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Unintentional injuries and potential determinants of falls in young children: Results from the Piccolipiù Italian birth cohort. PLoS One 2022; 17:e0275521. [PMID: 36191030 PMCID: PMC9529104 DOI: 10.1371/journal.pone.0275521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 09/19/2022] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Unintentional injuries such as falls, are particularly frequent in early childhood. To date, epidemiological studies in this field have been carried out using routine data sources or registries and many studies were observational studies with a cross-sectional design. The aims of the study are to describe unintentional injuries in the first two years of life in the Piccolipiù birth cohort, and to investigate the association between mother and children characteristics and the First Event of Raised surface Fall (FERF). METHODS This longitudinal observational study included 3038 children from an Italian birth cohort. Data on socio-demographic factors, socio-economic indicators, maternal health and lifestyle characteristics and child's sleeping behavior, obtained from questionnaires completed at birth, 12 and 24 months of age, were considered in the analyses as potential risk factors of FERF. Time of occurrence of FERF was analyzed using the Kaplan-Meier method. The multivariable analysis for time to event was carried out using a Cox proportional hazards model. RESULTS Falls from raised surfaces are the leading cause of unintentional injuries in the cohort with 610 (21.1%) and 577 (20.0%) cases among children during the first and second year of life, respectively. An increased risk of FERF was associated with several risk factors: maternal psychological distress (HR 1.41, 95%CI 1.10-1.81), maternal alcohol intake (HR 1.26, 95%CI 1.10-1.45), and child's sleeping problems (HR 1.28, 95%CI 1.09-1.51). Children with older aged mothers (HR 0.98, 95%CI 0.96-0.99) and living in northern Italy (HR 0.64, 95%CI 0.55-0.75) had a lower risk of FERF. CONCLUSION The results of the study suggest that a higher risk of FERF is associated with socio-demographic factors, maternal characteristics and child sleeping behavior that could hinder parent empowerment.
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Mohammed Z, Aledhaim A, AbdelSalam EM, El-Setouhy M, El-Shinawi M, Hirshon JM. Factors associated with injuries among preschool children in Egypt: demographic and health survey results, 2014. BMC Public Health 2020; 20:595. [PMID: 32357864 PMCID: PMC7193349 DOI: 10.1186/s12889-020-08658-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 04/06/2020] [Indexed: 11/22/2022] Open
Abstract
Background Childhood injuries are a significant and growing global public health problem, often with high morbidity and, at times, mortality. A large proportion of injuries in preschool children occur in or around the home. We aimed to identify socioeconomic and demographic factors associated with preschool children injuries in Egypt. Methods Secondary data analysis were done for the Egyptian Demographic and Health Surveys (EDHS), 2014. Potential associated factors were measured from data on child welfare and questions on the prevalence of accidents and injuries of preschool children. These data were linked to the children demographic data, maternal age at marriage, working status of the mother, and questions on childcare arrangements. Results Out of the 634 injured children, 520 (83.4%) children required medical care for their injuries. The most common reported injury was an open wound 288 (45.5%), followed by fractures 237 (35.7%), burns 124 (19.7%), electrical shock 12 (1.9%) and other unknown types of injury 15 (2.4%). There was a positive correlation between injury and child’s age, household wealth, mother’s age at marriage, and unsupervised children or children left in the care of a minor. Conclusion Leaving children unsupervised or in the presence of other young children is significantly associated with the occurrence of child injuries.
