bluuebunny/crossref_metadata_2025 huggingface dataset:
Population based characteristics of fatalities and hospital admissions for acute poisoning in Fiji
Authors: Peiris-John R , Wainiqolo I , Kafoa B , McCaig E , Ameratunga S
Published: October 2012

Background

Globally, the burden of acute poisoning is disproportionately borne by low- and middle-income countries. Culturally mediated factors have been suggested to account for the variations in the epidemiology of poisoning within countries.

Aim

To investigate the incidence and demographic characteristics of poisoning fatalities and hospital admissions among indigenous Fijians and Indians in Viti Levu, Fiji.

Methods

Individuals with a mechanism of injury classified as poisoning were identified using the Fiji Injury Surveillance in Hospitals system, a population-based trauma registry established for 12-months in Viti Levu. Relevant data were extracted and analysed.

Results

The 17 fatalities and 169 primary hospital admissions accounted for mean annual rates of 2.3 and 26.0/100 000 respectively. Overall, more than two-thirds of the poisonings occurred among people of Indian ethnicity. The annual rate of hospital admissions among Indians was 3.1 times that of Fijians (41.2 cf 13.3/100 000). Unintentional poisoning admission rates were highest among Indian males aged 0–14 years (36.1/100 000). Most intentional poisoning admissions occurred among females (n=50, 59.5%) and in 15–29 year olds (n=65, 79.3%). The annual hospital admission rate in this age group was 9.8/100 000, with a seven-fold excess rate among Indians compared with Fijians. Over 75% of poisoning events occurred at home.

Significance

This population-based study identifies important differences in the socio-demographic characteristics associated with poisoning in Fiji. These differences indicate the need for culturally relevant strategies that consider the specific contexts for suicide and self-harm among the Indian population in Fiji, as well as broader implications for hazards at home for the population in Fiji more generally.
Systematic review and meta-analysis evaluating the effectiveness of home safety interventions (education and provision of safety equipment) for child injury prevention
Authors: Kendrick D , Wynn P , Young B , Mason-Jones A , Ilyas N , Achana F , Cooper N. , Hubbard S , Sutton A , Smith S , Mulvaney C , Watson M , Coupland C
Published: October 2012

Background

Injuries are the leading cause of childhood death in industrialised countries with steep social gradients in morbidity and mortality. Most injuries in pre-school children occur at home, however there is little meta-analytic evidence that home safety interventions (HSI) reduce injury rates, improve safety practices or impact on injury inequalities.

Aims/Objectives/Purpose

To investigate effectiveness of HSI in increasing home safety practices and reducing child injury rates and whether the effect varied by social group.

Methods

Bibliographic databases, relevant websites, conference proceedings, bibliographies of relevant studies, and previously published reviews were searched.

Results/Outcome

54 studies were included in at least one meta-analysis. HSI were effective in promoting safe hot tap water temperatures (OR 1.41, 95% CI 1.07 to 1.86), functional smoke alarms (OR 1.81, 95% CI 1.30 to 2.52), fire escape plans (OR 2.01, 95% CI 1,45 to 2.77), storing medicines (OR 1.53, 95% CI 1.27 to 1.84) and cleaning products (OR 1.55, 95% CI 1.22 to 1.96) out of reach, having syrup of ipecac (OR 3.34, 95% CI 1.50 to 7.44) and poison control centre numbers accessible (OR 3.30, 95% CI 1.70 to 6.39) and fitted stair gates (OR 1.61, 95% CI 1.19 to 2.17). HSI may reduce injury rates especially when delivered at home (IRR 0.75, 95% CI 0.62 to 0.91). There was no consistent evidence that HSI were less effective in those at greater risk of injury.

Significance/Contribution to the Field

HSI are effective in increasing a range of safety practices and may reduce injury rates without widening existing inequalities.
Can lay educators be used to integrate injury prevention messages into home visitation programmes?
Authors: Stephens-Stidham S , Colunga I , Mowell C , Johnson U , Istre G
Published: October 2012

Background

Home visitation programmes by professionals have been proven effective at reducing certain injuries, yet there are limited data about the efficacy of the use of non-professionals in these programmes. The Injury Prevention Center (IPC) partnered with an established education-oriented home visitation programme, to include burn prevention messages, and evaluated its impact on two measurable prevention behaviors: smoke alarm (SA) prevalence and hot water temperature (H2O temp).

Aims/Objectives/Purpose

To measure the impact of the intervention on working SA prevalence and H2O temp in Irving, TX.

Methods

Home visitors provided literature and verbal educational messages about the importance of SAs and appropriate H2O temp (ie, <120 F) to parents. Trained IPC staff assessed working SA status and tap H2O temp in each intervention home initially and 2 months later.

Results/Outcome

Ninety-six homes were included in analysis. Twelve (13%) had both optimal SA coverage and optimal H2O temp. Of the remaining 84, 23 (27%) either acquired a SA or lowered H2O temp by >5° on follow-up assessment. Of those who still lacked optimal SA or H2O temp, 38 (62%) reported trying to make one of the changes. Participants reported that the most important factor for making a change was having an individual check the SA and H2O temp.

