bluuebunny/crossref_metadata_2025 huggingface dataset:
Childhood injury prevention through community-based participatory research: a multidimensional approach in the love and safety Omura study in Nagasaki, Japan
Authors: Kimiko Deguchi , Mikiko Oono , Koji Kitamura , Yoshifumi Nishida
Published: October 2012

Background

In Japan the leading cause of death of 1–19 years is unintentional injuries. However, people's awareness of the issue and its preventability remain low.

Purpose

To implement a community-based injury prevention programme which citizens, educators, engineers, manufacturers and policy makers work together, recognising one another's strengths.

Methods

In Omura, Nagasaki, we conducted a community-based participatory research project, named ‘Love & Safety Omura Study’. We worked with Nagasaki Medical Center and the fire department to collect injury data and identify the causes and characteristics of childhood injury in Omura.

Results

Ninety-nine children's injury cases were identified. The number one cause of injury was falls followed by bicycle-related injuries, car crashes, and collisions. Bicycles were most often involved in childhood injuries. Agricultural machinery and two-wheeled carts were also related to injuries, reflecting the regional characteristics of Omura. We developed digital content based on the results of data analysis and presented it at a workshop for citizens. Effectiveness of the workshop was evaluated by questionnaires.

Workshop Evaluation

Only 65% of the respondents were aware that unintentional injury is the number one cause of death in children before attending the workshop. All 94% of the respondents believed that injuries are preventable after attending the workshop, and they successfully indicated preventive actions such as buying childproofing products, pulling the plug on a bathtab, and replacing the rubber seal for a hot water pot, which were introduced in the developed DVD.

Conclusion

A collaborative and multidisciplinary approach is key to effective community-based injury prevention.
Parental influence on adolescent risk behaviours: a strategy to empower parents
Authors: Groff P , Morrish J , Smith V
Published: October 2012

Background

Adolescence is a developmental period marked by a rise in risk-taking, injury and mortality rates. Mortality rates increase by 200% during this developmental period. This rise has been related to adolescents' increased involvement in maladaptive risk-taking (eg, risky driving). Research highlights the importance of teenagers' parents in the risk decisions they make.

Aims/Objectives/Purpose

In order to deepen the understanding of parental influence on risk-taking, Parachute, sponsored by State Farm Insurance, conducted an in-depth study and has begun developing parent programming.

Methods

An extensive literature review revealed that parents have more influence than they may be aware of. A Canada-wide survey was conducted on 300 parents (76 males, 224 females) and their 300 teenagers (150 males, 148 females) to test the theories emerging from the literature review. Parent and child responses to these surveys were compared using paired-samples t tests and regression analyses.

Results/Outcome

Analyses demonstrated significant relationships between parental variables and levels of parental influence. In fact, regression analyses revealed that a child's perception of their parent's risk-taking behaviours significantly predicted 30% of the variability in their risk-taking frequencies.

Significance/Contribution to the Field

Overall, it was found that Canadian parents have a great deal of influence over their children's risk-taking, through their behaviours and home environments. These results support the need to work with parents around their influence over their teens' behaviours. Parachute has begun developing parent programming to engage and empower parents around becoming the most positive influence possible, aiding in the long-term reduction of injuries and deaths.
Assessing fathers' attitudes towards protecting children from injuries and engaging in physical risks
Authors: Lise Olsen , Mariana Brussoni , Takuro Ishikawa , Louise Mâsse
Published: October 2012

Background

While most child injury prevention research has focused on mothers, research suggests fathers also play an important role. In a recent study, fathers described how they constantly balanced efforts to expose their children to new and potentially risky situations with needs to protect children from injury.

Aim

To develop and validate an instrument that measures fathers' attitudes and practices towards promoting risk engagement for their children and towards protective strategies to reduce injury risk.

Methods

We developed a survey instrument for testing with 300 fathers of children ages 6–12 years accessing services at a Canadian paediatric hospital. Survey items were developed using findings from past qualitative research with fathers, and existing literature. Content validity assessment was completed using expert opinion and cognitive interviews with fathers. The full sample consists of fathers with children attending hospital due to injury as well as non-injury reasons.

Results

Survey development included opinion from three content experts and cognitive interviews with five fathers. Items include fathers' attitudes and practices related to protecting children from injuries and children's engagement with risky, physical activities. Questions also address child injury history and fathers' perceptions of their role and level of involvement. Results will be compared and reported for the injured and the non-injured groups.

Contribution

Understanding fathers' attitudes towards child risk and safety is important for designing prevention messages that fit with their views on parenting. Potential uses for the instrument for further research and injury prevention practice will be discussed.
Temperament and fracture risk among preschool children: a target kids! Cross-sectional survey
Authors: Howard A , Camden A , Macarthur C , Maguire J , Birken C , Parkin P
Published: October 2012

Background

Previous studies have reported an association between temperament and fracture risk among school-age children; however, few studies have examined this association among preschool children.

