Systematic screening for child abuse at emergency departments

Child abuse is a serious problem and has serious consequences for the victim, his or her environment and for society itself. It has been estimated that one in every 30 Dutch children is exposed to child abuse.1 While preventable morbidity and mortality of infectious diseases in childhood is enormously reduced over the past decades, unfortunately this has not been the case for the staggering statistics surrounding child abuse.2 Child abuse includes all forms of physical and emotional maltreatment, sexual abuse and neglect that result in actual or potential harm to the child’s health, development or dignity.3 Child abuse was already addressed as a public health problem in the 19th century by a French forensic expert, Ambroise Tardieu (Born in Paris on March 10, 1818). He was the fi rst physician to acknowledge the appearance of children being mistreated at the hands of their parents, and described the classical features of almost all forms of child abuse and neglect. A century later, in 1962, American physicians wrote a landmark article about child abuse being a pediatric and public health problem, called “The battered childsyndrome”. This was the starting point for further recognition and awareness of child abuse. The increasing awareness of child abuse by health care professionals since 1962 is refl ected in the enormous increase in articles published in the MEDLINE database. In 1963, 12 articles were categorized under the newly added keyword “child abuse” versus 914 in 2011.7 In 1970 the Dutch Association Against Child Abuse was founded

Effective use of the assisting hand in adolescents with cerebral palsy

Part one of this thesis evaluates the development, validation and reliability of the Assisting Hand Assessment for adolescents (Ad-AHA). The scale showed good construct validity within the whole age range (18 months to 18 years). The Ad-AHA is a valid performance-based instrument to monitor development from childhood to young adulthood, evaluate interventions and guide intervention planning. The Ad-AHA has good-to-excellent interrater and test-retest reliability in adolescents with unilateral CP. Reliable AHA-scores can be generated by using different age-appropriate tests activities. The Ad-AHA can be used to evaluate change over time with a score change of 5 AHA-units. Part two evaluates the effect of two interventions on the ability to perform daily activities in children and adolescents with CP. The performance of bimanual activities in children wearing a functional hand orthosis improved significantly. With evaluation on the level of individual AHA items, the therapist can decide in which activities the individual child will most likely be able to benefit most from the orthosis. The systematic review summarizes the clinical postoperative outcomes of upper extremity surgery (UES) on hand use in children and adolescents with CP. Considering the overall very low quality of the evidence, it is not possible to make clinical recommendations on the effect of upper extremity surgery. The outcomes of the clinical cohort study show that careful patient selection, based on multidisciplinary assessment and shared decision-making, results in clinically relevant improvements in patient-specific functional and/or cosmetic goals and manual ability after UES

The Role of the Auditor in Managing Public Disclosures: Audit Opinion Modifications for Potentially Misleading Information in Documents Containing Audited Financial Statements

We investigate empirically the incidence of auditor modification of audit reports for misleading information included in other documents containing audited financial statements. Professional standards (specifically, SAS No. 8) require modification of the auditor\u27s report for annual report information considered to be materially inconsistent in content or in manner of disclosure with information contained in the financial statements. Exhaustive data base key word searches for phrases that would be associated with such report modifications did not reveal a single instance in which other information accompanying audited financial statements was considered materially misleading since the implementation of SAS No. 8 (1975). Despite this finding, numerous examples from recent research identify what appear to be potentially misleading disclosures in annual reports. Using examples from these studies, we surveyed CPAs and financial statement users and found that that four of the five issues presented were seen as misleading. More authoritative guidance and/or more awareness on the part of auditors may be in order

Poster 216: Utility of Ultrasound in Evaluation of a Spontaneous Plantar Fascia Rupture: A Case Report

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/147055/1/pmr2s98.pd

Poster 277: Cervical Transforaminal Epidural Steroid Injection in the Management of a Stinger Injury: A Case Report

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146964/1/pmr2s124a.pd