bluuebunny/crossref_metadata_2025_split huggingface dataset:
Demographic risk factors for injury among Hispanic and non-Hispanic white children: an ecologic analysis
Authors: Anderson Craig L , Agran Phyllis F , Winn Diane G , Tran Cecile 
Published: December 2008

Objectives—To determine the effects of neighborhood levels of poverty, household crowding, and acculturation on the rate of injury to Hispanic and non-Hispanic white children.Setting—Orange County, California.Methods—An ecologic study design was used with census block groups as the unit of analysis. Measures of neighborhood poverty, household crowding, and acculturation were specific to each ethnic group. Poisson regression was used to calculate mutually adjusted incidence rate ratios (IRRs) corresponding to a 20% difference in census variables.Results—Among non-Hispanic white children, injury rates were more closely associated with neighborhood levels of household crowding (adjusted IRR 2.36, 95% confidence interval (CI) 1.22 to 4.57) than with neighborhood poverty (adjusted IRR 1.06, 95% CI 0.89 to 1.26). For Hispanic children, the strongest risk factors were the proportion of Hispanic adults who spoke only some English (compared with the proportion who spoke little or no English, adjusted IRR 1.26, 95% CI 1.04 to 1.53) and the proportion who were US residents for <5 years (adjusted IRR 1.20, 95% CI 1.001 to 1.43). Neighborhood levels of household crowding were not related to injury among Hispanic children (adjusted IRR 0.98, 95% CI 0.89 to 1.08), but surprisingly, neighborhood poverty was associated with lower injury rates (adjusted IRR 0.89, 95% CI 0.81 to 0.97).Conclusions—Cultural and geographic transitions, as well as socioeconomic differences, appear to contribute to differences in childhood injury rates between ethnic groups.
A case-control study of risk factors for playground injuries among children in Kingston and area
Authors: Mowat David L , Wang Feng , Pickett William , Brison Robert J 
Published: December 2008

Objective—To determine the risk for injury associated with environmental hazards in public playgrounds.Setting—One hundred and seventeen playgrounds operated by municipalities or school boards in and around Kingston, Ontario, Canada.Methods—A regional surveillance database was used to identify children presenting to emergency departments who were injured on public playgrounds; each case was individually matched (by sex, age, and month of occurrence) with two controls—one non-playground injury control, and one child seen for non-injury emergency medical care. Exposure data were obtained from an audit of playgrounds conducted using Canadian and US safety guidelines. Exposure variables included the nature of playground hazards, number of hazards, frequency of play, and total family income. No difference in odds ratios (ORs) were found using the two sets of controls, which were therefore combined for subsequent analysis.Results—Multivariate analysis showed strong associations between injuries and the use of inappropriate surface materials under and around equipment (OR 21.0, 95% confidence interval (CI) 3.4 to 128.1), appropriate materials with insufficient depth (OR 18.2, 95% CI 3.3 to 99.9), and inadequate handrails or guardrails (OR 6.7, 95% CI 2.6 to 17.5).Conclusion—This study confirms the validity of guidelines for playground safety relating to the type and depth of surface materials and the provision of handrails and guardrails. Compliance with these guidelines is an important means of preventing injury in childhood.
All terrain vehicle ownership, use, and self reported safety behaviours in rural children
Authors: Warda Lynne , Klassen Terry P , Buchan Norma , Zierler Amy 
Published: December 2008

