bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis ofyggXandgshAMutants Provides Insights into the Labile Iron Pool inSalmonella enterica
Authors: Thorgersen Michael P. , Downs Diana M.
Published: October 2008

Strains ofSalmonella entericalacking YggX and the cellular reductant glutathione exhibit defects similar to those resulting from iron deficiency and oxidative stress. Mutant strains are sensitive to hydrogen peroxide and superoxide, deregulate the expression of the Fur-regulated geneentB, and fail to grow on succinate medium. Suppression of someyggX gshAmutant phenotypes by the cell-permeable iron chelator deferoxamine allowed the conclusion that increased levels of cellular Fenton chemistry played a role in the growth defects. The data presented are consistent with a scenario in which glutathione acts as a physiological chelator of the labile iron pool and in which YggX acts upstream of the labile iron pool by preventing superoxide toxicity.
Interaction of the Mycobacterial Heparin-Binding Hemagglutinin with Actin, as Evidenced by Single-Molecule Force Spectroscopy
Authors: Verbelen Claire , Dupres Vincent , Raze Dominique , Bompard Coralie , Locht Camille , Dufrêne Yves F.
Published: October 2008

Although
Mycobacterium tuberculosis
and related species are considered to be typical endosomal pathogens, recent studies have suggested that mycobacteria can be present in the cytoplasm of infected cells and cause cytoskeleton rearrangements, the mechanisms of which remain unknown. Here, we used single-molecule force spectroscopy to demonstrate that the heparin-binding hemagglutinin (HBHA), a surface adhesin from
Mycobacterium tuberculosis
displaying sequence similarities with actin-binding proteins, is able to bind to actin. Force curves recorded between actin and the coiled-coil, N-terminal domain of HBHA showed a bimodal distribution of binding forces reflecting the detection of single and double HBHA-actin interactions. Force curves obtained between actin and the lysine-rich C-terminal domain of HBHA showed a broader distribution of binding events, suggesting they originate primarily from intermolecular electrostatic bridges between cationic HBHA domains and anionic actin residues. We also explored the dynamics of the HBHA-actin interaction, showing that the binding force and binding frequency increased with the pulling speed and contact time, respectively. Taken together, our data indicate that HBHA is able to specifically bind actin, via both its N-terminal and C-terminal domains, strongly suggesting a role of the HBHA-actin interaction in the pathogenesis of mycobacterial diseases.
Streptomyces scabies87-22 Possesses a Functional Tomatinase
Authors: Seipke Ryan F. , Loria Rosemary
Published: October 2008

The actinomyceteStreptomyces scabies87-22 is the causal agent of common scab, an economically important disease of potato and taproot crops. Sequencing of theS. scabies87-22 genome revealed the presence of a gene with high homology to the gene encoding the α-tomatine-detoxifying enzyme tomatinase found in fungal tomato pathogens. ThetomAgene fromS. scabies87-22 was cotranscribed with a putative family 1 glycosyl hydrolase gene, and purified TomA protein was active only on α-tomatine and not potato glycoalkaloids or xylans. Tomatinase-null mutants were more sensitive to α-tomatine than the wild-type strain in a disk diffusion assay. Interestingly, tomatine affected only aerial mycelium and not vegetative mycelium, suggesting that the target(s) of α-tomatine is not present during vegetative growth. Severities of disease for tomato seedlings affected byS. scabies87-22 wild-type and ΔtomA1strains were indistinguishable, suggesting that tomatinase is not important in pathogenicity on tomato plants. However, conservation oftomAon a pathogenicity island inS. acidiscabiesandS. turgidiscabiessuggests a role in plant-microbe interaction.
Regulation of Fatty Acid Metabolism by FadR Is Essential for
Vibrio vulnificus
To Cause Infection of Mice
Authors: Brown Roslyn N. , Gulig Paul A.
Published: October 2008

The opportunistic bacterial pathogen
Vibrio vulnificus
causes severe wound infection and fatal septicemia. We used alkaline phosphatase insertion mutagenesis in a clinical isolate of
V. vulnificus
to find genes necessary for virulence, and we identified
fadR
, which encodes a regulator of fatty acid metabolism. The
fadR
::mini-Tn
5
Km2
phoA
mutant was highly attenuated in a subcutaneously inoculated iron dextran-treated mouse model of
V. vulnificus
disease, was hypersensitive to the fatty acid synthase inhibitor cerulenin, showed aberrant expression of fatty acid biosynthetic (
fab
) genes and fatty acid oxidative (
fad
) genes, produced smaller colonies on agar media, and grew slower in rich broth than did the wild-type parent. Deletion of
fadR
essentially recapitulated the phenotypes of the insertion mutant, and the Δ
fadR
mutation was complemented in
trans
with the wild-type gene. Further characterization of the Δ
fadR
mutant showed that it was not generally hypersensitive to envelope stresses but had decreased motility and showed an altered membrane lipid profile compared to that of the wild type. Supplementation of broth with the unsaturated fatty acid oleate restored wild-type growth in vitro, and infection with oleate in the inoculum increased the ability of the Δ
fadR
mutant to infect mice. We conclude that
fadR
and regulation of fatty acid metabolism are essential for
V. vulnificus
to be able to cause disease in mammalian hosts.
The
Bacillus anthracis
SleL (YaaH) Protein Is an
N
-Acetylglucosaminidase Involved in Spore Cortex Depolymerization
Authors: Lambert Emily A. , Popham David L.
Published: October 2008

