[Correspondence analysis of association between types of unintentional injuries and influential factors among rural rear pupils].

PubMed

Dou, Dongmei; Wang, Peixi

2015-07-01

To explore the association between types of unintentional injuries and influential factors among rural rear pupils. The multistage stratified sampling method was used to select the study participant and thus 594 rural pupils were sampled, 292 rear pupils were confirmed and measured with unintentional injuries and influential factors of rural rear pupils scale. Binary logistic regression analysis indicate that the risk facts related to unintentional injury were left-behind status (OR = 2.68, 95% CI 1.06-6.79), gender (OR = 5.12, 95% C2.68-9.79) and surrounding environment (OR = 3.44, 95% CI 1.37-8.70). Correspondence analysis showed living with father, middle personality and low age were related possibly with traffic accident injury. Living with grandparents, extrovert personality and elder pupils were related possibly with unintentional falls injury. Living with mother, introvert personality and middle-age pupils were related possibly with animmal injury. The personality, ages and guardian types of rural rear pupils are correlated with types of unintentional injuries.

Relating Off-Premises Alcohol Outlet Density to Intentional and Unintentional Injuries

PubMed Central

Morrison, Christopher; Smith, Karen; Gruenewald, Paul J.; Ponicki, William R.; Lee, Juliet P.; Cameron, Peter

2015-01-01

Aims This study investigated the hypotheses that (i) intentional and unintentional injuries occur more frequently in areas with greater density of off-premises alcohol outlets; and (ii) larger and chain outlets selling cheaper alcohol contribute more substantially to injury risk than smaller and independent outlets. Design Ecological cross-sectional. Setting From the 256 Statistical Area level 2 (SA2) Census units in Melbourne, Australia, we selected a random sample of 62 units. There were 2,119 Statistical Area level 1 (SA1) units nested within the selected SA2 units. Participants The selected units contained 295 off-premises outlets. Measurements Two independent observers conducted premises assessments in all off-premises outlets, assessing the volume of alcohol available for sale (paces of shelf space), price (least wine price), and other operating characteristics (chain vs. independent, drive-through). Outlet counts, assessed outlet characteristics, and other area characteristics (population density, median age, median income, retail zoning) were aggregated within SA1 units. Dependent variables were counts of ambulance attended intentional injuries (assaults, stabbings, shootings) and unintentional injuries (falls, crush injuries, and object strikes). Findings In univariable analyses, chain outlets were larger (r = 0.383; p < 0.001) and sold cheaper alcohol (r = −0.484; p < 0.001) compared with independent outlets. In Bayesian spatial Poisson models, off-premises outlet density was positively related to both intentional (Incidence Rate Ratio = 1.38; 95% Credible Interval: 1.19, 1.60) and unintentional injuries (IRR = 1.18; 95% CI: 1.06, 1.30). After disaggregation by outlet characteristics, chain outlet density was also related to both intentional (IRR = 1.35; 95% CI: 1.11, 1.64) and unintentional injuries (IRR = 1.20; 95% CI: 1.08, 1.38). Conclusions Greater off-premises outlet density is related to greater incidence of traumatic injury, and chain outlets

Legislative and regulatory strategies to reduce childhood unintentional injuries.

PubMed

Schieber, R A; Gilchrist, J; Sleet, D A

2000-01-01

Laws and regulations are among the most effective mechanisms for getting large segments of the population to adopt safety behaviors. These have been applied at both the state and federal levels for diverse injury issues. Certain legal actions are taken to prevent the occurrence of an otherwise injury-producing event, while other legal actions are designed to prevent injury once an event has occurred. At the federal level, effective laws and regulations have been directed at dangers posed by unsafe manufactured products or motor vehicle design. At the state level, effective safety laws and regulations have been directed at encouraging safety behaviors and regulating the use of motor vehicles or other forms of transportation. In this article, six legislative efforts are described to point out pros and cons of the legislative approach to promoting safety. Three such efforts are aimed at preventing injury-producing events from occurring: mandating child-resistant packaging for prescription drugs and other hazardous substances, regulating tap water temperature by presetting a safe hot-water heater temperature at the factory, and graduated licensing. Three other examples illustrate the value and complexities of laws designed to prevent injuries once an injury-producing event does occur: mandatory bicycle helmet use, sleep-wear standards, and child safety seat use. This article concludes with specific recommendations, which include assessing the value of laws and regulations, preventing the rescission of laws and regulations known to work, refining existing laws to eliminate gaps in coverage, developing regulations to adapt to changing technology, exploring new legal means to encourage safe behavior, and increasing funding for basic and applied research and community programs. Further reductions in childhood injury rates will require that leaders working in the field of injury prevention together provide the creativity to devise new safety devices and programs, incentives

Unintentional injury prevention and the role of occupational therapy in the Solomon Islands: an integrative review.

PubMed

Daufanamae, Barbara U; Franklin, Richard C; Eagers, Jackie

2016-01-01

Unintentional injuries (injuries for which there is no evidence of a predetermined intent) are one of the leading causes of death worldwide, particularly in low- and middle-income countries (LMICs). Although evidence demonstrates unintentional injuries are preventable it is a public health challenge for many LMICs such as the Solomon Islands. Occupational therapists are well placed to contribute to injury prevention, as they have specialised skills to analyse the accessibility and safety of the environments within which people conduct their daily occupations. While the role of occupational therapy in unintentional injury prevention is well known in high-income countries, it is unfamiliar in LMICs, especially in the Solomon Islands. This integrative review aimed to explore the incidence of common unintentional injuries, and the burden in the Solomon Islands; and explore the potential role of occupational therapy in unintentional injury prevention in the Solomon Islands, based on current activities in LMICs. Articles were reviewed from six databases (Medline, CINAHL, OTDBase, OT Seeker, Scopus and PsychInfo). Five articles met the inclusion criteria for the first objective and 15 articles met the inclusion criteria for the second objective. These articles were thematically analysed where themes and codes associated with the research objectives were extracted and analysed. Unintentional injuries in the Solomon Islands reported in the literature included ocular trauma, falls from fruit trees and coconut palms, and road traffic crashes. Burden of injury reported was mostly associated with loss of productivity. Occupational therapists undertook rehabilitative, biomechanical, neurodevelopmental and educational roles in LMIC, focusing on tertiary and secondary injury prevention. This integrative review suggests that there is limited information regarding injury in the Solomon Islands. However, evidence is available in LMICs to suggest that occupational therapy services can

Individual risk factors associated with general unintentional injuries and the relationship to traumatic dental injuries among children aged 0-15 years in the Swedish BITA study.

PubMed

Oldin, Anna; Lundgren, Jesper; Norén, Jörgen G; Robertson, Agneta

2016-08-01

To investigate general unintentional injuries (GUI) and traumatic dental injuries (TDI) in relation to behavioral and psychosocial strengths and difficulties among Swedish children aged 0-17 years, and to investigate general unintentional injuries in relation to temperament and socioeconomic status among the same children. The study included 2363 children in four different age cohorts aged 3, 7, 11, and 15 years at the study start. Twelve Public Dental Service clinics in Sweden participated, representing different types of demographic areas, both rural and urban. Data were collected from parents and children through an interview, questionnaires, and dental records. Twenty-four percentage (24%) of the children had experienced a serious general unintentional injury (GUI) at some point during their lifetime up until 3 months prior to the study start. Children who were regarded by their parents as being injured more often than other children also had occasions with general unintentional injuries to a greater extent. Most general unintentional injuries occurred at home. Children with incidents of general unintentional injuries had occasions with TDI to a greater extent than children without general unintentional injury. Children, whose mothers had 11 years of school/education or less, were involved in more general unintentional injuries during the 3-month period prior to the study start, compared to children of mothers with higher education level. Children with general unintentional injuries had more traumatic dental injuries. Children who were assessed by their parents as being injured more often than other children also had occasions with general unintentional injuries to a greater extent. Temperament, behavioral and psychosocial strengths and difficulties had different impacts at different ages for experiencing a general unintentional injury. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The effect of contextual factors on unintentional injury hospitalization: from the Korea National Hospital Discharge Survey.

PubMed

Lee, Hye Ah; Han, Hyejin; Lee, Seonhwa; Park, Bomi; Park, Bo Hyun; Lee, Won Kyung; Park, Ju Ok; Hong, Sungok; Kim, Young Taek; Park, Hyesook

2018-03-13

It has been suggested that health risks are affected by geographical area, but there are few studies on contextual effects using multilevel analysis, especially regarding unintentional injury. This study investigated trends in unintentional injury hospitalization rates over the past decade in Korea, and also examined community-level risk factors while controlling for individual-level factors. Using data from the 2004 to 2013 Korea National Hospital Discharge Survey (KNHDS), trends in age-adjusted injury hospitalization rate were conducted using the Joinpoint Regression Program. Based on the 2013 KNHDS, we collected community-level factors by linking various data sources and selected dominant factors related to injury hospitalization through a stepwise method. Multilevel analysis was performed to assess the community-level factors while controlling for individual-level factors. In 2004, the age-adjusted unintentional injury hospitalization rate was 1570.1 per 100,000 population and increased to 1887.1 per 100,000 population in 2013. The average annual percent change in rate of hospitalizations due to unintentional injury was 2.31% (95% confidence interval: 1.8-2.9). It was somewhat higher for females than for males (3.25% vs. 1.64%, respectively). Both community- and individual-level factors were found to significantly influence unintentional injury hospitalization risk. As community-level risk factors, finance utilization capacity of the local government and neighborhood socioeconomic status, were independently associated with unintentional injury hospitalization after controlling for individual-level factors, and accounted for 19.9% of community-level variation in unintentional injury hospitalization. Regional differences must be considered when creating policies and interventions. Further studies are required to evaluate specific factors related to injury mechanism.

Do Attention Deficit Hyperactivity Disorder and Oppositional Defiant Disorder Influence Preschool Unintentional Injury Risk?

PubMed Central

Garzon, Dawn Lee; Huang, Hongyan; Todd, Richard D.

2008-01-01

Purpose This study explores the relationship between preschool attention deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), injury risk-taking behavior, and unintentional injury. Method Emergency department case control study of parent reported child behavior. Findings Children with ODD and ADHD had significantly more injury risk-taking behaviors (OR=7.68, 95% CI 2.25–26.25, OR 4.87, 95% CI 1.17–20.28 respectively) and injured children had a 17-fold increase in high risk-taking behaviors (OR 17.2, 95% CI 2.14–138.0). No significant association existed between ODD or ADHD and ED-treated unintentional injury. Implications Disruptive behavior disorders are not major contributors to ED-treated unintentional injury in preschool children. PMID:18809121

Unintentional injuries and parental violence against children during flood: a study in rural Bangladesh.

PubMed

Biswas, Animesh; Rahman, Aminur; Mashreky, Saidur; Rahman, Fazlur; Dalal, Koustuv

2010-01-01

Violence and injuries are under-reported in developing countries, especially during natural disasters such as floods. Compounding this, affected areas are isolated from the rest of the country. During 2007 Bangladesh experienced two consecutive floods which affected almost one-third of the country. The objective of this study was to examine unintentional injuries to children in rural Bangladesh and parental violence against them during floods, and also to explore the association of socioeconomic characteristics. A cross-sectional rural household survey was conducted in the worst flood-affected areas. A group of 638 randomly selected married women of reproductive age with at least one child at home were interviewed face-to-face using pre-tested structured questionnaires. The chi2 test and logistic regression were used for data analysis. The majority of families (90%) were affected by the flood and were struggling to find food and shelter, resulting in the parents becoming violent towards their children and other family members in the home. Cuts (38%), falls (22%) and near drowning (21%) comprised the majority of unintentional injuries affecting children during the floods. A large number of children were abused by their parents during the floods (70% by mothers and 40% by fathers). The incidence of child injuries and parental violence against children was higher among families living in poor socio-economic conditions, whose parents were of low occupational status and had micro-credit loans during the floods. Floods can have significant effects on childhood injury and parental violence against children. The improvement of socio-economic conditions would assist in preventing child injuries and parental violence.

Childhood and adult mortality from unintentional falls in India

PubMed Central

Jagnoor, Jagnoor; Suraweera, Wilson; Keay, Lisa; Ivers, Rebecca Q; Thakur, JS; Gururaj, Gopalkrishna

2011-01-01

Abstract Objective To estimate fall-related mortality by type of fall in India. Methods The authors analysed unintentional injury data from the ongoing Million Death Study from 2001–2003 using verbal autopsy and coding of all deaths in accordance with the International statistical classification of diseases and related health problems, tenth revision, in a nationally representative sample of 1.1 million homes throughout the country. Findings Falls accounted for 25% (2003/8023) of all deaths from unintentional injury and were the second leading cause of such deaths. An estimated 160 000 fall-related deaths occurred in India in 2005; of these, nearly 20 000 were in children aged 0–14 years. The unintentional-fall-related mortality rate (MR) per 100 000 population was 14.5 (99% confidence interval, CI: 13.7–15.4). Rates were similar for males and females at 14.9 (99% CI: 13.7–16.0) and 14.2 (99% CI: 13.1–15.4) per 100 000 population, respectively. People aged 70 years or older had the highest mortality rate from unintentional falls (MR: 271.2; 99% CI: 249.0–293.5), and the rate was higher among women (MR: 281; 99% CI: 249.7–311.3). Falls on the same level were the most common among older adults, whereas falls from heights were more common in younger age groups. Conclusion In India, unintentional falls are a major public health problem that disproportionately affects older women and children. The contexts in which these falls occur and the resulting morbidity and disability need to be better understood. In India there is an urgent need to develop, test and implement interventions aimed at preventing falls. PMID:22084511

CDC School Health Guidelines to Prevent Unintentional Injuries and Violence

ERIC Educational Resources Information Center

Barrios, Lisa C.; Sleet, David A.; Mercy, James A.

2003-01-01

Approximately two-thirds of all deaths among children and adolescents aged five to 19 years results from injury-related causes: motor-vehicle crashes, all other unintentional injuries, homicide, and suicide. Schools have a responsibility to prevent injuries from occurring on school property and at school-sponsored events. In addition, schools can…

Higher Psychological Distress is Associated with Unintentional Injuries in U.S. Adults

PubMed Central

McAninch, Jana; Greene, Christina; Sorkin, John D.; Lavoie, Marie-Claude; Smith, Gordon S.