Objectives—To describe all terrain vehicle (ATV) ownership, access, use, and safety behaviours in rural Manitoba children.Methods—Questionnaire administered to a convenience sample of grade 6 students attending an agricultural fair.Results—162 grade 6 children participated. The mean age was 11.4 years, and 46% were male. 125 students (77%) reported having access to ATVs, including 69 four wheeled, 24 three wheeled, and four both three and four wheeled ATVs. ATV experience was reported in 95 students, significantly more often in males and among those with a family owned ATV, with no difference between children living on a farm and in a town. Use of helmets and protective clothing was inadequate (10–40%), and dangerous riding habits common, with males and children living on a farm reporting significantly fewer desirable behaviours.Conclusions—ATVs are commonly used by children in rural Manitoba, with inadequate protective gear and dangerous riding habits. Mandatory rider training, consumer and dealer education, and legislation enforcement could improve ATV safety in this population.
Rates of, and the factors affecting, cycle helmet use among secondary schoolchildren in East Sussex and Kent
Authors: Cryer P Colin , Cole Jeremy , Davidson Leslie L , Rahman Mohammed , Ching Vivian , Goodall Janet B 
Published: December 2008

Objectives—To assess the level of cycle helmet wearing among young people in two counties in the South East of England in 1994, and to identify the factors associated with helmet wearing.Design—Cross sectional survey in a convenience sample.Setting—Secondary schools in East Sussex and Kent.Subjects—Students in year 7 (aged 10–12 years) and year 11 (aged 14–16 years).Main outcome measures—Self reported “always wears a helmet”.Results—Among those who ride a bicycle, 32% of boys and 29% of girls aged 10–12 years, and 14% of boys and 10% of girls aged 14–16, reported that they always wear helmets. The variables that were most consistently associated with helmet wearing (that is significantly associated with helmet wearing in at least five of the six age, sex, and county subgroups) were: “parental encouragement to wear a helmet”, “closest friend wears a helmet”, “belief that laws that make children wear helmets are good”, and “sometimes rides off-road”.Conclusions—The self reported rates of always wearing a cycle helmet in East Sussex and Kent are consistent with overseas findings for populations who had not been exposed to intensive helmet promotion. The evidence suggests that parental encouragement has a favourable effect on rates of cycle helmet use among secondary schoolchildren, which is separate from and additional to peer influences. When designing a helmet promotion programme, therefore, it will have added impact if both parents and children are addressed.
Evaluation of a bicycle skills training program for young children: a randomized controlled trial
Authors: Macarthur Colin , Parkin Patricia C , Sidky Malak , Wallace Will 
Published: December 2008

Objective—To evaluate the effectiveness of a skills training program in improving safe cycling behavior, knowledge, and attitudes in young children.Methods—Grade 4 children from six elementary schools in East York (a borough of Metropolitan Toronto) participated. The intervention—playground based instruction on bicycle handling skills by certified instructors—was randomly allocated to three schools. Altogether 141 children participated: 73 in the intervention group and 68 in the control group, with follow up evaluations available on 117 (83%). The primary outcome was safe cycling behavior (straight line riding, coming to a complete stop, and shoulder checking before a left turn). A self report questionnaire collected data on knowledge and attitudes. Baseline assessments were made in June, with follow up evaluations in September, 1995.Results—The prevalence of safe cycling behaviors at follow up in the intervention and control groups respectively, were: straight line riding (90%v88%; p=0.782), coming to a complete stop (90%v76%; p=0.225), and shoulder checking (0%v2%; p=1.000). Over time (from baseline to follow up) children in both groups were more likely to maintain straight line riding, less likely to ride on the sidewalk, and less likely to consider that a car had more right to the road.Conclusions—This brief skills training program was not effective in improving safe cycling behavior, knowledge, or attitudes among grade 4 children.
Fractures among children: incidence and impact on daily activities
Authors: Kopjar Branko , Wickizer Thomas M 
Published: December 2008

