The development and piloting of the ISPCAN child abuse screening tool-parent version (ICAST-P)

Objective Child maltreatment is a problem that has longer recognition in the northern hemisphere and in high-income countries. Recent work has highlighted the nearly universal nature of the problem in other countries but demonstrated the lack of comparability of studies because of the variations in definitions and measures used. The International Society for the Prevention of Child Abuse and Neglect has developed instrumentation that may be used with cross-cultural and cross-national benchmarking by local investigators. Design and sampling The instrument design began with a team of expert in Brisbane in 2004. A large bank of questions were subjected to two rounds of Delphi review to develop the fielded version of the instrument. Convenience samples included approximately 120 parent respondents with children under the age of 18 in each of six countries (697 total). Results This paper presents an instrument that measures parental behaviors directed at children and reports data from pilot work in 6 countries and 7 languages. Patterns of response revealed few missing values and distributions of responses that generally were similar in the six countries. Subscales performed well in terms of internal consistency with Cronbach's alpha in very good range (0.77–0.88) with the exception of the neglect and sex abuse subscales. Results varied by child age and gender in expected directions but with large variations among the samples. About 15% of children were shaken, 24% hit on the buttocks with an object, and 37% were spanked. Reports of choking and smothering were made by 2% of parents. Conclusion These pilot data demonstrate that the instrument is well tolerated and captures variations in, and potentially harmful forms of child discipline. Practice implications The ISPCAN Child Abuse Screening Tool – Parent Version (ICAST-P) has been developed as a survey instrument to be administered to parents for the assessment of child maltreatment in a multi-national and multi-cultural context. It was developed with broad input from international experts and subjected to Dephi review, translation, and pilot testing in six countries. The results of the Delphi study and pilot testing are presented. This study demonstrates that a single instrument can be used in a broad range of cultures and languages with low rates of missing data and moderate to high internal consistency.

ISPCAN child abuse screening tool children's version (ICAST-C): Instrument development and multi-national pilot testing

Objective To develop a child victimization survey among a diverse group of child protection experts and examine the performance of the instrument through a set of international pilot studies. Methods The initial draft of the instrument was developed after input from scientists and practitioners representing 40 countries. Volunteers from the larger group of scientists participating in the Delphi review of the ICAST P and R reviewed the ICAST C by email in 2 rounds resulting in a final instrument. The ICAST C was then translated and back translated into six languages and field tested in four countries using a convenience sample of 571 children 12–17 years of age selected from schools and classrooms to which the investigators had easy access. Results The final ICAST C Home has 38 items and the ICAST C Institution has 44 items. These items serve as screeners and positive endorsements are followed by queries for frequency and perpetrator. Half of respondents were boys (49%). Endorsement for various forms of victimization ranged from 0 to 51%. Many children report violence exposure (51%), physical victimization (55%), psychological victimization (66%), sexual victimization (18%), and neglect in their homes (37%) in the last year. High rates of physical victimization (57%), psychological victimization (59%), and sexual victimization (22%) were also reported in schools in the last year. Internal consistency was moderate to high (alpha between .685 and .855) and missing data low (less than 1.5% for all but one item). Conclusions In pilot testing, the ICAST C identifies high rates of child victimization in all domains. Rates of missing data are low, and internal consistency is moderate to high. Pilot testing demonstrated the feasibility of using child self-report as one strategy to assess child victimization. Practice implications The ICAST C is a multi-national, multi-lingual, consensus-based survey instrument. It is available in six languages for international research to estimate child victimization. Assessing the prevalence of child victimization is critical in understanding the scope of the problem, setting national and local priorities, and garnering support for program and policy development aimed at child protection.