2014-01-01

Background Links between mental illness, self-inflicted injury, and interpersonal violence are well recognized, but the association between poor mental health and unintentional injuries is not well understood. Methods We used the 2010 National Health Interview Survey to assess the association between psychological distress and unintentional non-occupational injuries among U.S. adults. Psychological distress was measured by the Kessler Psychological Distress Scale, a symptom scale shown to identify community-dwelling persons with mental illness. Multivariable logistic regression was used to estimate adjusted odds ratios (AOR) and 95% confidence intervals. Results Of the 26,776 individuals analyzed, 2.5% reported a medically-attended unintentional injury in the past three months. Those with moderate and severe psychological distress had 1.5 [1.2-1.8] and 2.0 [1.4 -2.8] times higher odds of injury, respectively, as compared to those with low distress levels, after adjusting for age, sex, race, marital status, education level, alcohol use, physical functional limitation, medical comorbidity, employment status, and health insurance status. Psychological distress was significantly associated with falls [AOR 1.4 (1.1-1.9)] and sprain/strain injuries [AOR 2.0 (1.5-2.8)], but not transportation-related injuries [AOR 1.2 (0.7-1.9)] or fractures [AOR 1.1 (0.8-1.6)]. Conclusion Among community-dwelling U.S. adults, psychological distress is significantly associated with unintentional non-occupational injury, and the magnitude of association increases with severity of distress. The association between psychological distress and injury may be particularly strong for falls and sprain/strain injuries. These findings draw attention to a large group of at-risk individuals that may merit further targeted research, including longitudinal studies. PMID:24174466

Relationships between depressive symptoms and self-reported unintentional injuries: the cross-sectional population–based FIN-D2D survey

PubMed Central

2012-01-01

Background There is a lack of knowledge on the influence of different levels of physical activity (PA) on unintentional injuries among those with depressive symptoms (DS). The aim of this study was to evaluate the relationship between PA categories and unintentional injuries among participants with and without DS based on a cross-sectional population–based FIN-D2D survey conducted in 2007. Methods Out of 4500, 2682 participants (60%) aged 45–74 years attended in this study. The unintentional injuries over the past year were captured in a questionnaire. DS were determined with the Beck Depression Inventory (≥ 10 points) and PA with the International Physical Activity Questionnaire. The statistical significance between DS and unintentional injury categories was evaluated by using t-test, chi-square test, or permutation test, analysis of covariance, or regression models. The factors related to unintentional injuries were estimated by univariate and multivariate logistic regression models. Results The proportion of subjects with unintentional injuries was higher among those with DS (17%) compared to those without DS (10%) (age- and gender-adjusted p = 0.023). The median (range) number of activity-loss days after injury was 22 (0–365) in participants with DS and 7 (0–120) in participants without DS ( p = 0.009). The percentage of subjects with unintentional injuries was not significantly different between PA categories in participants with DS and without DS. A stepwise multivariate logistic regression analysis showed that DS, functional ability, and musculoskeletal diseases were related to unintentional injuries. Conclusions PA level was not related to unintentional injuries, whereas those with DS had a higher prevalence of unintentional injuries and prolonged activity-loss after injury. These results underline the importance of injury prevention, especially among those who have DS and additional risk factors. PMID:22781103

Relating off-premises alcohol outlet density to intentional and unintentional injuries.

PubMed

Morrison, Christopher; Smith, Karen; Gruenewald, Paul J; Ponicki, William R; Lee, Juliet P; Cameron, Peter

2016-01-01

This study investigated the hypotheses that (i) intentional and unintentional injuries occur more frequently in areas with greater density of off-premises alcohol outlets; and (ii) larger and chain outlets selling cheaper alcohol contribute more substantially to injury risk than smaller and independent outlets. Ecological cross-sectional. From the 256 Statistical Area level 2 (SA2) census units in Melbourne, Australia, we selected a random sample of 62 units. There were 2119 Statistical Area level 1 (SA1) units nested within the selected SA2 units. The selected units contained 295 off-premises outlets. Two independent observers conducted premises assessments in all off-premises outlets, assessing the volume of alcohol available for sale (paces of shelf space), price (least wine price) and other operating characteristics (chain versus independent, drive-through). Outlet counts, assessed outlet characteristics and other area characteristics (population density, median age, median income, retail zoning) were aggregated within SA1 units. Dependent variables were counts of ambulance attended intentional injuries (assaults, stabbings, shootings) and unintentional injuries (falls, crush injuries and object strikes). In univariable analyses, chain outlets were larger (r = 0.383; P < 0.001) and sold cheaper alcohol (r = -0.484; P < 0.001) compared with independent outlets. In Bayesian spatial Poisson models, off-premises outlet density was positively related to both intentional [incidence rate ratio (IRR) = 1.38; 95% credible interval (CI) = 1.19, 1.60] and unintentional injuries (IRR = 1.18; 95% CI = 1.06, 1.30). After disaggregation by outlet characteristics, chain outlet density was also related to both intentional (IRR = 1.35; 95% CI = 1.11, 1.64) and unintentional injuries (IRR = 1.20; 95% CI = 1.08, 1.38). Greater off-premises outlet density is related to greater incidence of traumatic injury, and chain outlets appear to

Unintentional injury mortality among indigenous communities of Taiwan: trends from 2002 to 2013 and evaluation of a community-based intervention.

PubMed

Pan, Stephen W; Chong, Hiu Ha; Kao, Hui-Chuan

2017-11-27

Indigenous communities in Taiwan shoulder a disproportionate burden of unintentional injury fatalities. We compare unintentional injury mortality rate trends among Taiwan's indigenous communities and the general population from 2002 to 2013, and evaluate potential impact of a community-based injury prevention programme on indigenous unintentional injury death rates. Standardised and crude unintentional injury mortality rates were obtained from Taiwan government reports. Segmented linear regression was used to estimate and compare unintentional injury mortality rate trends before and after the intervention. Between 2002 and 2013, unintentional injury mortality rates among Taiwan's indigenous population significantly declined by about 4.5 deaths per 100 000 each year (p<0.0001). During that time, the unintentional injury mortality rate ratio between indigenous Taiwanese and the general population significantly decreased by approximately 1% each successive year (p=0.02). However, we were unable to detect evidence that the 'Healthy and Safe Tribe' programme was associated with a statistically significant decrease in the unintentional injury mortality rate trend among indigenous persons (p=0.81). Taiwanese indigenous communities remain at significantly higher risk of unintentional injury death, though the gap may be slowly narrowing. We found no evidence that the 'Healthy and Safe Tribe' indigenous injury-prevention programme significantly contributed to the nationwide decline in unintentional injury mortality among indigenous Taiwanese communities from 2009 to 2013. Future interventions to address the disproportionate burden of unintentional injury fatalities among indigenous Taiwanese should consider interventions with wider coverage of the indigenous population, and complementing grass roots led community-based interventions with structural policy interventions as well. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article

[The incidence and patterns of unintentional injuries in daily life in Korea: a nationwide study].

PubMed

Park, Kunhee; Eun, Sang Jun; Lee, Eun-Jung; Lee, Chae-Eun; Park, Doo Yong; Han, Kyounghun; Kim, Yoon; Lee, Jin-Seok

2008-07-01

This study was conducted to estimate the cumulative incidence rate (CIR) of unintentional injuries in Korean daily life and to describe the pattern of unintentional injuries. The study population was the people who used the National Health Insurance because of injuries (ICD code: S00-T98) during 2006. The stratified sample according to gender, age and the severity of injury (NISS, New Injury Severity Score) was randomly selected. The questions on the questionnaire were developed as a reference for an international classification tool (ICECI, International Classification of External Causes of Injury). The questions included the locations of injury, the mechanisms of injury and the results of injury. Moreover, we used age, gender, region and income variables for analysis. The CIR of unintentional injuries that occurred in daily life for 1 year per 100,000 persons was 17,606, and the CIR of severe injuries was 286. Many injuries were occurred at home (29.6%), public places (19.0%), school (13.7%) and near home (12.0%). The major mechanisms of injuries were slipping (48.8%), contact (14.0%), physical over-exertion (13.8%), and fall (6.6%). Infants and old aged people were vulnerable to injuries, and those who lived rural area and who were in a low income level were vulnerable too. We signified the risk groups and risk settings of unintentional injuries in Korean daily life. These results could contribute to establishing strategies for injury prevention and implementing these strategies.

Vulnerability to unintentional injuries associated with land-use activities and search and rescue in Nunavut, Canada.

PubMed

Clark, Dylan G; Ford, James D; Pearce, Tristan; Berrang-Ford, Lea

2016-11-01

Injury is the leading cause of death for Canadians aged 1 to 44, occurring disproportionately across regions and communities. In the Inuit territory of Nunavut, for instance, unintentional injury rates are over three times the Canadian average. In this paper, we develop a framework for assessing vulnerability to injury and use it to identify and characterize the determinants of injuries on the land in Nunavut. We specifically examine unintentional injuries on the land (outside of hamlets) because of the importance of land-based activities to Inuit culture, health, and well-being. Semi-structured interviews (n = 45) were conducted in three communities that have varying rates of search and rescue (SAR), complemented by an analysis of SAR case data for the territory. We found that risk of land-based injuries is affected by socioeconomic status, Inuit traditional knowledge, community organizations, and territorial and national policies. Notably, by moving beyond common conceptualizations of unintentional injury, we are able to better assess root causes of unintentional injury and outline paths for prevention. Copyright © 2016 Elsevier Ltd. All rights reserved.

Knowledge for unintentional injury and risky behavior among the school-age children in Changsha city of China.

PubMed

Tian, Lingyun; Liu, Minhui; Li, Li; Fang, Zhengqing; Xiao, Hongling; Wu, Ying; Xia, Yanping

2016-07-01

To investigate the current status on knowledge for unintentional injury and risky behavior among school-age children in Changsha, China, and to provide scientific evidence for the preventive strategies.
 A cross-sectional study was conducted on 866 students who were between 6 and 12 years old in Changsha. Two primary schools were selected by stratified cluster random sampling from all primary schools of Changsha city to collect the information regarding knowledge for unintentional injury and risky behavior occurring in the 6-month period before the survey.
 The mean score for knowledge of unintentional injury was 11.83±2.38. The levels of knowledge for unintentional injury differed significantly in child's age, parents' education background and child's injury history (P<0.05). The child's knowledge level was correlated with child's age, mother's education, child's injury history. The mean score for risky behavior was 17.61±10.35. The levels of risky behavior differed significantly in child's gender, father's age to have the child, parents' marriage status, whom does/do child live with, child's injury history and medical history since the birthday (P<0.05). There was a linear regression relationship between risky behavior and child's injury history, parents' marriage status, child's gender. There was no significant correlation between knowledge and risky behavior (P>0.05).
 It is a common phenomenon in school-age children who are lack of the knowledge for unintentional injury and risky behavior. This study provides useful information on the risk factors for unintentional injury and risky behavior, which would be significant for prevention program.

Behavioral and Social Sciences Theories and Models: Are They Used in Unintentional Injury Prevention Research?

ERIC Educational Resources Information Center

Trifiletti, L. B.; Gielen, A. C.; Sleet, D. A.; Hopkins, K.

2005-01-01

Behavioral and social sciences theories and models have the potential to enhance efforts to reduce unintentional injuries. The authors reviewed the published literature on behavioral and social science theory applications to unintentional injury problems to enumerate and categorize the ways different theories and models are used in injury…

Suicide and unintentional injury mortality among homeless people: a Danish nationwide register-based cohort study.

PubMed

Feodor Nilsson, Sandra; Hjorthøj, Carsten Rygaard; Erlangsen, Annette; Nordentoft, Merete

2014-02-01

Homeless people have elevated mortality, especially due to external causes. We aimed to examine suicide and unintentional injury mortality levels and identify predictors in the homeless population. A nationwide, register-based cohort study of homeless people aged 16 years and older was carried out using the Danish Homeless Register, 1999-2008. In all, 32 010 homeless people (70.5% men) were observed. For men, the mortality rate was 174.4 [95% confidence interval (CI) = 150.6-198.1] per 100 000 person-years for suicide and 463.3 (95% CI = 424.6-502.0) for unintentional injury. For women, the corresponding rates were 111.4 (95% CI = 81.7-141.1) for suicide and 241.4 (95% CI = 197.6-285.1) for unintentional injury. Schizophrenia spectrum, affective, personality and substance use disorders were strongly associated with increased risk of suicide; the highest risk estimates were found for schizophrenia spectrum disorders among both men [hazard ratio (HR) = 3.1, 95% CI = 2.0-4.9] and women (HR = 15.5, 95% CI = 4.5-54.0). Alcohol and drug use disorders were predictors of death by unintentional injury for both men and women, whereas schizophrenia spectrum disorders and personality disorders were only significant predictors among men; the highest risk estimates were found for drug use disorders among men (HR = 2.2, 95% CI = 1.8-2.8) and women (HR = 3.1, 95% CI = 1.8-5.4). A history of psychiatric admission and emergency room contact were predictors for dying by suicide and unintentional injury. People in the homeless shelter population with a history of a psychiatric disorder constitute a high-risk group regarding the elevated suicide and unintentional injury mortality.

Childhood Injuries in Singapore: Can Local Physicians and the Healthcare System Do More to Confront This Public Health Concern?

PubMed

Ong, Alvin Cong Wei; Low, Sher Guan; Vasanwala, Farhad Fakhrudin

2016-07-16

Childhood injury is one of the leading causes of death globally. Singapore is no exception to this tragic fact, with childhood injuries accounting up to 37% of Emergency Department visits. Hence, it is important to understand the epidemiology and risk factors of childhood injuries locally. A search for relevant articles published from 1996-2016 was performed on PubMed, Cochrane Library and Google Scholar using keywords relating to childhood injury in Singapore. The epidemiology, mechanisms of injury, risk factors and recommended prevention strategies of unintentional childhood injuries were reviewed and described. Epidemiological studies have shown that childhood injury is a common, preventable and significant public health concern in Singapore. Home injuries and falls are responsible for majority of the injuries. Injuries related to childcare products, playground and road traffic accidents are also important causes. Healthcare professionals and legislators play an important role in raising awareness and reducing the incidence of childhood injuries in Singapore. For example, despite legislative requirements for many years, the low usage of child restraint seats in Singapore is worrisome. Thus, greater efforts in public health education in understanding childhood injuries, coupled with more research studies to evaluate the effectiveness and deficiencies of current prevention strategies will be necessary.

Childhood Injuries in Singapore: Can Local Physicians and the Healthcare System Do More to Confront This Public Health Concern?