Aims/Objective/Purpose

The purpose of this study was to examine the association between temperament and fracture risk among preschool children (3–5 years).

Methods

A cross-sectional study with a case-control analytic approach was used to examine the association between temperament and fracture risk among preschool children in Toronto, Canada. Participants were selected from TARGet Kids!—a community-based pediatric primary care research network. Cases were children who had experienced a fracture. Controls were children with no history of fracture. A 1 : 12 ratio of cases: controls was used, with all cases selected and random sampling of controls. Primary exposure variables included three temperament subscales from the Children's Behavior Questionnaire—Surgency, Effortful Control and Negative Affect. Logistic regression was conducted to estimate the ORs and 95% CIs of fractures predicted by temperament, adjusted for sex and daycare status. Models were run for each temperament subscale.

Results/Outcomes

A total of 48 cases and 600 controls were selected. No significant association between temperament and fracture risk was found. Sex (females vs males, unadjusted OR 2.46, 95% CI 1.29 to 4.68) and daycare attendance (attends vs does not attend, unadjusted OR 0.44, 95% CI 0.24 to 0.80) were the only significant predictors of fracture risk among preschool children.

Significance/Contribution to the Field

These findings contrast with results among school-age children. The lack of association between temperament and injury may relate to increased supervision of preschool children and developmental stage.

Conference theme

Safety, Design and Sustainability

Conference topic

Child safety
Injury prevention counselling during well-child visits in the USA: rates and determinants
Authors: Carlson KF , Fernandez AG , Ryan AD , Betz ME
Published: October 2012

Background

Pediatric and adolescent injury prevention counselling (IPC) is recommended by USA medical organisations. Current rates and determinants of IPC in US child preventive care (‘well-child’) visits are unknown.

Aims/Objectives/Purpose

We examined rates and determinants of IPC during well-child visits in US ambulatory care encounters.

Methods

Data were from the 2009 National Ambulatory Medical Care Survey, a probability sample survey conducted annually by the US National Center for Health Statistics and designed to represent all US office-based physician visits. We conducted descriptive analyses on rates of IPC by patient characteristics and estimated the likelihood of IPC in reference to hypothesised determinants. OR and 95% CI were calculated using multivariable logistic regression.

Results/Outcome

There were approximately 57 million (95% CI 47.2 to 66.8) well-child visits in US office-based physician clinics in 2009; 24% involved IPC. Patient gender was not associated with IPC, but age, race/ethnicity, and region were. Rates of IPC decreased from 28% in visits with children aged 0–2 years to 17% in those aged 13–18 years. Rates were lower for Hispanic (21%) and Black (19%) patients than for non-Hispanic Whites (25%). In multivariable models, visits occurring in non-metropolitan regions were less likely to involve IPC (11%) than visits in metropolitan (urban) regions (26%; OR  0.4; 95% CI 0.2 to 0.7).

Significance/Contribution to the Field

IPC can be effective in reducing injury among paediatric patients. Public health efforts should focus on increasing overall rates of IPC. Emphasis on children who are older, racial/ethnic minority, and seeking preventive care in rural regions may be needed.
Exploring a new method to promote perceptions of susceptibility and severity of childhood injury
Authors: Oono UM , Nishida Y , Kitamura K , Yamanaka T , Joh H
Published: October 2012

Purpose

To explore a new method to promote parents' perceptions of susceptibility and severity of childhood injury.

Method

We formulated two hypotheses: (1) Showing an internal phenomenon that is not visible from outside such as bleeding within the brain can effectively increase parents' severity perception, and (2) The fact that an injury occurred in one's on local community makes one be convinced that an injury could occur to one's child and promotes parents' perceived susceptibility. We developed animations that show the process of occurrence of internal injuries. Animations depicted: traumatic brain injury by falling from a bicycle, oesophageal erosion by swallowing a button battery, choking of cherry tomato, and choking of peanuts. To increase perceived susceptibility, we indicated the city name where participants reside on top of animations. Eighty-six mothers who have at least one child aged under 6-year-old participated and were assigned to one of four groups: (group 1) Internal+City, (group 2) No Internal+City, (group 3) Internal+No City, and (group 4) No Internal+No City.

Results

When we compared ‘Internal group’ (group 1 and 3 combined) to ‘No internal group’ (group 2 and 4 combined), Internal group had higher severity perception than No internal group in the case of brain injury (p=0.012). The differences were not statistically significant but adverse effects were found in other types of injuries. When compared groups 1–3, group 1 had superiority in perceptions of severity and susceptibility in all animations.

Conclusion

Combination of animation with an internal phenomenon and a city name is effective in promoting mothers' risk perception for injury.

Screenshots of animations that show the process of occurrence of internal injuries
Using change theory to elucidate complexities in child safety
Authors: Simpson JC , McGee R , Fougere G
Published: October 2012

Background

As a rich nation, New Zealand ranks poorly for child safety. Despite proven interventions reducing specific causes of unintentional injury, serious events occur and in the home environment, many young children experience injuries for which there is no proven intervention. From a health promotion perspective, lack of progress often indicates complexity, so obtaining insights into dynamic environments, such as the home, to improve design and delivery of initiatives for children safety becomes crucial.