Bacillus anthracis
spores, the infectious agents of anthrax, are notoriously difficult to remove from contaminated areas because they are resistant to many eradication methods. These resistance properties are due to the spore's dehydration and dormancy and to the multiple protective layers surrounding the spore core, one of which is the cortex. In order for
B. anthracis
spores to germinate and resume growth, the cortex peptidoglycan must be depolymerized. This study reports on analyses of
sleL
(
yaaH)
, which encodes a cortex-lytic enzyme. The inactivation of
sleL
does not affect vegetative growth, spore viability, or the initial stages of germination, including dipicolinic acid release. However, mutant spores exhibit a slight delay in the loss of optical density compared to that of wild-type spores. Mutants also retain more diaminopimelic acid and
N
-acetylmuramic acid during germination than wild-type spores, suggesting that the cortex peptidoglycan is not being hydrolyzed as rapidly. This finding is supported by high-pressure liquid chromatography analysis of the peptidoglycan structure used to confirm that SleL acts as an
N
-acetylglucosaminidase. When
sleL
is inactivated, the cortex peptidoglycan is not depolymerized into small muropeptides but instead is retained within the spore as large fragments. In the absence of the
sleL
-encoded
N
-acetylglucosaminidase, other cortex-lytic enzymes break down the cortex peptidoglycan sufficiently to allow rapid germination and outgrowth.
A Unique Combination of Genetic Systems for the Synthesis of Trehalose in
Rubrobacter xylanophilus
: Properties of a Rare Actinobacterial TreT
Authors: Nobre Ana , Alarico Susana , Fernandes Chantal , Empadinhas Nuno , da Costa Milton S.
Published: October 2008

Trehalose is the primary organic solute in
Rubrobacter xylanophilus
under all conditions tested, including those for optimal growth. We detected genes of four different pathways for trehalose synthesis in the genome of this organism, namely, the trehalose-6-phosphate synthase (Tps)/trehalose-6-phosphate phosphatase (Tpp), TreS, TreY/TreZ, and TreT pathways. Moreover,
R. xylanophilus
is the only known member of the phylum
Actinobacteria
to harbor TreT. The Tps sequence is typically bacterial, but the Tpp sequence is closely related to eukaryotic counterparts. Both the Tps/Tpp and the TreT pathways were active in vivo, while the TreS and the TreY/TreZ pathways were not active under the growth conditions tested and appear not to contribute to the levels of trehalose observed. The genes from the active pathways were functionally expressed in
Escherichia coli
, and Tps was found to be highly specific for GDP-glucose, a rare feature among these enzymes. The trehalose-6-phosphate formed was specifically dephosphorylated to trehalose by Tpp. The recombinant TreT synthesized trehalose from different nucleoside diphosphate-glucose donors and glucose, but the activity in
R. xylanophilus
cell extracts was specific for ADP-glucose. The TreT could also catalyze trehalose hydrolysis in the presence of ADP, but with a very high

K
m

. Here, we functionally characterize two systems for the synthesis of trehalose in
R. xylanophilus
, a representative of an ancient lineage of the actinobacteria, and discuss a possible scenario for the exceptional occurrence of
treT
in this extremophilic bacterium.
HetF and PatA Control Levels of HetR in
Anabaena
sp. Strain PCC 7120
Authors: Risser Douglas D. , Callahan Sean M.
Published: October 2008

Anabaena
sp. strain PCC 7120 is a filamentous cyanobacterium that differentiates heterocysts in response to deprivation of combined nitrogen. A
hetF
deletion strain lacked heterocysts and had aberrant cell morphology. Site-directed mutagenesis of the predicted active-site histidine and cysteine residues of this putative caspase-hemoglobinase fold protease abolished HetF function, supporting the hypothesis that HetF is a protease. Deletion of
patA
, which is necessary for the formation of most intercalary heterocysts, or
hetF
resulted in an increase in HetR protein, and extra copies of
hetF
on a plasmid functionally bypassed the deletion of
patA
. A
hetR
-
gfp
translational fusion expressed from an inducible promoter demonstrated that
hetF
-dependent downregulation of HetR levels occurs rapidly in vegetative cells, as well as developing heterocysts. “Mosaic” filaments in which only one cell of a filament had a copy of
hetR
or
hetF
indicated that
hetF
is required for differentiation only in cells that will become heterocysts.
hetF
was required for transcription from a
hetR
-dependent transcription start point of the
hetR
promoter and induction of transcription from the
patS
promoter. The inverse correlation between the level of HetR protein and transcription from
hetR
-dependent promoters suggests that the transcriptional activity of HetR is regulated by HetF and PatA.
Direct Observation of
Staphylococcus aureus
Cell Wall Digestion by Lysostaphin
Authors: Francius Grégory , Domenech Oscar , Mingeot-Leclercq Marie Paule , Dufrêne Yves F.
Published: October 2008

