The Implementation of a Validated CSEC Screening Tool for Youth Age 11 - 17 in a Pediatric Emergency Room

Abuse of children is a public health issue covering a range of inflicted harm from neglect to physical to sexual abuse. A severe form of child sexual abuse is the Commercial Sexual Exploitation of Children (CSEC). This phenomenon involves sexual crimes against children, including exploitation for gain. High-risk indicators are noted throughout the literature to aid in identification, but some children are vulnerable because of their young age. Perpetrators can be family, friends, or acquaintances and choose their potential victims by recognizing a child’s vulnerabilities. Inevitable physical and mental health consequences are associated with CSEC involvement; hence these youth seek out healthcare. They do not self-identify because they do not see themselves as victims and are not identified by Healthcare Providers (HCP) due to knowledge deficit and decreased awareness. Healthcare providers are in pivotal roles in identifying these victims as they seek out healthcare, however, training and a validated screening tool are needed to enable the identification of high-risk youth. Research questions: 1) Will a CSEC educational intervention and the implementation of a validated CSEC screening tool, increase the confidence levels of licensed healthcare providers in a Pediatric Emergency Room in identifying high-risk youth age 11 – 17 over baseline confidence levels? 2) Will the implementation of a validated CSEC screening tool in a Pediatric Emergency Room increase the rate of referrals of high-risk youth age 11 – 17 over pre-implementation rate as determined by retrospective chart review? Sample/population: Licensed HCPs in a Pediatric Emergency Room Research Design: Cross-sectional with pre and post-test (confidence levels) and retrospective chart review (referral rate). Statistical analysis using descriptive statistics, paired-samples t-tests, and Pearson’s r and Spearman’s rho correlations were performed. Results showed that there was an increase in perceived confidence levels, no increase in the referral rate; however, documentation by the HCP did improve

The Implementation of a Validated CSEC Screening Tool for Youth Age 11 - 17 in a Pediatric Emergency Room

Abstract Youth are a vulnerable population due to their age, developmental level, and dependability on others. Child abuse is a public health issue that addresses a broad range of inflicted harm ranging from neglect to physical and sexual maltreatment. A severe form of child sexual abuse is the Commercial Exploitation of Children (CSEC), also known as Child Sex Trafficking (CST), and Human Minor Sex Trafficking (HMST). For purposes of this paper, CSEC is used for CSEC, CST, and HMST. Commercial sexual exploitation of children includes sexual crimes involving children and adolescents for gain. Due to the child being less than 18 years old, no evidence of force must be proven. The prevalence of CSEC is unknown due to the absence of tracking, multiple definitions, lack of awareness and education, and the covert nature of the exploitation. There are risk factors associated with CSEC and residual sequela resulting in physical and mental health disabilities. Due to the health consequences experienced with exploitation, these victims seek out healthcare but are not identified by the healthcare provider. Healthcare providers are in pivotal roles in recognizing these victims with adequate education and an effective screening tool. This translational project aims to increase confidence levels in the pediatric emergency room nurses at the Beverly Knight Olsen Children\u27s Hospital by educating on CSEC and the utilization of a validated screening tool to assist in identifying potential high–risk youth 11 – 17 years, referring them, and connecting them with essential resources

The Implementation of a Validated CSEC Screening Tool for Youth Age 11 - 17 in a Pediatric Emergency Room

Youth are a vulnerable population due to their age, developmental level, and dependability on others. Child abuse is a public health issue that addresses a broad range of inflicted harm ranging from neglect to physical and sexual maltreatment. A severe form of child sexual abuse is the Commercial Exploitation of Children (CSEC), also known as Child Sex Trafficking (CST), and Human Minor Sex Trafficking (HMST). For purposes of this paper, CSEC is used for CSEC, CST, and HMST. Commercial sexual exploitation of children includes sexual crimes involving children and adolescents for gain. Due to the child being less than 18 years old, no evidence of force must be proven. The prevalence of CSEC is unknown due to the absence of tracking, multiple definitions, lack of awareness and education, and the covert nature of the exploitation. There are risk factors associated with CSEC and residual sequela resulting in physical and mental health disabilities. Due to the health consequences experienced with exploitation, these victims seek out healthcare but are not identified by the healthcare provider. Healthcare providers are in pivotal roles in recognizing these victims with adequate education and an effective screening tool. This translational project aims to increase confidence levels in the pediatric emergency room nurses at the Beverly Knight Olsen Children\u27s Hospital by educating on CSEC and the utilization of a validated screening tool to assist in identifying potential high–risk youth 11 – 17 years, referring them, and connecting them with essential resources