PubMed Central

Ong, Alvin Cong Wei; Low, Sher Guan; Vasanwala, Farhad Fakhrudin

2016-01-01

Childhood injury is one of the leading causes of death globally. Singapore is no exception to this tragic fact, with childhood injuries accounting up to 37% of Emergency Department visits. Hence, it is important to understand the epidemiology and risk factors of childhood injuries locally. A search for relevant articles published from 1996–2016 was performed on PubMed, Cochrane Library and Google Scholar using keywords relating to childhood injury in Singapore. The epidemiology, mechanisms of injury, risk factors and recommended prevention strategies of unintentional childhood injuries were reviewed and described. Epidemiological studies have shown that childhood injury is a common, preventable and significant public health concern in Singapore. Home injuries and falls are responsible for majority of the injuries. Injuries related to childcare products, playground and road traffic accidents are also important causes. Healthcare professionals and legislators play an important role in raising awareness and reducing the incidence of childhood injuries in Singapore. For example, despite legislative requirements for many years, the low usage of child restraint seats in Singapore is worrisome. Thus, greater efforts in public health education in understanding childhood injuries, coupled with more research studies to evaluate the effectiveness and deficiencies of current prevention strategies will be necessary. PMID:27438844

Evaluation of unintentional injuries sustained by children: A hospital based study from Ankara-Turkey

PubMed Central

Birgul, Piyal; Esin Ocaktan, Mine; Akdur, Recep; Mustafa Soner, Yilmaz; Sevil, Ikinci; Safa, Celik

2013-01-01

Objectives: Unintentional injuries are one of the leading causes of death, hospitalization and disability across the world. Detailed work on child injury in low-income and middle-income countries began more recently and is now indicating priorities for prevention. This study aims to draw attention to the subject with the assessment of the injuries sustained by the study group. Methodology: Data of the descriptive study was collected at the Emergency Department’s trauma section of a Training and Research Hospital, located in Ankara during the period of October-November 2010. Children visiting the hospital due to an injury under the age of 18 were included to the study group by assent of the child and consent of the parents. Results: Of the study group 75.3% were boys, 35.31% were 11-15 year of age. The most frequent cause of the injuries were falls among boys (48.3%), girls (50.0%) and, 11-15 years of age (32.8%). Most injured organs (63.6%) were extremities and most frequent damage caused by the injury was fracture (29.5%). Almost half of the injuries (44.0%) occurred in and around the school. Conclusion: Development and implementation of systematic surveillance is necessary to identify the epidemiologic characteristics of childhood injuries at national level. Definition of the risk factors and protective factors is a priority of countries to prevent such injuries. PMID:24353638

Analysis of Behavioural Characteristics Related to Unintentional Injury in Southeast Chinese Adolescents: Evidence from a School-Based Survey.

PubMed

Feng, Wei; Gong, Qinghai; Liu, Kui; Li, Hui

2017-03-01

The purpose of this study was to explore the epidemiological features of common unintentional injury-related behaviours and to identify possible factors that lead to these unsafe behaviours among adolescents. A representative sample of 10,806 students was recruited from 77 schools by using the two-stage stratified random sampling method. All participants took a self-administered questionnaires and data were analysed to estimate the prevalence of unintentional injury-related behaviours and to identify the influential factors for these behaviours. The prevalence of unsafe swimming, jaywalking, illegal bicycling and not wearing a seat belt was 6.35%, 33.08%, 18.10% and 15.73%, respectively. The proportion of students who had two, three or four unintentional injury-related behaviours was 14.59%, 4.27% and 0.57%, respectively. Multiple regression analysis showed that male adolescents, living in an urban area and attending a vocational-technical school might contribute to the occurrence of four unintentional injury-related behaviours. In addition, the marital status of parents and father with a college degree or above were negatively associated with the adolescent's behaviour of not wearing a seat belt. Considering diverse epidemiological characteristics of unintentional injury-related behaviours among adolescents, targeted interventions such as enhancing self-protection capabilities and strengthening safety consciousness by family, school and related departments should be implemented to lower the occurrence of unintentional injury-related behaviours.

Age of drinking onset and unintentional injury involvement after drinking

DOT National Transportation Integrated Search

2001-01-01

This study assessed whether persons who begin drinking at younger ages are more likely to report unintentional injuries under the influence of alcohol. A national survey conducted for the National Institute on Alcohol Abuse and Alcoholism in 1992, as...

Does living density matter for nonfatal unintentional home injury in Asian urban settings? Evidence from Hong Kong.

PubMed

Chan, Emily Y Y; Kim, Jean H; Griffiths, Sian M; Lau, Joseph T F; Yu, Ignatius

2009-11-01

Injury is a major global disease burden for the twenty-first century. There are, however, few studies of unintentional household injury in Asian urban settings where living environments are characterized by extremely compact, high-living-density, multistory apartments. This study investigated the association between nonfatal unintentional household injuries with the resident's sociodemographic attributes and household characteristics in Hong Kong, the city with the world's highest population density. A cross-sectional retrospective recall study was conducted in May 2007 using a random telephone survey with a modified Chinese version of the World Health Organization Injury and Violence instrument. The study sample included 1,001 noninstitutionalized Cantonese-speaking Hong Kong residents of all ages, including foreign live-in domestic helpers. Multivariate regression was conducted to identify risk factors for nonfatal unintentional injuries in Hong Kong. Among a predominantly adult sample, household size and time spent at home were not associated with nonfatal unintentional household injuries in the general population in Hong Kong. The multivariate analyses indicated that female gender, owners of private homes, lower square footage of living space per person, and those with slip prevention devices in the bathroom were significantly associated with household injuries. Injured and noninjured groups were found to have adopted different injury prevention strategies toward household injuries. The results identified potential target groups for household injury prevention programs.

Unintentional injuries in children with disabilities: a systematic review and meta-analysis.

PubMed

Shi, Xiuquan; Shi, Junxin; Wheeler, Krista K; Stallones, Lorann; Ameratunga, Shanthi; Shakespeare, Tom; Smith, Gary A; Xiang, Huiyun

2015-12-01

Children with disabilities are thought to have an increased risk of unintentional injuries, but quantitative syntheses of findings from previous studies have not been done. We conducted a systematic review and meta-analysis to assess whether pre-existing disability can increase the risk of unintentional injuries among children when they are compared to children without disability. We searched 13 electronic databases to identify original research published between 1 January 1990 and 28 February 2013. We included those studies that reported on unintentional injuries among children with pre-existing disabilities compared with children without disabilities. We conducted quality assessments and then calculated pooled odds ratios of injury using random-effects models. Fifteen eligible studies were included from 24,898 references initially identified, and there was a total sample of 83,286 children with disabilities drawn from the eligible studies. When compared with children without disabilities, the pooled OR of injury was 1.86 (95 % CI 1.65-2.10) in children with disabilities. The pooled ORs of injury were 1.28, 1.75, and 1.86 in the 0-4 years, 5-9 years, and ≥10 years of age subgroups, respectively. Compared with children without disabilities, the pooled OR was 1.75 (95 % CI 1.26-2.43) among those with International Classification of Functioning (ICF) limitations. When disability was defined as physical disabilities, the pooled OR was 2.39 (95 % CI 1.43-4.00), and among those with cognitive disabilities, the pooled OR was 1.77 (95 % CI 1.49-2.11). There was significant heterogeneity in the included studies. Compared with peers without disabilities, children with disabilities are at a significantly higher risk of injury. Teens with disabilities may be an important subgroup for future injury prevention efforts. More data are needed from low- and middle-income countries.

Leading causes of unintentional injury and suicide mortality in Canadian adults across the urban-rural continuum.

PubMed

Burrows, Stephanie; Auger, Nathalie; Gamache, Philippe; Hamel, Denis

2013-01-01

We examined the leading causes of unintentional injury and suicide mortality in adults across the urban-rural continuum. Injury mortality data were drawn from a representative cohort of 2,735,152 Canadians aged ≥ 25 years at baseline, who were followed for mortality from 1991 to 2001. We estimated hazard ratios and 95% confidence intervals for urban-rural continuum and cause-specific unintentional injury (i.e., motor vehicle, falls, poisoning, drowning, suffocation, and fire/burn) and suicide (i.e., hanging, poisoning, firearm, and jumping) mortality, adjusting for socioeconomic and demographic characteristics. Rates of unintentional injury mortality were elevated in less urbanized areas for both males and females. We found an urban-rural gradient for motor vehicle, drowning, and fire/burn deaths, but not for fall, poisoning, or suffocation deaths. Urban-rural differences in suicide risk were observed for males but not females. Declining urbanization was associated with higher risks of firearm suicides and lower risks of jumping suicides, but there was no apparent trend in hanging and poisoning suicides. Urban-rural gradients in adults were more pronounced for unintentional motor vehicle, drowning, and fire/burn deaths, as well as for firearm and jumping suicide deaths than for other causes of injury mortality. These results suggest that the degree of urbanization may be an important consideration in guiding prevention efforts for many causes of injury fatality.

Unintentional injuries among Chinese children with different types and severity of disability

PubMed Central

Zhu, Huiping; Xiang, Huiyun; Xia, Xin; Yang, Xia; Li, Dan; Stallones, Lorann; Du, Yukai

2014-01-01

Purpose Little research has been done in China to study injury in individuals with disability. We investigated impact of type and severity of disability on injury among children with disability in Hubei Province of China. Methods A sample of 1201 children with disability were matched with 1201 healthy children on gender, age, and neighborhood. Disability type and severity were determined using the Chinese national standards. Caregivers were interviewed face-to-face about nonfatal unintentional injuries suffered by the child in the past 12 months prior to the interview. Univariate Chi-square test and logistic regression models were used to investigate association between disability type/severity and nonfatal unintentional injuries. Results Injury rate among children with disability was significantly higher than that among children without disability (10.2% vs. 4.4%; P <.001). Children with multiple disabilities had the highest risk of injury after controlling for confounding variables (OR=4.54; 95% CI=2.82, 7.30; P<.001). The magnitude of the association between disability and injury varied by type and severity of disability. Conclusions The magnitude of the association between the presence or absence of disability in children and their risk of injury was large and significant, regardless of the type or severity of the children's disabilities. PMID:24331162

Emotional responses to unintentional and intentional traumatic injuries among urban black men: A qualitative study.

PubMed

Jiang, Tammy; Webster, Jessica L; Robinson, Andrew; Kassam-Adams, Nancy; Richmond, Therese S

2018-05-01

The burden of injuries is disproportionately concentrated among Black men in the United States. Previous studies suggest that the mental health effects of trauma may vary by the intentionality of the injury (intentional vs. unintentional), yet little is known about this experience among Black men. We explored the emotional responses to traumatic injuries in the context of injury intentionality among Black men in an urban area. We conducted semi-structured, qualitative interviews with 74 Black men who were traumatically injured. The interviews took place three months after discharge from the hospital and they were audiotaped, transcribed, and de-identified. We used systematic thematic analysis to identify themes about post-trauma emotional responses to intentional and unintentional injuries. The narratives of intentionally injured men revealed persistent exposure to neighborhood violence and their distrust of others including the people they knew and to whom they felt close. Survivors of unintentional injuries did not express a similar distrust of others. Our findings suggest that survivors of intentional injuries experience loss of social support following their injuries. Emotional responses can differ by intentionality of traumatic injury among urban Black men. Intentional injuries may be a marker for chronic exposure to violence and limited social support for recovery. Additional resources should be targeted to survivors of intentional injury who return to disadvantaged communities after medical treatment to decrease risk of re-traumatization and adverse emotional responses. Copyright © 2017 Elsevier Ltd. All rights reserved.

Status and risk factors of unintentional injuries among Chinese undergraduates: a cross-sectional study.

PubMed

Shi, Hongying; Yang, Xinjun; Huang, Chenping; Zhou, Zumu; Zhou, Qiang; Chu, Maoping

2011-07-05

Injuries affect all age groups but have a particular impact on young people. To evaluate the incidence of non-fatal, unintentional, injuries among undergraduates in Wenzhou, China, assess the burden caused by these injuries, and explore the associated risk factors for unintentional injuries among these undergraduates, we conducted a college-based cross-sectional study. Participants were selected by a multi-stage random sampling method, and 2,287 students were asked whether they had had an injury in the last 12 months; the location, cause, and consequences of the event. The questionnaire included demographic and socioeconomic characteristics, lifestyle habits, and the scale of type A behaviour pattern (TABP). Multivariate logistic regression models were used; crude odds ratios (ORs), adjusted ORs and their 95% confidence intervals (CIs) were estimated, with students having no injuries as the reference group. The incidence of injuries among undergraduates in Wenzhou was 18.71 injuries per 100 person-years (95%CI: 17.12~20.31 injuries per 100 person-years). Falls were the leading cause of injury, followed by traffic injuries, and animal/insect bites. Male students were more likely to be injured than female students. Risk factors associated with unintentional injuries among undergraduates were: students majoring in non-medicine (adjusted OR: 1.53; 95% CI: 1.19-1.96); type A behaviour pattern (adjusted OR: 2.99; 95% CI: 1.45-6.14); liking sports (adjusted OR: 1.86; 95% CI: 1.41-2.45). Injuries have become a public health problem among undergraduates. Falls were the major cause of non-fatal injury. Therefore, individuals, families, schools and governments should promptly adopt preventive measures aimed at preventing and controlling morbidity due to non-fatal injury, especially among students identified to be at high-risk; such as male students with type A behaviour pattern who like sports.

Status and risk factors of unintentional injuries among Chinese undergraduates: a cross-sectional study

PubMed Central

2011-01-01

Background Injuries affect all age groups but have a particular impact on young people. To evaluate the incidence of non-fatal, unintentional, injuries among undergraduates in Wenzhou, China, assess the burden caused by these injuries, and explore the associated risk factors for unintentional injuries among these undergraduates, we conducted a college-based cross-sectional study. Methods Participants were selected by a multi-stage random sampling method, and 2,287 students were asked whether they had had an injury in the last 12 months; the location, cause, and consequences of the event. The questionnaire included demographic and socioeconomic characteristics, lifestyle habits, and the scale of type A behaviour pattern (TABP). Multivariate logistic regression models were used; crude odds ratios (ORs), adjusted ORs and their 95% confidence intervals (CIs) were estimated, with students having no injuries as the reference group. Results The incidence of injuries among undergraduates in Wenzhou was 18.71 injuries per 100 person-years (95%CI: 17.12~20.31 injuries per 100 person-years). Falls were the leading cause of injury, followed by traffic injuries, and animal/insect bites. Male students were more likely to be injured than female students. Risk factors associated with unintentional injuries among undergraduates were: students majoring in non-medicine (adjusted OR: 1.53; 95% CI: 1.19-1.96); type A behaviour pattern (adjusted OR: 2.99; 95% CI: 1.45-6.14); liking sports (adjusted OR: 1.86; 95% CI: 1.41-2.45). Conclusions Injuries have become a public health problem among undergraduates. Falls were the major cause of non-fatal injury. Therefore, individuals, families, schools and governments should promptly adopt preventive measures aimed at preventing and controlling morbidity due to non-fatal injury, especially among students identified to be at high-risk; such as male students with type A behaviour pattern who like sports. PMID:21729294

The Unintentional Injurer: Results From the Boston Youth Survey

PubMed Central

Solnick, Sara J.