The advent of
Staphylococcus aureus
strains that are resistant to virtually all antibiotics has increased the need for new antistaphylococcal agents. An example of such a potential therapeutic is lysostaphin, an enzyme that specifically cleaves the
S. aureus
peptidoglycan, thereby lysing the bacteria. Here we tracked over time the structural and physical dynamics of single
S. aureus
cells exposed to lysostaphin, using atomic force microscopy. Topographic images of native cells revealed a smooth surface morphology decorated with concentric rings attributed to newly formed peptidoglycan. Time-lapse images collected following addition of lysostaphin revealed major structural changes in the form of cell swelling, splitting of the septum, and creation of nanoscale perforations. Notably, treatment of the cells with lysostaphin was also found to decrease the bacterial spring constant and the cell wall stiffness, demonstrating that structural changes were correlated with major differences in cell wall nanomechanical properties. We interpret these modifications as resulting from the digestion of peptidoglycan by lysostaphin, eventually leading to the formation of osmotically fragile cells. This study provides new insight into the lytic activity of lysostaphin and offers promising prospects for the study of new antistaphylococcal agents.
Regulation of Cell Growth during Serum Starvation and Bacterial Survival in Macrophages by the Bifunctional Enzyme SpoT in
Helicobacter pylori
Authors: Zhou Yan Ning , Coleman William G. , Yang Zhaoxu , Yang Yi , Hodgson Nathaniel , Chen Fuxiang , Jin Ding Jun
Published: October 2008

In
Helicobacter pylori
the stringent response is mediated solely by
spoT
. The
spoT
gene is known to encode (p)ppGpp synthetase activity and is required for
H. pylori
survival in the stationary phase. However, neither the hydrolase activity of the
H. pylori
SpoT protein nor the role of SpoT in the regulation of growth during serum starvation and intracellular survival of
H. pylori
in macrophages has been determined. In this study, we examined the effects of SpoT on these factors. Our results showed that the
H. pylori spoT
gene encodes a bifunctional enzyme with both a hydrolase activity and the previously described (p)ppGpp synthetase activity, as determined by introducing the gene into
Escherichia coli relA
and
spoT
defective strains. Also, we found that SpoT mediates a serum starvation response, which not only restricts the growth but also maintains the helical morphology of
H. pylori.
Strikingly, a
spoT
null mutant was able to grow to a higher density in serum-free medium than the wild-type strain, mimicking the “relaxed” growth phenotype of an
E. coli relA
mutant during amino acid starvation. Finally, SpoT was found to be important for intracellular survival in macrophages during phagocytosis. The unique role of (p)ppGpp in cell growth during serum starvation, in the stress response, and in the persistence of
H. pylori
is discussed.
Genetic Dissection of the
Francisella novicida
Restriction Barrier
Authors: Gallagher Larry A. , McKevitt Matthew , Ramage Elizabeth R. , Manoil Colin
Published: October 2008

Francisella tularensis
is the causative agent of tularemia and is a category A select agent.
Francisella novicida
, considered by some to be one of four subspecies of
F. tularensis
, is used as a model in pathogenesis studies because it causes a disease similar to tularemia in rodents but is not harmful to humans.
F
.
novicida
exhibits a strong restriction barrier which reduces the transformation frequency of foreign DNA up to 10
6
-fold. To identify the genetic basis of this barrier, we carried out a mutational analysis of restriction genes identified in the
F. novicida
genome. Strains carrying combinations of insertion mutations in eight candidate loci were created and assayed for reduced restriction of unmodified plasmid DNA introduced by transformation. Restriction was reduced by mutations in four genes, corresponding to two type I, one type II, and one type III restriction system. Restriction was almost fully eliminated in a strain in which all four genes were inactive. The strongest contributor to the restriction barrier, the type II gene, encodes an enzyme which specifically cleaves Dam-methylated DNA. Genome comparisons show that most restriction genes in the
F. tularensis
subspecies are pseudogenes, explaining the unusually strong restriction barrier in
F. novicida
and suggesting that restriction was lost during evolution of the human pathogenic subspecies. As part of this study, procedures were developed to introduce unmodified plasmid DNA into
F. novicida
efficiently, to generate defined multiple mutants, and to produce chromosomal deletions of multiple adjacent genes.
Sensory deficit and the risk of pedestrian injury.
Authors: Roberts I. , Norton R.
Published: October 2008

OBJECTIVES: To examine the association between sensory deficit and the risk of child pedestrian-motor vehicle collisions. SETTING: The Auckland region of New Zealand. METHODS: A community based case-control study was conducted. Cases (n = 190) were all children (< 15 years) killed or hospitalised as a result of a pedestrian injury occurring on a public road between 1 January 1992 and 1 March 1994. Controls (n = 479) were a random sample of the child population. RESULTS: The risk of pedestrian injury for children whose parents reported abnormal vision was over four times that of children with reported normal vision (odds ratio = 4.25, 95% confidence interval 1.68 to 10.8). The risk of injury for children whose parents reported abnormal hearing was close to twice that of children with reported normal hearing (odds ratio = 1.73, 95% confidence interval 0.83 to 3.61). CONCLUSIONS: Children with sensory deficits constitute a high risk group for pedestrian injuries. Paediatricians caring for children with sensory impairments should be aware of this increased risk.
Gender differences in injuries among rural youth.
Authors: Alexander C. S. , Somerfield M. R. , Ensminger M. E. , Kim Y. J. , Johnson K. E.
Published: October 2008