Cultural Diversity Professional Development in Schools Survey

This report presents findings from the Metropolitan Educational Research Consortium (MERC) Cultural Diversity Within Schools Survey. This survey was designed for school- based professionals (i.e., teachers, instructional staff, administrators) within the MERC region. Administered in the fall of 2018, the survey collected information about experiences of professional development related to cultural diversity, attitudes toward cultural diversity within schools, perceptions of barriers and opportunities, and perspectives on the need for professional development. Section 1 of the report discusses the context for this survey effort: increased cultural diversity in our schools, increased cultural mismatch between students and teachers, and multicultural education as a promising practice. This is followed in section 2 with information about the survey development and administration process. In section 3, we present the findings from the survey in several subsections that explore group comparisons and results related to the different topics covered in the survey. In section 4, we share recommendations for policy, practice and future scholarship. These recommendations are informed by the relevant literature as well as the results of the survey. The report also includes two appendices: Appendix A presents a full version of the survey, Appendix B provides detailed tables of survey results disaggregated by school division. A third appendix, Appendix C provides technical information about the survey methodology, and is available online

Developing a coding taxonomy to analyze dental regulatory complaints

Background: As part of their mandate to protect the public, dental regulatory authorities (DRA) in Canada are responsible for investigating complaints made by members of the public. To gain an understanding of the nature of and trends in complaints made to the Royal College of Dental Surgeons of Ontario (RCDSO), Canada’s largest DRA, a coding taxonomy was developed for systematic analysis of complaints. Methods: The taxonomy was developed through a two-pronged approach. First, the research team searched for existing complaints frameworks and integrated data from a variety of sources to ensure applicability to the dental context in terms of the generated items/complaint codes in the taxonomy. Second, an anonymized sample of complaint letters made by the public to the RCDSO (n = 174) were used to refine the taxonomy. This sample was further used to assess the feasibility of use in a larger content analysis of complaints. Inter-coder reliability was also assessed using a separate sample of letters (n = 110). Results: The resulting taxonomy comprised three domains (Clinical Care and Treatment, Management and Access, and Relationships and Conduct), with seven categories, 23 sub-categories, and over 100 complaint codes. Pilot testing for the feasibility and applicability of the taxonomy’s use for a systematic analysis of complaints proved successful. Conclusions: The resulting coding taxonomy allows for reliable documentation and interpretation of complaints made to a DRA in Canada and potentially other jurisdictions, such that the nature of and trends in complaints can be identified, monitored and used in quality assurance and improvement

Bosutinib in Resistant and Intolerant Pediatric Patients With Chronic Phase Chronic Myeloid Leukemia: Results From the Phase I Part of Study ITCC054/COG AAML1921

PURPOSE Bosutinib is approved for adults with chronic myeloid leukemia (CML): 400 mg once daily in newly diagnosed (ND); 500 mg once daily in resistant/intolerant (R/I) patients. Bosutinib has a different tolerability profile than other tyrosine kinase inhibitors (TKIs) and potentially less impact on growth (preclinical data). The primary objective of this first-in-child trial was to determine the recommended phase II dose (RP2D) for pediatric R/I and ND patients. PATIENTS AND METHODS In the phase I part of this international, open-label trial (ClinicalTrials.gov identifier: NCT04258943), children age 1-18 years with R/I (per European LeukemiaNet 2013) Ph+ CML were enrolled using a 6 + 4 design, testing 300, 350, and 400 mg/m$^{2}$ once daily with food. The RP2D was the dose resulting in 0/6 or 1/10 dose-limiting toxicities (DLTs) during the first cycle and achieving adult target AUC levels for the respective indication. As ND participants were only enrolled in phase II, the ND RP2D was selected based on data from R/I patients. RESULTS Thirty patients were enrolled; 27 were evaluable for DLT: six at 300 mg/m$^{2}$, 11 at 350 mg/m$^{2}$ (one DLT), and 10 at 400 mg/m$^{2}$ (one DLT). The mean AUCs at 300 mg/m$^{2}$, 350 mg/m$^{2}$, and 400 mg/m$^{2}$ were 2.20 μg h/mL, 2.52 μg h/mL, and 2.66 μg h/mL, respectively. The most common adverse event was diarrhea (93%; ≥grade 3: 11%). Seven patients stopped because of intolerance and eight because of insufficient response. Complete cytogenetic and major molecular response to bosutinib appeared comparable with other published phase I/II trials with second-generation TKIs in children. CONCLUSION Bosutinib was safe and effective. The pediatric RP2D was 400 mg/m$^{2}$ once daily (max 600 mg/d) with food in R/I patients and 300 mg/m$^{2}$ once daily (max 500 mg/d) with food in ND patients, which achieved targeted exposures as per adult experience

Bosutinib in Resistant and Intolerant Pediatric Patients With Chronic Phase Chronic Myeloid Leukemia:Results From the Phase I Part of Study ITCC054/COG AAML1921