2011-01-01

Objectives. We sought to provide additional information about the characteristics of adolescents who were most likely to cause unintentional injury to other people. Methods. In 2008, as part of a randomized survey of high-school students in the Boston Public School system, more than 1800 respondents answered questions about unintentionally causing an injury to someone else in the past year. Results. More than 20% of boys and 13% of girls reported unintentionally injuring another person in the past year. Being male, exercising, participating in organized activities, and having carried a knife were risk factors for unintentionally causing an injury during sports. Using illegal drugs, having friends who are a bad influence, and having carried a knife were risk factors for unintentionally causing an injury not associated with sports. Conclusions. Unintentionally injuring another person is a fairly common event for high-school students. Characteristics differ between adolescents who unintentionally injure others during sports versus those who unintentionally injure others during nonsports activities. Many of the risk factors for causing unintentional injury unrelated to sports are similar to those for intentionally causing injury. PMID:21389291

Association between the inception of a SAFE KIDS Coalition and changes in pediatric unintentional injury rates

PubMed Central

Tamburro, R; Shorr, R; Bush, A; Kritchevsky, S; Stidham, G; Helms, S

2002-01-01

Setting: Shelby County, Tennessee. Design: Retrospective observational analysis. Patients: County residents nine years of age or younger presenting to the children's medical center, its emergency department, or its outpatient clinics from 1990–97. Intervention: Implementation of a SAFE KIDS Coalition. Main outcome measures: Rates of unintentional injuries targeted by the SAFE KIDS Coalition that resulted in hospitalization or in death. Rates of motor vehicle occupant injuries that resulted in hospitalization or in death. Rates of non-targeted unintentional injuries, namely injuries secondary to animals and by exposure to toxic plants. Rates of severe injuries (defined as those targeted injuries that required hospitalization or resulted in death), and specifically, severe motor vehicle occupant injuries were compared before and after the inception of the coalition using Poisson regression analysis. Results: The relative risk of targeted severe injury rates decreased after implementation of the coalition even after controlling for changes in hospital admission rates. Specifically, severe motor vehicle occupant injury rates decreased 30% (relative risk 0.70; 95% confidence interval 0.54 to 0.89) after initiation of the coalition. Conclusions: The implementation of a SAFE KIDS Coalition was associated with a decrease in severe targeted injuries, most notably, severe motor vehicle occupant injuries. Although causality cannot be determined, these data suggest that the presence of a coalition may be associated with decreased severe unintentional injury rates. PMID:12226125

Intelligence in early adulthood and subsequent risk of unintentional injury over two decades: cohort study of 1,109,475 Swedish men

PubMed Central

Whitley, Elise; Batty, G. David; Gale, Catharine R.; Deary, Ian J.; Tynelius, Per; Rasmussen, Finn

2014-01-01

Background There is growing evidence of an inverse association between intelligence (IQ) and unintentional injuries. Methods Analyses are based on a cohort of 1,109,475 Swedish men with IQ measured in early adulthood. Men were followed-up for an average 24 years and hospital admissions for unintentional injury were recorded. Results 198,133 (17.9%) men had at least one hospital admission for any unintentional injury during follow-up. The most common cause of unintentional injury was falling, followed by road accidents, poisoning, fire and drowning. In addition, 14,637 (1.3%) men had at least one admission for complications of medical care. After adjusting for confounding variables, lower IQ scores were associated with an elevated risk of any unintentional injury (Hazard ratio (95% confidence interval) per standard deviation decrease in IQ: 1.15 (1.14, 1.15)), and of cause-specific injuries other than drowning (poisoning (1.53 (1.49, 1.57)), fire (1.36 (1.31, 1.41)), road traffic accidents (1.25 (1.23, 1.26)), medical complications (1.20 (1.18, 1.22)), and falling (1.17 (1.16, 1.18)). These gradients were stepwise across the full IQ range. Conclusions Low IQ scores in early adulthood were associated with a subsequently increased risk of unintentional injury. A greater understanding of mechanisms underlying these associations may provide opportunities and strategies for prevention. PMID:19955099

Profile and Risk Factor Analysis of Unintentional Injuries in Children.

PubMed

Bhamkar, Rahul; Seth, Bageshree; Setia, Maninder Singh

2016-10-01

To study the profile and various risk factors associated with unintentional injuries in children. The study is a cross sectional analysis of data collected from 351 children presenting with unintentional injury to a tertiary care hospital in Navi Mumbai, India. Data were collected about variables based on Haddon Phase Factor Matrix - host, environment and agent factors. Proportions for categorical variables across various groups were compared using Chi square test or Fisher's exact test. Logistic regression model was used to evaluate the factors. Falls (36 %) were the most common injuries followed by bites (23 %). Majority of children were school going children (38 %) followed by preschool children (29 %). Forty-seven percent were from lower socioeconomic class. Commonest place of injury was home (48 %) and the commonest time was evening (49 %). Though there was male predominance in injuries, the difference across gender did not vary significantly (p = 0.15). Poisonings were significantly more common in infants and toddlers and in rural population (p < 0.001); kerosene being the commonest agent. Rural population is at more risk of bites compared to urban (p < 0.001); dog bites being the commonest followed by scorpion bites. Foreign bodies were significantly more common in upper and middle socioeconomic class and bites, in lower socioeconomic class (p < 0.005). Injuries from rural area and lower socioeconomic class were more serious, requiring hospitalization; they were also more likely to present late to the hospital (p < 0.05). Profile of injuries varies widely as per the variations in agent, host and environmental factors. Socio-environmental, economic conditions and infancy-toddler age groups are predisposing risk factors for bites and poisoning. Although rural areas and lower socioeconomic class population are more vulnerable to serious types of injuries, they still lack essential basic medical care.

Prevention of Unintentional Injury to People with Intellectual Disability: A Review of the Evidence

ERIC Educational Resources Information Center

Sherrard, J.; Ozanne-Smith, J.; Staines, C.

2004-01-01

Recent research evidence shows that people with intellectual disability (ID) have double the unintentional injury risk of the general population and the risk is further increased in the presence of psychopathology and epilepsy. The pattern of injury and the circumstances surrounding an injury event in those with ID have some similarity with that…

Rate and pattern of unintentional injuries among 9-12 grades schoolchildren in Yemen and their associated factors.

PubMed

Alshahethi, Ahmed; Al Serouri, Abdulwahed; Khader, Yousef S

2018-03-11

The burden and pattern of unintentional child injuries in Yemen are not yet studied. This study aimed to determine the rate of unintentional injuries and their associated factors and describe the pattern of these injuries among schoolchildren in Sana'a city, Yemen. A cross-sectional school-based study was conducted among students in grades 9-12 in Sana'a Capital City. A total of 10 schools were selected using multistage sampling technique. A self-administered questionnaire was used to collect the data. A total of 1140 students (558 girls and 582 boys) participated in the study. Of all students, 550 (48.2%) students reported unintentional injuries during the last 12-months. In the multivariate analysis, boys were more likely to be injured compared to girls (OR = 1.6) and being a child of divorced or widowed parents was significantly associated with increased odds of injury (OR = 1.7). Age of the household head ≤ 45 years was associated with deceased odds of injuries (OR = 0.76). Fall was the leading cause of injury. More than half of girls (58.9%) and 30.9% of boys were injured at home. About two thirds (64.9%) of injuries affected the lower or upper extremities. One quarter of students (24.5%) received care for their injuries in outpatient clinics and 15.3% were hospitalized because of the injury. About 26.0% of injured students missed schools for one week or more. The vast majority of students (98.4%) recovered the injury while 1.6% of injuries resulted in disability. Schoolchildren in Yemen had a high rate of unintentional injuries being higher in boys and in children of divorced or widowed parents. These injuries should be recognized as a public health problem in Yemen and should be included in the Ministry of Education and Ministry of Health agenda. The reported injury mechanisms and activities posing injury risks should have implications for future interventions and awareness programs.

Media accounts of unintentional child injury deaths in New Zealand: a teachable moment?

PubMed

John, Savesh; Kool, Bridget

2017-09-01

To review media accounts of fatal child unintentional injury events reported in leading New Zealand newspapers for their completeness and potential to deliver evidence-based injury prevention messages. Media accounts of fatal unintentional child (0-14 years) injury events in New Zealand's four largest newspapers between 2011 and 2015 were reviewed. Variables of interest included: date, mechanism of injury and victim details. The article prominence, presence of prevention messages and case ascertainment for the two leading causes of death (2011 to 2013 only) were evaluated. Two hundred and forty-two media accounts detailing 122 fatal child injury events (133 deaths) were located for the five-year period. The most common causes of injury were transport-related (56%) and drownings (21%). Only 20% (n=49) of accounts included clear prevention messages. Just over 33% of accounts included images and 66% were located within the first three pages. Case ascertainment in the media accounts was complete for all transport deaths and all but one drowning. The low frequency of prevention messages in the media accounts reviewed highlights a missed opportunity for the dissemination of prevention messages to the New Zealand public. The findings confirm the utility of these accounts as a timely source of fatal child injury information.

Impact of high ambient temperature on unintentional injuries in high-income countries: a narrative systematic literature review

PubMed Central

Otte im Kampe, Eveline; Kovats, Sari; Hajat, Shakoor

2016-01-01

Objectives Given the likelihood of increased hot weather due to climate change, it is crucial to have prevention measures in place to reduce the health burden of high temperatures and heat waves. The aim of this review is to summarise and evaluate the evidence on the effects of summertime weather on unintentional injuries in high-income countries. Design 3 databases (Global Public Health, EMBASE and MEDLINE) were searched by using related keywords and their truncations in the title and abstract, and reference lists of key studies were scanned. Studies reporting heatstroke and intentional injuries were excluded. Results 13 studies met our inclusion criteria. 11 out of 13 studies showed that the risk of unintentional injuries increases with increasing ambient temperatures. On days with moderate temperatures, the increased risk varied between 0.4% and 5.3% for each 1°C increase in ambient temperature. On extreme temperature days, the risk of injuries decreased. 2 out of 3 studies on occupational accidents found an increase in work-related accidents during high temperatures. For trauma hospital admissions, 6 studies reported an increase during hot weather, whereas 1 study found no association. The evidence for impacts on injuries by subgroups such as children, the elderly and drug users was limited and inconsistent. Conclusions The present review describes a broader range of types of unintentional fatal and non-fatal injuries (occupational, trauma hospital admissions, traffic, fire entrapments, poisoning and drug overdose) than has previously been reported. Our review confirms that hot weather can increase the risk of unintentional injuries and accidents in high-income countries. The results are useful for injury prevention strategies. PMID:26868947

Unintentional Epinephrine Auto-injector Injuries: A National Poison Center Observational Study.

PubMed

Anshien, Marco; Rose, S Rutherfoord; Wills, Brandon K

2016-11-24

Epinephrine is the only first-line therapeutic agent used to treat life-threatening anaphylaxis. Epinephrine auto-injectors are commonly carried by patients at risk for anaphylaxis, and reported cases of unintentional auto-injector injury have increased over the last decade. Modifications of existing designs and release of a new style of auto-injector are intended to reduce epinephrine auto-injector misuse. The aim of the study was to characterize reported cases of unintentional epinephrine auto-injector exposures from 2013 to 2014 and compare demographics, auto-injector model, and anatomical site of such exposures. The American Association of Poison Control Center's National Poison Data System was searched from January 1, 2013, to December 31, 2014, for cases of unintentional epinephrine auto-injector exposures. Anatomical site data were obtained from all cases reported to the Virginia Poison Center and participating regional poison center for Auvi-Q cases. A total of 6806 cases of unintentional epinephrine auto-injector exposures were reported to US Poison Centers in 2013 and 2014. Of these cases, 3933 occurred with EpiPen, 2829 with EpiPen Jr, 44 with Auvi-Q, and no case reported of Adrenaclick. The most common site of unintentional injection for traditional epinephrine auto-injectors was the digit or thumb, with 58% of cases for EpiPen and 39% of cases with EpiPen Jr. With Auvi-Q, the most common site was the leg (78% of cases). The number of unintentional epinephrine auto-injector cases reported to American Poison Centers in 2013-2014 has increased compared with previous data. Most EpiPen exposures were in the digits, whereas Auvi-Q was most frequently in the leg. Because of the limitations of Poison Center data, more research is needed to identify incidence of unintentional exposures and the effectiveness of epinephrine auto-injector redesign.

The health consequences of child mental health problems and parenting styles: unintentional injuries among European schoolchildren.

PubMed

Keyes, Katherine M; Susser, Ezra; Pilowsky, Daniel J; Hamilton, Ava; Bitfoi, Adina; Goelitz, Dietmar; Kuijpers, Rowella C W M; Lesinskiene, Sigita; Mihova, Zlatka; Otten, Roy; Kovess, Viviane

2014-10-01

Unintentional injury is the leading cause of death for schoolchildren. We assessed the association between externalizing psychopathology, parenting style, and unintentional injury in European children in the community. Data were drawn from the School Children Mental Health in Europe project and included 4517 schoolchildren across seven diverse European regions. Past-year injuries serious enough to seek medical attention were reported by mothers. Child mental health problems were assessed using validated measures and reported by the mothers, teachers, and children. Parenting styles were based on The Parenting Scale and the Parent Behaviors and Attitudes Questionnaire. Children with attention-deficit/hyperactivity symptoms and oppositional defiant symptoms had a higher risk of injury compared to other children whether based on parent report (OR=1.47, 95% C.I. 1.2-1.9), teacher report (OR=1.36, 95% C.I. 1.1-1.7), or parent and teacher report combined (OR=1.53, 95% C.I. 1.1-2.1). Children who self-reported oppositional symptoms also had higher risk of injury (OR=1.6, 95% C.I. 1.1-2.4). Low-caring behavior of parents increased the risk of injury (OR=1.4, 95% C.I. 1.1-1.9). Unintentional injury is a potential adverse health consequence of child externalizing problems. Interventions to improve parent-child relationships and prevention as well as focused treatment for externalizing problems may reduce the burden of injury. Copyright © 2014 Elsevier Inc. All rights reserved.

The burden of childhood injuries and evidence based strategies developed using the injury surveillance system in Pasto, Colombia.

PubMed

Espitia-Hardeman, Victoria; Borse, Nagesh N; Dellinger, Ann M; Betancourt, Carmen Elena; Villareal, Alba Nelly; Caicedo, Luz Diana; Portillo, Carlos

2011-02-01

This article characterises the burden of childhood injuries and provides examples of evidence-based injury prevention strategies developed using a citywide injury surveillance system in Pasto, Colombia. Fatal (2003-2007) and non-fatal (2006-2007) childhood injury data were analysed by age, sex, cause, intent, place of occurrence, and disposition. Boys accounted for 71.5% of fatal and 64.9% of non-fatal injuries. The overall fatality rate for all injuries was 170.8 per 100,000 and the non-fatal injury rate was 4,053 per 100,000. Unintentional injuries were the leading causes of fatal injuries for all age groups, except for those 15-19 years whose top four leading causes were violence-related. Among non-fatal injuries, falls was the leading mechanism in the group 0-14 years. Interpersonal violence with a sharp object was the most important cause for boys aged 15-19 years. Home was the most frequent place of occurrence for both fatal and non-fatal injuries for young children 0-4 years old. Home, school and public places became an important place for injuries for boys in the age group 5-15 years. The highest case-fatality rate was for self-inflicted injuries (8.9%). Although some interventions have been implemented in Pasto to reduce injuries, it is necessary to further explore risk factors to better focus prevention strategies and their evaluation. We discuss three evidence-based strategies developed to prevent firework-related injuries during festival, self-inflicted injuries, and road traffic-related injuries, designed and implemented based on the injury surveillance data.