Significance/Contribution to the Field

Using non-professional educators to incorporate injury prevention messages into an existing home visitation programme may be an effective way to increase working SA prevalence and improving H2O temp, especially if it includes physically checking the status of SAs and H2O temp.
Role of rescue 1122 in the development of safer communities in Pakistan
Authors: Naseer R , Tahir N , Akbar AH
Published: October 2012

Until recent past, people of the Pakistan were deprived of their basic human right of availability of timely pre-hospital emergency care. There were 95% chances that an injured person dying on the road, shall not get an ambulance in time. Similarly, emergency services like fire, rescue and disaster response teams were virtually non-existent in the country.

Rescue 1122 was initially launched as an ambulance service from Lahore in 2004. Successively, the service was not only extended to all 36 districts of the Province Punjab, but also crossed the provincial boundaries. Presently, it has developed into a comprehensive system of emergency care and safety promotion that is offering ambulance, fire, rescue, water rescue, disaster emergency response teams and safer community programme to over 80 Million inhabitants of Pakistan. So far, the service has rescued over 1.4 million victims of various emergencies.

Today, Rescue 1122 has become a largest humanitarian organisation in the country, but the job has not been completed yet, because the mission of the service is to develop an efficient system of emergency care and build safer communities. Therefore, we look forward with the vision Saving Lives: Changing Minds, and every effort is going on to work for injury prevention and safety promotion. Injury prevention research and emergency data is regularly presented to policy makers at local and national levels to formulate an evidence based strategies to bring down the rate of various emergencies. These initiatives are providing basis for the establishment of safer communities in Pakistan.
Epidemiological study on disability causes by injury in the Chinese population
Authors: Dai Dai Jinfang
Published: October 2012

Objective

To describe and analyse the prevalence and epidemiological feature of people with disability caused by injury in the Chinese population, and then to provide the scientific basis for the prevention and control of injury.

Method

The statistical description and inference were used to analyse the data of the Second China National Sample Survey on injury-caused Disability. Cluster analysis was used to analyse the differences in regions.

Result

The overall prevalence of disability caused by injury was 99.68/10 000 which occupied 15.59% of all disability (multiple disability was excluded). Physical disability and hearing disability account for 65.59% and 23.35% of all the injury-caused disability respectively, while those ranked Grade IV and III make up the overwhelming majority (55.14% and 25.83% respectively). There were significant differences in the distribution of injury-caused disability among different age groups (χ2=23 106.14, p<0.001) and gender (χ2=2 161.74, p<0.001). Agedness and men have a higher risk of encountering an injury-caused disability. Five clusters were identified by cluster analysis which injury-caused disability were severe in the fifth (Sichuan province) and. the fourth cluster (Hunan, Chongqing, Guizhou, Ningxia province).

Conclusion

The problem raised by injury-caused disability in the Chinese population cannot be ignored. Physical disability and hearing disability were the two main types. Age, gender and region were related to injury-caused disability and different-aimed strategy should be worked out to decrease the injury-caused disability in China.
Perceptions of ‘emergency’ between health care providers and community
Authors: Chantarasiri J , Nuntaboot K
Published: October 2012

Background

According to the pilot study, it was found that there were various emergency cases. Such phenomena showed that apart from the different definition of emergency given by the Health Care Provider and Community.

Objectives

To discover perceptions of ‘Emergency’ between Health care providers and community.

Methods

The qualitative ethnographic research was used and conducted in the rural area. The data were collected by in-depth interviews and focus groups. The key informants were 84 persons and the general informants were 137 persons. Content analysis was used.

Results

The definition given was presented as both a biological and a social dimension. The community gave the definition of an emergency as it was not only about illnesses, but it was also a social issue affecting lifestyle of individual, family and community. Emergency cases of this aspect included disturbances, controversy, urgent issues and disasters. The severity of the symptoms are difference between Health care providers and community. The Health care providers cited ‘Emergency’ follow through medical criterions and assess the severity according to the medical investigations but the community are more sensational.

Contribution to the Field

If the Health care providers use the view of social perspective towards emergency cases to fulfil the biomedical perspective, the demands of the people will actually be met and it will help the management system of assistance for emergency cases of the community to be completed and will cover all problems especially when using social perspective view. This will lead to the happiness in the community.
Sink or swim? the perceptions of return to work coordinators
Authors: Bohatko-naismith J , Rivett D , James C
Published: October 2012

Background

Returns to Work Coordinator's (RTW) were introduced to the Australian workplace two decades ago and they are now critical in the facilitation of workplace RTW. Training for the role was developed and is considered mandatory in some states. There is no Australian research available to determine if the current training provided is meeting the needs of RTW Coordinators.

Purpose

The study aimed to understand the perceptions and experiences of RTW Coordinators with respect to their current training and to ascertain whether it is meeting their requirements.