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Affiliation(s)
- Zeinab Mohammed
- Public Health and Community Medicine Department, Faculty of Medicine, Beni-Suef University, Beni Suef, Egypt. .,Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
| | - Ali Aledhaim
- Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | | | - Maged El-Setouhy
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia.,Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mohamed El-Shinawi
- Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.,Department of General Surgery, Ain Shams University, Cairo, Egypt
| | - Jon Mark Hirshon
- Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.,Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
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Yang J, Lee SY, Zhou Y, Cui Y, Han Y, Song H, Zhang H. Parent supervision attributes profile questionnaire (PSAPQ) for young children: psychometric properties of the Chinese version. BMC Public Health 2019; 19:1073. [PMID: 31474230 PMCID: PMC6717994 DOI: 10.1186/s12889-019-7362-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Accepted: 07/24/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND In China, thousands of children die from unintentional injury each year: the incidence rate of injury is from 19.4 to 64.3% which is the leading cause of mortality for children. An important factor to injury may be inadequate supervision. Thus, a linguistic and culturally appropriated, validated instrument to measure the supervision of children in Chinese primary caregiver is important and necessary. The purpose of this study was to translate and test the psychometric properties of the Chinese version of the Parent Supervision Attributes Profile Questionnaire (C-PSAPQ). METHODS This is a two-phase study. In phase I, the C-PSAPQ was produced by for- and back-ward translation. A total of 296 primary caregivers of 3-6 years old children were invited to participate in the second phase of the psychometric study. In order to assess the reliability of the C-PSAPQ, internal consistency and test-retest methods were performed. Additionally, construct validity was examined by using confirmatory factor analysis (CFA). The averaged variance extracted (AVE) and Bootstrap were used to test the convergent and to discriminate validity. The concurrent validity was assessed by evaluating the association between the self-reported C-PSAPQ and naturalistic observations. RESULTS The Cronbach's α and intraclass correlation coefficients were acceptable for the C-PSAPQ and four subscales. The CFA supported a 4-factor loading model; however, the convergent validity was not acceptable (AVE < .5 for two subscales). The concurrent validity was supported. CONCLUSIONS Due to the unacceptable convergent validity of the C-PSAPQ, an exploratory factor analysis is needed to ensure that the same trait is measured by its indicators in different cultures.
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Affiliation(s)
- Jun Yang
- School of Nursing, Harbin Medical University (Daqing), No. 39 Xinyang Road, Gaoxin District, Daqing, 163319 Hei Longjiang Province China
| | - Shih-Yu Lee
- University of Texas at Tyler, 3900 University Blvd, Tyler, TX 75799 USA
| | - Yuqiu Zhou
- School of Nursing, Harbin Medical University (Daqing), No. 39 Xinyang Road, Gaoxin District, Daqing, 163319 Hei Longjiang Province China
| | - Yuxia Cui
- School of Nursing, Harbin Medical University (Daqing), No. 39 Xinyang Road, Gaoxin District, Daqing, 163319 Hei Longjiang Province China
| | - Yongkui Han
- School of Nursing, Harbin Medical University (Daqing), No. 39 Xinyang Road, Gaoxin District, Daqing, 163319 Hei Longjiang Province China
| | - Hongling Song
- English Department, Harbin Medical University (Daqing), Daqing, Hei Longjiang Province China
| | - Hui Zhang
- School of Nursing, Harbin Medical University (Daqing), No. 39 Xinyang Road, Gaoxin District, Daqing, 163319 Hei Longjiang Province China
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Abstract
Unintentional injury prevention research focuses on parental supervision as critical to reducing toddler injury. We examine how the promotion of childproofing-as a mode of supervision-sells mothers "peace of mind" while also increasing "intensive mothering" and the "privatization of risk." Drawing on the childproofing literature and meaning centered interviews with mothers of toddlers and childproofing business owners, we argue that the connection made by these groups between childproofing and "good parenting" ultimately obscures how this form of harm reduction economically and socially individualizes responsibility for child care.
