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https://www.readbyqxmd.com/read/30312886/potential-impact-of-the-validated-predicting-abusive-head-trauma-predaht-clinical-prediction-tool-a-clinical-vignette-study
#1
Laura E Cowley, Daniel M Farewell, Alison M Kemp
BACKGROUND: The validated Predicting Abusive Head Trauma (PredAHT) tool estimates the probability of abusive head trauma (AHT) in children <3 years old with intracranial injury. OBJECTIVE: To explore the impact of PredAHT on clinicians' AHT probability estimates and child protection (CP) actions, and assess inter-rater agreement between their estimates and between their CP actions, before and after PredAHT. PARTICIPANTS AND SETTING: Twenty-nine clinicians from different specialties, at teaching and community hospitals...
October 9, 2018: Child Abuse & Neglect
https://www.readbyqxmd.com/read/30194647/infant-skull-fracture-risk-for-low-height-falls
#2
Marzieh Hajiaghamemar, Ingrid S Lan, Cindy W Christian, Brittany Coats, Susan S Margulies
Skull fractures are common injuries in young children, typically caused by accidental falls and child abuse. The paucity of detailed biomechanical data from real-world trauma in children has hampered development of biomechanical thresholds for skull fracture in infants. The objectives of this study were to identify biomechanical metrics to predict skull fracture, determine threshold values associated with fracture, and develop skull fracture risk curves for low-height falls in infants. To achieve these objectives, we utilized an integrated approach consisting of case evaluation, anthropomorphic reconstruction, and finite element simulation...
September 7, 2018: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/30190186/child-maltreatment-red-flags-two-cases-of-bruising-in-premobile-infants
#3
Abigail Kleinschmidt
Child maltreatment is a serious public health concern in the United States. Young infants and children younger than 3 years are at the highest risk of being abused and can experience both acute injuries and long-term developmental, behavioral, and mental health problems. Health care providers are mandated reporters of suspected abuse but may misdiagnose potentially abusive injuries because of lack of knowledge in recognizing maltreatment. Premobile infants rarely have bruising or intraoral injuries without a reported accident or underlying systemic disease and should raise concern for abuse...
September 3, 2018: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/30178625/flawed-swedish-study-on-traumatic-shaking-is-already-being-used-by-defence-lawyers-and-its-findings-must-be-ignored
#4
Anne Laurent-Vannier, Catherine Adamsbaum, Jean-S├ębastien Raul, Caroline Rey-Salmon, Caroline Rambaud
No abstract text is available yet for this article.
September 3, 2018: Acta Paediatrica
https://www.readbyqxmd.com/read/30174411/clinical-comparison-of-ocular-and-systemic-findings-in-diagnosed-cases-of-abusive-and-non-abusive-head-trauma
#5
Linda A Morgan, Samiksha Fouzdar Jain, Austin Svec, Claire Svec, Suzanne B Haney, Sandra Allbery, Robin High, Donny W Suh
Purpose: Child abuse is a leading cause of death in infants, which is often associated with abusive head trauma (AHT). The purpose of this retrospective analysis was to identify ocular and systemic findings in confirmed cases of AHT and compare them to a group of non-abusive head trauma (NAHT) patients. Patients and methods: A retrospective chart review of 165 patients with accidental and non-accidental trauma admitted between 2013 and 2015 to Children's Hospital and Medical Center in Omaha, NE, USA, was performed...
2018: Clinical Ophthalmology
https://www.readbyqxmd.com/read/30048385/pathology-of-perimacular-folds-due-to-vitreoretinal-traction-in-abusive-head-trauma
#6
Waleed Abed Alnabi, Garland J Tang, Ralph C Eagle, Sam Gulino, Avrey Thau, Alex V Levin
PURPOSE: To demonstrate vitreoretinal traction as a mechanism for perimacular folds in abusive head trauma. METHODS: We performed gross and histopathologic examination of eyes of children with suspected abusive head trauma and identified those with typical perimacular folds. Information was collected regarding the incident that led to the child's death and systemic manifestations noted at autopsy. Eyes were prepared in a fashion that allowed for demonstration of the vitreoretinal interface...
