and in the use of the ICD-10 to code the data reported on such certificates, there is little cohesion in the way that certifiers of deaths receive instruction in how to complete the death certificate, which is the main source document for mortality statistics. Complete and accurate documentation of the immediate, underlying and contributory causes of death of the decedent on the death certificate is a requirement to produce standardised statistical information and to the ability to produce cause-specific mortality statistics that can be compared between populations and across time. This paper reports on a research project conducted to determine the efficacy and accessibility of the certification module of the WHO’s newly-developed web based training tool for coders and certifiers of deaths. Involving a population of medical students from the Fiji School of Medicine and a pre and post research design, the study entailed completion of death certificates based on vignettes before and after access to the training tool. The ability of the participants to complete the death certificates and analysis of the completeness and specificity of the ICD-10 coding of the reported causes of death were used to measure the effect of the students’ learning from the training tool. The quality of death certificate completion was assessed using a Quality Index before and after the participants accessed the training tool. In addition, the views of the participants about accessibility and use of the training tool were elicited using a supplementary questionnaire. The results of the study demonstrated improvement in the ability of the participants to complete death certificates completely and accurately according to best practice. The training tool was viewed very positively and its implementation in the curriculum for medical students was encouraged. Participants also recommended that interactive discussions to examine the certification exercises would be an advantage.

Implementation of ICD-11... perspectives from the Australian Bureau of Statistics

As the development of ICD-11 progresses, the Australian Bureau of Statistics is beginning to consider what will be required to successfully implement the new version of the classification. This paper will present early thoughts on the following: building understanding amongst the user community of upcoming changes and the implications of those changes; the need for training of coders and data users; development of analytical methods and conduct of comparability studies; processes to test, accept and implement new or updated coding software; assessment of coding quality; changes to data analyses and reporting processes; updates to regular publications; and assessing the resources required for successful implementation.

The QUTeach@Redcliffe program

The QUTeach@Redcliffe program enables senior secondary students from a disadvantaged region of Queensland to commence teacher education degrees while completing school. Introduced in mid-2008, QUTeach is a collaboration between Queensland University of Technology and Queensland’s Bays Cluster of State High Schools. It is currently in pilot form. The program emerged as the result of equity concerns in relation to students who face barriers to university entrance, in terms of social, racial or financial disadvantage. It was also motivated by a desire to generate a stream of new teachers who come from the region and understand its circumstances, and who can relate well to the school students they teach. Rather than learning as individuals on a university campus, students in the program are taught as a class so that they can learn from one another as well as from their instructors. The classes are conducted two evenings per week on the premises of Redcliffe State High School, which is more familiar and easier to access than the university campus. However, the students also attend the QUT’s Kelvin Grove campus one or two days each semester to familiarise themselves with the university environment and participate in lectures on campus.

Classifying external causes of injury : history, current approaches, and future directions

The International Classification of Diseases (ICD) is used to categorise diseases, injuries and external causes, and is a key epidemiological tool enabling the storage and retrieval of data from health and vital records to produce core international mortality and morbidity statistics. The ICD is updated periodically to ensure the classification remains current and work is now underway to develop the next revision, ICD-11. There have been almost 20 years since the last ICD edition was published and over 60 years since the last substantial structural revision of the external causes chapter. Revision of such a critical tool requires transparency and documentation to ensure that changes made to the classification system are recorded comprehensively for future reference. In this paper, the authors provide a history of external causes classification development and outline the external cause structure. Approaches to manage ICD-10 deficiencies are discussed and the ICD-11 revision approach regarding the development of, rationale for and implications of proposed changes to the chapter are outlined. Through improved capture of external cause concepts in ICD-11, a stronger evidence base will be available to inform injury prevention, treatment, rehabilitation and policy initiatives to ultimately contribute to a reduction in injury morbidity and mortality.

The internal validity of web-based studies

Honing and Ladinig (2008) make the assertion that while the internal validity of web-based studies may be reduced, this is offset by an increase in external validity possible when experimenters can sample a wider range of participants and experimental settings. In this paper, the issue of internal validity is more closely examined, and it is agued that there is no necessary reason why internal validity of a web-based study should be worse than that of a lab-based one. Errors of measurement or inconsistencies of manipulation will typically balance across conditions of the experiment, and thus need not necessarily threaten the validity of a study’s findings.

Particle nucleation in urban subtropical atmosphere

New particle formation (NPF) and growth have been observed in different environments all around the world and NPF affects the environment by forming cloud condensation nuclei (CCN). Detailed characterisation of NPF events in a subtropical urban environment is the main aim of this study. Particle size distribution (PSD) of atmospheric aerosol particles in range 9-414 nm were measured using a Scanning Mobility Particle Sizer (SMPS), within the framework of the “Ultrafine Particles from Traffic Emissions and Children’s Health” (UPTECH) study, which seeks to determine the relationship between exposure to traffic related ultrafine particles and children’s health (http://www.ilaqh.qut. edu.au/Misc/UPTECH%20Home.htm). The UPTECH study includes measurements of air quality, meteorological and traffic parameters in 25 randomly selected state primary school within the Brisbane metropolitan area, in Queensland, Australia. Measurements at 17 schools have been completed so far.

Mastering medical terminology : Australia and New Zealand

Mastering Medical Terminology: Australia and New Zealand is medical terminology book of relevance to an audience in Australia and New Zealand. Australian terminology, perspectives, examples and spelling have been included and Australian pronunciation specified. The textbook is accompanied by a self-help workbook, an online workbook and a Smartphone app. Throughout Mastering Medical Terminology, review of medical terminology as it is used in clinical practice is highlighted. Features of the textbook, workbook and electronic product include: • Simple, non-technical explanations of medical terms • Workbook format with ample spaces to write answers • Explanations of clinical procedures, laboratory tests and abbreviations used in Australian clinical practice, as they apply to each body system and speciality area • Pronunciation of terms and spaces to write meanings of terms • Practical applications sections • Exercises that test understanding of terminology as students work through the text chapter by chapter • Review activities that pull together terminology to help students study • Comprehensive glossary and appendices for reference • Links to other useful references, such as websites and textbooks.

Mastering medical terminology : Australia and New Zealand Workbook

Mastering Medical Terminology: Australia and New Zealand Workbook is the indispensable companion to Mastering Medical Terminology Textbook. Packed with a range of exercises and activities to accompany the main text, the Workbook provides an ideal resource for self-testing and revision in a fun, practical and accessible format, and forms a key part of the Mastering Medical Terminology suite of products which are all available for separate purchase enabling you to pick and choose the right package for your learning requirements. Featuring a variety of question types including crossword puzzles, anagrams, multiple-choice questions and label-the-diagram exercises, the Workbook uses entirely Australian spelling and aligns to the chapters of the main text. When used in combination with the main text and MedWords app, Mastering Medical Terminology: Australia and New Zealand Workbook will make the scholarship of medical terminology not only manageable, but fun!