GOAL: This paper presents injury data from the first year of a three year longitudinal study of risk taking behaviors among adolescents. SAMPLE: Study subjects were a cohort of 758 rural students from Maryland's Eastern Shore who were in the eighth grade in 1987. METHODS: Students completed a 45 minute, self administered survey in which they reported numbers of injuries experienced in the past year, risk taking behaviors, anger expression, delinquency, alcohol and drug use, physical exercise, work experience, and level of parental supervision. In addition, students had their height and weight measurements taken by trained research staff and completed a self rating of pubertal development using Tanner drawings. RESULTS: Slightly more than half (53.2%) of the boys and over one third (37.7%) of the girls reported experiencing one or more medically attended injuries during the last year. Poisson regression analyses were conducted to estimate the extent to which gender differences in injuries could be accounted for by adolescent behaviors. Gender effects became non-significant when adjustments were made for risk taking, school discipline problems, and exercise frequency. Gender differences in injuries were reduced but remained significant when substance use, employment, and anger were controlled. Poisson regression analyses were conducted separately for males and females to assess whether factors associated with injuries were similar across genders. For boys, risk taking, anger, and school discipline problems were significantly related to number of injuries. Boys with a low body mass index and late pubertal development (mean ratio 3.09), as well as those with high body mass index and early pubertal development (mean ratio 2.16), reported greater numbers of injuries than average boys. For girls, substance use, cruising, risk taking, anger, and exercise frequency were significantly associated with injuries. Girls with an early onset of menses reported, on average, twice the number of injuries than those who were on time. Girls with high body mass index who were late in their pubertal development reported, on average, five times more injuries than other girls. CONCLUSIONS: Although gender is a significant risk factor for injuries, certain behaviors like risk taking, school related delinquency, and physical exercise partially explain the higher number of injuries among adolescent males in this study. For both males and females, indicators of pubertal and physical development are important factors to consider in studies of injuries during early adolescence.
Head injuries in helmeted child bicyclists.
Authors: Grimard G. , Nolan T. , Carlin J. B.
Published: October 2008

OBJECTIVE: To determine the characteristics and the severity of head and facial injuries to helmeted child bicyclists, and whether the helmet contributed to the injury, and to study factors related to bicycle accidents. DESIGN: Retrospective review of two case series. Children sustaining head injury while not wearing helmets were studied as a form of reference group. SETTING: Large paediatric teaching hospital. SUBJECTS: 34 helmeted child bicyclists and 155 non-helmeted bicyclists, aged 5-14 years. MAIN OUTCOME MEASURES: Number of injuries, type of injuries, injury severity score, deaths, and accident circumstances. RESULTS: 79% of the head injuries of the helmeted child group were mild and two thirds of these had facial injuries. Children in the helmet group were in a greater proportion of bike-car collisions than the no helmet group and at least 15% of the helmets were lost on impact. There were no injuries secondary to the helmet. CONCLUSIONS: Most of the head injuries sustained by the helmeted children were of mild severity and there was no evidence to suggest that the helmet contributed to injury. Nevertheless, consideration should be given to designing a facial protector for the bicycle helmet and to improvement of the fastening device.
Determinants of modern health care use by families after a childhood burn in Ghana.
Authors: Forjuoh S. N. , Guyer B. , Strobino D. M.
Published: October 2008

OBJECTIVES: This study examined determinants of modern health care use by families after their child aged 0-5 years sustained a burn injury in the Ashanti Region of Ghana. METHODS: A community based survey of children aged 0-5 years was conducted in 50 enumeration areas in the region. Mothers of all children with scars as evidence of a burn were selected for a follow up interview using a standard questionnaire two to three months later. Determinants of health care use were investigated through a multivariate logistic regression using interview responses from mothers of 617 children for whom report on some treatment was given. RESULTS: Overall, 48% of the burned children were taken to a modern health facility for treatment. Of those taken to a modern health facility, 68% were sent within 24 hours of the burn event. Factors with large adjusted odds ratios for modern health care use included wound infection, burns covering 6% or more of the body surface, and third degree burns. Compared with scalds, children with contact and flame burns were less likely to be taken to a health facility, as were burns to rural children, and those given first aid treatment at home. CONCLUSIONS: It is concluded that families, particularly rural residents, should be educated about appropriate health care seeking practices after a burn.
Methodologic issues in injury case-control studies.
Authors: Roberts I.
Published: October 2008