Aims

To understand influences on parents' perceptions of, and responses to, injury risk, from the perspective of experienced practitioners, and analyse emergent themes utilising a theory of change.

Methods

Using an interpretive methodology, experiences, perceptions and beliefs of parents and community professionals working with young families were examined. ‘Downstream’ and ‘upstream’ influences were qualitatively identified. This presentation reports on the downstream aspects explored using Bandura's Social Cognitive Theory.

Results

Influences identified were complex and interactive. The dynamic nature of the home environment was an underlying theme affecting the implementation and effectiveness of interventions. Some influences are well-recognised (knowledge of child development and safety strategies, and supervision style) while others are discussed rarely (parental fatigue). Bandura's Social Cognitive Theory proved a ‘good fit’, and in particular, the concepts of reciprocal determinism, observational learning, expectations and emotional coping provide new insights.

Contribution to the Field

Child safety strategies often require social and behavioural changes. This study identified influences that affect managing child safety in a dynamic environment that can be used to develop effective strategies for child safety.
‘Down the Back Paddock’: a programme to educate local primary school children about safety on rural properties
Authors: Kerry Miles
Published: October 2012

Background

With 38% of the Waimakariri District population living rurally on farms or lifestyle blocks, rural safety is key area of focus for Injury Prevention Waimakariri. Furthermore, since the earthquakes more Christchurch people are moving to the Waimakariri District. Therefore, the need for rural safety education is now greater than ever. Not only rural children, but also those living in urban areas who regularly visit rural properties are being injured through unsafe practices being employed or through lack of knowledge about rural dangers.

Aim

‘Down the Back Paddock’ is a rural education programme aimed at increasing children and teachers' awareness of the risks associated with a rural environment. The purpose is to better educate children and, through them, adults to help create a better safety culture on farms and lifestyle blocks in the future.

Method

‘Down the Back Paddock’ is run in schools with experts delivering messages on a variety of safety-related topics specific to rural contexts. The programme has been developed by a local school principal and also designed to fit the New Zealand Curriculum Framework objectives. Schools are visited on a 4-yearly basis to reinforce the message; with each child receiving the message twice during their primary school years. Now in its eighth year of operation ‘Down the Back Paddock’ has been run in all the rural primary schools at least twice and now includes many urban schools.

Result/Outcome

Evaluations from teachers, tutors and the children, plus feedback from parents point to the programme's success. Word of this success and we are receiving enquires from other Local Authorities and organisations inquiring about running it in their area.
Determination of risks and risk awareness for indoor and outdoor injuries in 0–5 years old children during child health surveillance
Authors: Ugur Baysal Serpil , Oz Seda Ozkan , Gokcay E Gulbin
Published: October 2012

‘Frequency of accidents and changes in accidents overtime are of the predictors of population health’ Barbara Barlow, MD

According to the World Report by WHO-UNICEF, more than 2000 children die as a result of an unintentional injury every day. Risk factors and preventability of childhood injuries are not widely appreciated in Turkey yet. The aim of this study was to determine the risks of injuries, inquiring the risk awareness of parents during well-child visits. The parents of children among 0–5 year-age who follow up regularly at The Child Health Surveillance Clinic, Istanbul University Medical Faculty participated in the study. The parents were asked to fill a questionnaire with 60 items. They were consequently given safety counselling by a physician. The computer based statistical analysis of data was performed. Mean age was 20.09±14.85 months, median: 15 months. The rate of previous injuries was 15.3%. A total of 59.8% were boys; 95.3% were less than 4 years old. The most common cause was falls (77.1%), following by burns and foreign body aspiration. Less than 1% of children were found having no risk for any given type of accident. The risk awareness was highest for intoxications, least for burns. A total of 50.5% of parents were previously informed about injury prevention. Only 17.7% of parents believe that injuries can not be prevented. Studies for improving risk awareness must be a priority. Health professionals should spend time to inquire the risks during well child visits. Individual counselling for injury control, must be emphasized and placed in daily practice. INJURY PREVENTION IS A RIGHT FOR EVERY CHILDREN.
Empowerment of school teachers for school based injury prevention and safety promotion
Authors: Park N , Yang H
Published: October 2012

Background

Teachers are key participants for injury prevention and safety promotion in school setting. For participatory programme, it should be identified the teachers' capacities and then developed the empowerment programme based on it.

Objectives

The objective is identification of interests, awareness and education and training status on injury prevention and safety promotion of school teachers in Korea.

Methods

It was implemented to all schools (K to 12 including special schools) in Korea by web based self-reported survey. The location, level and size of school and teacher's position were applied to survey design. Among 15 103 schools, 7019 schools responded. Questionnaire was developed and revised by literature review, expert discussion and pretest. It is analysed by descriptive statistics using weighting method, χ2test and F test.