The burden of child maltreatment in China: a systematic review

Objective To estimate the health and economic burdens of child maltreatment in China. Methods We did a systematic review for studies on child maltreatment in China using PubMed, Embase, PsycInfo, CINAHL-EBSCO, ERIC and the Chinese National Knowledge Infrastructure databases. We did meta-analyses of studies that met inclusion criteria to estimate the prevalence of child neglect and child physical, emotional and sexual abuse. We used data from the 2010 global burden of disease estimates to calculate disability-adjusted life-years (DALYs) lost as a result of child maltreatment. Findings From 68 studies we estimated that 26.6% of children under 18 years of age have suffered physical abuse, 19.6% emotional abuse, 8.7% sexual abuse and 26.0% neglect. We estimate that emotional abuse in childhood accounts for 26.3% of the DALYs lost because of mental disorders and 18.0% of those lost because of self-harm. Physical abuse in childhood accounts for 12.2% of DALYs lost because of depression, 17.0% of those lost to anxiety, 20.7% of those lost to problem drinking, 18.8% of those lost to illicit drug use and 18.3% of those lost to self-harm. The consequences of physical abuse of children costs China an estimated 0.84% of its gross domestic product – i.e. 50 billion United States dollars – in 2010. The corresponding losses attributable to emotional and sexual abuse in childhood were 0.47% and 0.39% of the gross domestic product, respectively. Conclusion In China, child maltreatment is common and associated with large economic losses because many maltreated children suffer substantial psychological distress and might adopt behaviours that increase their risk of chronic disease.

The burden of child maltreatment in the East Asia and Pacific region

This study estimated the health and economic burden of child maltreatment in the East Asia and Pacific region, addressing a significant gap in the current evidence base. Systematic reviews and meta-analyses were conducted to estimate the prevalence of child physical abuse, sexual abuse, emotional abuse, neglect, and witnessing parental violence. Population Attributable Fractions were calculated and Disability-Adjusted Life Years (DALYs) lost from physical and mental health outcomes and health risk behaviors attributable to child maltreatment were estimated using the most recent comparable Global Burden of Disease data. DALY losses were converted into monetary value by assuming that one DALY is equal to the sub-region’s per capita GDP. The estimated economic value of DALYs lost to violence against children as a percentage of GDP ranged from 1.24% to 3.46% across sub-regions defined by the World Health Organization. The estimated economic value of DALYs (in constant 2000 US$) lost to child maltreatment in the EAP region totaled US $151 billion, accounting for 1.88% of the region’s GDP. Updated to 2012 dollars, the estimated economic burden totaled US $194 billion. In sensitivity analysis, the aggregate costs as a percentage of GDP range from 1.36% to 2.52%. The economic burden of child maltreatment in the East Asia and Pacific region is substantial, indicating the importance of preventing and responding to child maltreatment in this region. More comprehensive research into the impact of multiple types of childhood adversity on a wider range of putative health outcomes is needed to guide policy and programs for child protection in the region, and globally.

Bone health in children with inflammatory bowel disease : adjusting for bone age

OBJECTIVES: Clinical results of bone mineral density for children with inflammatory bowel disease are commonly reported using reference data for chronological age. It is known that these children, particularly those with Crohn disease, experience delayed growth and maturation. Therefore, it is more appropriate to compare clinical results with bone age rather than chronological age. MATERIALS AND METHODS: Areal bone mineral density (aBMD) was measured using dual energy x-ray absorptiometry, and bone age was assessed using the Tanner-Whitehouse 3 method from a standard hand/wrist radiograph. Results were available for 44 children ages 7.99 to 16.89 years. Areal bone mineral density measurements were converted to z scores using both chronological and bone ages for each subject. RESULTS: Areal bone mineral density z scores calculated using bone age, as opposed to chronological age, were significantly improved for both the total body and lumbar spine regions of interest. When subjects were grouped according to diagnosis, bone age generated z scores remained significantly improved for those with Crohn disease but not for those diagnosed with ulcerative colitis. Grouping of children with Crohn disease into younger and older ages produced significantly higher z scores using bone age compared with chronological for the older age group, but not the younger age group. CONCLUSIONS: Our findings, in accordance with those presented in the literature, suggest that aBMD results in children with Crohn disease should include the consideration of bone age, rather than merely chronological age. Bone size, although not as easily available, would also be an important consideration for interpreting results in paediatric populations. © 2009 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.