July 25, 2018: Retina
https://www.readbyqxmd.com/read/30037976/the-eye-examination-in-the-evaluation-of-child-abuse
#7
Cindy W Christian, Alex V Levin
Child abuse can cause injury to any part of the eye. The most common manifestations are retinal hemorrhages (RHs) in infants and young children with abusive head trauma (AHT). Although RHs are an important indicator of possible AHT, they are also found in other conditions. Distinguishing the number, type, location, and pattern of RHs is important in evaluating a differential diagnosis. Eye trauma can be seen in cases of physical abuse or AHT and may prompt referral for ophthalmologic assessment. Physicians have a responsibility to consider abuse in the differential diagnosis of pediatric eye trauma...
August 2018: Pediatrics
https://www.readbyqxmd.com/read/29913434/factors-influencing-child-protection-professionals-decision-making-and-multidisciplinary-collaboration-in-suspected-abusive-head-trauma-cases-a-qualitative-study
#8
Laura E Cowley, Sabine Maguire, Daniel M Farewell, Harriet D Quinn-Scoggins, Matthew O Flynn, Alison M Kemp
Clinicians face unique challenges when assessing suspected child abuse cases. The majority of the literature exploring diagnostic decision-making in this field is anecdotal or survey-based and there is a lack of studies exploring decision-making around suspected abusive head trauma (AHT). We aimed to determine factors influencing decision-making and multidisciplinary collaboration in suspected AHT cases, amongst 56 child protection professionals. Semi-structured interviews were conducted with clinicians (25), child protection social workers (10), legal practitioners (9, including 4 judges), police officers (8), and pathologists (4), purposively sampled across southwest United Kingdom...
August 2018: Child Abuse & Neglect
https://www.readbyqxmd.com/read/29903429/simulation-based-research-to-improve-infant-health-outcomes-using-the-infant-simulator-to-prevent-infant-shaking
#9
Kirsten Bechtel, Ambika Bhatnagar, Marc Auerbach
Simulation is a technique that creates a situation or environment to allow persons to experience a representation of a real event for the purpose of practice, learning, evaluation, testing, or to gain understanding of systems or human actions. We will first provide an introduction to simulation in healthcare and describe the two types of simulation-based research (SBR) in the pediatric population. We will then provide an overview of the use of SBR to improve health outcomes for infants in health care settings and to improve parent-child interactions using the infant simulator...
June 11, 2018: Infant Behavior & Development
https://www.readbyqxmd.com/read/29771763/recognizing-diagnosing-and-preventing-child-maltreatment-an-update-for-pediatric-clinicians
#10
Fiona Danaher, Andrea Vandeven, Aine Blanchard, Alice W Newton
PURPOSE OF REVIEW: Despite an increasing understanding of the impact of emotional trauma and physical abuse on children, clinicians and hospitals still sometimes miss the diagnosis of abuse. The literature in 2017 focused on creating standardized approaches to recognition and diagnosis of physical abuse and occult injury, including using the electronic medical record to provide triggers for consultation of the hospital Child Protection Program. The American College of Radiology updated their standardized approach to the evaluation of physical abuse in the child, and other authors gave us screening tools for commercial exploitation, as well as guidance about how to recognize risks for emotional abuse in families...
