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101.
102.

Objective

In order to be reimbursed for the care they provide, hospitals in the United States are required to use a standard system to code all discharge diagnoses: the International Classification of Disease, 9th Revision, Clinical Modification (ICD-9). Although ICD-9 codes specific for child maltreatment exist, they do not identify all maltreatment-related hospital and emergency department discharges. To increase the usefulness of medical data for public health surveillance of child maltreatment, this project sought to identify ICD-9 codes that are suggestive of child maltreatment.

Methods

After review of the literature and discussions with experts, injuries and conditions that should raise suspicion of child maltreatment (physical or sexual abuse or neglect) were identified and a list of corresponding ICD codes was compiled. Using a statewide electronic database of hospital discharges and emergency department (ED) visits for the year 2000, visits by children assigned these ICD codes were identified, a sample of visits was selected, and medical records were reviewed to assess the circumstances of the injury or illness that led to the visit. Based on information in the medical record, the injury or illness was classified as maltreatment-related, or not.

Results

There were 3,684 visits selected for review. Of these, 2,826 records were reviewed and classified; 1,200 (43%) records met the criteria for being maltreatment-related, 1,419 (50%) contained adequate information indicating the injury/condition was not likely maltreatment-related, and 207 (7%) records did not contain enough information to classify. Sixty-eight ICD codes had >66% of visits classified as maltreatment-related, the a priori criteria for a code to be considered suggestive of maltreatment. Codes suggestive of maltreatment include specific fractures, burns, and injuries of undetermined intent, among others.

Conclusion

Several ICD codes were found that, when used with age restrictions and other specific exclusion criteria, are suggestive of maltreatment. This information may increase the usefulness of hospital discharge data for public health surveillance of child maltreatment.

Practice implications

Use of these suggestive codes facilitates identifying conditions and injuries that are likely maltreatment-related in hospital discharge and ED visit data. When used in conjunction with ICD maltreatment-specific codes, these suggestive codes may enhance the use of medical data for monitoring child maltreatment trends.  相似文献   
103.
This paper measures and decomposes socioeconomic-related inequality in mathematics achievement in 15 European Union member states. Data is taken from the 2003 wave of the OECD Programme for International Student Assessment (PISA). There is socioeconomic-related inequality in mathematics achievement, favoring the higher socioeconomic groups in each country. There are important differences among countries. The inequality is higher in Germany, Greece, Great Britain, Belgium, and Portugal and is lower in Sweden and Finland. Socioeconomic factors represent between 14.9% and 34.6% of the overall inequality in education.  相似文献   
104.
The quality of handwriting curriculum and instructional practices in actual classrooms was investigated in an in-depth case study of four inner city kindergarten classrooms using quantitative and qualitative methods. The handwriting proficiency of students was also evaluated to assess the impact of the instructional practices observed. The findings suggest that even though teachers employ a number of effective strategies, there is room for improvement in implementing effective, research-approved handwriting instruction. In particular, daily, explicit instruction, writing for fluency, writing from memory, and use of self-evaluation are areas that need improvement. Results indicate that the lack of emphasis on these practices impacted the quality of teaching and learning of handwriting skills. Future research is needed on the impact of teacher training, use of an assessment tool that objectively assesses students’ handwriting, use of reading and handwriting curriculum that complement and reinforce one another, and the effectiveness of research-based strategies in practice.  相似文献   
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This research seeks to expand the body of knowledge surrounding International Open Access Week (OA Week) practices among small to medium-sized U.S. institutions, examining the rationales guiding these, and creating a baseline activity inventory which may be elaborated upon as open access continues to evolve and as OA Week matures beyond its fifth (2013) anniversary. An electronic survey with closed- and open-ended questions was used to collect data, which were analyzed for recurring themes. Of respondents whose campuses did observe OA Week, the most reported reason for doing so was related to supporting the library's educational outreach program; fewer respondents cited the library's philosophical commitment to open access. Lack of time was the most frequently given reason for OA Week non-participation, however around one quarter of non-participating respondents reported that they were unaware of OA Week, and another quarter reported that it did not figure in their strategic plan. The conditions that were found to best support celebrating OA Week included a grasp of the principles guiding OA on the part of at least one librarian, reinforced by: the educational mission of the library; adequate personnel; and sufficient time for planning. This exploratory study yields points for library- and self-assessment.  相似文献   
109.
By changing the level of competition and/or affecting the allocation of resources, institutions can play a very important role on innovation activity. In this paper we investigate the relative importance of institutional variation across European countries in explaining differences in their innovation intensity at the industry level. We employ a novel indicator of innovation therefore circumventing the limitations of more traditional indicators. Our results are broadly consistent with previous empirical literature. They show that stringent product and labor market regulation affects innovation intensity negatively, and that more developed credit markets foster innovation. However, the empirical findings also raise doubts with respect to the strengthening of intellectual property rights as a means to stimulate innovation, a result that is in accordance with recent propositions in the literature.  相似文献   
110.
This paper outlines the electronic ‘short loan’ collection of high-demand journal articles developed by Project ACORN (Access to Course Readings via Networks) (1). It summarises some preliminary findings on the volume and type of use made of the service, and users' reactions to it. Factors affecting non-use are also presented. Issues and developments for the future are discussed in the light of experiences to date.  相似文献   
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