Epidemiology of Unintentional Child Injuries in the Makwanpur District of Nepal: A Household Survey

PubMed Central

Pant, Puspa Raj; Towner, Elizabeth; Ellis, Matthew; Manandhar, Dharma; Pilkington, Paul; Mytton, Julie

2015-01-01

Secondary sources of information indicate that the proportion of child deaths due to injuries is increasing in Nepal. This study aimed to describe the epidemiology of unintentional injuries in children, explore risk factors and estimate the burden faced by families and the community in the Makwanpur district. We conducted a household survey in Makwanpur, covering 3441 households. Injuries that occurred during the 12 months before the survey and required treatment or caused the child to be unable to take part in usual activities for three or more days were included. We identified 193 cases of non-fatal unintentional child injuries from 181 households and estimated an annual rate of non-fatal injuries of 24.6/1000 children; rates for boys were double (32.7/1000) that for girls (16.8/1000). The rates were higher among the children of age groups 1–4 years and 5–9 years. Falls were the most common cause of non-fatal child injuries followed by burns in preschool children and road traffic injuries were the most likely cause in adolescence. Mean period of disability following injury was 25 days. The rates and the mechanisms of injury vary by age and gender. Falls and burns are currently the most common mechanisms of injury amongst young children around rural homes. PMID:26633439

Experiences and Attitudes of Collegiate Athletic Trainers Regarding Alcohol-Related Unintentional Injury in Athletes

PubMed Central

Brenner, James W.; Metz, Stacie M.; Entriken, Jack; Brenner, Christina J.

2014-01-01

Context: Alcohol-related unintentional injury (ARUI) has been an unexamined consequence of alcohol consumption by collegiate athletes. It has a potentially devastating effect on their athletic performances and careers. Awareness of this problem in athletes could have a huge effect on what athletic trainers (ATs) do to recognize, treat, and prevent it in a collegiate athlete population. Objective: To examine the experiences and attitudes among collegiate and university ATs about ARUI in the athletes in their care. Design: Cross-sectional study. Setting: Web-based survey. Patients or Other Participants: A total of 1767 e-mail addresses for collegiate and university ATs within National Athletic Trainers' Association Districts 1, 2, 3, and 9. Main Outcome Measure(s): We calculated frequencies, percentages, and attitudes of ATs regarding ARUI in collegiate athletes during the 2010–2011 academic year. Results: The resulting sample size for the analysis was 459 (26.0%) participants of the initial total sample. More than 56% (n = 260) of the ATs reported that they had evaluated, treated, or referred if needed at least 1 ARUI in a collegiate athlete. On average, these ATs had evaluated, treated, or referred if needed 3 alcohol-related unintentional injuries within the 2010–2011academic year. About 73% (n = 331) of ATs agreed that ARUI is a serious problem. Nearly 80% (n = 358) indicated they believe ATs should receive more training to identify student–athletes with alcohol-related problems. Conclusions: Alcohol-related unintentional injury is a common and serious consequence of alcohol use among collegiate athletes. Many ATs also view it as a serious problem yet would like more training in how to address it. Alcohol-related unintentional injury may have important negative effects on the careers and athletic performances of athletes. Researchers need to determine how prevalent ARUI is in the collegiate athlete population and what ATs can do to address it. PMID:24377956

The economic burden of unintentional injuries: a community-based cost analysis in Bavi, Vietnam.

PubMed

Thanh, Nguyen Xuan; Hang, Hoang Mihn; Chuc, Nguyen Thi Kim; Lindholm, Lars

2003-01-01

Relatively little is known about patterns of injury at the community level in Vietnam and their economic consequences. This study sought to estimate the costs of various unintentional injuries in Bavi District during one year; to describe how costs depended on gender, age, circumstances, and severity of injury; and to describe how the economic burden of unintentional injuries was distributed between households, government, and health insurance agency. A cohort study was undertaken, which involved four cross-sectional household surveys among sampled communities in the Bavi District during the year 2000, each asking about injuries in the preceding three months. The costing system in public healthcare in Vietnam was applied as well as information from the victims. The total cost of injuries over one year in Bavi District was estimated to be D3,412,539,000 (Vietnamese dong) (US$235,347), equivalent to the annual income of 1,800 people. In total, 90% of this economic burden fell on households, only 8% on government, and 2% on the health insurance agency. The cost of a severe injury to the corresponded to approximately seven months of earned income. Home and traffic injuries together accounted for more than 80% of the total cost, 45% and 38% respectively. The highest unit cost was related to traffic injuries, followed by home, "other", work-related, and school injuries in descending order. The results can be considered as an economic baseline that can be used in evaluations of future interventions aimed at preventing injuries.

Depression and Risk of Unintentional Injury in Rural Communities—A Longitudinal Analysis of the Australian Rural Mental Health Study

PubMed Central

Inder, Kerry J.; Holliday, Elizabeth G.; Handley, Tonelle E.; Fragar, Lyn J.; Lower, Tony; Booth, Angela; Kelly, Brian J.

2017-01-01

Limited longitudinal research has examined relationships between depression and injury, particularly in rural contexts. This paper reports cross-sectional and longitudinal analyses from the Australian Rural Mental Health Study (ARMHS) exploring relationships between “probable depression” episodes and unintentional injury. Participants completed four surveys over five years. Multivariate logistic regressions were employed to assess the causal effect of prior depression episodes on subsequent injury risk. Of 2621 baseline participants, 23.3% experienced a probable depression episode recently and 15.9% reported a serious injury during the previous 12 months. Factors associated with a 12-month injury at baseline included male gender, being unemployed or unable to work, being involved in a serious incident, hazardous alcohol use, and having experienced a recent depression episode. Longitudinal analyses revealed that probable depression was significantly associated with subsequent unintentional injury (OR 1.68, 99%CI 1.20–2.35), as was male gender (OR 1.39, 99%CI 1.06–1.82), while alcohol consumption did not mediate these relationships. Campaigns to reduce the impact of mental illness should consider unintentional injuries as a contributor, while injury prevention initiatives may benefit from addressing mental health issues. Such strategies are particularly important in rural and remote areas where injuries are more common and mental health services are less readily available. PMID:28926999

The health consequences of child mental health problems and parenting styles: Unintentional injuries among European schoolchildren☆,☆☆

PubMed Central

Keyes, Katherine M.; Susser, Ezra; Pilowsky, Daniel J.; Hamilton, Ava; Bitfoi, Adina; Goelitz, Dietmar; Kuijpers, Rowella C.W.M.; Lesinskiene, Sigita; Mihova, Zlatka; Otten, Roy; Kovess, Viviane

2015-01-01

Objective Unintentional injury is the leading cause of death for schoolchildren. We assessed the association between externalizing psychopathology, parenting style, and unintentional injury in European children in the community. Methods Data were drawn from the School Children Mental Health in Europe project and included 4517 schoolchildren across seven diverse European regions. Past year injuries serious enough to seek medical atten tion were reported by mothers. Child mental health problems were assessed using validated measures and re ported by the mothers, teachers, and children. Parenting styles were based on The Parenting Scale and the Parent Behaviors and Attitudes Questionnaire. Results. Children with attention deficit/hyperactivity symptoms and oppositional defant symptoms had a higher risk of injury compared to other children whether based on parent report (OR = 1.47, 95% C.I. 1.2 1.9), teacher report (OR = 1.36, 95% C.I. 1.1 1.7), or parent- and teacher-report combined (OR = 1.53, 95% C.I. 1.1 2.1). Children who self reported oppositional symptoms also had higher risk of injury (OR = 1.6, 95% C.I. 1.1 2.4). Low caring behavior of parents increased the risk of injury (OR = 1.4, 95% C.I. 1.1-1.9). Conclusion Unintentional injury is a potential adverse health consequence of child externalizing problems. Interventions to improve parent child relationships and prevention as well as focused treatment for externaliz ing problems may reduce the burden of injury. PMID:25073079

Taking the long view: a systematic review reporting long-term perspectives on child unintentional injury.

PubMed

Mytton, Julie A; Towner, Elizabeth M L; Powell, Jane; Pilkington, Paul A; Gray, Selena

2012-10-01

The relative significance of child injury as a cause of preventable death has increased as mortality from infectious diseases has declined. Unintentional child injuries are now a major cause of death and disability across the world with the greatest burden falling on those who are most disadvantaged. A review of long-term data on child injury mortality was conducted to explore trends and inequalities and consider how data were used to inform policy, practice and research. The authors systematically collated and quality appraised data from publications and documents reporting unintentional child injury mortality over periods of 20 years or more. A critical narrative synthesis explored trends by country income group, injury type, age, gender, ethnicity and socioeconomic group. 31 studies meeting the inclusion criteria were identified of which 30 were included in the synthesis. Only six were from middle income countries and none were from low income countries. An overall trend in falling child injury mortality masked rising road traffic injury deaths, evidence of increasing vulnerability of adolescents and widening disparities within countries when analysed by ethnic group and socioeconomic status. Child injury mortality trend data from high and middle income countries has illustrated inequalities within generally falling trends. There is scope for greater use of existing trend data to inform policy and practice. Similar evidence from low income countries where the burden of injury is greatest is needed.

County Poverty Concentration and Disparities in Unintentional Injury Deaths: A Fourteen-Year Analysis of 1.6 Million U.S. Fatalities

PubMed Central

Karb, Rebecca A.; Subramanian, S. V.; Fleegler, Eric W.

2016-01-01

Unintentional injury is the fourth leading cause of death in the United States, and mortality due to injury has risen over the past decade. The social determinants behind these rising trends have not been well documented. This study examines the relationship between county-level poverty and unintentional injury mortality in the United States from 1999–2012. Complete annual compressed mortality and population data for 1999–2012 were obtained from the National Center for Health Statistics and linked with census yearly county poverty measures. The outcomes examined were unintentional injury fatalities, overall and by six specific mechanisms: motor vehicle collisions, falls, accidental discharge of firearms, drowning, exposure to smoke or fire, and unintentional poisoning. Age-adjusted mortality rates and time trends for county poverty categories were calculated, and multivariate negative binomial regression was used to determine changes over time in both the relative risk of living in high poverty concentration areas and the population attributable fraction. Age-adjusted mortality rates for counties with > 20% poverty were 66% higher mortality in 1999 compared with counties with < 5% poverty (45.25 vs. 27.24 per 100,000; 95% CI for rate difference 15.57,20.46), and that gap widened in 2012 to 79% (44.54 vs. 24.93; 95% CI for rate difference 17.13,22.09). The relative risk of living in the highest poverty counties has increased for all injury mechanisms with the exception of accidental discharge of firearms. The population attributable fraction for all unintentional injuries rose from 0.22 (95% CI 0.13,0.30) in 1999 to 0.35 (95% CI 0.22,0.45) in 2012. This is the first study that uses comprehensive mortality data to document the associations between county poverty and injury mortality rates for the entire US population over a 14 year period. This study suggests that injury reduction interventions should focus on areas of high or increasing poverty. PMID:27144919

County Poverty Concentration and Disparities in Unintentional Injury Deaths: A Fourteen-Year Analysis of 1.6 Million U.S. Fatalities.

PubMed

Karb, Rebecca A; Subramanian, S V; Fleegler, Eric W

2016-01-01

Unintentional injury is the fourth leading cause of death in the United States, and mortality due to injury has risen over the past decade. The social determinants behind these rising trends have not been well documented. This study examines the relationship between county-level poverty and unintentional injury mortality in the United States from 1999-2012. Complete annual compressed mortality and population data for 1999-2012 were obtained from the National Center for Health Statistics and linked with census yearly county poverty measures. The outcomes examined were unintentional injury fatalities, overall and by six specific mechanisms: motor vehicle collisions, falls, accidental discharge of firearms, drowning, exposure to smoke or fire, and unintentional poisoning. Age-adjusted mortality rates and time trends for county poverty categories were calculated, and multivariate negative binomial regression was used to determine changes over time in both the relative risk of living in high poverty concentration areas and the population attributable fraction. Age-adjusted mortality rates for counties with > 20% poverty were 66% higher mortality in 1999 compared with counties with < 5% poverty (45.25 vs. 27.24 per 100,000; 95% CI for rate difference 15.57,20.46), and that gap widened in 2012 to 79% (44.54 vs. 24.93; 95% CI for rate difference 17.13,22.09). The relative risk of living in the highest poverty counties has increased for all injury mechanisms with the exception of accidental discharge of firearms. The population attributable fraction for all unintentional injuries rose from 0.22 (95% CI 0.13,0.30) in 1999 to 0.35 (95% CI 0.22,0.45) in 2012. This is the first study that uses comprehensive mortality data to document the associations between county poverty and injury mortality rates for the entire US population over a 14 year period. This study suggests that injury reduction interventions should focus on areas of high or increasing poverty.

Toddlers’ Unintentional Injuries: The Role of Maternal-Reported Paternal and Maternal Supervision*

PubMed Central

Kuhn, Jennifer

2013-01-01

Research indicates that mothers’ supervision protects children from injuries. However, little research has examined the role of fathers’ supervision in children’s injuries. Objectives This study compared the role of maternal and paternal supervision in children’s injury risk and severity using maternal reports. Methods Mothers (n = 170) of toddlers were interviewed for 6 months about their children’s unintentional injuries. Results Children were more likely to engage in high activity levels and were at higher risk for injury when being cared for by their fathers. Although higher supervision predicted lower injury risk for both mothers and fathers, fathers’ close supervision (as reported by mothers) was a stronger predictor of injury risk than mothers’ supervision. Conclusion Children’s higher levels of activities may have accounted for their higher risk of injury when in their fathers’ care. These findings indicate the need to include fathers in injury prevention efforts. PMID:23143608

Insomnia Symptoms and Risk for Unintentional Fatal Injuries—The HUNT Study

PubMed Central

Laugsand, Lars Erik; Strand, Linn B.; Vatten, Lars J.; Janszky, Imre; Bjørngaard, Johan Håkon

2014-01-01

Study Objectives: To assess the association between insomnia symptoms and risk of fatal unintentional injuries. Design: Population-based prospective cohort study with a mean follow-up of 14 y, linking health survey data with information on insomnia symptoms to the National Cause of Death Registry. Setting: Nord-Trøndelag County, Norway. Participants: A total of 54,399 men and women 20-89 y of age who participated in the Nord-Trøndelag Health Study between 1995 and 1997. Interventions: N/A. Measurements and results: There were 277 unintentional fatal injuries, including 57 fatal motor vehicle injuries during follow-up. There was a dose-dependent association between the number of insomnia symptoms and risk of unintentional fatal injuries (P for trend 0.001) and fatal motor vehicle injuries (P for trend 0.023), respectively. The proportion of unintentional fatal injuries cases that could have been prevented in the absence of difficulties initiating sleep, difficulties maintaining sleep, and having a feeling of nonrestorative sleep were 8%, 9%, and 8%, respectively. The corresponding estimates for motor vehicle injuries were 34%, 11%, and 10%. Conclusion: Insomnia is a major contributor to both unintentional fatal injuries in general as well as fatal motor vehicle injuries. Increasing public health awareness about insomnia and identifying persons with insomnia may be important in preventing unintentional fatal injuries. Citation: Laugsand LE, Strand LB, Vatten LJ, Janszky I, Bjørngaard JH. Insomnia symptoms and risk for unintentional fatal injuries—the HUNT Study. SLEEP 2014;37(11):1777-1786. PMID:25364073

Past Year Intentional and Unintentional injury Among Teens Treated In An Inner City Emergency Department

PubMed Central

Cunningham, Rebecca M.; Walton, Maureen A.; Harrison, Stephanie Roahen; Resko, Stella M.; Stanley, Rachel; Zimmerman, Marc; Bingham, C. Raymond; Shope, Jean T.