Methods

Focus groups were conducted with RTW Coordinators in five capital cities in Australia. RTW Coordinators with a minimum of two years' experience and who were involved in the development and implementation of relevant policies and procedures were recruited. Focus group discussions were recorded, transcribed and coded using a phenomenological approach.

Results

Three key themes relating to the current training available for RTW Coordinators were identified. These were: professional development, specialised trainers and practical content.

Contribution to the Field

RTW Coordinators are pivotal in the RTW process and it is crucial that training they receive provides the necessary skills to perform this role. This study identified the importance of ongoing professional development as a method of supporting RTW Coordinators in the workplace, and providing specialised trainers with a practical approach. The findings will begin to build a body of knowledge in the Australian context and may inform appropriate educational and training standards.
Development and pilot testing of a new acute paediatrics and injury course for ambulance providers in Karachi, Pakistan
Authors: Chandran A , Kazi G , Eckerle M , Qureshi S , Hyder AA , Razzak J
Published: October 2012

Background

Appropriate and timely provision of pre-hospital care is critical for improving outcomes to injury and trauma. Pre-hospital providers in Pakistan as in most low and middle income countries do not receive standardised training in evidence-based acute paediatric care.

Aims/Objectives/Purpose

Develop an Acute Paediatrics and Injury Care (APIC) course tailored to the local context and pilot test the course in ambulance providers in Karachi, Pakistan.

Methods

APIC, a combination didactic and practical exercise-based course, was developed using validated international course materials and modifying them to the local context in collaboration with local paediatric and emergency providers. The course was piloted in 24 ambulance providers who were asked to complete pre and post-course knowledge assessments and a 3 month follow up knowledge retention test.

Results/Outcome

Upon course completion, students exhibited a statistically significant knowledge gain (57.9% in the pre-test to 73.9% in the post-test, p=<0.001). Of the 19 students completing the knowledge retention test, students exhibited statistically significant gain in knowledge in the area of airway management/respiratory distress (56% to 74%, p=0.027), and a trend towards increased knowledge in shock (42% to 68%, p=0.06), fluid administration (74% to 95%, p=0.13) and trauma resuscitation (74% to 84%, p=1.0).

Significance/Contribution to the Field

The APIC course provided ambulance providers in Pakistan with important knowledge gains in paediatric-specific emergency care, particularly in the area of airway management and respiratory distress. Further studies are needed for expansion to a wider audience and to assess the impact of such courses on actual outcomes of paediatric illness, injuries and trauma.
Establishing a trauma registry in a level 1 trauma centre in Subsaharan Africa—challenges and local experience
Authors: Ifesanya AO , Afuwape OO , Rukewe A , Alonge TO
Published: October 2012

Background

In developing countries, the accurate burden of trauma usually cannot be quantified. Our hospital, the largest in the country does not have a trauma registry.

Objectives

We share experiences in establishing a trauma registry in our hospital, reviewing the first 103 cases and identifying the challenges.

Methods

A trauma study group consisting of emergency physicians and 3 trauma surgeons drew up modalities of the project and funding was from personal contributions. A questionnaire was developed and administered to all trauma patients presenting to the emergency room and updated until discharge. Monthly meetings were held by the group to review progress.

Results

Mean age was 34.2±18.2 years with a male: female ratio of 3.1. Most injuries occurred between 13 : 00–18 : 59 h. Average revised trauma score was 11.5±1.1 (range=7–12). Delay before reaching the first hospital was 16.2 h and 24.9 h before arrival at our A&E. Blunt injuries caused 72% and penetrating injuries 14%. About half were traffic crash victims, 12% falls, 7% gunshot and burns 6%. About 62% of injuries occurred on roads. Passers-by provided first aid in 12%, 47% received none. Only one patient received on-scene cardiopulmonary resuscitation. Orthopaedics (41%), Neurosurgery (22%), and Plastic, reconstructive and burns (18%) teams were the most called. Our challenges included duplicate or incomplete documentation, missed cases, cost of registry software, payment of staff, unretrieved questionnaires and cumbersome data spreadsheet.

Significance

The study shows that personal effort could be successful at developing a trauma registry. The use of expensive software is not always necessary.
Who goes where? determining factors that influence where severely injured Canadian children are treated
Authors: Harrington AM , Yanchar N , Pike I , Macpherson AK
Published: October 2012

Background

To date research has suggested that paediatric trauma systems are associated with a reduction in preventable deaths. However, there has been little work to determine what factors are associated with determining where a severely injured paediatric patient is treated.

Aims/Objectives/Purpose

To determine factors that are associated with where a paediatric patient with a severe injury receives definitive treatment. Treatment location will be classified by hospital type; paediatric trauma centre (level I/II), adult trauma centre (level I/II) or other.