In this paper some methodological problems particularly relevant to case-control studies of injury are illustrated by reference to previous childhood injury case-control studies. In contrast to studies of disease, where 'person time' constitutes the observational experience of interest, in injury studies person time engaged in a particular activity to often more appropriate. The implications for the definition of the study base are discussed. The potential for hospital admission bias in injury case-control studies is considered along with potential strategies for avoiding it. The importance of errors in exposure measurement, including those arising from inappropriate induction time assumptions, are illustrated. Finally, the potential for bias resulting from the combination of etiologically unrelated injury outcomes into a single outcome measure is illustrated and discussed.
Attitudes to and use of baby walkers in Dublin.
Authors: Laffoy M. , Fitzpatrick P. , Jordan M. , Dowdall D.
Published: October 2008

OBJECTIVES: To identify the rate of baby walker use, parental attitudes, and associated injuries. DESIGN: Parents of babies attending clinics for developmental assessment were surveyed by self administered questionnaire about their use, attitudes, and history of injuries associated with walkers. SETTING: Dublin, Ireland. SUBJECTS: Parents of 158 babies. RESULTS: Fifty five per cent of the sample used a walker. The main reasons for doing so included babies' enjoyment of them and the fact that the walker was used for an older sibling. Although none of the users listed safety concerns as a reason to stop using the walker, non-users (45%) did so; 12.5% of the users had at least one walker related injury. CONCLUSIONS: Parents of babies who use a walker perceive them as beneficial. However these babies are placed at unnecessary risk. It behoves all health professionals and child carers to alert parents to these dangers and the sale of walkers should be reviewed.
Non-intentional asphyxiation deaths due to upper airway interference in children 0 to 14 years.
Authors: Altmann A. , Nolan T.
Published: October 2008

OBJECTIVE: This study was undertaken to identify avoidable, contributing factors associated with non-intentional asphyxiation deaths due to upper airway interference in children 0 to 14 years. DESIGN: Historical population based incidence study. METHODS: All postneonatal and childhood deaths by asphyxiation from 1985 to 1994, using appropriate ICD-9-CM codes, were compiled from the Victorian government legislated paediatric mortality surveillance system. Recent cases were identified from the State Coroner's Office. Case definition included children under 15 years who died from upper airway interference such as facial occlusion, head and neck entrapment, rope or cord strangulation, or foreign body. RESULTS: Of the identified 42 deaths, eight (19%) were caused by a foreign body in the airway, five (12%) were due to facial occlusion, 16 (38%) were due to ropes and similar material (seven were homemade rope swings), and 13 (31%) were caused by entrapment (seven were in cots or beds). The average annual rate for asphyxiation deaths by all causes for children 0 to 14 years was 4.7 million. Infants under 1 year had a rate of 20.1/million, while the rate for 10 to 14 year olds dropped to 2.0/million. CONCLUSION: Rope swings and rope material are inherently dangerous and frequently prove fatal, especially for older children. For infants, environmental factors are important; in particular food and bedding. Prevention strategies need to be developed that include obligatory standards for the design and manufacture of products for children, appropriate labelling and warnings, and education for children, their carers, and health care professionals.
Evaluation of the Think First head and spinal cord injury prevention program.
Authors: Wright M. , Rivara F. P. , Ferse D.
Published: October 2008

OBJECTIVE: Evaluation of the impact of the Think First head and spinal cord injury prevention program on knowledge, attitudes, and behavior of 11-15 year old students toward injury risks and preventive strategies. SETTING: Three junior high and three senior high schools in rural and urban areas of Washington state. METHODS: Questionnaire survey before intervention, two weeks and three months after intervention to assess knowledge, attitude, and self reported behavior change. Observations of students as they left school property to determine bicycle helmet and seat belt use. RESULTS: Little impact on attitudes and no consistent change in knowledge or self reported behaviors. Too few students rode bicycles to accurately assess helmet use; no consistent change in seat belt use. CONCLUSION: The Think First program appears to have little impact on changes in knowledge, self reported behavior, or observed behavior. Other strategies to decrease injuries in adolescents may be more successful.
Children and bicycles: what is really happening? Studies of fatal and non-fatal bicycle injury.
Authors: Acton C. H. , Thomas S. , Nixon J. W. , Clark R. , Pitt W. R. , Battistutta D.
Published: October 2008

OBJECTIVES: The objectives of the study were to ascertain the causes of accidents, injuries, and deaths in children who ride bicycles. Fatality and injury rates were also studied in order to compare with other studies. METHODS: Two studies of children were undertaken in children aged less than 15 years. In the first (retrospective fatality study), children who died as a result of a bicycle incident during the period 1981-92 were reviewed. In the second (prospective injury study) data were obtained prospectively between April 1991 and June 1992 about children who were injured while riding a bicycle and treated at a public hospital in Brisbane. RESULTS: Study 1: fatality rates for boys were twice those for girls. The rate was highest for boys of 14 years in the metropolitan area at 6.23/100,000. All deaths involved vehicles, and the majority involved head injury or multiple injuries including head injury. Study 2: similar numbers of children were injured at onroad and off-road locations. Faculty riding was described by the rider or caregiver as the cause in 62.5% of cases. The most common time of injury was between 3 and 6 pm on both school and non-school days. Only 5.5% of all incidents involved a moving vehicle. CONCLUSIONS: Bicycle riding by children is a common cause of injury, particularly for boys. Equal numbers of injuries occurred on the road as at other locations. Faulty riding caused most accidents. Injury prevention for bicycle riders should involve not only compulsory wearing of helmets, but should also include education and training about safe riding habits, separation of motorised vehicles from bicycles, modified helmet design to incorporate facial protection, and improved handlebar design.
Biosocial variables and auditory acuity as risk factors for non-fatal childhood injuries in Greece.
Authors: Petridou E. , Zervos I. , Christopoulos G. , Revinthi K. , Papoutsakis G. , Trichopoulos D.
Published: October 2008