Objectives—The study's objective was to examine incidence of fractures and associated activity restriction among children aged 0–12 years.Design—Injuries were prospectively recorded over the four year period from 1992–95 in a cohort of children aged 0–12 years, representing 193 540 children years. Information about length and extent of activity restriction was collected from parents by a mailed questionnaire for a subsample of 192 children with a fracture.Results—A total of 2477 fractures occurred in the study population (128 per 10 000 children annually). The incidence increased linearly with age, by 14 cases per 10 000 children year for each year of age. Boys and girls showed similar patterns of fracture occurrence. There was a significant difference in length of activity restrictions for different types of fractures. The mean and 95% confidence interval (CI) of activity restricted days for leg fractures were 26 (95% CI 7 to 45) days, for arm fractures, 14 (95% CI 8 to 20) days, and for other fractures, 5 (95% CI 1 to 8) days. Arm fractures represented 66% of the cases and 62% of the activity restricted days; leg fractures 19% of cases and 33% of all activity restricted days; and other fractures 16% of the cases but only 5% of the activity restricted days in this population.Conclusion—The incidence of fractures increases in childhood. Different types of fractures among children cause different amounts of activity restriction.
Characteristics of a gun exchange program, and an assessment of potential benefits
Authors: Romero Michael P , Wintemute Garen J , Vernick Jon S 
Published: December 2008

Objectives—To describe a gun exchange program and assess potential benefits for participants and host communities.Methods—Mail survey of participants in a Sacramento, California gun exchange program, August 1993; the response rate was 79%. Comparative data were obtained from nationwide polls of gun owners.Results—Most (62%) respondents were men; 40% were more than 55 years old; none was less than 25. Concern that children might find and use the gun was the most frequently cited reason for participating (46% of respondents). Of 141 firearms exchanged, 72% were handguns; 23% of respondents indicated that the guns they turned in were not in working order. Of respondents who owned a gun at the time of the program (rather than those who owned no guns and turned in a gun owned by someone else), 41% owned no guns after participating; the prevalence of handgun ownership declined from 79% to 32%. Those who continued to own guns were as likely as gun owners nationwide to keep a gun loaded in the house (odds ratio (OR) 0.9, 95% confidence interval (CI) 0.4 to 1.7) or to carry a gun with them (OR 1.5, 95% CI 0.6 to 3.8).Conclusions—Gun exchange programs may reduce risk for firearm violence among some participants, but a number of factors limit their overall benefits to host communities.
Motor vehicle related injuries among American Indian and Alaskan Native youth, 1981–92: analysis of a national hospital discharge database
Authors: Quinlan Kyran P , Wallace L J David , Furner Sylvia E , Brewer Robert D , Bolen Julie , Schieber Richard A 
Published: December 2008

Objective—To describe national trends in hospitalizations for motor vehicle related injuries among children and youth (0–24 years) of the United States Indian Health Service (IHS) from 1981–92.Design—Descriptive epidemiologic study of the E coded national hospital discharge database of the IHS.Results—From 1981 to 1992, the age standardized annual incidence of motor vehicle related injury hospitalizations (per 100 000 population) among American Indian and Alaskan Native (AI/AN) youth decreased more than 65% from 269 to 93. Substantial declines in hospitalization rates for all age and sex groups, all IHS areas, and most injury types were seen over this time. Injuries to vehicle occupants accounted for 78% of all motor vehicle related injury hospitalizations. The annual incidence of hospitalization (per 100 000 population) ranged from 291 in the Billings (Wyoming/Montana) and Aberdeen (the Dakotas) areas to 38 in the Portland area (Pacific Northwest).Conclusions—National motor vehicle related injury hospitalization rates of AI/AN children and youth decreased significantly from 1981–92. This may be due to a reduction in the incidence of severe motor vehicle related trauma, changing patterns of medical practice, and changes in the use of services. Additional measures, such as passage and enforcement of tribal laws requiring the use of occupant restraints and stronger laws to prevent alcohol impaired driving, might further reduce the incidence of serious motor vehicle related injuries in this high risk population.
Bicycle helmet promotion among low income preschool children
Authors: Britt John , Silver Ilene , Rivara Frederick P 
Published: December 2008