2010-01-01

An inner-city Emergency Department (ED) visit provides an opportunity for contact with high-risk adolescents for promoting injury prevention. Objectives To identify the prevalence of injuries sustained over the past year by teens presenting to an inner city ED, and to identify factors associated with recent injury to inform future ED-based injury prevention initiatives. Methods Over one year, seven days a week, from 1:00–11:00 PM, patients ages 14–18 years presenting to the ED participated in a survey regarding past-year risk behaviors and injuries. Results Of the entire group of teens presenting to the ED (n=1128) who completed the survey (83.8% response rate), 46% were male, and 58% were African-American. Past-year injuries were reported by 768 (68.1%) of the teens; 475 (61.8%) reported an unintentional injury and 293 (38.1%) reported an intentional injury. One-third of all youth seeking care reported a past-year sports-related injury (34.5%) or an injury related to driving or riding in a car (12.3%), and 8.2% reported a gun-related injury. Logistic regression found binge drinking (adjusted odds ratio [AOR]=1.95) and illicit weapon carrying (AOR=2.31) predicted a past-year intentional injury. African American youth (AOR=0.56) and those receiving public assistance (AOR=0.73) were less likely to report past-year unintentional injuries. Conclusions Adolescents seeking care in an inner city ED, regardless of reason for seeking care, report an elevated prevalence of recent injury including violence. Future injury screening and prevention efforts should consider universal screening of all youth seeking ED care. PMID:20149570

Unintentional Injuries and Violence among Adults in Northern Jordan: A Hospital-Based Retrospective Study

PubMed Central

Alzghoul, Manal M.; Shakhatreh, Mohammed K.; Al-sheyab, Nihaya

2017-01-01

Injuries (unintentional and intentional) are the main cause of death and disability worldwide, including Jordan. The main purpose of this hospital-based retrospective study was to identify characteristics, causes, and risk factors of unintentional injuries and violence among all adult patients who approached the Accidents and Emergency department because of injury in Northern Jordan. Data were collected retrospectively from four major hospitals from January 2008 to January 2013. A total of 2425 Jordanian individuals who accessed and were treated by the four hospitals were included in this study. The findings show that the majority of patients who approached the Accidents and Emergency departments in the four hospitals were males (n = 2044, 87.16%) versus females (n = 301, 12.8%). Violence was the most common reason of injury (70.66%), followed by road traffic crashes (23.21%). The most common anatomical locations of reported injuries were the head (38.74%), followed by abdomen/pelvis and lower back, among males and females (9.93%). Violence had a high significant effect on the site of injuries. Patients who had been injured to the head because of a stab wound or fighting were substantially over-involved in head injuries, with injury rates 3.88 and 7.51 times higher than those who had been injured to the head due to gunshot, respectively. Even patients who had been injured to the head because of assault show much higher involvement in injury risk than non-assault patients (Odds Ratio = 8.46). These findings highlight the need for a large national study to confirm the findings. It also draws attention to the importance of public awareness and to special injury prevention programs that not only focus on saving lives and lessening the number of injuries, illnesses, and fatalities, but also to limit the social and economic burden of injury among adults in Northern Jordan. PMID:28338614

Effective interventions for unintentional injuries: a systematic review and mortality impact assessment among the poorest billion.

PubMed

Vecino-Ortiz, Andres I; Jafri, Aisha; Hyder, Adnan A

2018-05-01

Between 1990 and 2015, the global injury mortality declined, but in countries where the poorest billion live, injuries are becoming an increasingly prevalent cause of death. The vulnerability of this population requires immediate attention from policy makers to implement effective interventions that lessen the burden of injuries in these countries. Our aim was two-fold; first, to review all the evidence on effective interventions for the five main types of unintentional injury; and second, to estimate the potential number of lives saved by effective injury interventions among the poorest billion. For our systematic review we used references in the Disability Control Priorities third edition, and searched PubMed and the Cochrane database for papers published until Sept 10, 2016, using a comprehensive search strategy to find interventions for the five major causes of unintentional injuries: road traffic crashes, falls, drowning, burns, and poisoning. Studies were included if they presented evidence with significant effects sizes for any outcome; no inclusions or exclusions made on the basis of where the study was carried out (ie, low-income, middle-income, or high-income country). Then we used data from the Global Burden of Disease 2015 study and a Monte Carlo simulation technique to estimate the potential annual attributable number of lives saved among the poorest billion by these evidence-based injury interventions. We estimated results for 84 countries where the poorest billion live. From the 513 papers identified, 47 were eligible for inclusion. We identified 11 interventions that had an effect on injury mortality. For road traffic deaths, the most successful interventions in preventing deaths are speed enforcement (>80 000 lives saved per year) and drink-driving enforcement (>60 000 lives saved per year). Interventions potentially most effective in preventing deaths from drowning are formal swimming lessons for children younger than 14 years (>25 000 lives

Risk factors for unintentional occupational injury among urban transit bus drivers: a cohort longitudinal study.

PubMed

Wei, Chia; Gerberich, Susan G; Ryan, Andrew D; Alexander, Bruce H; Church, Timothy R; Manser, Michael

2017-12-01

Although many studies have focused on bus operators' occupational diseases, work-related injury and associated risk factor data are limited. The purpose of this longitudinal study was to investigate unintentional injury and exposures that may affect injury risk among metropolitan bus operators. Demographic, work-related, and injury data obtained from a metropolitan transit company for a 5-year period, enabled estimates of rates per 100 full time equivalents (FTEs) and adjusted Hazard Ratios (HRs), with 95% confidence intervals (CIs), using Generalized Estimating Equations and Cox proportional hazards models, respectively. The 2095 bus operators, included in this study, had an unintentional injury rate (95% CI) of 17.8 (16.1-19.7) per 100 FTEs. Multivariable analysis identified increased risks for operators who were female, compared to male (HR = 2.4; 2.0-2.8); worked less than 7 versus 7 to less than 12 hours per day (HR = 4.6; 3.8-5.5); and drove less than 7 versus 7 to less than 12 hours per day (HR = 3.2; 2.7-3.8). Suggestive increased risks were identified for operators working split versus straight shifts (HR = 1.2; 1.0-1.4) and for driving limited versus regular bus routes (HR = 1.36; 1.0-1.8). Results serve as a basis for further studies and inform the development of targeted intervention strategies to reduce bus operators' occupational injuries. Copyright © 2017 Elsevier Inc. All rights reserved.

Unintentional fall injuries associated with walkers and canes in older adults treated in U.S. emergency departments.

PubMed

Stevens, Judy A; Thomas, Karen; Teh, Leesia; Greenspan, Arlene I

2009-08-01

To characterize nonfatal, unintentional, fall-related injuries associated with walkers and canes in older adults. Surveillance data of injuries treated in hospital emergency departments (EDs), January 1, 2001, to December 31, 2006. The National Electronic Injury Surveillance System All Injury Program, which collects data from a nationally representative stratified probability sample of 66 U.S. hospital EDs. People aged 65 and older treated in EDs for 3,932 nonfatal unintentional fall injuries and whose records indicated that a cane or a walker was involved in the fall. Sex, age, whether the fall involved a cane or walker, primary diagnosis, part of the body injured, disposition, and location and circumstances of the fall. An estimated 47,312 older adult fall injuries associated with walking aids were treated annually in U.S. EDs: 87.3% with walkers, 12.3% with canes, and 0.4% with both. Walkers were associated with seven times as many injuries as canes. Women's injury rates exceeded those for men (rate ratios=2.6 for walkers, 1.4 for canes.) The most prevalent injuries were fractures and contusions or abrasions. Approximately one-third of subjects were hospitalized for their injuries. Injuries and hospital admissions for falls associated with walking aids were frequent in this highly vulnerable population. The results suggest that more research is needed to improve the design of walking aids. More information also is needed about the circumstances preceding falls, both to better understand the contributing fall risk factors and to develop specific and effective fall prevention strategies.

A systematic review of technology-based interventions for unintentional injury prevention education and behaviour change.

PubMed

Omaki, Elise; Rizzutti, Nicholas; Shields, Wendy; Zhu, Jeffrey; McDonald, Eileen; Stevens, Martha W; Gielen, Andrea

2017-04-01

The aims of this literature review are to (1) summarise how computer and mobile technology-based health behaviour change applications have been evaluated in unintentional injury prevention, (2) describe how these successes can be applied to injury-prevention programmes in the future and (3) identify research gaps. Studies included in this systematic review were education and behaviour change intervention trials and programme evaluations in which the intervention was delivered by either a computer or mobile technology and addressed an unintentional injury prevention topic. Articles were limited to those published in English and after 1990. Among the 44 technology-based injury-prevention studies included in this review, 16 studies evaluated locally hosted software programmes, 4 studies offered kiosk-based programmes, 11 evaluated remotely hosted internet programmes, 2 studies used mobile technology or portable devices and 11 studies evaluated virtual-reality interventions. Locally hosted software programmes and remotely hosted internet programmes consistently increased knowledge and behaviours. Kiosk programmes showed evidence of modest knowledge and behaviour gains. Both programmes using mobile technology improved behaviours. Virtual-reality programmes consistently improved behaviours, but there were little gains in knowledge. No studies evaluated text-messaging programmes dedicated to injury prevention. There is much potential for computer-based programmes to be used for injury-prevention behaviour change. The reviewed studies provide evidence that computer-based communication is effective in conveying information and influencing how participants think about an injury topic and adopt safety behaviours. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Traumatic Stress, Depression, and Recovery: Child and Parent Responses After Emergency Medical Care for Unintentional Injury.

PubMed

Kassam-Adams, Nancy; Bakker, Anne; Marsac, Meghan L; Fein, Joel A; Winston, Flaura Koplin

2015-11-01

To assess psychological symptoms in injured children (aged 8-17 years) and their parents after emergency department (ED) care to examine the relationship between posttraumatic stress and depression symptoms, co-occurrence of symptoms within families, and the relationship of these symptoms to parent-reported overall recovery. Children and parents (n = 263 child-parent dyads) were enrolled during ED treatment for unintentional injury. Approximately 5 months later, children and parents (n = 178 dyads) completed standardized measures of posttraumatic stress and depression symptoms and parents reported on child overall recovery. Follow-up assessments found significant posttraumatic stress symptoms in 15% of children and 5% of parents, significant depression symptoms in 13% of children and 16% of parents, and problematic overall recovery in 17% of children. For both children and parents, posttraumatic stress and depression symptom severity were strongly associated. Child and parent symptoms were only modestly associated with each other, and there were few families in which both child and parent had significant posttraumatic stress or depression. Parent symptoms, but not child symptoms, were inversely associated with children's overall recovery. For about 1 in 6 children and parents, unintentional injury treated in the ED can be associated with negative psychological sequelae and suboptimal recovery. Within families, child and parent responses may differ; their relative association with overall recovery deserves additional research. To promote emotional recovery, ED clinicians should be aware of the potential psychological impact of unintentional injury, provide timely evidence-based anticipatory guidance, and communicate these concerns to primary care clinicians.

The First-aid Advice and Safety Training (FAST) parents programme for the prevention of unintentional injuries in preschool children: a protocol.

PubMed

Mytton, Julie A; Towner, Elizabeth Ml; Kendrick, Denise; Stewart-Brown, Sarah; Emond, Alan; Ingram, Jenny; Blair, Peter S; Powell, Jane; Mulvaney, Caroline; Thomas, James; Deave, Toity; Potter, Barbara

2014-02-01

Unintentional injury is the leading cause of preventable death in children in the UK, and 0-4-year-olds frequently attend emergency departments following injuries in the home. Parenting programmes designed to support parents, promote behaviour change and enhance parent-child relationships have been shown to improve health outcomes in children. It is not known whether group-based parenting programmes have the potential to prevent unintentional injuries in preschool children. A study to develop a group-based parenting programme to prevent unintentional home injuries in preschool children, and assess the feasibility of evaluation through a cluster-randomised controlled trial. The intervention, designed for parents of children who have sustained a medically attended injury, will be developed with two voluntary sector organisations. The feasibility study will assess ability to recruit parents, deliver the programme and follow-up participants. Participants will complete questionnaires at baseline, 3 months and 6 months, and report injuries in their preschool children using a tool designed and validated for this study. Qualitative methods will assess user and deliverer perceptions of the programme. This study will develop the first group-based parenting programme to prevent injuries in preschool children, and design tools for parent-reported injury outcomes. A key challenge will be to recruit parents to participate in a manner that is non-stigmatising, and does not result in feelings of guilt or belief that they are perceived to be a bad parent. The findings will be used to prepare a trial to assess the effectiveness and cost-effectiveness of the intervention.

Incidence, patterns and severity of reported unintentional injuries in Pakistan for persons five years and older: results of the National Health Survey of Pakistan 1990-94.

PubMed

Fatmi, Zafar; Hadden, Wilbur C; Razzak, Junaid A; Qureshi, Huma I; Hyder, Adnan A; Pappas, Gregory

2007-07-10

National level estimates of injuries are not readily available for developing countries. This study estimated the annual incidence, patterns and severity of unintentional injuries among persons over five years of age in Pakistan. National Health Survey of Pakistan (NHSP 1990-94) is a nationally representative survey of the household. Through a two-stage stratified design, 18, 315 persons over 5 years of age were interviewed to estimate the overall annual incidence, patterns and severity of unintentional injuries for males and females in urban and rural areas over the preceding one year. Weighted estimates were computed adjusting for complex survey design using surveyfreq and surveylogistic option of SAS 9.1 software. The overall annual incidence of all unintentional injuries was 45.9 (CI: 39.3-52.5) per 1000 per year; 59.2 (CI: 49.2-69.2) and 33.2 (CI: 27.0-39.4) per 1000 per year among males and females over five years of age, respectively. An estimated 6.16 million unintentional injuries occur in Pakistan annually among persons over five years of age. Urban and rural injuries were 55.9 (95% CI: 48.1-63.7) and 41.2 (95% CI: 32.2-50.0) per 1000 per year, respectively. The annual incidence of injuries due to falls were 22.2 (95% CI: 18.0-26.4), poisoning 3.3 (95%CI: 0.5-6.1) and burn was 1.5 (95%CI: 0.9-2.1) per 1000 per year. The majority of injuries occurred at home 19.2 (95%CI: 16.0-22.4) or on the roads 17.0 (95%CI: 13.8-20.2). Road traffic/street, school and urban injuries were more likely to result in handicap. There is high burden of unintentional injuries among persons over five years of age in Pakistan. These results are useful to plan further studies and prioritizing prevention programs on injuries nationally and other developing countries with similar situation.

Unintentional Injuries in Preschool Age Children: Is There a Correlation With Parenting Style and Parental Attention Deficit and Hyperactivity Symptoms.