In-vehicle filming of driver fatigue on YouTube: Vlogs, crashes and bad advice

Background: Driver fatigue contributes to 15-30% of crashes, however it is difficult to objectively measure. Fatigue mitigation relies on driver self-moderation, placing great importance on the necessity for road safety campaigns to engage with their audience. Popular self-archiving website YouTube.com is a relatively unused source of public perceptions. Method: A systematic YouTube.com search (videos uploaded 2/12/09 - 2/12/14) was conducted using driver fatigue related search terms. 442 relevant videos were identified. In-vehicle footage was separated for further analysis. Video reception was quantified in terms of number of views, likes, comments, dislikes and times duplicated. Qualitative analysis of comments was undertaken to identify key themes. Results: 4.2% (n=107) of relevant uploaded videos contained in-vehicle footage. Three types of videos were identified: (1) dashcam footage (n=82); (2) speaking directly to the camera - vlogs (n=16); (3) passengers filming drivers (n=9). Two distinct types of comments emerged, those directly relating to driver fatigue and those more broadly about the video or its uploader. Driver fatigue comments included: attribution of behaviour cause, emotion experienced when watching the video and personal advice on staying awake while driving. Discussion: In-vehicle footage related to driver fatigue is prevalent on YouTube.com and is actively engaged with by viewers. Comments were mixed in terms of criticism and sympathy for drivers. Willingness to share advice on staying awake suggests driver fatigue may be seen as a common yet controllable occurrence. This project provides new insight into driver fatigue perception, which may be considered by safety authorities when designing education campaigns.

Resting energy expenditure in children with inflammatory bowel disease

OBJECTIVES: There is controversy in the literature regarding the effect of inflammatory bowel disease (IBD) on resting energy expenditure (REE). In many cases this may have resulted from inappropriate adjustment of REE measurements to account for differences in body composition. This article considers how to appropriately adjust measurements of REE for differences in body composition between individuals with IBD. PATIENTS AND METHODS: Body composition, assessed via total body potassium to yield a measure of body cell mass (BCM), and REE measurements were performed in 41 children with Crohn disease and ulcerative colitis in the Royal Children's Hospital, Brisbane, Australia. Log-log regression was used to determine the power function to which BCM should be raised to appropriately adjust REE to account for differences in body composition between children. RESULTS: The appropriate value to "adjust" BCM was found to be 0.49, with a standard error of 0.10. CONCLUSIONS: Clearly, there is a need to adjust for differences in body composition, or at the very least body weight, in metabolic studies in children with IBD. We suggest that raising BCM to the power of 0.5 is both a numerically convenient and a statistically valid way of achieving this aim. Under circumstances in which the measurement of BCM is not available, raising body weight to the power of 0.5 remains appropriate. The important issue of whether REE is changed in cases of IBD can then be appropriately addressed. © 2007 Lippincott Williams & Wilkins, Inc.

Successful topical tacrolimus (FK506) therapy in a child with pyoderma gangrenosum

The inflammatory skin disease pyoderma gangrenosum is characterized by destructive ulceration, typically occurring on the calves and thighs and less commonly on the buttocks and face. Lesions vary in size and may be multiple, often rapidly ulcerating to form deep painful wounds. Ulcers characteristically have ragged purple edges that overhang. In many patients a concomitant condition can be identified such as inflammatory bowel disease, rheumatoid arthritis, chronic autoimmune hepatitis, and various hematologic and solid tumours (1,2). Treatment of these ulcers in the past has been disappointing. The large lesions usually run a chronic course and heal very slowly, with traditional dressings often in combination with systemic steroids or immunosuppressants. Since 1998, a small number of case have been reported of adults with pyoderma gangrenosum whose lesions heal with the use of topical tacrolimus (FK506) (2–4). We report, to the best of our knowledge, the first successful treatment of a child with pyoderma gangrenosum using topical tacrolimus.