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Affiliation(s)
- Amy Dao
- a Department of Geography and Anthropology , California State Polytechnic University , Pomona , California , USA
| | - Juliet McMullin
- b Department of Anthropology , University of California, Riverside , Riverside , California , USA
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Boles R, Gawaziuk JP, Cristall N, Logsetty S. Pediatric frostbite: A 10-year single-center retrospective study. Burns 2018; 44:1844-1850. [PMID: 30072195 DOI: 10.1016/j.burns.2018.04.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 03/29/2018] [Accepted: 04/04/2018] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To describe frostbite (freezing cold injured tissue) in children and intrinsic (psychological and behavioral) and extrinsic (meteorological and safety hazard) factors related to the injury. METHODS Retrospective chart review of children <18 years old referred to a regional pediatric hospital for frostbite, to determine the demographics, environment, and risk factors related to injuries. RESULTS 47 patients met the inclusion criteria. Median age was 15 years (IQR 12-16). All injuries occurred between November and March. 49% were admitted to the hospital and frostbite was associated with use of alcohol (53%), cigarettes (34%), marijuana (23%), and symptoms of depression (with and without suicidal ideation) (32%). Frostbite injury treated with conservative wound management presented at <-6°C and injury that underwent surgical procedures occurred at temperatures ≤-23°C (p=0.001). Longer exposure duration also significantly increased the likelihood of a surgical procedure (p<0.001). Intoxication and lack of supervision were two common factors, with lack of supervision at time of injury most common among patients 0-12 years (64%), and intoxication most common among patients ages 13-17 (61%). CONCLUSION Frostbite injuries in children begins at temperatures <-6°C; with risk of tissue loss increasing at temperatures below -23°C. Lack of supervision and intoxication are major risk factors for frostbite in children. Two-thirds of younger children were unsupervised, whereas intoxication was frequently related to frostbite in adolescents. Both of these factors can be addressed through an education-based prevention program.
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Affiliation(s)
- Ramy Boles
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Justin P Gawaziuk
- Manitoba Firefighters' Burn Unit, Health Sciences Centre, Winnipeg, Manitoba, Canada
| | - Nora Cristall
- Departments of Surgery and Psychiatry, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Sarvesh Logsetty
- Manitoba Firefighters' Burn Unit, Health Sciences Centre, Winnipeg, Manitoba, Canada; Departments of Surgery and Psychiatry, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
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Nonadult Supervision of Children in Low- and Middle-Income Countries: Results from 61 National Population-Based Surveys. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15081564. [PMID: 30042321 PMCID: PMC6121274 DOI: 10.3390/ijerph15081564] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 06/29/2018] [Accepted: 06/29/2018] [Indexed: 11/17/2022]
Abstract
Despite scarce empirical research in most countries, evidence has shown that young children are unsupervised or under the supervision of another young child while their adult caregivers attend work or engage in other activities outside the home. Lack of quality supervision has been linked to unintentional childhood injuries and other negative outcomes. Nationally representative, population-based data from rounds four and five of the Multiple Indicator Cluster Surveys (MICS) and four to eight of the Demographic and Health Surveys (DHS) from 61 low- and middle-income countries were used to estimate prevalence and socio-economic factors associated with leaving children under five years old home alone or under the care of another child younger than 10 years of age. Socio-economic factors included age and sex of the child, rurality, wealth, maternal education, and household composition. Large variations in the prevalence rates (0.1⁻35.3% for children home alone and 0.2⁻50.6% for children supervised by another child) and associated factors have been recorded within and across regions and countries. Understanding why and under what conditions children are home alone or under the supervision of another child is crucial to the development of suitable policies and interventions to protect young children, promote healthy growth, and support caregivers.