OBJECTIVES: To examine whether biosocial variables and auditory acuity are risk factors for injuries among children. SETTING: Children with injuries who presented at the emergency clinics of one of the two university hospitals for children in Athens, Greece between December 1993 and April 1994. METHODS: 144 children aged 5-14 years, residents of Athens, were brought to the emergency clinics for a moderate to severe injury. For each of these children one hospital control, matched for age and sex, and one classmate control similarly matched were identified. A standard interview form was completed for all 432 children and acouometric and tympanometric examinations were performed in each of them. Analysis was done through conditional logistic regression. RESULTS: The likelihood of an accident was higher in children of younger fathers (odds ratio (OR) = 0.7, p = 0.04), children of mothers with non-professional jobs (OR = 1.9, p = 0.03) as well as in children of higher birth order (OR = 1.7, p = 0.01), in those with predominantly other than parental daily supervision (OR = 2.6, p = 0.001), and those with a history of previous accident (OR = 1.3, p = 0.002). Somatometric factors, school performance, use of corrective eyeglasses and subnormal auditory acuity were not found to be risk factors, but auditory imbalance and abnormal tympanograms were positively related to the risk of childhood injury (OR = 2.6, p = 0.02; and OR = 2.3, p = 0.08 respectively). CONCLUSIONS: the findings of this study underline the importance of attentive supervision and safety training of children living in modern cities; they also suggest that children with auditory imbalance and history of an accident are at higher injury risk and they should be targeted with specific intervention programs.
Fatal and hospitalized agricultural machinery injuries to children in Ontario, Canada.
Authors: Pickett W. , Brison R. J. , Hoey J. R.
Published: October 2008

OBJECTIVES: To assess rates and patterns of agricultural machinery injuries in farm children in order to both determine priorities and develop strategies for injury control in this population. METHODS: Coroners' files and hospital discharge data were examined for Ontario farm children aged 0-19 who had agricultural machinery injuries over a five year period ending 31 March 1990. Injury rates were described by age, sex, geographic region, type of machinery, and mechanism of injury. Common patterns of injury deserving of priority for prevention were then identified and described. RESULTS: 283 machinery injuries to children were identified. Injury rates were 116 and 25/100,000/year for boys and girls respectively. Boys were at increasing risk relative to girls as their ages increased. Young children were at greatest risk for fatal injury. There is a prominent summer peak in occurrence. The farm tractor was the machine most commonly associated with these injuries (33.2%), and entanglement, usually of clothing, was the mechanism cited most often (36.3%). The case fatality ratio (ratio of hospitalizations:deaths) was generally low whether assessed by machinery type or by mechanism of injury. This provides an indication of the lethality of these injuries. Common patterns associated with injury risk included: (1) inadequate supervision of small children; (2) permitting children to be in the area of moving or unguarded machinery; (3) allowing children to accompany workers using farm machinery; and (4) having children performing work related tasks inappropriate for their age. CONCLUSIONS: Machinery related injuries are not uncommon in farm children and have a high case fatality rate. These rates changed little over the five year study period. Feasible strategies for prevention of these injuries, four of which are presented here, need to be developed and implemented by public health professionals working in cooperation with members of the agricultural industry.
Who's prepared for advocacy? Another inverse law.
Authors: Roberts I.
Published: October 2008

OBJECTIVES: To examine the characteristics of parents responding to a petition calling for greater efforts to ensure the safety of children as pedestrians and to contrast factors predictive of advocacy with risk factors for child pedestrian injury. SETTING: The Auckland region of New Zealand. METHODS: Parents participating in the Auckland Child Pedestrian Injury Study, a community based case-control study, were invited to support a series of recommendations based on the study results, by signing and returning a petition that was to be delivered to the New Zealand Minister for Transport. Characteristics of petitioners were determined by linking their petition responses to the study questionnaires using an unique identifier. The characteristics of petitioners and nonpetitioners were summarised using odds ratios. RESULTS: 31% of parents signed and returned the petition; 19% were parents of cases and 36% were parents of controls. The sociodemographic groups whose children were at the lowest risk of pedestrian injury were the most likely to return the petition. Children in the most disadvantaged socioeconomic group and children of Pacific Island parents were at greatest risk of injury but the parents of these children were the least likely to respond to the petition. CONCLUSIONS: The frequency with which parents advocate for child safety varies inversely with the need for it. Models of health promotion based on community ownership and empowerment alone are unlikely to address the steep socioeconomic gradients in childhood injury mortality.
How do practice nurses see their role in childhood injury prevention?
Authors: Kendrick D. , Marsh P. , Williams E. I.
Published: October 2008

