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.

Empirical basis for adopting a theory-driven approach to preventing alcohol and other drug impairment (AOD) in the workplace

Background: A State-based industry in Australia is in the process of developing a programme to prevent AOD impairment in the workplace. The objective of this study was to determine whether the Theory of Planned Behaviour can help explain the mechanisms by which behaviour change occurs with regard to AOD impairment in the workplace. ---------- Method: A survey of 1165 employees of a State-based industry in Australia was conducted, and a response rate of 98% was achieved. The survey included questions relevant to the Theory of Planned Behaviour: behaviour; behavioural intentions; attitude; perceptions of social pressure; and perceived behavioural control with regard to workplace AOD impairment. ---------- Findings: Less than 3% of participants reported coming to work impaired by AODs. Fewer than 2% of participants reported that they intended to come to work impaired by AODs. The majority of participants (over 80%) reported unfavourable attitudes toward AOD impairment at work. Logistic regression analyses suggest that, consistent with the theory of planned behaviour: attitudes, perceptions of social pressure, and perceived behavioural control with regard to workplace AOD impairment, all predict behavioural intentions (P < .001); and behavioural intentions predict (self-reported) behaviour regarding workplace AOD impairment (P < .001). ---------- Conclusions: The Theory of Planned Behaviour appears to assist with understanding the mechanisms by which behaviour change occurs with regard to AOD impairment in the workplace. An occupational AOD programme which targets those mechanisms for change may improve its impact in preventing workplace AOD impairment.

Workplace emotion : fear and anger

This original screen drama functioned as the stimulus in an audience response experiment, undertaken as part of research into workplace emotion. Commissioned and scripted by researchers at the University of Queensland and Griffith University, the film portrays the same narrative (a workplace conflict) twice, but played differently each time. The first version is intended to evince in viewers a fear response, and the second, an anger response. In preparing and rehearsing their performance choices, the actors utilised established taxonomies of fear and anger, in order to produce the optimum stimulus for conducting the experiment.

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.

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.

New media pathways : navigating the links between home, school and the workplace

The terms ‘literacy’ and ‘technology’ remain highly contentious within the field of education. What is meant by ‘literacy’ and the methods used to measure it vary quite markedly in educational and historical contexts across the world. Similarly, while there is a shared concern to research the potential impact of new information and communication technologies (ICTs) on patterns of teaching and learning, there are major discrepancies about which aspects and uses of these technologies should be incorporated into formal learning environments and how this can be accomplished. While government policy makers tend to regard ICTs in relation to ideas of ‘smartness’, efficiency, and the ‘knowledge’ (or ‘new’) economy, educators and educational researchers promote them as offering new tools for learning and critical thinking and the development of new literacies and socio-cultural identities. This clearly has ramifications for the ways literacy is taught and conceptualised throughout the years of schooling, K-12. Outside school, meanwhile, students engage with ICTs on another level entirely, as tools for the maintenance of social networks, for leisure, and for learning and participating in the cultures of their peers. Whatever the differences in perspective, it remains the case that a society’s dominant understandings about literacy and technology will have significant implications for the development of school curriculum.

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.

Development of a workplace wellness promotion pilot framework : a case study of the Blue Care Staff Wellness Program

Workplace wellness initiatives are currently unreflective of the multidimensional and holistic nature of the wellness construct. There exists an opportunity for promoters of health to move toward models of workplace wellness promotion that more fully appreciate the interconnected nature of health dimensions and promote them even-handedly. The Blue Care Staff Wellness Program framework was developed in response to a recognised need for consistent and wellness-focused constructs for workplace wellness promotion and dissemination. The framework promotes and supports the individual and organisational wellness of the Blue Care employee population by providing a comprehensive and sustainable employee wellness program. This has been achieved by the adoption of consistent wellness principles to guide the framework conception and theory based development. The use of the framework in a pilot program will provide insight into the frameworks effectiveness in promoting a comprehensive workplace wellness program, and go further to establish the relationship between wellness and productivity in the workplace.

Adult learning in a workplace context

In light of the changing nature of contemporary workplaces, this chapter attempts to identify employer expectations and the associated skills required to workers to function effectively in such workplaces. Workers are required to participate in informed discussion about their specific jobs and to contribute to the overall development of organisations. This requires deep understanding of domain-specific knowledge, which at times can be very complex. Workers are also required to take responsibility for their actions and are expected to be flexible so that they can be deployed to other related jobs depending on demand. Finally, workers are expected to be pro-active, be able to anticipate situations and continuously update their knowledge to address new situations. This chapter discusses the nature of knowledge and skills that will facilitate the above qualities.

Sacked! Workplace dismissals amongst youth employees

Limited academic attention has been afforded to young workers relative to their adult counterparts. This study addresses a phase of the employment relationship for young people that is very infrequently examined - during or around the time when the relationship ends. It examines the relative frequency of different forms of dismissal and the circumstances preceding the dismissals via a content analysis of 1259 cases of employee enquiries to a community advocacy organisation in Australia. Results indicate that dismissal was most commonly associated with bullying, harassment, and taking personal leave. Young men, compared to young women, were disproportionately likely to report allegations of misconduct as preceding dismissal, while females experienced higher rates of sexual harassment and discrimination. The research highlights the types and circumstances of dismissal across a range of employment contexts and reveals the complexities of youth employment relationships which may differ from those of the general workforce.

Workplace sexual harassment 30 years on : a review of the literature

Despite its proscription in legal jurisdictions around the world, workplace sexual harassment (SH) continues to be experienced by many women and some men in a variety of organizational settings. The aims of this review article are threefold: first, with a focus on workplace SH as it pertains to management and organizations, to synthesize the accumulated state of knowledge in the field; second, to evaluate this evidence, highlighting competing perspectives; and third, to canvass areas in need of further investigation. Variously ascribed through individual (psychological or legal consciousness) frameworks, sociocultural explanations and organizational perspectives, research consistently demonstrates that, like other forms of sexual violence, individuals who experience workplace SH suffer significant psychological, health- and job-related consequences. Yet they often do not make formal complaints through internal organizational procedures or to outside bodies. Laws, structural reforms and policy initiatives have had some success in raising awareness of the problem and have shaped rules and norms in the employment context. However, there is an imperative to target further workplace actions to effectively prevent and respond to SH.

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.

A control and surveillance ITS location model to improve safety

Traffic safety in rural highways can be considered as a constant source of concern in many countries. Nowadays, transportation professionals widely use Intelligent Transportation Systems (ITS) to address safety issues. However, compared to metropolitan applications, the rural highway (non-urban) ITS applications are still not well defined. This paper provides a comprehensive review on the existing ITS safety solutions for rural highways. This research is mainly focused on the infrastructure-based control and surveillance ITS technology, such as Crash Prevention and Safety, Road Weather Management and other applications, that is directly related to the reduction of frequency and severity of accidents. The main outcome of this research is the development of a ‘ITS control and surveillance device locating model’ to achieve the maximum safety benefit for rural highways. Using cost and benefits databases of ITS, an integer linear programming method is utilized as an optimization technique to choose the most suitable set of ITS devices. Finally, computational analysis is performed on an existing highway in Iran, to validate the effectiveness of the proposed locating model.