Results

Interests on safety are higher in teachers of kindergarten, special school and manager position (p<0.001). Regarding to nine school safety issues, it is differentiated by variables, especially teacher's position (p<0.001). Training experience is higher in kindergarten, school manager but contents are not helpful for them. Ability on first aid and CPR education is good in lower school level and manager. It is reported to be need mandatory safety education for teachers college and training course.

Contribution to the field

It can support for comprehensive identification for teachers programme and be developed and tailored by school and teachers' character for empowerment.
Children on all-terrain vehicles: development of simulated crash scenarios for educational intervention
Authors: Chandrashekhar Thorbole , Mary Aitken , James Graham , Beverly Miller , Hope Mullins
Published: October 2012

Background

All-terrain vehicle (ATV) rollover crashes are associated with major injuries and deaths. ATV and rider kinematics in rollover incidents are poorly understood. Computer simulation techniques for modelling crash events provides an opportunity to evaluate and improve the vehicle dynamic performance to prevent injuries.

Objectives

To develop computer simulation models of ATV rollover events of child and adult riders using previously validated model of an adult-sized ATV.

Methods

Simulations of ATVs with biofidelic models of 6-year-old and 10-year-old child riders were produced using MADYMO software. Crash simulations of ATVs under varying conditions of speed and slope were produced with underlying assumptions of grip and surface conditions. Video animations/movies were developed from the simulations.

Results

The validated computer model of the ATV demonstrated rollover crashes at 10 MPH and 30° with the child riders. This study standardises a methodology for differing scenarios of ATV use and for injury pattern analysis. Validation of models for grip strength and tire/surface contact interaction are planned.

Significance

The validated computer model of an adult-sized ATV and video animations demonstrating dynamic performance of ATVs with child riders provides a potential educational tool to convey risks and promote safety. These models may support studies of injury patterns and improved designs for ATVs and protective gear.
Impact assessment of Pappu Zebra road sense campaign in Indian cities
Authors: Bikash Mohapatra , Surendra Nath Samantray
Published: October 2012

Background

Safety for all, especially for our children going to schools and back is of prime importance to everyone. So, in order to achieve this objective ‘Forum for Prevention of Road Accidents’ launched ‘Pappu Zebra Road Sense Campaign’ in Bhubaneswar and Cuttack cities. It was a bottom-up approach for inculcating a sense of responsibility among the young road users about various aspects of road safety. This study provides an assessment of the impact of the campaign in both the cities.

Objectives

To assess knowledge and current level of road safety practices and to evaluate the gain in Pappu Zebra Road Sense Campaign among the school children.

Methods

This study was undertaken on a sample of 286 school children (162+124 students) from Bhubaneswar and Cuttack. A pre-tested questionnaire was used to assess knowledge and practices of these children. This was followed by the Road Sense Campaign and a post campaign assessment of gain in awareness was done after 1 month.

Results

Areas of concern at baseline were (1) unsafe walking practices (64.7%) (2) not cycling properly (41.9%), (3) hazard in crossing the roads (55.3%), (4) violation of traffic sings and signals (47.9%), (5) indiscipline in boarding the school bus (34%), and non-use of seatbelts and child restraints (76.1%). Post assessment study after the campaign, results revealed improved road safety awareness amongst the children.

Significance

Our study was based on how to minimise road traffic injuries and deaths through an educational campaign. The findings suggest a number of preventive measures.
A competence-based approach to training child restraint technicians to build sector-wide capacity to give informed advice to parents and caregivers.
Authors: Margaret Stevenson-Wright , Kari Miller
Published: October 2012

Background

New Zealand has one of the highest child road fatality rates in the OECD. Part of this is due to the lack of, or incorrect use of, appropriate restraints. This presentation will examine the process used to move child restraint technician training to a competence-based assessment model which was based on national standards. It engages the wider sector in building capacity to give informed advice to parents and caregivers.

Aims/Objectives/Purpose

The NZTA's competence-based assessment model aims to contribute to the reduction of child injury and fatality when travelling in vehicles. It also supports the 2020 goal identified within the Safer Journeys Action Plan to ‘Achieve a correct use and fitting rate of 90% or child restraints, and make the use of booster seats the norm for children aged 5–10’.

Methods

The process involved consulting with a wide range of stakeholders to identify the scope of change required, developing the national standards for registration on the New Zealand Qualifications Framework and developing the process and materials used to support the training, assessment and reporting involved.

Results/Outcome

Issues relating to the introduction of the competence-based assessment model will be explored and an outline given of where things have progressed to in the 2 years since its inception.

Significance/Contribution to the Field

The new model has brought a quality systems approach to the significant and varied sector audience who deliver child restraint advice to parents and caregivers. This includes volunteers, not for profits, DHBs, local authorities, and the retail sector and will provide a level of professionalism to an area that is vital to keeping our children safe when travelling in cars.
Implementation matters: developing an injury prevention briefing
Authors: Hayes M , Towner E , Kendrick D , Deave T , Stewart J ,   on behalf of the Keeping Children Safe Programme team
Published: October 2012

Background

A major challenge for injury prevention is how effective interventions can be implemented more widely. Little is known about the art of implementing interventions in real-world settings. This presentation builds on a structured process, which integrates practitioner knowledge into the evidence base and reflects local contexts.