Methods

The Discharge Abstract Database will be used to discern factors that are associated with where a severely injured child receives definitive treatment. Children (≤16 years) who have sustained a severe injury (defined by ICD-10 codes) will be isolated. The primary outcome variable will be treatment location classified into three groups by hospital type; paediatric trauma centre (level I/II), adult trauma centre (level I/II) or other. Demographic, hospital and other care related factors will be included in the final adjusted models

Outcome

Analysis is currently underway.

Significance/Contribution

This study will provide an overview of the current functioning of the regional Canadian paediatric trauma systems and what factors are related to definitive care. This will provide key information to address any disparities in access to proper trauma care for severely injured paediatric patients. Additionally, it will allow for future work to determine if where definitive treatment is received impacts on patient outcomes.
Pre-hospital care in Ilorin: a call for action
Authors: Ofoegbu C , Nasir A , Lawal I , Abubakar S , Babalola O , Solagberu B
Published: October 2012

Background

Many fatal injuries may be prevented or their severity reduced by adequate prehospital trauma care. Lack of emergency medical services in Nigeria accounted for significant mortality and morbidity.

Aims/Objectives/Purpose

To evaluate quality and availability of pre-hospital trauma care in Ilorin, Nigeria.

Methods

A prospective study was undertaken at the emergency room (ER) over 4 months period. Intervention at site of injury, mode of transportation, intervention during transportation, person who brought patient to the hospital and injury arrival time was recorded. Data was analysed with SPSS 15.0

Results

A total of 151 patients were included, of which 126 (83.4%) were male. Most injuries 84.8% (n=128) occurred on highway/street. Traffic crashes accounted for 72.2% (109). Only six (4.5%) patients had intervention at the site of injury (four had splinting and two cleansing of external wounds). Only two (1.5%) patients had fracture splinting provided during transport. Patients were brought to hospital by relatives (81, 53.6%), Police/Federal road safety corps (33, 21.8%) and bystanders (24, 15.9%). Only 75 patients had documentation of mode of transport: public vehicles (41, 54.7%), private cars (23, 30.7%), police/Federal Road Safety Corps patron van (6, 8%). only two (2.7%) patients were transported with ambulances. Sixty-six percent of patients arrived in hospital within 1hrs (70% brought by relatives/bystanders, p=0.0001).

Significance/Contribution to Field

This study shows that most injured persons were still first seen and transported by untrained relatives, bystanders or police officers. Training of community members in first respondent care may benefit large numbers of victims of serious and life-threatening injury.
A SAFER CANDLE PROJECT – SOUTH AFRICA
Authors: Mtambeka PP , Schulman D , du Toit N , Rode H , Van As AB
Published: October 2012

Background

There are two main causes of shack fires in South Africa: Fallen candles and paraffin-related burns. These fires lead to devastating consequences and huge economic losses.

Aim/Goal

The goal of this project is to facilitate and promote safer use of candles in a glass jar, with the ultimate aim to prevent fires, burn injuries and deaths caused by fallen candles, targeting individuals and families who live in informal homes.

Material and Methods

Childsafe South Africa personnel conducted a number of trials to test the “Candle in a glass jar” concept. In 2006, the project was piloted in an informal area that exclusively uses candles as source of light. Further demonstration and educational sessions have taken place and over 100,000 jar units have been distributed to various communities to date.

Results

The Safer Candle Project is six years old, and has become one of Childsafe's established programmes. It has been widely accepted and been approved by World Wide Fund for Nature SA (WWF) for Earth Hour 2011& 2012.

Significance

The idea of candle in the glass jar is recommended as its very simple and preventative measure to reduce fires mainly caused by candles tipping. One of its advantages is that it places no financial burden on families, as there are virtually no costs involved.
An audit of burns mortality between November 2007 and June 2008 using mortuary injury data in Lusaka, Zambia
Authors: Mtonga R
Published: October 2012

Lusaka, the Capital City of Zambia, runs a Death Registry Office, which captures all deaths in a catchment area of nearly 2 000 000 people before disposal of the body by burial or cremation.

Objectives

To audit burns-related mortality between November 2007 and June 2009 at the Lusaka Death Registry.

Methods

This was a retrospective study employing all records including Certificates of Deaths, Burial Permits and Postmortem findings. The data was then compared with originating Health centre and Police death Records.

Results

A total of 614 injury-related deaths were recorded with 104 or 16.9% due to burns. The majority 78(75%) involved children under 6 years of age, 27(15%) aged 7–35 years while the rest 10(4%) were over 36 years old. 58(55.8%) were males and 46(44.2%) were female. Dry and wet heat, open fires, hot water, porridge, combustible agents such as petroleum products were the causative agents.

Contribution to the Field

Burns mortality, a largely preventable cause of death in Lusaka, mainly affects children under 6 years of age. Clinician's early and prudent use of antibiotics, bactericidal creams, skin grafting, adequate rehydration and good nutrition can help prevent burns mortality. Studying and taking measures to reduce contact with causative agents will help reduce burns mortality and injury-related mortality overall. Death Registries can be used to not only to show burns mortality trends and causative agents but monitor effectiveness of treatment regimens.
Source of safety information—the importance of a personal appeal for service utilisation among urban families
Authors: Vanya Jones , Andrea Gielen , Eileen McDonald , Chris Gibbons M
Published: October 2012

Background

Interpersonal dialogue and the Internet have been established as sources of health information. However, little is known about how urban families learn about community programmes.