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Martin-Storey A, Prickett KC, Crosnoe R. Alcohol use and change over time in firearm safety among families with young children. Drug Alcohol Depend 2018; 186:187-192. [PMID: 29604526 PMCID: PMC5916849 DOI: 10.1016/j.drugalcdep.2018.01.032] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 01/19/2018] [Accepted: 01/20/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND Improperly stored firearms pose a clear health risk to children. Previous research concurrently links alcohol use with lower levels of firearm safety. The objectives of this study were to assess (1) how families move from unsafe to safer firearm storage practices and (2) how parental drinking was associated with moving away from unsafe firearm storage practices. METHODS This study used data from the Early Childhood Longitudinal Study-Birth Cohort, 2003 when children were two years old and again when they were four years old. Parents were asked about firearm storage practices, alcohol consumption, and information to measure other confounding variables. Their responses were used to identify families who engaged in unsafe firearm storage practices (n = 650) during the initial testing period and to assess how alcohol consumption and other variables were associated with moving to safer firearm storage practices at the second testing period. RESULTS Families grew more likely to adopt safer firearm storage practices as their children aged, compared with continuing unsafe practices. Multivariate logistic regressions indicated that parental drinking, however, reduced the likelihood that parents moved to safer storage practices, controlling for covariates. Other families- and community-level variables, in particular, family structure, were also associated with the likelihood of moving to safer firearm storage behaviors. CONCLUSIONS Families with higher levels of alcohol use may need additional assistance in addressing firearm safety. The findings call for future research to better understand how physicians can counsel at-risk families to help them store firearms more securely.
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Affiliation(s)
- Alexa Martin-Storey
- Département de Psychoéducation, Université de Sherbrooke, 150, Place Charles-Le Moyne, 12e étage Longueuil, Quebec, J4 K 0A8, Canada.
| | - Kate C. Prickett
- Harris School of Public Policy, University of Chicago, 1155 East 60th Street, Chicago, IL, 60637, USA
| | - Robert Crosnoe
- Department of Sociology, University of Texas at Austin, 2315 Red River Street, Austin, TX, 78712, USA
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Carson V, Lee EY, Hewitt L, Jennings C, Hunter S, Kuzik N, Stearns JA, Unrau SP, Poitras VJ, Gray C, Adamo KB, Janssen I, Okely AD, Spence JC, Timmons BW, Sampson M, Tremblay MS. Systematic review of the relationships between physical activity and health indicators in the early years (0-4 years). BMC Public Health 2017; 17:854. [PMID: 29219090 PMCID: PMC5753397 DOI: 10.1186/s12889-017-4860-0] [Citation(s) in RCA: 317] [Impact Index Per Article: 45.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background Given the rapid development during the early years (0-4 years), an understanding of the health implications of physical activity is needed. The purpose of this systematic review was to examine the relationships between objectively and subjectively measured physical activity and health indicators in the early years. Methods Electronic databases were originally searched in April, 2016. Included studies needed to be peer-reviewed, written in English or French, and meet a priori study criteria. The population was apparently healthy children aged 1 month to 59.99 months/4.99 years. The intervention/exposure was objectively and subjectively measured physical activity. The comparator was various volumes, durations, frequencies, patterns, types, and intensities of physical activity. The outcomes were health indicators ranked as critical (adiposity, motor development, psychosocial health, cognitive development, fitness) and important (bone and skeletal health, cardiometabolic health, and risks/harm). The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework was used to assess the quality of evidence for each health indicator by each study design. Results Ninety-six studies representing 71,291 unique participants from 36 countries were included. Physical activity interventions were consistently (>60% of studies) associated with improved motor and cognitive development, and psychosocial and cardiometabolic health. Across observational studies, physical activity was consistently associated with favourable motor development, fitness, and bone and skeletal health. For intensity, light- and moderate-intensity physical activity were not consistently associated with any health indicators, whereas moderate- to vigorous-intensity, vigorous-intensity, and total physical activity were consistently favourably associated with multiple health indicators. Across study designs, consistent favourable associations with health indicators were observed for a variety of types of physical activity, including active play, aerobic, dance, prone position (infants; ≤1 year), and structured/organized. Apart from ≥30 min/day of the prone position for infants, the most favourable frequency and duration of physical activity was unclear. However, more physical activity appeared better for health. Evidence ranged from “very low” to “high” quality. Conclusions Specific types of physical activity, total physical activity, and physical activity of at least moderate- to vigorous-intensity were consistently favourably associated with multiple health indicators. The majority of evidence was in preschool-aged children (3-4 years). Findings will inform evidence-based guidelines. Electronic supplementary material The online version of this article (10.1186/s12889-017-4860-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Valerie Carson
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB, T6G 2H9, Canada.