OBJECTIVES: To assess the knowledge of unintentional injury epidemiology, the attitudes towards, and current practices in injury prevention among practice nurses. SETTING: Practice nurses employed by general practitioners in Nottinghamshire, United Kingdom. METHOD: A postal questionnaire was sent to all practice nurses on the Family Health Services Authority list (n = 322) with questions covering sociodemographic details, occupational details, unintentional injury epidemiology, attitudes towards the injury prevention activities suggested by a government report as part of the role of the primary health care team, and current practices in injury prevention. RESULTS: A response rate of 71.1% was achieved. More than 50% knew that unintentional injuries were the most common cause of death in childhood. A similar per cent knew the site of most fatal injuries in the under 1 and 5-16 year age groups. More than two thirds correctly identified a range of risk factors for unintentional injury. However, only two fifths of nurses believed they could be effective in preventing injuries. There were considerable gaps between attitudes and practice for most activities. The activities most commonly undertaken include displaying posters and leaflets (69.4%), giving advice on prevention (51.1%), and advice on first aid (45.0%) during injury consultations. CONCLUSIONS: Most practice nurses hold positive attitudes towards injury prevention activities, but fewer undertake these activities regularly. The activities most commonly undertaken employ an educational model. Further research is needed on the barriers to practice nurses undertaking more injury prevention work, the effectiveness of systems to overcome such barriers, and the effectiveness of these injury prevention activities.
General practitioners' attitudes to child injury prevention in the UK: a national postal questionnaire.
Authors: Carter Y. H. , Morgan P. S. , Lancashire R. J.
Published: October 2008

OBJECTIVE: To survey the level of interest and involvement in child injury prevention among general practitioners and their practice teams, and to identify factors associated with current interest. DESIGN: Postal survey of a random sample of United Kingdom (UK) medical practitioners. SETTING: Medical practices throughout the UK. SUBJECTS: 957 general practitioners (50% of the total sample) who responded to the survey questionnaire. OUTCOMES: Answer to questions about role in injury prevention. RESULTS: Despite a response rate of only 50%, this study is the largest to examine the role of general practitioners in child injury prevention. Seven hundred and twenty five (77%) of the respondents considered injury prevention to be part of the general practitioner's role, but only 260 (28%) felt that they did enough in this area. Time was cited as the most significant limiting factor. Women doctors, rural practitioners, members of the Royal College of General Practitioners, and doctors with previous personal experience of serious accidents all had more positive attitudes to injury prevention as a routine part of their activities (p < 0.05). Practices providing first aid training for staff were also associated with an interest in injury prevention. The most appropriate times for offering prevention advice were thought to be during child health surveillance clinics and during treatment of an accident. CONCLUSIONS: Awareness about injury prevention opportunities might be improved by emphasising the roles of individual team members and by better addressing the training needs of the whole team.
The Lidköping Accident Prevention Programme--a community approach to preventing childhood injuries in Sweden.
Authors: Svanström L. , Ekman R. , Schelp L. , Lindström A.
Published: October 2008

OBJECTIVES: In Sweden about 100 children 0-14 years die from accidental injuries every year, roughly 40 girls and 60 boys. To reduce this burden the Safe Community concept was developed in Falköping, Sweden in 1975. Several years later a second programme was initiated in Lidköping. The objectives of this paper are to describe the programme in Lidköping and to relate it to changes in injury occurrence. SETTING: The Lidköping Accident Prevention Programme (LAPP) was compared with four bordering municipalities and to the whole of Skaraborg County. METHODS: The programme included five elements: surveillance, provision of information, training, supervision, and environmental improvements. Process evaluation was based mainly on notes and reports made by the health planners, combined with newspaper clippings and interviews with key people. Outcome evaluation was based on information from the hospital discharge registry. RESULTS: In Lidköping there was an on average annual decrease in injuries leading to hospital admissions from 1983 to 1991 of 2.4% for boys and 2.1% for girls compared with a smaller decline in one comparison area and an increase in the other. CONCLUSION: Because the yearly injury numbers are small there is a great variation from year to year. However, comparisons over the nine year study period with the four border municipalities and the whole of Skaraborg County strengthen the impression that the programme has had a positive effect. The findings support the proposition that the decrease in the incidence of childhood injuries after 1984 could be attributed to the intervention of the LAPP. Nevertheless, several difficulties in drawing firm conclusions from community based studies are acknowledged and discussed.
Injury surveillance in children--usefulness of a centralised database of accident and emergency attendances.
Authors: Lyons R. A. , Lo S. V. , Heaven M. , Littlepage B. N.
Published: October 2008