Aims

The aims of this study are to determine: (1) sources of information for community programmes among urban residents and (2) if source of information is associated with utilising a free smoke alarm distribution programme.

Methods

Surveys were conducted with a random sample of city residents to measure safety information. χ2tests were used to determine differences between sources of information and knowledge and utilisation of the smoke alarm programme.

Results

Of the 603 participants interviewed most received information from friends/neighbours (64%), newspapers (54%), and the Internet (35%). Women compared to men were more likely to use personal (88% and 81%, respectively, p=0.01) and sources of information (78% and 67%, p=0.01). Compared to those with a high school diploma, those without one were less likely to identify the Internet (p=0.01) as an informational source. Those who cited personal and print sources were more likely to have heard about the smoke alarm programme (89% and 79%, respectively, p=0.01) compared to those who cited Internet or television and radio (34% and 58%, respectively, p=0.01). Individuals who used personal sources were more likely to have participated in the smoke alarm programme (p=0.01).

Significance

This work underscores the continued importance of personal appeals to promote safety services in communities.
Fire-related injuries requiring inpatient care: descriptive analysis, incidence and patients during 2000–2009
Authors: Pirjo Lillsunde , Kari Haikonen , Philippe Lunetta , Anne Lounamaa
Published: October 2012

Background

Incidence of fire-related deaths in Finland is higher than in majority of the westernised countries exceeding 2 deaths/100 000 persons. No nationwide epidemiological study focused on severe fire-related injuries existed.

Aims/Objectives/Purpose

This study attempts to provide comprehensive overview on injuries due to smoke, fire and flames during 2000–2009 in Finland.

Methods

Patients with fire-related injury following with inpatient care during 2000–2009 were studied in a register based study.

Results/Outcome

Annually 293 patients on average (population 5.3 million) had fire-related injuries with in-patient care. Majority of these patients were males (74%). Females were older in general having mean age of 51 years while mean age for males was 40 years. During the 10 year period the mean age of both males and females has been increasing.

Significance/Contribution to the Field

The nationwide picture was provided and the findings showed several implications for prevention. House fires were the most typical for late middle aged and older while injuries from campfires, barbecues, incinerating and flammable substances were distinctively more associated with younger age. Interesting is also the increasing trend among combustion gas poisonings.
The model school zone project at St. Andrews School supports the decade of action for road safety: Safe Kids Philippines experience
Authors: Rolloque A , Consunji R , Perez MT , Alcantra M , Azas PD
Published: October 2012

Background

Safe Kids Philippines (SKP) observed that the walking environments of many schools in the Philippines are not safe for children pedestrians. Thus SKP joined Safe Kids Worldwide to implement the Model School Zone project.

Aims/Objectives/Purpose

To convert St. Andrew's School into a Model School Zone, to improve the safety of pedestrians by evaluating the school zone, and to implement interventions including permanent environmental and infrastructure improvements are the goals of the project.

Methods

SKP identified a school, solicited the commitments of the stakeholders from the government and community. The project has three phases: collection of baseline data, developing interventions and evaluation of the project. The Photovoice Methodology, where students took photos of the walking environments and wrote about their perceptions, was also utilised.

Results/Outcomes

Findings through the school zone assessment tool were: the walking environments were chaotic. There was a mix of pedestrians and vehicles on the roadway. A total of 600 motorcycles of more than 2000 vehicles were the majority among the road users in an hour. Sidewalks were not available. Traffic enforcers did not know standard signages. Highways were used as parking lots. About 2000 students were in need pedestrian safety education. After presenting data to stakeholders, interventions addressed education, engineering and enforcement needs.

Significance/Contribution to the Field

In aligning to the goals of the Decade of Action for Road Safety, SKP recognises that baseline data is as important as interventions and evaluation in reducing road traffic injuries. In this direction, SKP is connecting pathways for a vibrant and safer future.
Risk of fracture in children with epilepsy: a cohort study using the general practice research database
Authors: Prasad V , West J , Kendrick D , Sayal K
Published: October 2012

Background

Epilepsy is thought to be associated with an increased risk of fractures but information on the estimated risk, especially in children, has been limited. Childhood injuries, including fractures, are a leading cause of morbidity and mortality in the UK and worldwide.

Aims

To measure the rates of fracture injuries in children and young people with epilepsy aged 0–24 years compared to children without epilepsy in the UK primary care population.

Methods

A historical cohort study was conducted using data from the General Practice Research Database (GPRD) from 1 January 1987 to 31 December 2009. All participants with epilepsy (aged 0–24 years) were frequency-matched, by 5-year age band and practice, to up to five participants without epilepsy. Incidence rate ratios for fracture were estimated and adjusted for potential confounders.