PubMed

Acar, Ethem; Dursun, Onur Burak; Esin, İbrahim Selcuk; Öğütlü, Hakan; Özcan, Halil; Mutlu, Murat

2015-08-01

Unintentional injuries are the leading cause of death among children. Previous research has shown that most of the injuries occur in and around the home. Therefore, parents have a key role in the occurrence and prevention of injuries. In this study, we examined the relationship among home injuries to children and parental attention deficit hyperactivity disorder (ADHD) symptoms, parental attitudes, and children's behavioral problems.Forty children who were admitted to the emergency department because of home injuries constitute the study group. The control group also consisted of 40 children, who were admitted for mild throat infections. The parents filled out questionnaires assessing parental ADHD, child behavioral problems, and parenting attitudes.Scores were significantly higher for both internalizing disorders and externalizing disorders in study groups. We also found that ADHD symptoms were significantly higher among fathers of injured children compared with fathers of control groups. Democratic parenting was also found to correlate with higher numbers of injuries.Parenting style, as well as the psychopathology of both the parents and children, is important factors in children's injuries. A child psychiatrist visit following an emergency procedure may help to prevent further unintentional injuries to the child.

Mothers' supervision and perception of young children's risk of unintentional injury in the home.

PubMed

Gärling, A; Gärling, T

1993-02-01

Investigated whether control exerted through supervision is believed by mothers to reduce risk of unintentional injury to their children. 150 mothers of 1-, 2-, and 3-year-old children rated the risk of their child having an injury and indicated what injuries they anticipated in different rooms of the home under four conditions of supervision. A clear effect of supervision was observed in that rated risk and the number of anticipated injuries decreased depending on whether the mother was in the same room or not. Furthermore, a decrease was found when the mother was in the same room engaged in the same activity as the child (either playing with or being assisted by the child). The observed effects of supervision were less strong for older children and for rooms perceived as less dangerous.

The Epidemiology of Unintentional and Violence-Related Injury Morbidity and Mortality among Children and Adolescents in the United States.

PubMed

Ballesteros, Michael F; Williams, Dionne D; Mack, Karin A; Simon, Thomas R; Sleet, David A

2018-03-28

Injuries and violence among young people have a substantial emotional, physical, and economic toll on society. Understanding the epidemiology of this public health problem can guide prevention efforts, help identify and reduce risk factors, and promote protective factors. We examined fatal and nonfatal unintentional injuries, injuries intentionally inflicted by other (i.e., assaults and homicides) among children ages 0-19, and intentionally self-inflicted injuries (i.e., self-harm and suicides) among children ages 10-19. We accessed deaths (1999-2015) and visits to emergency departments (2001-2015) for these age groups through the Centers for Disease Control and Prevention's (CDC) Web-based Injury Statistics Query and Reporting System (WISQARS), and examined trends and differences by age, sex, race/ethnicity, rural/urban status, and injury mechanism. Almost 13,000 children and adolescents age 0-19 years died in 2015 from injury and violence compared to over 17,000 in 1999. While the overall number of deaths has decreased over time, there were increases in death rates among certain age groups for some categories of unintentional injury and for suicides. The leading causes of injury varied by age group. Our results indicate that efforts to reduce injuries to children and adolescents should consider cause, intent, age, sex, race, and regional factors to assure that prevention resources are directed at those at greatest risk.

Work-Related Unintentional Injuries Associated With Hurricane Sandy in New Jersey.

PubMed

Marshall, Elizabeth G; Lu, Shou-En; Shi, Zhengyang; Swerdel, Joel; Borjan, Marija; Lumia, Margaret E

2016-06-01

We aimed to evaluate the occurrence of work-related injuries after Hurricane Sandy potentially related to response and recovery. Emergency and hospital discharges (patients aged 18-65 years) with a diagnosis of unintentional injury were obtained from the New Jersey Department of Health. Work-related injuries were identified as those with a workers' compensation payer or other work-related codes. Counties were categorized as high-, medium-, or low-impact areas. Poisson regression analysis was used to compare the rate of work-related injury the year following Sandy landfall with the 3 previous years. Total work-related injuries declined the week immediately after Sandy (rate ratio [RR]: 0.85; 95% confidence interval [CI]: 0.69-1.05) and no overall increase was found in the year after Hurricane Sandy. However, high-impact counties showed an elevated risk of work-related injuries in the first and third quarters after Hurricane Sandy among men, especially for blacks and Hispanics. The greatest excesses occurred in the third quarter after the storm, May to July, for falls (RR: 1.30; 95% CI: 1.08-1.57), cut/pierce injuries (RR: 1.24; 95% CI: 1.09-1.40), struck-by injuries (RR: 1.17; 95% CI: 1.02-1.34), and overexertion (RR: 1.26; 95% CI: 1.10-1.44). Hospital data suggested an increase in injuries associated with rebuilding and recovery rather than with initial response. Future efforts aimed at prevention should evaluate the mechanisms and circumstances of injury in more detail. (Disaster Med Public Health Preparedness. 2016;10:394-404).

Unintentional Injuries and Psychosocial Correlates among in-School Adolescents in Malaysia.

PubMed

Peltzer, Karl; Pengpid, Supa

2015-11-20

The study aimed to provide estimates of the prevalence and psychosocial correlates of unintentional injury among school-going adolescents in Malaysia. Cross-sectional data from the Global School-Based Health Survey (GSHS) included 21,699 students (predominantly ≤13 to ≥17 years) that were selected by a two-stage cluster sample design to represent all secondary school students in Forms 1 to 5. The percentage of school children reporting one or more serious injuries in the past year was 34.9%, 42.1% of boys and 27.8% of girls. The two major causes of the most serious injury were "fall" (9.9%) and motor vehicle accident or being hit by a motor vehicle (5.4%), and the most frequent type of injury sustained was cut, puncture, or stab wound (6.2%) and a broken bone or dislocated joint (4.2%). In multivariable logistic regression analysis, sociodemographic factors (being male and low socioeconomic status), substance use (tobacco and cannabis use), frequent soft drink consumption, attending physical education classes three or more times a week, other risky behavior (truancy, ever having had sex, being bullied), psychological distress, and lack of parental or guardian bonding were associated with annual injury prevalence. Several factors were identified, which could be included in injury prevention promotion programs among secondary school children.

Unintentional Injuries and Psychosocial Correlates among in-School Adolescents in Malaysia

PubMed Central

Peltzer, Karl; Pengpid, Supa

2015-01-01

The study aimed to provide estimates of the prevalence and psychosocial correlates of unintentional injury among school-going adolescents in Malaysia. Cross-sectional data from the Global School-Based Health Survey (GSHS) included 21,699 students (predominantly ≤13 to ≥17 years) that were selected by a two-stage cluster sample design to represent all secondary school students in Forms 1 to 5. The percentage of school children reporting one or more serious injuries in the past year was 34.9%, 42.1% of boys and 27.8% of girls. The two major causes of the most serious injury were “fall” (9.9%) and motor vehicle accident or being hit by a motor vehicle (5.4%), and the most frequent type of injury sustained was cut, puncture, or stab wound (6.2%) and a broken bone or dislocated joint (4.2%). In multivariable logistic regression analysis, sociodemographic factors (being male and low socioeconomic status), substance use (tobacco and cannabis use), frequent soft drink consumption, attending physical education classes three or more times a week, other risky behavior (truancy, ever having had sex, being bullied), psychological distress, and lack of parental or guardian bonding were associated with annual injury prevalence. Several factors were identified, which could be included in injury prevention promotion programs among secondary school children. PMID:26610542

Risk factors for unintentional injuries due to falls in children aged 0–6 years: a systematic review

PubMed Central

Khambalia, A; Joshi, P; Brussoni, M; Raina, P; Morrongiello, B; Macarthur, C

2006-01-01

Objective To identify risk factors for unintentional injuries due to falls in children aged 0–6 years. Design A systematic review of the literature. Methods Electronic databases from 1966 to March 2005 were comprehensively searched to identify empirical research that evaluated risk factors for unintentional injuries due to falls in children aged 0–6 years and included a comparison group. Results 14 studies met the inclusion criteria. Studies varied by the type of fall injury that was considered (ie, bunk bed, stairway, playground or infant walker) and with respect to the quality of evidence. In general, major risk factors for the incidence or severity of injuries due to falls in children included age of the child, sex, height of the fall, type of surface, mechanism (dropped, stairway or using a walker), setting (day care v home care) and socioeconomic status. Conclusion Despite a high burden, few controlled studies have examined the risk and protective factors for injuries due to falls in children aged 0–6 years. The only study to examine falls from a population health perspective suggests that age, sex and poverty are independent risk factors for injuries due to falls in children. PMID:17170185

Presence of minor and major mental health impairment in adolescence and death from suicide and unintentional injuries/accidents in men: a national longitudinal cohort study.

PubMed

Fadum, Elin Anita; Fønnebø, Vinjar; Borud, Einar Kristian

2017-01-01

To examine the association between minor and major mental health impairment in late adolescence and death from suicide and unintentional injuries/accidents in men. In Norway, all men attend a compulsory military medical and psychological examination. We included 558 949 men aged 17-19 years at the time of military examination in 1980-1999 and followed them up for death from suicide and unintentional injuries/accidents until the end of 2013. We used Cox proportional hazard models to examine the association between the presence of minor and major mental health impairments at examination and death from suicide and unintentional injuries/accidents. Compared to men with no mental health impairment, those with minor mental health impairment was associated with an increased risk of death from suicide (adjusted HR (HR adj )=1.63, 95% CI 1.39 to 1.92), transport accidents (HR adj =1.33, 95% CI 1.09 to 1.63), accidental poisoning (HR adj =2.27, 95% CI 1.79 to 2.88) and other unintentional injuries/accidents (HR adj =1.54, 95% CI 1.17 to 2.02). In men with major mental health impairment, the risk of death from suicide and accidental poisoning was elevated two times (HR adj =2.29, 95% CI 1.85 to 2.85) and three times (HR adj =3.53, 95% CI 2.61 to 4.79), respectively. We found an increased risk of death from suicide and unintentional injuries/accidents in men who had minor and major mental health impairment at age 17-19 years. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Pattern of unintentional burns: A hospital based study from Pakistan.

PubMed

Adil, Syed Omair; Ibran, Ehmer-Al; Nisar, Nighat; Shafique, Kashif

2016-09-01

Burns are major cause of morbidity and mortality in developing countries. Better understanding of the nature and extent of injury remains the major and only available way to halt the occurrence of the event. The present study was conducted to determine the prevalence of by self and by other unintentional burn, their comparison and the possible mode of acquisition by obtaining the history of exposure to known risk factors. A cross-sectional questionnaire based survey was conducted in Burns Centre of Civil Hospital Karachi, Pakistan and 324 hospitalized adult patients with unintentional burns were consecutively interviewed during August 2013 to February 2014. Information was collected on socio-demographic profile. The source of burn, affected body part and place of injury acquisition in terms of home, outside or work were also noted. Logistic regression model was conducted using SPSS software. Out of 324 patients, 295 (91%) had unintentional burn by self and 29 (9%) had unintentional burn by others. Male gender were 2.37 times and no schooling were 1.75 times more likely to have self-inflicted unintentional burn. Lower limb and head and neck were less likely to involve in unintentional burn by self. The burden of unintentional burn by self was considerably higher. Male gender and no schooling were found more at risk to have unintentional burn by self. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

[Treatment of childhood injuries and violence in public emergency services].

PubMed

Malta, Deborah Carvalho; Mascarenhas, Márcio Denis Medeiros; Neves, Alice Cristina Medeiros das; Silva, Marta Alves da

2015-05-01

This study aimed to analyze the profile of treatment for accidents and violence involving children under 10 years of age in Brazil in the year 2011. This was a cross-sectional descriptive study in 71 emergency services in the Brazilian Unified National Health System (SUS), located in the national capital and 24 state capitals. Data were obtained from the Ministry of Health's system of sentinel surveillance services for Violence and Accidents (VIVA Survey). The highest proportion of injuries (67.4%) occurred inside the child's home. Among unintentional injuries, falls were the most frequent (52.4%), followed by running into objects or persons (21.8%) and traffic injuries (10.9%), especially as passengers (bicycles were an important means of transportation involved in the injuries). The vast majority of unintentional injuries are avoidable, and educational measures should be adopted, especially with parents, teachers, the community, and health workers, calling attention to the risks and the adoption of safe behaviors in the home, at school, and in leisure-time activities. Cases of violence are subject to mandatory reporting, and prompt measures should be taken to protect victims.

Trends and Patterns in Unintentional Injury Fatalities in Australian Agriculture.

PubMed

Lower, Tony; Rolfe, Margaret; Monaghan, Noeline

2017-04-26

Agriculture is recognized internationally as a hazardous industry. This article describes the trends and patterns of unintentional farm fatalities in Australia. Data from the National Coronial Information System were analyzed to assess all unintentional farm fatalities for the 2001-2015 period. A secondary comparison with earlier coronial system data from 1989-1992 was also completed to ascertain historical changes. There was no statistically significant change in the rate of work-related fatalities per 100,000 workers in the 2001-2015 period. However, there was a significant curvilinear reduction in all cases of fatality (work and non-work related) per 10,000 agricultural establishments, which decreased from 2001 to 2009-2011 and then increased to 2015. The longer-term data from 1989-2015 revealed a reduction of 30% in work-related cases per 100,000 workers and a reduction of 35% in all cases (work and non-work) per 10,000 agricultural establishments. For both work-related and all cases, there was a statistically significant reduction from 1989 to 2005 and then no change thereafter. The longer-term reduction in farm fatalities ceased in the mid-2000s, and the rate has remained stable since. Fatal injuries continue to impose a significant burden on Australian farming communities, with the rate remaining relatively static for the past ten years. New evidence-based interventions targeting priority areas are required to reduce the incidence of fatalities in Australia agriculture. Copyright© by the American Society of Agricultural Engineers.

Unintentional injury outcomes secondary to pedestrian traffic crashes: a descriptive analysis from a major medical center.