PURPOSE Bosutinib is approved for adults with chronic myeloid leukemia (CML): 400 mg once daily in newly diagnosed (ND); 500 mg once daily in resistant/intolerant (R/I) patients. Bosutinib has a different tolerability profile than other tyrosine kinase inhibitors (TKIs) and potentially less impact on growth (preclinical data). The primary objective of this first-in-child trial was to determine the recommended phase II dose (RP2D) for pediatric R/I and ND patients. PATIENTS AND METHODS In the phase I part of this international, open-label trial (ClinicalTrials.gov identifier: NCT04258943), children age 1-18 years with R/I (per European LeukemiaNet 2013) Ph+ CML were enrolled using a 6 + 4 design, testing 300, 350, and 400 mg/m2 once daily with food. The RP2D was the dose resulting in 0/6 or 1/10 dose-limiting toxicities (DLTs) during the first cycle and achieving adult target AUC levels for the respective indication. As ND participants were only enrolled in phase II, the ND RP2D was selected based on data from R/I patients. Results Thirty patients were enrolled; 27 were evaluable for DLT: six at 300 mg/m2, 11 at 350 mg/m2 (one DLT), and 10 at 400 mg/m2 (one DLT). The mean AUCs at 300 mg/m2, 350 mg/m2, and 400 mg/m2 were 2.20 g h/mL, 2.52 g h/mL, and 2.66 g h/mL, respectively. The most common adverse event was diarrhea (93%; ≥grade 3: 11%). Seven patients stopped because of intolerance and eight because of insufficient response. Complete cytogenetic and major molecular response to bosutinib appeared comparable with other published phase I/II trials with second-generation TKIs in children. CONCLUSION Bosutinib was safe and effective. The pediatric RP2D was 400 mg/m2 once daily (max 600 mg/d) with food in R/I patients and 300 mg/m2 once daily (max 500 mg/d) with food in ND patients, which achieved targeted exposures as per adult experience.</p

Bosutinib in Resistant and Intolerant Pediatric Patients With Chronic Phase Chronic Myeloid Leukemia:Results From the Phase I Part of Study ITCC054/COG AAML1921

PURPOSE Bosutinib is approved for adults with chronic myeloid leukemia (CML): 400 mg once daily in newly diagnosed (ND); 500 mg once daily in resistant/intolerant (R/I) patients. Bosutinib has a different tolerability profile than other tyrosine kinase inhibitors (TKIs) and potentially less impact on growth (preclinical data). The primary objective of this first-in-child trial was to determine the recommended phase II dose (RP2D) for pediatric R/I and ND patients. PATIENTS AND METHODS In the phase I part of this international, open-label trial (ClinicalTrials.gov identifier: NCT04258943), children age 1-18 years with R/I (per European LeukemiaNet 2013) Ph+ CML were enrolled using a 6 + 4 design, testing 300, 350, and 400 mg/m2 once daily with food. The RP2D was the dose resulting in 0/6 or 1/10 dose-limiting toxicities (DLTs) during the first cycle and achieving adult target AUC levels for the respective indication. As ND participants were only enrolled in phase II, the ND RP2D was selected based on data from R/I patients. Results Thirty patients were enrolled; 27 were evaluable for DLT: six at 300 mg/m2, 11 at 350 mg/m2 (one DLT), and 10 at 400 mg/m2 (one DLT). The mean AUCs at 300 mg/m2, 350 mg/m2, and 400 mg/m2 were 2.20 g h/mL, 2.52 g h/mL, and 2.66 g h/mL, respectively. The most common adverse event was diarrhea (93%; ≥grade 3: 11%). Seven patients stopped because of intolerance and eight because of insufficient response. Complete cytogenetic and major molecular response to bosutinib appeared comparable with other published phase I/II trials with second-generation TKIs in children. CONCLUSION Bosutinib was safe and effective. The pediatric RP2D was 400 mg/m2 once daily (max 600 mg/d) with food in R/I patients and 300 mg/m2 once daily (max 500 mg/d) with food in ND patients, which achieved targeted exposures as per adult experience.</p

Toro Times: Raising Our Voices!

During the Spring 2019 semester, Dr. Noah Asher Golden\u27s Teaching of Writing K-12 students partnered with the Journalism class at Yorba Academy for the Arts. Through collaboration over a four-month period, Chapman\u27s future teachers and Yorba\u27s junior high journalists engaged a deep writing process to write a series of features, editorials, and news articles related to a number of global issues. Thank you to Principal Preciado-Martin, former principal Tracy Knibb, Mrs. Andrea Lopez, Mrs. Kori Shelton, and the Lloyd E. and Elisabeth H. Klein Family Foundation for supporting this project.https://digitalcommons.chapman.edu/yorba-chapman/1004/thumbnail.jp