| | - Eun-Young Lee
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB, T6G 2H9, Canada
| | - Lyndel Hewitt
- Early Start Research Institute, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Cally Jennings
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB, T6G 2H9, Canada
| | - Stephen Hunter
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB, T6G 2H9, Canada
| | - Nicholas Kuzik
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB, T6G 2H9, Canada
| | - Jodie A Stearns
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB, T6G 2H9, Canada
| | - Stephanie Powley Unrau
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB, T6G 2H9, Canada
| | - Veronica J Poitras
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, K1H 8L1, Canada
| | - Casey Gray
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, K1H 8L1, Canada
| | - Kristi B Adamo
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, K1N 1A2, Canada
| | - Ian Janssen
- School of Kinesiology and Health Studies, and Department of Public Health Sciences, Queen's University, Kingston, ON, K7L 3N6, Canada
| | - Anthony D Okely
- Early Start Research Institute, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - John C Spence
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB, T6G 2H9, Canada
| | - Brian W Timmons
- Child Health & Exercise Medicine Program, Department of Pediatrics, McMaster University, Hamilton, ON, L8S 4K1, Canada
| | - Margaret Sampson
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, K1H 8L1, Canada.,Library and Media Services, Children's Hospital of Eastern Ontario, Ottawa, ON, K1H 8L1, Canada
| | - Mark S Tremblay
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, K1H 8L1, Canada
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Morrongiello BA, Hou S, Bell M, Walton K, Filion AJ, Haines J. Supervising for Home Safety Program: A Randomized Controlled Trial (RCT) Testing Community-Based Group Delivery. J Pediatr Psychol 2017; 42:768-778. [PMID: 27771617 DOI: 10.1093/jpepsy/jsw083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 08/30/2016] [Indexed: 11/14/2022] Open
Abstract
Objective The individually delivered Supervising for Home Safety (SHS) program improves caregivers' injury-related beliefs and supervision practices. The current randomized controlled trial used a group delivery in a community setting and assessed program impact, feasibility, and acceptance. Methods Caregivers of 2-5-year-olds were randomized to receive either the SHS or an attention-matched control program. Results In the SHS group only, there were increases from baseline to postintervention in the following: beliefs about children's vulnerability to injury, caregiver preventability of injuries, and self-efficacy to do so; readiness for change in supervision; and watchful supervision. Face-to-face recruitment by staff at community organizations proved most successful. Caregivers' satisfaction ratings were high, as was caregiver engagement (95% completed at least seven of the nine sessions). Conclusion The SHS program can be delivered to groups of caregivers in community settings, is positively received by caregivers, and produces desirable changes that can be expected to improve caregivers' home safety practices.