Aims/Objectives/Purpose

To document the development of an Injury Prevention Briefing (IPB), incorporating different sources of scientific evidence and practitioner knowledge about what works. The IPB has been prepared as part of the ‘Keeping Children Safe at Home’ programme.

Methods

Structured consultation which included workshops of experienced practitioners and policy makers. Four workshops were held in different locations in England and involved 83 participants.

Results/Outcome

The IPB contains sections: directed at health commissioners, Children's Centre managers and practitioners working directly with families, with practical exercises to use with families. The IPB has incorporated the findings of systematic reviews of what interventions work in preventing injuries; surveys and interviews with Children Centre managers; interviews with parents of pre-school children and key informant Interviews on national child injury policy. The workshops of local practitioners and policy makers have refined the IPB and tailored it to local conditions.

Significance/Contribution to the Field

The Injury Prevention Briefing (IPB) is being evaluated in a randomised controlled trial of guidance materials in Children's Centres. Although the output (IPB) is specific to the national and local context in England, the methods employed in this case study have far wider application both in terms of injury type and context.
Progress on child safety action in Europe: the results of the 2012 child safety country profiles
Authors: Turner SL , Lyons RA , Macey SM , MacKay M , Vincenten J
Published: October 2012

Background

Despite injury reductions and safety improvements over the last 30 years, injury remains a leading cause of death and disability for children and adolescents in Europe. As part of the European TACTICS (Tools to Address Childhood Trauma, Injury and Children's Safety) project, Child Safety Country Profiles were developed to measure child injury rates in 36 European countries; enabling European-level comparisons.

Aims/Objectives/Purpose

To calculate child injury mortality and morbidity rates for 36 European countries included in the CSAP project.

Methods

Child injury data were extracted from the World Health Organization Mortality and Morbidity databases', for all countries excluding England and Wales, where data were provided by the Office for National Statistics and Public Health Wales, respectively. Age standardised injury rates were calculated by gender, age, cause and intent of injury, using the most recent data available. Potential years of life lost (PYLL) and select socio-demographic measures were also identified.

Results/Outcomes

Child injury death and disability rates vary greatly between European countries. In 2010, the Netherlands reported the lowest child injury death rate (4.98 per 100 000) and Lithuania reported the highest (23.91 per 100 000); over four times higher than in the Netherlands. Sweden reported the lowest unintentional injury mortality rate (2.73 per 100 000), and Greece the lowest intentional injury mortality rate (0.48/100 000).

Significance/Contribution to the field

Results from these analyses, will support the TACTICS project, and will help measure progress towards and setting of targets for the reduction of child and adolescent injury-related death and disability in Europe.
Inequalities in child injuries in Nepal: findings of a community based survey in Makwanpur
Authors: Pant PR , Towner E , Ellis M , Pilkington P
Published: October 2012

Background

The lack of data on prevalence, risk factors, costs and consequences of child injuries has led to a lack of awareness and understanding of the problem in low income countries.

Aim

To investigate whether socio-economic status of families is associated with injury morbidity among children in rural Nepal.

Results

A community based household survey was conducted in Makwanpur district, Nepal. Families of children with injuries, which required treatment or caused problems for at least 3 days, were interviewed. A total of 2868 households were analysed using Factor Analysis to create SES wealth status and the households were ranked into five quintiles. The relationship of wealth status with socio-economic and demographic characteristics will be presented.

Findings

Only 6.3% (181) of survey households reported that a child was injured. Injured children disproportionately came from the lowest wealth quintiles. The ratio of lowest to highest quintiles was 1.37 (PCA). OR for the lowest SES quintile (1.27; 95% CI 0.78 to 2.06) when compared to the highest. OR for having 3–4 children per household (2.30; 95% CI 1.62 to 3.27) and for having 5 or more children per household (3.42; 95% CI 2.45 to 5.21) compared to 1–2 children per household; the second lowest and middle quintiles have highest injury risk. Having three or more children/household was found to be a risk factor for child injury. The ORs exhibit complex trends with increased SES levels.

Significance

There are few examples of studies examining child injury and inequalities in low and middle income countries. There is a need to study inequalities in injury to help guide more effective prevention.
Community based study on parent related contributory factors for unintentional injuries among preschool children in Sri Lanka
Authors: Samarakkody DC , Fernando DN , McClure RJ
Published: October 2012

Background

Unintentional injuries are one of the leading causes of hospitalisation among preschool children in Sri Lanka resulting disability and death. Though majority of unintentional injuries among this age group occur when the children are at home with their parents, there is dearth of information on parent related contributory factors.