OBJECTIVE: To assess the usefulness of a centralised injury database in monitoring progress towards nationally set health targets for the reduction of childhood injuries. SETTING: West Glamorgan County, Wales. METHODS: Analysis was undertaken of data held in the West Glamorgan injury database which amalgamates population data with data from the three hospital units covering a population of 370,000. All first attendances due to a new injury in children aged 0-14 occurring in 1993 were analysed, with subgroup analysis for injuries occurring in the home and injuries resulting in fractures. Standardised injury ratios were compared with the distance travelled, car ownership, and Townsend index of deprivation at the ward level, using multiple linear regression. RESULTS: A total of 10,117 first time visits due to injuries were recorded, representing a rate of 182 injuries/1000 children aged 0-14 in West Glamorgan County. Distance from home to the accident and emergency departments was inversely correlated with total injury attendances, and injuries occurring at home, but not with injuries resulting in fractures. Visit rates for any type of injury were not associated with local car ownership rates or deprivation indices. CONCLUSIONS: Proximity to accident and emergency departments is a strong determinant of the use of the service by children with overall injuries, and injuries occurring at home. The lack of a significant association between travel distance and injuries resulting in fractures suggests that it is more meaningful to use a centralised database of accident and emergency department attendances to monitor the more severe spectrum of childhood injuries in assessing progress towards national targets for their reduction. The absence of an association between severe injuries and local socioeconomic factors suggests that national targets for the reduction of socioeconomic differentials in childhood injuries may need to be reassessed. These databases are also useful in generating information to direct preventive strategies and to target resources to areas of greatest need.
The New Zealand graduated driver licensing system: teenagers' attitudes towards and experiences with this car driver licensing system.
Authors: Begg D. J. , Langley J. D. , Reeder A. I. , Chalmers D. J.
Published: October 2008

OBJECTIVES: This study examined the attitudes of teenagers towards the New Zealand graduated driver licensing system (GDLS), and the extent to which it affected them. METHOD: Teenagers, who are members of a longitudinal study of a birth cohort, were interviewed at 15 years of age when the GDLS was first introduced and before they had begun licensure, and again at 18 years of age after they had experience with this licensing system. RESULTS: At both ages the majority (over 70%) agreed with the driving restrictions imposed by this system. After experience with the restrictions, however, significantly more reported being affected a lot by them, than had expected to be at age 15. This was especially true of the restrictions on the carrying of passengers and the night time curfew (10 pm - 5 am). However, few reported that they were affected by the alcohol restriction. Sixty eight per cent of those with a graduated licence reported breaking at least one of the conditions, most frequently carrying passengers. Very few were penalised by the police for this. CONCLUSIONS: Generally these young drivers were positively disposed towards the driving restrictions, but noncompliance was common. A full evaluation of all aspects of this licensing system is recommended.
'What I said' versus 'what you heard': a comparison of physicians' and parents' reporting of anticipatory guidance on child safety issues.
Authors: Morrongiello B. A. , Hillier L. , Bass M.
Published: October 2008

OBJECTIVE: Unintentional injuries are the number one cause of death for infants. Many of these injuries could be prevented if parents took additional safety precautions. In this study physicians' and parents' perspectives regarding the part that physicians play in educating first time parents about child safety issues were compared. METHODS: All pediatricians and family physicians in London, Ontario were surveyed by mail (68% return rate) regarding their practices, attitudes, and beliefs related to parent education about child safety issues. A sample of 114 first time mothers, including 38 each with 6, 12, and 18 month old infants, completed a telephone interview. All parents had physicians who had returned questionnaires. RESULTS: There was good correspondence between parents' and physicians' judgments about the safety issues most often covered, and what role physicians should adopt regarding parent education about child safety issues. In addition, they both agreed that parents seldom seek out safety information by asking questions. Relative to parent reports, however, physicians significantly overestimated the time they spent on safety issues and the degree of their direct involvement in communicating this information. The best predictor of time spent by physicians on safety issues was their rating of the importance of assuming the role of parent educator. The best predictor of parents asking questions about child safety was their rating of the adequacy of physicians' responses to previously asked questions. CONCLUSIONS: The results suggest that both physicians and parents contribute to undermine communication about child safety during well-baby visits.
Water safety training as a potential means of reducing risk of young children's drowning.
Authors: Asher K. N. , Rivara F. P. , Felix D. , Vance L. , Dunne R.
Published: October 2008

OBJECTIVES: To determine the effects of training in swimming and water safety on young preschool-children's ability to recover safely from a simulated episode of falling into a swimming pool. DESIGN: Randomized trial of 12 or eight weeks' duration water safety and swimming lessons for children 24 to 42 months old. OUTCOME MEASURES: Swimming ability, deck behavior, water recovery, and swimming to side after jumping into pool were measured before, during, and after the training program. RESULTS: 109 children completed the study (61 in the 12 week group, 48 in the eight week group). The average age was 34.2 months, 54% were male. Swimming ability, deck behavior, water recovery, and jump and swim skills improved over baseline levels in both groups. By the end of training, the 12 week group improved more than the eight week group only in swimming ability. Improvements in water recovery and jump and swim skills were associated positively with changes in swimming ability. CONCLUSIONS: Swimming ability and safety skills of young preschool children can be improved through training. Such programs may offer some protection for children at risk of drowning and there was no indication that this program increased the risk of drowning. However, pool fencing, other barriers around water, and parental supervision still remain the most important prevention strategies to reduce drowning in young children.