Objective—To evaluate the effectiveness of a multifaceted bicycle helmet promotion program for low income children attending preschool enrichment programs throughout Washington State.Study sample—Preschool Head Start programs that conducted routine home visits among their enrolled families at least five times during the school year were eligible. Eighteen sites and 880 children met this criterion and were able and willing to carry out evaluation activities. Two hundred children were from control sites where no helmet promotion activities were carried out.Intervention—Classroom activities with children, education of parents during school meetings and home visits, fitting and distribution of helmets, a bicycle skills and safety “rodeo” event, and requiring children to wear helmets while riding on school grounds.Evaluation methods—Regularly scheduled home visits were used to observe helmet use of enrolled preschool children before and after the promotion program. Home visitors requested parental permission for enrolled children to ride, and then noted whether the child wore a helmet.Results—Helmet use in the intervention group more than doubled, from 43% to 89%, while use in the control group increased from 42% to 60% (p<0.05 for intervention group changesvcontrol group changes).Conclusions—This multifaceted helmet promotion program successfully increased helmet use. Similar home visit protocols may be useful to evaluate the impact of other injury intervention programs.
Did changes in minimum age drinking laws affect adolescent drowning (1970–90)?
Authors: Howland Jonathan , Birckmayer Johanna , Hemenway David , Cote Jennifer 
Published: December 2008

Objective—To test the hypothesis that changes in the minimum legal drinking age (MLDA) laws would affect drowning among adolescents, the effects of changes in state MLDA laws on drowning were examined for the targeted (18–20 years) and two adjacent (15–17 years and 21–23 years) age groups, over a period of 21 years (1970–90).Methods—Poisson maximum likelihood regression was used to estimate the effects of both lowering and increasing the MLDA. The dependent variable in these analyses was the number of drownings per state per year for the age groups observed. At first only state and year effects were controlled for and then any other variable potentially associated with the incidence of drowning was included. The other control variables included proportion of population living near border states with lower MLDA laws, urbanicity, unemployment, divorce, education, poverty, beer tax, and proxy measures for MLDA law enforcement.Results—No significant association between drowning and MLDA was found for any of the age groups studied.Conclusion—It is concluded that MLDA laws are not an important public policy strategy for affecting drowning rates among adolescents and young adults.
Measuring community/environmental interventions: the Child Pedestrian Injury Prevention Project
Authors: Stevenson Mark , Iredell Helena , Howat Peter , Cross Donna , Hall Margaret 
Published: December 2008

Objectives—To assess the effectiveness of community/environmental interventions undertaken as part of the Child Pedestrian Injury Prevention Project (CPIPP).Setting—Three communities (local government areas) in the Perth metropolitan area, Western Australia.Methods—A quasiexperimental community intervention trial was undertaken over three years (1995–97). Three communities were assigned to either: a community/environmental road safety intervention and a school based road/pedestrian safety education program (intervention group 1); a school based road/pedestrian safety education program only (intervention group 2); or to no road safety intervention (comparison group). Quantification of the various road safety community/environmental activities undertaken in each community during the trial was measured, and a cumulative community activity index developed. Estimates of the volume and speed of vehicular traffic were monitored over a two year period.Results—Greater road safety activity was observed in intervention group 1 compared with the other groups. A significant reduction in the volume of traffic on local access roads was also observed over the period of the trial in intervention group 1, but not in the remaining groups.Conclusions—The findings indicate that the various community/environmental interventions initiated in collaboration with CPIPP in intervention group 1 contributed, in part, to the observed reduction in the volume of traffic. A combination of community/environmental interventions and education are likely to reduce the rate of childhood pedestrian injury.
Unintentional poisoning hospitalisations among young children in Victoria
Authors: Hoy Julie L , Day Lesley M , Tibballs James , Ozanne-Smith Joan 
Published: December 2008

