Using routinely collected hospital data for child maltreatment surveillance : issues, methods and patterns

Background: International data on child maltreatment are largely derived from child protection agencies, and predominantly report only substantiated cases of child maltreatment. This approach underestimates the incidence of maltreatment and makes inter-jurisdictional comparisons difficult. There has been a growing recognition of the importance of health professionals in identifying, documenting and reporting suspected child maltreatment. This study aimed to describe the issues around case identification using coded morbidity data, outline methods for selecting and grouping relevant codes, and illustrate patterns of maltreatment identified. Methods: A comprehensive review of the ICD-10-AM classification system was undertaken, including review of index terms, a free text search of tabular volumes, and a review of coding standards pertaining to child maltreatment coding. Identified codes were further categorised into maltreatment types including physical abuse, sexual abuse, emotional or psychological abuse, and neglect. Using these code groupings, one year of Australian hospitalisation data for children under 18 years of age was examined to quantify the proportion of patients identified and to explore the characteristics of cases assigned maltreatment-related codes. Results: Less than 0.5% of children hospitalised in Australia between 2005 and 2006 had a maltreatment code assigned, almost 4% of children with a principal diagnosis of a mental and behavioural disorder and over 1% of children with an injury or poisoning as the principal diagnosis had a maltreatment code assigned. The patterns of children assigned with definitive T74 codes varied by sex and age group. For males selected as having a maltreatment-related presentation, physical abuse was most commonly coded (62.6% of maltreatment cases) while for females selected as having a maltreatment-related presentation, sexual abuse was the most commonly assigned form of maltreatment (52.9% of maltreatment cases). Conclusion: This study has demonstrated that hospital data could provide valuable information for routine monitoring and surveillance of child maltreatment, even in the absence of population-based linked data sources. With national and international calls for a public health response to child maltreatment, better understanding of, investment in and utilisation of our core national routinely collected data sources will enhance the evidence-base needed to support an appropriate response to children at risk.

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.

Ubiquitous eco cities : infrastructure, technology and management

Efficient and effective urban management systems for Ubiquitous Eco Cities require having intelligent and integrated management mechanisms. This integration includes bringing together economic, socio-cultural and urban development with a well orchestrated, transparent and open decision-making system and necessary infrastructure and technologies. In Ubiquitous Eco Cities telecommunication technologies play an important role in monitoring and managing activities via wired and wireless networks. Particularly, technology convergence creates new ways in which information and telecommunication technologies are used and formed the backbone of urban management. The 21st Century is an era where information has converged, in which people are able to access a variety of services, including internet and location based services, through multi-functional devices and provides new opportunities in the management of Ubiquitous Eco Cities. This chapter discusses developments in telecommunication infrastructure and trends in convergence technologies and their implications on the management of Ubiquitous Eco Cities.

Codes of conduct for mobile device use in meetings : an exploratory analysis

The present paper addresses the findings of a preliminary investigation into policy and codes of conduct pertaining to the use of laptops and PDA’s in business meetings. The purpose of this study was to conduct a review of policies or codes of conduct pertaining to the use of laptops and PDAs in meetings. The investigation included academic literature, policy searches in the public domain of the Internet, as well as personal contact with target industries (large corporations – N=1000 + employees). The results highlight the dearth of policy and codes of conducts pertaining to the use of laptops and PDA’s in business meetings. Consequently, given the growing interdependence between mobile technologies and the contemporary workplace, there exists an opportunity for communication professionals to further research and develop policy and codes of conduct in this area. Implications for corporate communication policies and practices are also discussed.

If Big Brother comes to a venue near you! Employee surveillance issues and the communication professional

Todoy's monogers-drowing on the expertise of their IT professiono/s-surveillance.