Objectives

To ascertain parent related contributory factors for unintentional injuries among preschool children.

Methods

A community based sample of 1117 preschool children was recruited using a two tier randomisation process. Parents of participating children completed an interviewer administered questionnaire that recorded the parent's recollection of their child having an unintentional injury needed medical attention, within 6 months prior to the interview. In addition parents completed measures assessing type and quality of parenting, quality of marital life, exposure to family stressors and Beck Depression Inventory. Psychosocial stimulation potential of child's home environment was assessed by the Home Observation for Measurement of the Environment inventory.

Results

Logistic regression analysis demonstrated poor quality of parenting (OR 4.9, CI 2.4 to 9.9) and depressive mental health status (OR 4.5, CI 2.5 to 7.9) of the mother, poor quality of parent's marital life (3.08, CI 1.8 to 5.2) and inadequacy of psychosocial stimulation at home (OR 2.4, CI 1.2 to 4.8) as the variables that predict the occurrence of unintentional injuries among the study group.

Contribution to the Field

Identification of parent related risk factors for unintentional injuries among preschool children will enable policy makers to plan and implement injury prevention programmes addressing these factors.
Characteristics, causes and consequences of hospitalised Traumatic Brain Injury in older adults
Authors: Lara Harvey , Jacqueline Close
Published: October 2012

Background

Traumatic brain injury (TBI) is an important cause of injury-related hospitalisation, disability and death worldwide, and is of particular concern in the older population where an acute insult to the brain can end independent living.

Aim

To examine trends in hospitalisations for TBI in adults aged 65 years and over, in New South Wales, Australia.

Methods

TBI cases from 1998 to 2011 were identified from hospitalisation data for all public and private hospitals in NSW. Age-standardised admission rates were calculated. Negative binomial regression modelling was used to examine trends over time.

Results

There were 12 564 hospitalisations for TBI over the 13 year study period. Hospitalisation rates increased by 7.2% (95% CI 6.4 to 8.0, p<0.0001) per year from 19.3/100 000 to 72.2/100 000. One third of all hospitalisations were for adults aged 85 years and over. Traumatic subdural haemorrhage (42.9%), concussive injury (24.1%) and traumatic subarachnoid haemorrhage (12.7%) were the most common type of injury. Falls were the most common cause of TBI (82.9%). Rates of fall-related TBI increased by 8.4% (95% CI 7.5 to 9.3, p<0.001) per year, whilst non-fall related TBI increased by 2.1% (95% CI 0.9 to 3.3, p<0.0001) per year. 13% of hospitalisations resulted in death, and the majority occurred in those who sustained a traumatic subdural haemorrhage.

Significance

The dramatic increase in hospitalised TBI is being predominantly driven by falls in the oldest old, resulting in intracranial haemorrhages. The cause for this is uncertain but may relate to the increasing use of anticoagulant therapies. More research is required to better understand the observed patterns.
Community based programme for fall prevention in home dwelling elderly: randomised controlled trial
Authors: Bae JY , Cho SI , An DH
Published: October 2012

Background

Fall related fractures in elderly are major health problems in Korea. Falls can result in injuries, a loss of confidence and a subsequent reduction in physical activity and community participant.

Purposes

The purposes of this study was to develop community based programme for fall prevention and to investigate effects of this programme on muscle strength, balance and fall efficacy in home dwelling elderly.

Methods

96 elderly were recruited from the community and randomised into two groups: the experimental group, submitted for balance exercise and elastics resistance exercise and the control, without intervention. Muscle strength, balance and fall efficacy were evaluated before and at the end of the trial, using the powertrack II, tetrax and the fall efficacy scale-K. The intervention was performed for twice a week in the senior centre and three times a week at home for 8 weeks. Participants received daily support physiotherapists through a telephone call.

Results

Developed programme was based predominantly on the social cognitive model of behavioural change to successfully increased activities participation in elderly. This programme is very useful because it not only focuses on exercise, but participants also learn fall prevention strategies. There were significantly improved in muscle strength, balance (p<0.001) and fall efficacy (p<0.001) in experimental group.

Contribution to the Field

This study demonstrated that an community based intervention are effective in improving muscle strength, balance and fall efficacy. It is concluded that this programme is a valuable tool for the prevention of fall in home dwelling elderly.
Fall and fall-related injury studies among older aboriginal people in Australia, Canada, New Zealand and the USA: a systematic review
Authors: Scott V , Metcalfe S , Yassin Y
Published: October 2012

Background

Little is known about the scope or nature of falls or fall prevention among older Aboriginal/Indigenous people.

Aims/Objectives/Purpose

To identify peer-reviewed literature with epidemiology and prevention evidence on the topic of falls and fall-related injury among older Aboriginal people in Australia, Canada, New Zealand and the United States.

Methods

A key word search of relevant databases was conducted using combinations of terminology for accidental falls and a comprehensive list of terms for Aboriginal status specific to each country. Each study was independently reviewed by two reviewers against the inclusion criteria with discrepancies determined by a third.