August 2018: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29753199/acceptability-of-the-predicting-abusive-head-trauma-predaht-clinical-prediction-tool-a-qualitative-study-with-child-protection-professionals
#11
Laura E Cowley, Sabine Maguire, Daniel M Farewell, Harriet D Quinn-Scoggins, Matthew O Flynn, Alison M Kemp
The validated Predicting Abusive Head Trauma (PredAHT) tool estimates the probability of abusive head trauma (AHT) based on combinations of six clinical features: head/neck bruising; apnea; seizures; rib/long-bone fractures; retinal hemorrhages. We aimed to determine the acceptability of PredAHT to child protection professionals. We conducted qualitative semi-structured interviews with 56 participants: clinicians (25), child protection social workers (10), legal practitioners (9, including 4 judges), police officers (8), and pathologists (4), purposively sampled across southwest United Kingdom...
July 2018: Child Abuse & Neglect
https://www.readbyqxmd.com/read/29622594/clinical-prediction-rules-for-abusive-head-trauma-a-systematic-review
#12
Helena Pfeiffer, Louise Crowe, Alison Mary Kemp, Laura Elizabeth Cowley, Anne S Smith, Franz E Babl
OBJECTIVE: Misdiagnosis of abusive head trauma (AHT) has serious consequences for children and families. This systematic review identifies and compares clinical prediction rules (CPredRs) assisting clinicians in assessing suspected AHT. DESIGN: We searched MEDLINE, Embase, PubMed and Cochrane databases (January 1996 to August 2016). Externally validated CPredRs focusing on the detection of AHT in the clinical setting were included. RESULTS: Of 110 potential articles identified, three studies met the inclusion criteria: the Pediatric Brain Injury Research Network (PediBIRN) 4-Variable AHT CPredR, the Predicting Abusive Head Trauma (PredAHT) tool and the Pittsburgh Infant Brain Injury Score (PIBIS)...
August 2018: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/29523358/injury-patterns-of-child-abuse-experience-of-two-level-1-pediatric-trauma-centers
#13
MULTICENTER STUDY
Yangyang R Yu, Annalyn S DeMello, Christopher S Greeley, Charles S Cox, Bindi J Naik-Mathuria, David E Wesson
PURPOSE: This study examines non-accidental trauma (NAT) fatalities as a percentage of all injury fatalities and identifies injury patterns in NAT admissions to two level 1 pediatric trauma centers. METHODS: We reviewed all children (<5years old) treated for NAT from 2011 to 2015. Patient demographics, injury sites, and survival were obtained from both institutional trauma registries. RESULTS: Of 4623 trauma admissions, 557 (12%) were due to NAT...
May 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29510999/abusive-head-trauma-and-the-triad-a-critique-on-behalf-of-rcpch-of-traumatic-shaking-the-role-of-the-triad-in-medical-investigations-of-suspected-traumatic-shaking
#14
REVIEW
Geoffrey David Debelle, Sabine Maguire, Patrick Watts, Rosa Nieto Hernandez, Alison Mary Kemp
The Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU) has recently published what they purported to be a systematic review of the literature on 'isolated traumatic shaking' in infants, concluding that 'there is limited evidence that the so-called triad (encephalopathy, subdural haemorrhage, retinal haemorrhage) and therefore its components can be associated with traumatic shaking'. This flawed report, from a national body, demands a robust response. The conclusions of the original report have the potential to undermine medico-legal practice...
June 2018: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/29371238/potential-opportunities-for-prevention-or-earlier-diagnosis-of-child-physical-abuse-in-the-inpatient-setting
#15
Henry T Puls, James D Anderst, Jessica L Bettenhausen, Abbey Masonbrink, Jessica L Markham, Laura Plencner, Molly Krager, Matthew B Johnson, Jacqueline M Walker, Christopher S Greeley, Matthew Hall
OBJECTIVES: To compare rates of previous inpatient visits among children hospitalized with child physical abuse (CPA) with controls as well as between individual abuse types. METHODS: In this study, we used the Pediatric Health Information System administrative database of 44 children's hospitals. Children <6 years of age hospitalized with CPA between January 1, 2011, and September 30, 2015, were identified by discharge codes and propensity matched to accidental injury controls...