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Damashek A, Corlis M. The Role of Proximal Maternal Supervision in Children’s Risk for Injury in a Low-Income Sample. J Pediatr Psychol 2017; 42:727-737. [DOI: 10.1093/jpepsy/jsx044] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 01/06/2017] [Indexed: 11/13/2022] Open
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Kenny MC, Wurtele SK. Teaching preschoolers safety rules: A pilot study of injury prevention. CHILDRENS HEALTH CARE 2015. [DOI: 10.1080/02739615.2015.1065743] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Benford P, Young B, Coupland C, Watson M, Hindmarch P, Hayes M, Goodenough T, Majsak-Newman G, Kendrick D. Risk and protective factors for falls on one level in young children: multicentre case-control study. Inj Prev 2015; 21:381-8. [PMID: 26271259 DOI: 10.1136/injuryprev-2015-041581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 07/13/2015] [Indexed: 11/03/2022]
Abstract
BACKGROUND Childhood falls are an important global public health problem, but there is lack of evidence about their prevention. Falls on one level result in considerable morbidity and they are costly to health services. OBJECTIVE To estimate ORs for falls on one level in children aged 0-4 years for a range of safety behaviours, safety equipment use and home hazards. DESIGN, SETTING AND PARTICIPANTS Multicentre case-control study at hospitals, minor injury units and general practices in and around four UK study centres. Participants included 582 children less than 5 years of age with a medically attended fall injury occurring at home and 2460 controls matched on age, sex, calendar time and study centre. MAIN OUTCOME MEASURE Fall on one level. RESULTS Cases' most common injuries were bangs on the head (52%), cuts or grazes not needing stitches (29%) or cuts or grazes needing stitches (17%). Comparing cases to community controls in the adjusted analyses, significant findings were observed for only two exposures. Injured children were significantly less likely to live in a household without furniture corner covers (adjusted OR (AOR) 0.72, 95% CI 0.55 to 0.95), or without rugs and carpets firmly fixed to the floor (AOR 0.76, 95% CI 0.59 to 0.98). CONCLUSIONS We did not find any safety practices, use of safety equipment or home hazards associated with a reduced risk of fall on one level. Our findings do not provide evidence to support changes to current injury prevention practice.
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Affiliation(s)
- P Benford
- Division of Primary Care, School of Medicine, University of Nottingham, Nottingham, UK
| | - B Young
- Division of Primary Care, School of Medicine, University of Nottingham, Nottingham, UK
| | - C Coupland
- Division of Primary Care, School of Medicine, University of Nottingham, Nottingham, UK
| | - M Watson
- School of Health Sciences, University of Nottingham, D86, Queen's Medical Centre, Nottingham, UK
| | - P Hindmarch
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - M Hayes
- Child Accident Prevention Trust, London, UK
| | - T Goodenough
- Centre for Child & Adolescent Health, University of the West of England, Bristol, UK
| | - G Majsak-Newman
- Jenny Lind Paediatric Department, Norfolk and Norwich University Hospital, Norwich, UK
| | - D Kendrick
- Division of Primary Care, School of Medicine, University of Nottingham, Nottingham, UK
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Schnitzer PG, Dowd MD, Kruse RL, Morrongiello BA. Supervision and risk of unintentional injury in young children. Inj Prev 2014; 21:e63-70. [PMID: 24848998 DOI: 10.1136/injuryprev-2013-041128] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Assess the association between caregiver supervision and acute unintentional injury in young children; evaluate whether lower levels of supervision result in more severe injury. METHODS A case cross-over study was conducted. Parents of children aged ≤4 years whose injuries required emergency department (ED sample) treatment or admission to the hospital (inpatient sample) were interviewed. Information on supervision (3 dimensions: proximity, attention, continuity) at the time of injury and 1 h before the injury (control time) was collected. An overall supervision score was created; a higher score indicates closer supervision. Hospital admission served as a proxy for injury severity. ORs and 95% CIs were calculated. RESULTS Interviews were completed by 222 participants; 50 (23%) were in the inpatient sample. For each supervision dimension the inpatient sample had higher odds of injury, indicating effect modification requiring separate analyses for inpatient and ED samples. For both samples, proximity 'beyond reach' was associated with the highest odds of injury; compared with 1 h before injury, children were more likely to be beyond reach of their caregiver at the time of injury (inpatient sample: OR 11.5, 95% CI 2.7 to 48.8; ED sample: OR 2.9, 95% CI 1.8 to 4.9). Children with lower supervision scores had the greatest odds of injury (inpatient sample: OR 8.0, 95% CI 2.4 to 26.6; ED sample: OR 3.3, 95% CI 1.9 to 5.6). CONCLUSIONS Lower levels of adult supervision are associated with higher odds of more severe injury in young children. Proximity is the most important supervision dimension for reducing injury risk.
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Affiliation(s)
| | - M Denise Dowd
- Children's Mercy Hospital, Kansas City, Missouri, USA
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