Objectives—To describe the epidemiology of unintentional childhood poisoning hospitalisation in Victoria, Australia, in order to monitor trends and identify areas for research and prevention.Methods—For children under 5 years, all Victorian public hospital admissions, July 1987 to June 1995, due to unintentional poisoning by drugs, medicines, and other substances were analysed. Similar cases were also extracted from the database of the Royal Children's Hospital intensive care unit, Melbourne for the years 1979–91. Log linear regression modelling was used for trend analyses.Results—The annual average childhood unintentional poisoning rate was 210.7 per 100 000. Annual rates for males consistently exceeded those for females. The most common agents were those acting on the respiratory system and on smooth and skeletal muscles (muscle relaxants, cough and cold medicines, antiasthmatics), aromatic analgesics (paracetamol), and systemic agents (including antihistamines).Further investigation is justified for cardiac agents, some respiratory agents, and asthma medications.Conclusions—Childhood poisoning hospitalisation rates have not decreased in Victoria over recent years. A focused, agent specific approach, as well as a series of generic measures for the prevention of poisoning to children under 5 is advocated. The ongoing surveillance, collection and analysis of data, in addition to research on specific poisoning agents are essential components of any prevention strategy.
Child and adolescent injury and death from urban firearm assaults: association with age, race, and poverty
Authors: Powell Elizabeth C , Tanz Robert R 
Published: December 2008

Objective—To describe rates and trends in the incidence of non-fatal and fatal firearm assault among children (16 years old or younger) over an 11 year period in Chicago, Illinois and to identify the socioeconomic characteristics of community areas where assaults are common.Methods—The Chicago Police Department (CPD) records from 1986 through 1996 were reviewed for children assaulted with a firearm. United States census data for 1990 for Chicago were used to calculate incidence rates; census data were also used for community area (defined by census tract) socioeconomic descriptions.Results—The CPD recorded 11 163 pediatric firearm assaults during the study period: 10 571 non-fatal and 592 (5%) fatal. From 1986 through 1996 non-fatal assaults more than doubled, with the highest rates in 1994; fatal assaults tripled, with rates peaking in 1993–94. Significant increases in non-fatal firearm assaults occurred among black and Hispanic males and females. In 1994, compared with white males, the relative risk of non-fatal assault was 7.0 (95% confidence interval (CI) 5.3 to 9.1) for black males and 3.3 (95% CI 2.5 to 4.4) for Hispanic males; the relative risk was 1.5 (95% CI 1.1 to 2.1) for black females. A handgun was the firearm used in most assaults (88% of non-fatal and 84% of fatal).Within community areas, the correlation between non-fatal and fatal assault incidence was strong (r=0.80, p<0.001). The proportion of families with income below the 1989 poverty level ($12 674) and the per cent black race in the community area together accounted for 70% of the variance in assault rates.Conclusions—From 1986 to 1994 there were significant increases in both non-fatal and fatal firearm assaults, usually by handguns; thereafter, rates declined. Urban children who were victims of non-fatal firearm assault appear to come from the same population as those who suffer fatal assaults. Black and Hispanic youth living in poverty were at particular risk.
What pediatricians can do to further youth violence prevention—a qualitative study
Authors: Barkin Shari , Ryan Gery , Gelberg Lillian 
Published: December 2008

Objective—Youth violence is a public health problem world wide. However, the United States has the worst rate of youth violence among industralized countries. This study was conducted to learn what pediatricians, community leaders, and parents think the doctor's role is in youth violence prevention during the well-child examination for children.Methods—Interviews were conducted with pediatricians, community leaders, and parents living or working in Los Angeles, California.Results—All three groups interviewed believed that the physician should incorporate violence prevention counseling as part of the well-child examination. The mechanism of action differed for the three groups. Almost half of pediatricians' statements focused on their role as prevention counselor, with respect to such issues as appropriate discipline and gun safety. One third of community leaders' statements, however, related to physician referral to existing community resources. More than half of parents' statements referred to the pediatrician as someone who can directly educate their child about making positive choices.Conclusions—Although pediatricians cannot solve the problem of youth violence alone, findings from this study suggest that they should address this issue with their patients and should work in tandem with existing community resources to further a solution to this growing epidemic.