January 25, 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29292621/-seizure-in-a-baby-shaking-the-diagnosis
#16
REVIEW
Ayelet Shles, Rodica Stackievicz, Rama Schwartz
Abusive head trauma(AHT), formally known as "shaken baby syndrome" , is one of the most violent expressions of child abuse, and one of the leading causes of mortality due to trauma among infants. It occurs mainly in children under 1 year of age, and may result in severe consequences, such as physical and mental disabilities. Symptoms and signs of this form of abuse can be easily mistaken for common illnesses in children or accidental head injury. Therefore, the clinician can establish this diagnosis with confidence only if he/she maintains a high index of suspicion regarding the diagnosis...
December 2017: Harefuah
https://www.readbyqxmd.com/read/29160091/probabilistic-description-of-infant-head-kinematics-in-abusive-head-trauma
#17
T O Lintern, M P Nash, P Kelly, F H Bloomfield, A J Taberner, P M F Nielsen
Abusive head trauma (AHT) is a potentially fatal result of child abuse, but the mechanisms by which injury occur are often unclear. To investigate the contention that shaking alone can elicit the injuries observed, effective computational models are necessary. The aim of this study was to develop a probabilistic model describing infant head kinematics in AHT. A deterministic model incorporating an infant's mechanical properties, subjected to different shaking motions, was developed in OpenSim. A Monte Carlo analysis was used to simulate the range of infant kinematics produced as a result of varying both the mechanical properties and the type of shaking motions...
December 2017: Computer Methods in Biomechanics and Biomedical Engineering
https://www.readbyqxmd.com/read/29075919/a-systematic-autopsy-survey-of-human-infant-bridging-veins
#18
Emma C Cheshire, Roger D G Malcomson, Peng Sun, Evgeny M Mirkes, Jasmin M Amoroso, Guy N Rutty
In the first years of life, subdural haemorrhage (SDH) within the cranial cavity can occur through accidental and non-accidental mechanisms as well as from birth-related injury. This type of bleeding is the most common finding in victims of abusive head trauma (AHT). Historically, the most frequent cause of SDHs in infancy is suggested to be traumatic damage to bridging veins traversing from the brain to the dural membrane. However, several alternative hypotheses have been suggested for the cause and origin of subdural bleeding...
March 2018: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/28956988/recognition-and-nursing-management-of-abusive-head-trauma-in-children
#19
Francesca Louise Payne, Daphin Nazareth Fernandez, Lucy Jenner, Siba Prosad Paul
Abusive head trauma (AHT) describes an injury to the head caused by a deliberate impact or shaking by a parent or carer. It can cause significant morbidity and mortality in infants, and is most commonly seen in those aged under 2 years. The initial presentation of AHT can include vague symptoms and the correct diagnosis may be missed by health professionals. Subdural haematoma, brain oedema and retinal haemorrhages are well-known features associated with AHT. However, other conditions such as birth trauma, accidental falls in infants and bleeding disorders can all mimic AHT, thus making its recognition difficult...
September 28, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28685210/lifetime-cost-of-abusive-head-trauma-at-ages-0-4-usa
#20
Ted R Miller, Ryan Steinbeigle, Bruce A Lawrence, Cora Peterson, Curtis Florence, Marilyn Barr, Ronald G Barr
This paper aims to estimate lifetime costs resulting from abusive head trauma (AHT) in the USA and the break-even effectiveness for prevention. A mathematical model incorporated data from Vital Statistics, the Healthcare Cost and Utilization Project Kids' Inpatient Database, and previous studies. Unit costs were derived from published sources. From society's perspective, discounted lifetime cost of an AHT averages $5.7 million (95% CI $3.2-9.2 million) for a death. It averages $2.6 million (95% CI $1.0-2.9 million) for a surviving AHT victim including $224,500 for medical care and related direct costs (2010 USD)...
August 2018: Prevention Science: the Official Journal of the Society for Prevention Research
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