Results/Outcome

There were a total of 100 524 in the cohort. Of these 74 206 did not have epilepsy and 22 143 had epilepsy based on our inclusion criteria. Final results from the analysis on fracture rates will be presented at the conference.

Significance/Contribution to the Field

Accurate estimates of the risk of fracture in children with epilepsy compared to children without epilepsy would be useful to inform treatment decisions, educate families on fracture risk at the point of diagnosis and to inform lifestyle choices.
Adult opinions about the age at which children can be left home, bathe, or bike alone, Injury Control and Risk Survey (ICARIS), 2007–2008
Authors: Karin Mack , Ann Dellinger , Bethany West
Published: October 2012

Background

Supervision of children is widely considered a critical factor in injury prevention, yet it is poorly understood.

Purpose

This study describes adult opinions about the need for child supervision in various activities.

Methods

Data come from a representative survey of US adults. Respondents were asked to suggest the minimum age a child could safely: be left alone in their house; take a bath alone; ride a bike alone in a low traffic area. Respondents who reported having children were also asked if their child had ever been allowed to: play outside alone, or play alone in a room in the house, for more than 10 min; be in the bathtub with another child; and be in a bathtub alone.

Results

Overall the mean age that adults believed a child could be home alone was 13 years (95% CI 12.9 to 13.1), bathe alone was 7.5 years (95% CI 7.4 to 7.6), or bike alone was 10.1 years (95% CI 10.0 to 10.3). There were no significant differences by gender or age of respondent. There were significant differences in opinions by income, education, and race. For example, white respondents were significantly more likely to report a younger age (7.2 years) for bathing alone than Hispanic (8.3 years) or African American (8.4 years) respondents.

Significance

Assessing adult's understanding of the appropriate age for independent action helps set a context for providing guidance on parental supervision. Guidelines offered to parents should consider social norms as well as child development stages, and messaging can then be tailored by income, education and race.
Childhood injury surveillance in a Nigerian teaching hospital
Authors: Ofoegbu C , Nasir A , Burrows S , Abdur-Rahman L , Babalola O , Yusuf A , Solagberu B
Published: October 2012

Background

Information on childhood injury in Nigeria is scanty. There is a need to establish and strengthen childhood injury monitoring and reporting as a useful tool for childhood injury control.

Aims/Objectives/Purpose

The aim of this pilot study was to develop a childhood injury surveillance system at University of Ilorin Teaching Hospital, Nigeria.

Methods

All children aged ≤15 years presenting with injuries at the emergency room (ER) during a 10-month period were included. A structured form was designed to obtain information on injury history from parents/guardians. Clinical details were extracted from medical records. Data were compared using χ2/Fisher's exact test as appropriate.

Results/Outcome

A total of 111 children presented to the ER with injuries (10% of all patients seen). The median age was 72 months, with a male : female ratio of 1.9 : 1. Leading mechanisms of unintentional injuries were road traffic crashes (RTC) (44%), falls (37%) and burns (13%). In 58% of RTCs, the injured child was a pedestrian. Injuries mostly occurred in homes (43%) and on streets/highways (39%). Major injuries involved the head and neck (42%) and extremities (27%). Most injuries were moderate to severe (76%) with 12% resulting in death. RTCs accounted for 46% mortality. Mortality was significantly influenced by age (p=0.028), nature of injury (p=0.013) and injury severity (p=0.000).

Significance /Contribution to the Field

The injury surveillance system provided valuable information on childhood injuries presenting to the ER. The results suggest that improved home and road safety and increased parental supervision are needed to reduce childhood injury.
National survey of the injury prevention activities of sure start children's centres
Authors: Watson MC , Mulvaney C , Kendrick D , Stewart J , Coupland C , Hayes M , Wynn P ,   on behalf of the Keeping Children Safe at Home programme
Published: October 2012

Background

Children's Centres were an important part of the UK Government's 10-year childcare strategy and were established across England to improve health outcomes for children. Injury prevention is one of the many roles Centres have in protecting and promoting children's health. The Centres have the potential to make significant contributions to home safety for children under 5.

Aims/Objectives/Purpose

To ascertain what activities Children's Centres are undertaking to prevent or reduce unintentional injuries in the under fives.

Methods

A postal questionnaire was sent to a sample of Children's Centre managers. Cluster sampling was used and 694 Centres were included in the sample. The questionnaire included questions on current activities, knowledge and attitudes to child injury prevention, child health priorities and partnership working.

Results/Outcome

Responses were received from 56% of Centres. Most respondents (59%) did not know if there was an injury prevention group in their area, and 21% did not know if there was a local home safety equipment scheme. Only 11% knew the major cause of injury deaths in children under five. Lack of staff time and funding were seen as important barriers by staff to undertake injury prevention activities. There are considerable differences in the injury prevention activities between Children's Centres. There were gaps in knowledge both about injuries and local prevention initiatives.