Improved design method for biosecurity surveillance and early detection of non-indigenous rats

A recent advance in biosecurity surveillance design aims to benefit island conservation through early and improved detection of incursions by non-indigenous species. The novel aspects of the design are that it achieves a specified power of detection in a cost-managed system, while acknowledging heterogeneity of risk in the study area and stratifying the area to target surveillance deployment. The design also utilises a variety of surveillance system components, such as formal scientific surveys, trapping methods, and incidental sightings by non-biologist observers. These advances in design were applied to black rats (Rattus rattus) representing the group of invasive rats including R. norvegicus, and R. exulans, which are potential threats to Barrow Island, Australia, a high value conservation nature reserve where a proposed liquefied natural gas development is a potential source of incursions. Rats are important to consider as they are prevalent invaders worldwide, difficult to detect early when present in low numbers, and able to spread and establish relatively quickly after arrival. The ‘exemplar’ design for the black rat is then applied in a manner that enables the detection of a range of non-indigenous species of rat that could potentially be introduced. Many of the design decisions were based on expert opinion as data gaps exist in empirical data. The surveillance system was able to take into account factors such as collateral effects on native species, the availability of limited resources on an offshore island, financial costs, demands on expertise and other logistical constraints. We demonstrate the flexibility and robustness of the surveillance system and discuss how it could be updated as empirical data are collected to supplement expert opinion and provide a basis for adaptive management. Overall, the surveillance system promotes an efficient use of resources while providing defined power to detect early rat incursions, translating to reduced environmental, resourcing and financial costs.

Motivating domestic energy conservation through comparative, community-based feedback in mobile and social media

The progress of technology has led to the increased adoption of energy monitors among household energy consumers. While the monitors available on the market deliver real-time energy usage feedback to the consumer, the format of this data is usually unengaging and mundane. Moreover, it fails to address consumers with different motivations and needs to save and compare energy. This paper presents a study that seeks to provide initial indications for motivation-specific design of energy-related feedback. We focus on comparative feedback supported by a community of energy consumers. In particular, we examine eco-visualisations, temporal self-comparison, norm comparison, one-on-one comparison and ranking, whereby the last three allow us to explore the potential of socialising energy-related feedback. These feedback types were integrated in EnergyWiz – a mobile application that enables users to compare with their past performance, neighbours, contacts from social networking sites and other EnergyWiz users. The application was evaluated in personal, semi-structured interviews, which provided first insights on how to design motivation-related comparative feedback.

Review of de Bruijn, M., F. Nyamnjoh and I. Brinkman (eds.). 2009. Mobile phones : the new talking drums of everyday Africa

Since the late 1990s, there has been great enthusiasm expressed about the positive impact that can be obtained for poor and disadvantaged people from information and communication technologies (ICTs). This school of thought among researchers and practitioners is identified as ICTs for development (ICT4D). By contrast, a growing number of researchers eschew the technologically deterministic nature of the claims being made for development progress and seek to understand the role of technology in people’s lives, primarily through ethnographic studies. This book, which focuses on mobile telephony on the African continent, fits into the latter body of literature, with several authors explicitly stating they are examining social and cultural settings and are not taking a technologically deterministic view. The book captures the diverse ways various communities are using this communication technology. It adds to the burgeoning field of mobile phone studies, in which an increasing number of studies is emerging from developing countries.

Semi-supervised intelligent surveillance system for secure environments

This paper proposes a semi-supervised intelligent visual surveillance system to exploit the information from multi-camera networks for the monitoring of people and vehicles. Modules are proposed to perform critical surveillance tasks including: the management and calibration of cameras within a multi-camera network; tracking of objects across multiple views; recognition of people utilising biometrics and in particular soft-biometrics; the monitoring of crowds; and activity recognition. Recent advances in these computer vision modules and capability gaps in surveillance technology are also highlighted.

Ecological aspects of biosecurity surveillance design for the detection of multiple invasive animal species

Complex surveillance problems are common in biosecurity, such as prioritizing detection among multiple invasive species, specifying risk over a heterogeneous landscape, combining multiple sources of surveillance data, designing for specified power to detect, resource management, and collateral effects on the environment. Moreover, when designing for multiple target species, inherent biological differences among species result in different ecological models underpinning the individual surveillance systems for each. Species are likely to have different habitat requirements, different introduction mechanisms and locations, require different methods of detection, have different levels of detectability, and vary in rates of movement and spread. Often there is a further challenge of a lack of knowledge, literature, or data, for any number of the above problems. Even so, governments and industry need to proceed with surveillance programs which aim to detect incursions in order to meet environmental, social and political requirements. We present an approach taken to meet these challenges in one comprehensive and statistically powerful surveillance design for non-indigenous terrestrial vertebrates on Barrow Island, a high conservation nature reserve off the Western Australian coast. Here, the possibility of incursions is increased due to construction and expanding industry on the island. The design, which includes mammals, amphibians and reptiles, provides a complete surveillance program for most potential terrestrial vertebrate invaders. Individual surveillance systems were developed for various potential invaders, and then integrated into an overall surveillance system which meets the above challenges using a statistical model and expert elicitation. We discuss the ecological basis for the design, the flexibility of the surveillance scheme, how it meets the above challenges, design limitations, and how it can be updated as data are collected as a basis for adaptive management.

