Public Health News Roundup: March 14
Study: Minor Injuries in Some Children May Indicate the Possibility of More Serious Child Abuse Later On
A study in Pediatrics finds that relatively minor abuse injuries often precede more serious abuse of children. The study refers to “sentinel” injuries—a previous injury reported in a child’s medical history that was suspicious or had an implausible explanation. Researchers examined records of infants seen by the child protection team at Children’s Hospital of Wisconsin between March 2001 and October 2011. Of the 200 children who were definitely abused, 55 (27 percent) had a sentinel injury. Of those, 80 percent had a bruise, 11 percent had an injury inside the mouth, and 7 percent had a fracture. Of 100 children where abuse was suspected but not confirmed, 8 had a sentinel injury. None of the infants in the control group—who had no history of abusive injuries—had a sentinel injury. The study authors say their findings suggest that in more than a quarter of cases of definite physical abuse, there may be escalating and repeated violence toward the infant instead of a single event of momentary loss of control by a frustrated or angry caregiver. Improved recognition of sentinel injuries and interventions would prevent additional cases of child abuse, according to the researchers. Read more on injury prevention.
HUD Renews Grants for Local Communities’ Response to Homelessness
The U.S. Housing and Urban Development Department (HUD) is renewing funding for 7,000 local homeless housing and service programs across the country. The funding ensures the programs will remain open for at least the coming year, according to HUD, which has challenged local communities to review their response to homelessness and to emphasize proven strategies including “rapid re-housing” for homeless families and permanent supportive housing for people who experience chronic homelessness. The amount of renewed funding is $1.5 billion in grants that will support programs including street outreach, client assessment and direct housing assistance. HUD expects to award additional grants later this year. HUD recently announced its 2012 “point in time” estimate of the number of homeless persons in America. Approximately 3,000 cities and counties reported 633,782 homeless persons on a single night in January of 2012. Read more on housing.
Policy and Practice Changes Needed to Improve Survival in People who have Heart Attacks in the Hospital
Policy and practice changes by healthcare institutions, providers and others could greatly improve survival for people who have a have a heart attack in the hospital, according to an American Heart Association (AHA) consensus statement in its journal, Circulation. Each year, more than 200,000 adults and 6,000 children have in-hospital cardiac arrests, and survival has remained essentially unchanged for decades, according to the AHA. Only 24.2 percent of in-hospital cardiac arrest patients survive to hospital discharge.
Key recommendations include:
- Establishing competency of all hospital staff in recognizing a cardiac arrest, performing chest compressions and using an automated external defibrillator or AED.
- Ensuring that best practices are used in all stages of care for cardiac arrest.
- Requiring that all in-hospital cardiac arrests be reported, with survival data, using consistent definitions across hospitals. Definitions currently are not standardized, according to the researchers.
- Modifying billing codes to allow collection of more specific and accurate data for in-hospital cardiac arrest.
- Separate guidelines for in-hospital versus out-of-hospital cardiac arrests.
Read more on heart health.