Significance/Contribution to the Field

This is the first study analysing the unintentional injury prevention activities of Children's Centres. They need support (including training and resources) if they are to fulfil their unintentional injury prevention roles.
Guerrilla marketing in child injury prevention—winning the war to keep kids safe in New Zealand
Authors: Rola A
Published: October 2012

Background

Unintentional childhood injury is a serious but neglected public health issue in New Zealand. The casualties are high (two children killed every week and 8184 children hospitalised every year), and the economic burden is immense—it cost the government NZ$146.6 million in child injury claims during the 2007/2008 financial year.

Unintentional childhood injury is not seen as a priority issue, has few allies, and receives little support or recognition. The injury prevention workforce is facing an uphill battle, and Safekids, the child injury prevention service for New Zealand, is forced to pursue conventional goals with unconventional methods—using Guerrilla Marketing tactics. And somehow, Safekids New Zealand is winning the war.

Aims/Objectives/Purpose

The purpose of this study it to present Guerrilla Marketing as an effective public health tool when funding or resources are limited or non-existent. It presents tactics used during the Safekids Campaigns of 2009–2011 (Child Passenger and Driveway Runover Injury).

Methods

Safekids travels across the country to establish a network of coalitions to fight for child injury prevention. Safekids ‘arms’ communities with information and tools that encourage low-cost, innovative means to promote Safekids messages.

Results/Outcome

Guerrilla Marketing played an important role during the 2009–2011 Safekids Campaigns, raising national awareness on unintentional child injury issues, moved the Government to consider law change, and empowered injury prevention workers across the country.
The indigenous connection/Maori—aotearoa (NZ) context
Authors: Blackie Tohiariki
Published: October 2012

Background

On average, six Maori children are admitted to hospital every day for an unintentional injury. The main goal of Tamariki Haumaru ki Aotearoa (Safekids NZ) is to reduce the incidence and severity of unintentional injuries to our NZ children aged 0–14 years. In order to steer that process of addressing an indigenous focus ‘back to the future’ one needs to gain a basic understanding of some traditional aspects of Maori Health and well-being.

Aims/Objectives/Purpose

Provide a relevant Spectrum of Injury Prevention model that will serve as a pictorial representation of what will work in Aotearoa. Provide Safekids coalition leaders and collaborative injury prevention networks with proactive initiatives to recognise and address ‘The Indigenous Connection’.

Methods

A brief look at unintentional child injury mortality and morbidity for the indigenous peoples of Aotearoa—New Zealand. Identify a generic model that can be adopted to actively address indigenous issues and possibly reduce the incidence of unintentional Injuries.

Outcomes

To apply the indigenous Maori traditional concepts and philosophies from Birthing to Te Kohanga Reo (Early Childcare Language Nests) through Kura Kaupapa Maori (Immersion Primary Schools). These early seeds sown are the critical seeds for ‘safety’ across Maori indigenous pedagogy.

Conclusions

These idealolgies have been presented in many Maori Health promotion ‘models’—Te Whare Tapawha (Durie 1998), Te Pae Maahutonga (Durie 2000) and Kia Uruuru Mai a Hauora (Ratima 2001), all evolving from a traditional base of concepts, values, principles, processes and strategies with an underlying purpose of connecting ‘pathways for a vibrant and culturally safer future’.
The incidence of childhood injury following an ‘Inland Tsunami’: the experience of Toowoomba
Authors: Melissa Kaltner
Published: October 2012

Background

In January of 2011, the area of Toowoomba and Lockyer Valley in Queensland, Australia, experienced unprecedented flash flooding. Witness descriptions of a ‘wall’ of water reported to be up to 7 m (7.65 yards) in height led to the term ‘inland tsunami’ being adopted to describe the natural disaster. A large body of evidence highlights the negative psychosocial impact of natural disaster exposure, which has been hypothesised to increase the incidence of both intentional and unintentional childhood injury. Limited evidence suggests peaks in child injury following natural disasters, however further research is necessary to confirm these observations in varied natural disaster contexts.

Aims

The study outlined in this presentation examined physical injury incidence in Toowoomba and Lockyer Valley resident children during 12 month periods pre- and post-flash flooding to examine the association between natural disaster and child injury incidence.

Methods

Retrospective review of discharge records from two 12-month periods at Toowoomba Base Hospital was utilised to ascertain the incidence of physical injury in Toowoomba and Lockyer Valley resident children aged 0–14 years pre- and post-flash flooding. Differentiation of abusive, accidental and undetermined intent mechanisms of injury was made through ICD coding.

Results

Incidence was calculated for each period using a denominator of child population numbers in the geographic area, and a numerator of injury occurrence for each injury type in the 12-month periods pre- and post-natural disaster occurrence. Rates ratios were then used to examine change in incidence for each injury mechanism between pre- and post-flash flood periods.