Results/Outcome

34 publications met the review criteria; United States=14; Australia=8; Canada=7; New Zealand=3; international=2. Most are morbidity (14)/mortality (6) reports or reviews (5), with very little on fall prevention.

Significance/Contribution to the Field

The findings bring greater awareness to the seriousness of the issue and point to areas of urgent need for future research.
Fall injuries—a preventable public health issue: results from a pilot surveillance programme in a developing country
Authors: Jabeen F , Rahim K Uzma , Nukhba Z , Abdul R Junaid , Prasanthi P , Adnan H
Published: October 2012

Background

Unintentional injuries due to fall are a leading cause of emergency department visits in children under 14 years.

Aim

The aim of this study is to report the existing baseline facts on fall related injuries.

Methods

This was a secondary analysis of a childhood unintentional injury surveillance database setup in the emergency department of the Aga Khan Hospital, Karachi, Pakistan for 3 months. The data was collected by interviewing caretakers of children under 12 years of age presenting with an unintentional injury to the emergency departments of the four major tertiary care hospitals of Karachi, Pakistan.

Results

There were 281 cases of falls injuries. Of these 186 (66.2%) occurred in males giving a male female ratio of 1.95. Majority of fall were seen in the 5–11 years age group (n=170, 60.5%).Most of these injuries took place at home (n=238, 84.7%). Main reasons for these injuries were fall from height (n=147, 52.3%), from stairs/steps (n=70, 24.9%), playground equipment (n=28, 10%), from bed (n=25, 8.9) and attendants' arms (n=9, 3.2%)..The fall injuries were mostly minor (n=177, 63%) in severity. Around 84% (n=236) cases were directly discharged from the ED and 20 (7.1%) were admitted to the ward. There were two expires (case fatality 0.7). Short-term disability was found 104 cases (37%) and long-term in 47 (16.7%) cases.

Conclusion

Fall is common unintentional injuries occurring mostly at home. Strategies at home like installing stair gate or other barriers to heights can reduce the burden of fall related injuries.
The effects of home based nutrition and exercise interventions in improving functional capacity and preventing falls among older adults
Authors: Johnson CS
Published: October 2012

Background

Unintentional falls are one of the leading causes of mortality and morbidity among frail older adults. The higher incidence of falls coupled with a higher number of individuals at risk for poor nutrition and physical function among this group make it critical to explore this issue within the proposed context.

Purpose

The purpose of the study was to examine the synergistic role of functional capacity and nutrition on falls as well as the impact of combined, home-based nutrition and exercise interventions.

Methods

For the purpose of the study, 80 individuals over 65 years of age were recruited through Continuing Care and other community-based organisations. The participants were placed in one of four groups: exercise only, nutrition only, exercise and nutrition group, and no intervention comparison group. The exercise and nutrition interventions were the Home Support Exercise Programme and consumptions of liquid adult nutritional supplement (Ensure) daily for 6 months. The participants' demographic information, status on health, function, nutrition, and falls were assessed at baseline and again at 6 months.

Results

The participants' age ranged from 61–98 (ave=81). Of the participants, 83% were female, 50% lived alone, and 65% required personal assistance to leave their home. The 6 months follow-up showed improvement in improvement in functional capacity in the intervention groups.

Conclusion

Working with frail elderly provides unique opportunities and challenges.
Falls prevention resource for the aboriginal population in Western Australia
Authors: Anderson E , Harwood S , Page T , Butler S
Published: October 2012

Background

This project relates to falls prevention amongst Aboriginal communities. Although not necessarily a priority area in the eyes of health professionals, a number of chronic health conditions faced by this population contribute to their risk of falling.

Aim

To establish population specific and culturally appropriate resources to provide a consistent and coordinated approach to informing the Aboriginal population in Western Australia of the contributing risk factors and strategies to assist in the prevention of falls.

Methods

A needs assessment and stakeholder consultation was conducted with Aboriginal Health Workers from the Kimberley and South West regions of WA. Working parties and reference groups were established and consulted to guide the development of the resources format, content and method of dissemination as well as to ensure the resources were based on evidence and best practice guidelines.

Outcome

A ‘Falls Prevention for Aboriginal People: Toolkit for Health Professionals and Aboriginal Health Workers’ was finalised. Continuous improvement occurred with assistance from the South West Aboriginal Medical Service. From this trial an easy to use action plan has been developed as well as a culturally appropriate adaptation of an ‘Up From The Floor’ poster. The resource is currently going through an evaluation to further improve the resource for a new print run due in early 2013.

Contribution to the Field

There are limited resources to promote the prevention of falls targeting the Aboriginal community in Australia. This resource has been popular not only in Western Australia but has received interest from other states.
RISK FACTORS FOR FALLS IN CATARACT PATIENTS AWAITING SURGERY
Authors: Fraser M , Meuleners L , Lee A , Ng J , Morlet N
Published: October 2012

Background

Poor vision is a risk factor for falls among older adults. Unfortunately, in Western Australia (WA), cataract patients in the public health system can wait one year to 18 months for first eye surgery. It would be useful to determine risk factors for falls during this period.

