Importance Child maltreatment is a risk factor for poor health throughout the life course. Existing estimates of the proportion of the U.S. population maltreated during childhood are based on retrospective self-reports. Records of officially confirmed maltreatment have been used to produce annual rather than cumulative counts of maltreated individuals. Objective To estimate the proportion of U.S. children who are substantiated or indicated for maltreatment by Child Protective Services (referred to as confirmed maltreatment) by age 18. Design, Setting, and Participants The National Child Abuse and Neglect Data System (NCANDS) Child File includes information on all U.S. children with a confirmed report of maltreatment, totaling 5,689,900 children (2004-2011). We developed synthetic cohort life tables to estimate the cumulative prevalence of confirmed childhood maltreatment by age 18. Main Outcome Measure The cumulative prevalence of confirmed child maltreatment between birth and age 18 by race/ethnicity, sex, and year. Results At 2011 rates, 12.5% [95% CI: 12.5%, 12.6%] of U.S. children will experience a confirmed case of maltreatment by age 18. Girls have a higher cumulative prevalence than boys (13.0% [95% CI: 12.9%, 13.0%] vs. 12.0% [95% CI: 12.0%, 12.1%]). Black (20.9% [95% CI: 20.8%, 21.1%]), Native American (14.5% [95% CI: 14.2%, 14.9%]), and Hispanic (13.0% [95% CI: 12.9%, 13.1%]) children have higher prevalences than White (10.7% [95% CI: 10.6%, 10.8%]) or Asian/Pacific Islander (3.8% [95% CI: 3.7%, 3.8%]) children. The risk of maltreatment is highest in the first few years of life; 2.1% [95% CI: 2,1%, 2.1%] of children have confirmed maltreatment by age 1, and 5.8% [95% CI: 5.8%, 5.9%] have confirmed maltreatment by age 5. Estimates from 2011 were consistent with those from 2004-2010. Conclusions and Relevance Annual rates of confirmed child maltreatment dramatically understate the cumulative number of children confirmed as maltreated during childhood. Our findings indicate that 1 in 8 U.S. children will be confirmed as victims of maltreatment by age 18, far greater than the 1 in 100 children whose maltreatment is confirmed annually. For Black children, the cumulative prevalence is 1 in 5; for Native American children, it is 1 in 7.

Foster care placement is among the most tragic events a child can experience because it more often than not implies that a child has experienced or is at very high risk of experiencing abuse or neglect serious enough to warrant state intervention. Yet it is unclear how many children will experience foster care placement at some point between birth and age 18. Using synthetic cohort life tables and data from the Adoption and Foster Care Analysis and Reporting System (AFCARS), we estimated how many U.S. children were placed in foster care between birth and age 18, finding support for three conclusions. First, up to 5.91% of all U.S. children were ever placed in foster care between their birth and age 18. Second, Native American (up to 15.44%) and Black (up to 11.53%) children were at far higher risk of placement. Foster care is thus quite common in the U.S., especially for historically disadvantaged racial/ethnic groups. Third, differences in foster care placement were minimal between the sexes, indicating that the high risks of foster care placement are shared almost equally by boys and girls.

Objective: To gather pilot data on the economic impact of terminal illness on families and on the feasibility of training caregivers as a method of stemming illness-related poverty.

Although recent research suggests that the cumulative risk of foster care placement is far higher for American children than originally suspected, little is known about the cumulative risk of foster care placement in other countries, which makes it difficult to gauge the degree to which factor foster care placement is salient in other contexts. In this article, we provide companion estimates to those provided in recent work on the US by using Danish registry data and synthetic cohort life tables to show how high and unequally distributed the cumulative risk of foster care placement is for Danish children. Results suggest that at the beginning of the study period (in 1998) the cumulative risk of foster care placement for Danish children was roughly in line with the risk for American children. Yet, by the end of the study period (2010), the risk had declined to half the risk for American children. Our results also show some variations by parental ethnicity and sex, but these differences are small. Indeed, they appear quite muted relative to racial/ethnic differences in these risks in the United States. Last, though cumulative risks are similar between Danish and American children (especially at the beginning of the study period), the age-specific risk profiles are markedly different, with higher risks for older Danish children than for older American children.

Purpose: This study investigated advanced practices carried out by radiographers in New South Wales (NSW). Background: Due to a chronic shortage of radiologists, radiographers in the United Kingdom have extended their clinical roles. These additional responsibilities have increased professional accountability, as well as improved the quality of care provided to patients. While it is likely that such professional role extension occurs in Australia, no known study has been performed to date on this topic. Methods: Questionnaires were mailed to Chief Radiographers of medical imaging departments (MIDs) across NSW. Questions related to MIDs demographics and advanced practices of radiographers including triage systems, formal and informal reporting, cannulation, intravenous contrast media administration, roles during diagnostic enemas, and involvement in research. Returned questionnaires were analysed. Results: A total of 69 questionnaires were returned from 115 distributed (60%). Seventeen percent of MIDs with an Emergency department had radiographers involved in the triage process; 39% of MIDs utilised a radiographer‐reported abnormality detection system, whilst 30% provided a verbal report. Radiographer‐performed cannulations and intravenous contrast media administration occurred in 77% and 79% of MIDs respectively. A total of 40% reported radiographers performing roles other than image acquisition during diagnostic enemas, radiographers participated in research in 13% of MIDs while radiographer clinical presentations, journal club participation and conference organisation occurred in 45%, 7%, and 38% of MIDs respectively. Conclusions: This exploratory study provides important baseline information on the extended roles of radiographers in NSW. The results could be used for future planning of radiographer roles and health service delivery techniques.

Many defendants fail to appear (FTA) for court despite the prospect of legal consequences. In a field experiment, we compare the effectiveness of text message reminders to an intervention that combines reminders with personalized assistance. The treatments are equally effective, reducing FTA by 8 percentage points from a 21 percent baseline rate. However, personalized assistance facilitates greater take-up of court accommodations such as rescheduling and payment plans. For more serious cases, the treatments reduce arrests by two percentage points, implying FTAs have a large effect on arrests. For the least serious cases, an FTA has small effects on fines.

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