Contribution to the Field

This study provides evidence of increased accidental and inflicted child injury rates following the occurrence of natural disaster, supporting previous international examinations. The study findings highlight areas for injury prevention need to reduce injury burden in children following natural disaster experience.
The effectiveness of a school-based European injury prevention programme on adolescent risk behaviour in a South African setting
Authors: Najuwa Arendse , Samed Bulbulia , Ashley van Niekerk , Seedat Mohamed
Published: October 2012

Background

Unintentional injuries are identified as a major health concern among adolescents. The one factor that can contribute significantly to their increased rates of injury is their risk taking behaviour. Evidence shows that certain education based strategies in schools can promote safer behaviours, though it is unclear whether any changes are sustained. The current study formed part of a European-based educational programme that was implemented in a low-income South African context to help improve adolescents' attitudes and knowledge about injuries.

Aim

To assess changes in grade 11 high school learners' injury prevention knowledge and attitudes, after exposure to a comprehensive educational programme on the European Code Against Injuries (ECAI).

Methods

A randomised pre-test and post-test design was used to evaluate the outcome of an injury prevention educational programme shown to grade 11 adolescents living in a low-income community in South Africa. There were 56 participants in the control and 57 participants received the intervention. Pre- and post-level assessment took place before and after the intervention. The instrument covered knowledge and attitudes associated with self-reported potentially harmful and protective behaviours with regards to injury. Both descriptive and bi-variate analysis was undertaken.

Results

Adolescents that received the ECAI programme did show some improvements in knowledge when pre- and post-measures were compared, however, it was found not to be statistically significant.

Significance to the Field

These findings suggest that the multimedia approach did not significantly improve adolescents' knowledge and attitudes about injuries. Future studies should consider a contextually congruent curriculum that examines injury prevention within low-income settings. Reinforcement of these injury prevention messages at regular intervals may contribute to a significant shift in learners' knowledge and attitude about safety promotion.
Increases in best practice child restraint use among children aged 2–5 years in low socioeconomic areas after introduction of mandatory child restraint laws in NSW Australia
Authors: Brown J , Keay L , Hunter K , Bilston L , Simpson J , Ivers R
Published: October 2012

Background

In 2009 the Australian Road Rules were modified to specify use of age-appropriate restraints for children up to 7 years. Implementation of the new laws was expected to increase optimal restraint use, but international studies have reported little or no effect of legislation in low income and minority groups.

Aims/Objectives/Purpose

To compare restraint practices in children aged 2–5 years in low socioeconomic areas of NSW before and after introduction of legislation specifying age-appropriate restraint use.

Methods

Direct observations of children aged 2–5 years at sites within low socioeconomic areas were used to assess restraint practices. A pre-legislation sample was drawn from a 2008 cross-sectional observation survey (n=106) and post-legislation data were collected in 2010 from control sites in a cluster randomised trial (n=360). Logistic regression was used to compare restraint practices adjusting for variations in demographic distributions between the samples.

Results/Outcome

Age-appropriate restraint use increased from 41% to 73%, and correct use from 34% to 47% in the post-legislation sample. After controlling for child's age, parental education, income and language spoken at home, the odds of children in the post-legislation sample being appropriately restrained were 2.2 times greater (95% CI 1.4 to 3.6) and the odds of them being correctly restrained were 1.6 times greater (95% CI 1.0 to 2.7) than children in the pre-legislation sample.

Significance/Contribution to the Field

While there appears to have been an improvement in child restraint practices in low income populations following implementation of laws mandating age-appropriate restraint, the results indicate a need for further interventions to increase the number of children optimally restrained.
Unintentional injuries and the home environment: a qualitative study
Authors: Ablewhite J , Kendrick D , Watson M , Shaw I
Published: October 2012

Background

Childhood unintentional injury is a leading cause of death and disability in the UK.

Aims

To gain an understanding of parental perceptions of child unintentional injury risks, safety practices including parental supervision and implementation of safety information/advice. To explore reasons for inequalities in unintentional injury rates in children aged 0–4 years.

Methods

Qualitative interviews with parents of a child aged 0–4 years; 16 with mothers living in an area of socio-economic disadvantage and 21 with mothers living in an area of relative affluence. Thematic analysis was used to analyse the data.

Results

Low income mothers living in disadvantaged areas are not less aware of child home injury risks. Some parents perceive the risk of child injury based on their own experiences with their child rather than describing child injury risks with a more general awareness. Parents from both groups perceive a difference between ‘acceptable’ versus ‘unacceptable’ unintentional injuries. Parents do not seek to prevent ‘acceptable’ unintentional injuries. Listening is used as a supervision strategy for boys more than girls. Older children as supervisors of siblings are perceived differently by parents from different social groups. Parents living in circumstances of socio-economic disadvantage face greater barriers to adapting their homes. Parents living in disadvantaged areas describe a fear of talking to professionals due to a fear of the consequences.

Contribution to the Field

Few qualitative studies have investigated childhood unintentional injury by exploring differences between parents living in different socio-economic groups, in order to generate explanations for differential injury rates.