Aims/Objectives/Purpose

To determine visual and other risk factors for falls among bilateral cataract patients awaiting first eye surgery in WA.

Methods

Ninety nine drivers aged 55 years and older with bilateral cataract were recruited from three public hospitals in WA. Self-reported data on all falls during the previous 12 months was collected during the week before first eye cataract surgery. Visual measures including visual acuity, contrast sensitivity and stereopsis were assessed and cognitive tests administered. Age, gender, health conditions and living situation data was also collected. A logistic regression model was used to determine visual and other risk factors for falls.

Results/Outcomes

During the year before surgery, 29.3% of patients had at least one fall. Visual acuity in the better eye was the only visual measure associated with increased risk of a fall (p=0.038). Those with more co-morbid conditions were also at increased risk (p=0.005). Interestingly, increasing age was associated with decreased risk of a fall (p=0.020) as was living with others (p=0.036).

Significance/Contribution to the field

The better eye visual acuity measure could be used by clinicians to identify and possibly prioritise patients at risk of falls while waiting for cataract surgery.
The unexamined falls: the student experience and their solutions
Authors: Koe N , Wood G
Published: October 2012

The burden of falls by elderly persons is well documented. Unfortunately very little is known about the estimated 50–60% of elder falls that go unreported, either a result of the victim not presenting at medical care or the victim considers the fall insignificant. This student initiated project examined those unreported falls within an elder population known to them. Over 400 elderly people were surveyed in order to seek more understanding where and why these falls occurred. Findings and recommendations will be reported at the World Injury Prevention Conference in October 2012. The students acknowledge the kind assistance of Dr's J. Chester (Waitemata DHB), P. Kerstan, Auckland University of Technology and other experts who assisted them on the development of this study.
BARRIERS AND FACILITATORS TO HIP PROTECTOR COMPLIANCE: A SYSTEMATIC REVIEW
Authors: Scott V , Feldman F , Wasdell M , Gillan R , Ross D , Thompson-Franson T , Leung M , Lin L , Korall A
Published: October 2012

Background

Hip protectors (HP) represent an attractive strategy for reducing hip fractures in high-risk elderly individuals. However, clinical studies have yielded conflicting results regarding their clinical effectiveness. This is mainly due to poor compliance (acceptance and adherence) among users. As a result, there is an urgent need to identify potential barriers and facilitators to initial acceptance and continued adherence with HP use.

Aims/Objectives/Purpose

The objective of this Systematic Review is to (1) synthesize available research evidence to identify factors that influence HP compliance among older adults in long-term care facilities; (2) interpret the findings to identify the best strategies to overcome perceived barriers and improve acceptance and adherence with HP use; and (3) package and disseminate the findings in a form that is relevant, practical and easily interpreted by the knowledge users and decision makers.

Methods

A key word search was conducted for studies published in English between 2000 and 2011 that employed quantitative, qualitative, or mixed-methods research designs. Each study was independently reviewed by two reviewers against the inclusion criteria with discrepancies determined by a third.

Results/Outcomes

24 articles met the criteria and 63 barrier and facilitator factors were separated into 4 levels: organizational, staff, resident, and product.

Significance/Contribution to the field

The outcomes provide decision makers, health professionals, and caregivers with a greater awareness of strategies to improve compliance with the use of hip protectors. Furthermore, researchers will be able to use the information to design better clinical trials that will yield high acceptance and adherence.
Fractures following falls in Sri Lanka
Authors: Welgama IP , Dharmaratne SD
Published: October 2012

Background

Trauma is a leading cause of hospital admissions in Sri Lanka and of which, a major component are fractures sustained due to falls. However, only limited information is available on this important public health problem.

Aim

To describe the demography and characteristics of fractures sustained following falls, in Sri Lanka.

Methods

A descriptive, cross-sectional study was conducted on patients who sustained fractures following falls. The sample included all patients who attended the Orthopaedic post-surgical clinics of a tertiary care hospital, during 1 month in 2011. Data was collected using a structured, pre-tested, interviewer administered questionnaire, and analysed using SPSS 17.0 statistical software.

Results

In this study sample (n=266), 49.6% were of 20 to 65 years of age and 14.6% were over 65 years. The rest (35.8%) were children and adolescents. The sample had 54.5% males. Of the patients below 40 years, 69.7% were males, while 62.9% were females in the group above 40 years. Single fractures were sustained by 70.3% and the rest had multiple fractures. Upper limb fractures were sustained by 54.4%, while 39% sustained lower limb fractures. Among children and adolescents, 83.2% had upper limb fractures, while in adults and elderly, 51.5% had lower limb fractures.

Significance

Younger males and older females are at a higher risk of sustaining fractures following falls. Single fractures were more common than multiple fractures. Lower limbs were more affected in adults while children and adolescents had more upper limb fractures.