Noising around : investigations in mobile learning

In this paper we present an account of children's interactions with a mobile technology prototype within a school context. The Noise Detectives trial was conducted in a school setting with the aim of better understanding the role of mobile technology as a mediator within science learning activities. Over eighty children, aged between ten and twelve, completed an outdoor data gathering activity using a mobile learning prototype that included paper and digital components. They measured and recorded noise levels at a range of locations throughout the schools. We analyzed the activity to determine how the components of the prototype were integrated into the learning activity, and to identify differences in behavior that resulted from using these components. We present design implications that resulted from observed differences in prototype use and appropriation.

Robust suspicious behaviour detection for smart surveillance systems

Video surveillance technology, based on Closed Circuit Television (CCTV) cameras, is one of the fastest growing markets in the field of security technologies. However, the existing video surveillance systems are still not at a stage where they can be used for crime prevention. The systems rely heavily on human observers and are therefore limited by factors such as fatigue and monitoring capabilities over long periods of time. To overcome this limitation, it is necessary to have “intelligent” processes which are able to highlight the salient data and filter out normal conditions that do not pose a threat to security. In order to create such intelligent systems, an understanding of human behaviour, specifically, suspicious behaviour is required. One of the challenges in achieving this is that human behaviour can only be understood correctly in the context in which it appears. Although context has been exploited in the general computer vision domain, it has not been widely used in the automatic suspicious behaviour detection domain. So, it is essential that context has to be formulated, stored and used by the system in order to understand human behaviour. Finally, since surveillance systems could be modeled as largescale data stream systems, it is difficult to have a complete knowledge base. In this case, the systems need to not only continuously update their knowledge but also be able to retrieve the extracted information which is related to the given context. To address these issues, a context-based approach for detecting suspicious behaviour is proposed. In this approach, contextual information is exploited in order to make a better detection. The proposed approach utilises a data stream clustering algorithm in order to discover the behaviour classes and their frequency of occurrences from the incoming behaviour instances. Contextual information is then used in addition to the above information to detect suspicious behaviour. The proposed approach is able to detect observed, unobserved and contextual suspicious behaviour. Two case studies using video feeds taken from CAVIAR dataset and Z-block building, Queensland University of Technology are presented in order to test the proposed approach. From these experiments, it is shown that by using information about context, the proposed system is able to make a more accurate detection, especially those behaviours which are only suspicious in some contexts while being normal in the others. Moreover, this information give critical feedback to the system designers to refine the system. Finally, the proposed modified Clustream algorithm enables the system to both continuously update the system’s knowledge and to effectively retrieve the information learned in a given context. The outcomes from this research are: (a) A context-based framework for automatic detecting suspicious behaviour which can be used by an intelligent video surveillance in making decisions; (b) A modified Clustream data stream clustering algorithm which continuously updates the system knowledge and is able to retrieve contextually related information effectively; and (c) An update-describe approach which extends the capability of the existing human local motion features called interest points based features to the data stream environment.

Characterisation of public mobile data networks for aeronautical telemetry purposes

This paper describes the characterisation for airborne uses of the public mobile data communication systems known broadly as 3G. The motivation for this study was to explore how this mature public communication systems could be used for aviation purposes. An experimental system was fitted to a light aircraft to record communication latency, line speed, RF level, packet loss and cell tower identifier. Communications was established using internet protocols and connection was made to a local server. The aircraft was flown in both remote and populous areas at altitudes up to 8500ft in a region located in South East Queensland, Australia. Results show that the average airborne RF levels are better than those on the ground by 21% and in the order of -77 dbm. Latencies were in the order of 500 ms (1/2 the latency of Iridium), an average download speed of 0.48 Mb/s, average uplink speed of 0.85 Mb/s, a packet of information loss of 6.5%. The maximum communication range was also observed to be 70km from a single cell station. The paper also describes possible limitations and utility of using such a communications architecture for both manned and unmanned aircraft systems.