Moving on (part 2): Power and the child in curriculum history

This paper is the second in a two-part series that maps continuities and ruptures in conceptions of power and traces their effects in educational discourse on 'the child'. It delineates two post-Newtonian intellectual trajectories through which concepts of 'power' arrived at the theorization of 'the child': the paradoxical bio-physical inscriptions of human-ness that accompanied mechanistic worldviews and the explanations for social motion in political philosophy. The intersection of pedagogical theories with 'the child' and 'power' is further traced from the latter 1800s to the present, where a Foucaultian analytics of power-as-effects is reconsidered in regard to histories of motion. The analysis culminates in an examination of post-Newtonian (dis)continuities in the theorization of power, suggesting some productive paradoxes that inhabit turn of the 21st-century conceptualizations of the social.

In Perpetual Motion: Theories of Power, Educational History, and the Child

"In Perpetual Motion is an "historical choreography" of power, pedagogy, and the child from the 1600s to the early 1900s. It breaks new ground by historicizing the analytics of power and motion that have interpenetrated renditions of the young. Through a detailed examination of the works of John Locke, Jean-Jacques Rousseau, Johann Herbart, and G. Stanley Hall, this book maps the discursive shifts through which the child was given a unique nature, inscribed in relation to reason, imbued with an effectible interiority, and subjected to theories of power and motion. The book illustrates how developmentalist visions took hold in U.S. public school debates. It documents how particular theories of power became submerged and taken for granted as essences inside the human subject. In Perpetual Motion studiously challenges views of power as in or of the gaze, tracing how different analytics of power have been used to theorize what gazing could notice."--BOOK JACKET.

Interrupting the child/adult dichotomy: A genealogy of genius as an administrative object in educational discourse

Part of a special issue on childhood and cultural studies. The writer provides a genealogy of genius that interrupt the child/adult dichotomy and disrupts the notion of child as subject. Tracing the evolution of the notion of “genius,” she notes that although conceptualizations of genius have changed considerably over the years, it has continually been a concept that distinguishes the haves from the have-nots. The writer maintains that the idea of genius consistently invokes images of both maleness and whiteness and marginalizes the experiences of women and other groups.

Educational research and strategies of world-forming: The globe, the unconscious, and the child

The passion to eradicate alterity from the earth is also the passion for the home, the country, the dwelling, that authorizes this desire and rewards it. In its nationalism, parochialism and racism it constitutes a public and private neurosis. So, unwinding the rigid understanding of place that apparently permits me to speak, that guarantees my voice, my power, is not simply to disperse my locality within the wider coordinates of an ultimate planetary context. That would merely absolve me of responsibility in the name of an abstract and generic globalism, permitting my inheritance to continue uninterrupted in the vagaries of a new configuration. There is something altogether more precise and more urgent involved. For in the horror of the unhomely pulses the dread for the dispersal of Western humankind: the dread of a rationality confronted with what exceeds and slips its grasp. (Chambers, 2001, p. 196)

A methodological survey of future mobility literature: Opportunities for design research

This research establishes that the study of mobility and transportation is multi-disciplinary and highly complex, involving the diverse interplay between infrastructural and psychological factors. Coincidently, a new paradigm in personal mobility is developing. A new generation of mobility solutions is becoming widely available in the form of car and ride sharing services. These services build on the assumption that customers no longer need ownership of a product in order to benefit from it. With the emergence of this new paradigm, this paper presents a methodological review of current practises used by the wider research community. Therefore, this research piece aims to explore methodological approaches involved in the study the effect of community on an individual’s attitudes, perceptions and behaviours of future mobility solutions. The results of this review indicate that the majority of published literature uses quantitative methods as opposed to qualitative and even fewer studies have sought to understand the human factors in these new mobility solutions. This gap in knowledge is a valuable opportunity for design. Inherently qualitative and human focused, design research can fill this gap in knowledge by applying distinctly user-centred methods such as persona design, narrative storytelling, and in-depth observations to discover deeper human insights.

From “somatic scandals” to “a constant potential for violence”? The culture of dissection, brain-based learning, and the rewriting/rewiring of “the child”

This article analyzes the “messy and numberless beginnings” of the hope placed upon neurological foundationalism to provide a solution to the “problem” of differences between students and to the achievement of educational goals. Rather than arguing for or against educational neuroscience, the article moves through five levels to examine the conditions of possibility for subscribing to the brain as a causal organological locus of learning.