PubMed

Ifesanya, Adeleke O; Afuwape, Dolapo; Okoje, Victoria N; Agunloye, Atinuke; Odole, Olusola; Okolo, Clement A; Alonge, Temitope O

2009-01-01

An environment in which traffic regulations are not strictly enforced often is characterized by carnage from motor vehicular crashes resulting in severe injuries with unacceptably high mortality. The descriptive demographics and injury characteristics of pedestrian road crash victims presenting to a tertiary medical center in southwestern Nigeria are presented in order to provide baseline epidemiology as a first step in determining areas of potential mitigation for care of unintentional injuries. Consecutive pedestrian road traffic crash patients treated in the Accident and Emergency Department of a tertiary hospital were prospectively reviewed from March 2007 to February 2008 to determine baseline demographics and clinical outcomes. A total of 184 patients with a mean value of the ages of 31.4 years were studied; 27% of the patients were <11 years of age. The male to female ratio was 1.6:1. Fifty-four percent of the victims were struck by automobiles and 29% were struck by motorcycles. Sixty-five percent were struck while crossing common thoroughfares. Head injury was sustained in 61% of patients. The mortality rate was 31.0% (n = 57). The clinical course leading to death showed 22.8% of the patients who died initially experienced hemorrhagic shock, 17.5% suffered a severe head injury, and 17.5% suffered aspiration. Autopsy confirmed brainstem herniation in 28.1% of the patients who died. The average interval between injury and death was 5.5 +/-13.6 days (range: 0-77 days). In this setting, three out of every ten patients experiencing pedestrian vehicular trauma will die before leaving the hospital. The elderly are most at risk, with two-thirds of victims dying from injuries sustained. This raises serious questions about the prehospital- and hospital-based emergency services for vehicular road crash victims in this environment, and confirms the World Health Organization findings that Africa has the highest rate overall for unintentional injury deaths. A system

Factors Influencing Young Children's Risk of Unintentional Injury: Parenting Style and Strategies for Teaching about Home Safety

ERIC Educational Resources Information Center

Morrongiello, Barbara A.; Corbett, Michael; Lasenby, Jennifer; Johnston, Natalie; McCourt, Meghan

2006-01-01

This study examined mothers' teaching about home-safety issues to 24-30 month and 36-42 month old children, explored the relationship of teaching strategies to parenting styles, and assessed how these factors are related to children's risk of unintentional injury. A structured interview assessed home-safety issues relevant to falls, burns, cuts,…

Type A personality, hostility, time urgency and unintentional injuries among Chinese undergraduates: a matched case–control study

PubMed Central

2013-01-01

Background Associations between type A behaviour pattern (TABP) and injuries are inconsistent. These inconsistencies may be due to different effects of various components of TABP, namely time urgency/impatience, hostility and competitive drive. It is important to examine the relationship between the global TABP, its two components, and unintentional injuries, among undergraduates in China. Methods On the basis of a previous cross-sectional study, we conducted a matched case–control study. 253 cases and an equal number of age-, gender-, and major-matched controls were included. The questionnaire solicited socio-demographic information, the experience of injuries, the scale of TABP, and other potential confounding factors. Besides the correlation between the global TABP and injuries, the influences of the two components of TABP on injuries were also evaluated. Conditional logistic regression was used to determine the crude odds ratios (ORs) and adjusted ORs of injury events. Results A dose–response relationship was apparent among students who rated themselves higher on the TABP scale (P-value for trend, 0.002), with a crude OR of 2.93 (95% CI: 0.93–9.19) for injuries comparing those with TABP to those with type B behaviour pattern (TBBP). After adjustment for potential confounding factors, TABP remained statistically significant, and the adjusted OR was 5.52 (95% CI: 1.43–21.27); from a comparison of students with TABP to those with TBBP. A dose–response relationship was also apparent between the hostility component and nonfatal injuries, both in crude analysis and after adjusting for other confounders. The relationship between time-hurry and injuries was not statistically significant, based on univariate and multivariate analyses. Conclusions Both the global TABP and the hostility component were associated with a dose response increase in the risk of non-fatal unintentional injuries among Chinese undergraduates. Further studies need to be conducted to

Injury hospitalizations due to unintentional falls among the Aboriginal population of British Columbia, Canada: incidence, changes over time, and ecological analysis of risk markers, 1991-2010.

PubMed

Jin, Andrew; Lalonde, Christopher E; Brussoni, Mariana; McCormick, Rod; George, M Anne

2015-01-01

Aboriginal people in British Columbia (BC) have higher injury incidence than the general population. Our project describes variability among injury categories, time periods, and geographic, demographic and socio-economic groups. This report focuses on unintentional falls. We used BC's universal health care insurance plan as a population registry, linked to hospital separation and vital statistics databases. We identified Aboriginal people by insurance premium group and birth and death record notations. We identified residents of specific Aboriginal communities by postal code. We calculated crude incidence and Standardized Relative Risk (SRR) of hospitalization for unintentional fall injury, standardized for age, gender and Health Service Delivery Area (HSDA), relative to the total population of BC. We tested hypothesized associations of geographic, socio-economic, and employment-related characteristics with community SRR of injury by linear regression. During 1991 through 2010, the crude rate of hospitalization for unintentional fall injury in BC was 33.6 per 10,000 person-years. The Aboriginal rate was 49.9 per 10,000 and SRR was 1.89 (95% confidence interval 1.85-1.94). Among those living on reserves SRR was 2.00 (95% CI 1.93-2.07). Northern and non-urban HSDAs had higher SRRs, within both total and Aboriginal populations. In every age and gender category, the HSDA-standardized SRR was higher among the Aboriginal than among the total population. Between 1991 and 2010, crude rates and SRRs declined substantially, but proportionally more among the Aboriginal population, so the gap between the Aboriginal and total population is narrowing, particularly among females and older adults. These community characteristics were associated with higher risk: lower income, lower educational level, worse housing conditions, and more hazardous types of employment. Over the years, as socio-economic conditions improve, risk of hospitalization due to unintentional fall injury has

Health and Safety: Involving Community Workers in Early Childhood Classrooms

ERIC Educational Resources Information Center

Wallinga, Charlotte; Coleman, Mick; Bales, Diane

2007-01-01

Dramatic improvements have been made in the lives of children over the last century. Even so, many health and safety challenges remain unresolved. For example, unintentional injuries claim the lives of more children each year than any other cause of death. In addition, a panel of pediatricians reported that the incidence of childhood obesity…

Descriptive epidemiology of unintentional residential fire injuries in King County, WA, 1984 and 1985.

PubMed Central

Ballard, J E; Koepsell, T D; Rivara, F P; Van Belle, G

1992-01-01

Although most studies have concentrated on fatal residential fire injuries, which are a leading cause of fatal injuries in the United States, few investigators have examined in detail nonfatal injuries as a consequence of residential fires. This population-based study used the Washington State Fire Incident Reporting System to assess the incidence and descriptive epidemiology of fatal and nonfatal burns or respiratory tract damage resulting from unintentional residential fires. For the 2-year period 1984-85 in King County, WA, the mortality rate due to injury in a residential fire was 0.7 per 100,000 per year, and the incidence of nonfatal injuries was 5.6 per 100,000 per year. Of 17 fatalities, 59 percent of the deaths occurred at the scene of the fire. Of 128 persons with nonfatal injuries, 19 percent were hospitalized; although the 55 percent seen as outpatients and the 26 percent treated by the fire department or paramedics at the fire scene usually had minor injuries, they would not have been captured if only traditional data sources had been employed. Those injured averaged 2.8 days of restricted activity, but the range was from less than 1 day to 1 year. Injuries were more common in the households with a low socioeconomic status and among nonwhites, especially American Indians. Variation in incidence by age, sex, and source of ignition for deaths and nonfatal injuries suggests appropriate targets for future fire injury prevention programs. PMID:1641436

Unintentional Injury Mortality Among American Indians and Alaska Natives in the United States, 1990–2009

PubMed Central

Pokhrel, Pallavi; Worthington, Anne; Billie, Holly; Sewell, Mack; Bill, Nancy

2014-01-01

Objectives. We describe the burden of unintentional injury (UI) deaths among American Indian and Alaska Native (AI/AN) populations in the United States. Methods. National Death Index records for 1990 to 2009 were linked with Indian Health Service registration records to identify AI/AN deaths misclassified as non-AI/AN deaths. Most analyses were restricted to Contract Health Service Delivery Area counties in 6 geographic regions of the United States. We compared age-adjusted death rates for AI/AN persons with those for Whites; Hispanics were excluded. Results. From 2005 to 2009, the UI death rate for AI/AN people was 2.4 times higher than for Whites. Death rates for the 3 leading causes of UI death—motor vehicle traffic crashes, poisoning, and falls—were 1.4 to 3 times higher among AI/AN persons than among Whites. UI death rates were higher among AI/AN males than among females and highest among AI/AN persons in Alaska, the Northern Plains, and the Southwest. Conclusions. AI/AN persons had consistently higher UI death rates than did Whites. This disparity in overall rates coupled with recent increases in unintentional poisoning deaths requires that injury prevention be a major priority for improving health and preventing death among AI/AN populations. PMID:24754624

Self-harm, Unintentional Injury, and Suicide in Bipolar Disorder During Maintenance Mood Stabilizer Treatment: A UK Population-Based Electronic Health Records Study.

PubMed

Hayes, Joseph F; Pitman, Alexandra; Marston, Louise; Walters, Kate; Geddes, John R; King, Michael; Osborn, David P J

2016-06-01

Self-harm is a prominent cause of morbidity in patients with bipolar disorder and is strongly associated with suicide. There is evolving evidence that lithium use may reduce suicidal behavior, in addition to concerns that the use of anticonvulsants may increase self-harm. Information is limited about the effects of antipsychotics when used as mood stabilizer treatment. Rates of unintentional injury are poorly defined in bipolar disorder, and understanding drug associations with this outcome may shed light on mechanisms for lithium's potential antisuicidal properties through reduction in impulsive aggression. To compare rates of self-harm, unintentional injury, and suicide in patients with bipolar disorder who were prescribed lithium, valproate sodium, olanzapine, or quetiapine fumarate. This investigation was a propensity score (PS)-adjusted and PS-matched longitudinal cohort study in a nationally representative UK sample using electronic health records data collected between January 1, 1995, and December 31, 2013. Participants included all patients diagnosed as having bipolar disorder who were prescribed lithium, valproate, olanzapine, or quetiapine as maintenance mood stabilizer treatment. The primary outcome was any form of self-harm. Secondary outcomes were unintentional injury and suicide. Of the 14 396 individuals with a diagnosis of BPD, 6671 were included in the cohort, with 2148 prescribed lithium, 1670 prescribed valproate, 1477 prescribed olanzapine, and 1376 prescribed quetiapine as maintenance mood stabilizer treatment. Self-harm rates were lower in patients prescribed lithium (205; 95% CI, 175-241 per 10 000 person-years at risk [PYAR]) compared with those prescribed valproate (392; 95% CI, 334-460 per 10 000 PYAR), olanzapine (409; 95% CI, 345-483 per 10 000 PYAR), or quetiapine (582; 95% CI, 489-692 per 10 000 PYAR). This association was maintained after PS adjustment (hazard ratio [HR], 1.40; 95% CI, 1.12-1.74 for valproate, olanzapine

Into hot water head first: distribution of intentional and unintentional immersion burns.

PubMed

Daria, Sonya; Sugar, Naomi F; Feldman, Kenneth W; Boos, Stephen C; Benton, Scott A; Ornstein, Amy

2004-05-01

Experience with several, previously unreported, intentional face-first immersion burns led us to evaluate the distribution of inflicted and unintentional immersion scald burns in a hospital series. (1) Authors' clinical and legal practices; (2) Burn center at regional Level 1 trauma hospital. : (1) Case series of face-first, inflicted immersion burn victims; (2) Consecutive hospitalized scald burn victims younger than 5 years old, 1/3/1996 to 3/25/2000. (1) Individual case reports; (2) Retrospective records review. Simple descriptive statistics, Fisher Exact test and t test. (1) Six cases of inflicted head and neck immersion injury are described. Four were tap water and 2 food/drink scalds. (2) 22/195 hospitalized victims had sustained immersion burns, 13 from tap water and 9 from other fluids. Six (46%) tap water immersions and no (0%) other immersions had inflicted injuries (P = 0.05). Two of the tap water immersions and one other source immersion included burning of the head and neck. Of these, one tap water immersion, but no other immersion, was inflicted. In no patients were head and neck injuries the sole or predominant site of scalding. In all, 9 children sustained inflicted scalds. Bilateral lower extremity tap water immersion scalds occurred in 100% (6/6) of abusive and 29% (2/7) of unintentional injuries (P = 0.02). Buttock and perineal injuries occurred in 67% (4/6) inflicted versus 29% (2/7) unintentional tap water immersion scalds (P = 0.28). Other fluids caused bilateral lower extremity immersion burns in 3/9 (33 %) unintentionally injured patients, but no abused children (NS). Craniofacial immersion injury, although seen by the authors in legal cases, is infrequent. It was present incidentally in one inflicted tap water burn in the consecutive hospital series. This series affirms the predominance of bilateral lower extremity burns in inflicted tap water immersions. Buttock/perineal immersions were more common with abuse than with unintentional injury.

Risk of unintentional injuries in children and adolescents with ADHD and the impact of ADHD medications: protocol for a systematic review and meta-analysis

PubMed Central

Ruiz-Goikoetxea, Maite; Cortese, Samuele; Aznarez-Sanado, Maite; Magallon, Sara; Luis, Elkin O; Zallo, Noelia Alvarez; de Castro-Manglano, Pilar; Soutullo, Cesar

2017-01-01

Introduction Attention-deficit hyperactivity disorder (ADHD) has been related to increased rates of unintentional injuries. However, the magnitude of the effect and to which extent variables such as sex, age or comorbidity can influence this relationship is unknown. Additionally, and importantly, it is unclear if, and to which degree, ADHD medications can decrease the number of unintentional injuries. Due to the amount of economic and social resources invested in the treatment of injuries, filling these gaps in the literature is highly relevant from a public health standpoint. Here, we present a protocol for a systematic review and meta-analysis to estimate the relationship between ADHD and unintentional injuries and assess the impact of pharmacological treatment for ADHD Methods and analysis We will combine results from 114 bibliographic databases for studies relating ADHD and risk of injuries. Bibliographic searches and data extraction will be carried out independently by two researchers. The studies’ risk of bias will be assessed using the Newcastle-Ottawa Scale. Articles reporting ORs or HRs of suffering an injury in ADHD compared with controls (or enough data to calculate them) will be combined using Robust Variance Estimation, a method that permits to include multiple non-independent outcomes in the analysis. All analyses will be carried out in Stata. Age, sex and comorbid conduct disorders will be considered as potential causes of variance and their effect analysed through meta-regression and subgroup analysis. Sensitivity analyses will exclude articles with longer follow-ups, non-stringent definitions of ADHD or controls and statistically uncontrolled/controlled outcomes. Studies implementing a self-controlled case series methodology to investigate if ADHD drugs reduce the risk of injuries will be combined with a generalised linear mixed model using the Poisson distribution and a log link function. Registration details PROSPERO—Prospective Register of

A socio-ecological model for unintentional injuries in minorities: a case study of Arab Israeli children.

PubMed

Baron-Epel, Orna; Ivancovsky, Michal

2015-01-01

Minority children have often been reported to be at high risk of injury. The higher levels of reported unintentional injuries among Arab children compared to Jewish children in Israel are mainly due to pedestrian traffic crashes, falls and burns. Arab children aged 1-4 years have a higher relative risk of injury compared to Jews. We suggest a socio-ecological model to explain these differences in risk based on individual, interpersonal, community and societal ecological levels of society. Each level is divided into social and physical environments and behaviour. Two main factors may contribute to the high rates of injury among Arab children: the quality of the physical environment in which the children live and play and the levels of child supervision. Socio-economic status may contribute to these differences at all ecological levels of society. This approach could be useful for researchers and practitioners to analyse similar issues in other communities and help develop appropriate interventions.

Injury Hospitalizations Due to Unintentional Falls among the Aboriginal Population of British Columbia, Canada: Incidence, Changes over Time, and Ecological Analysis of Risk Markers, 1991-2010

PubMed Central

2015-01-01

Background Aboriginal people in British Columbia (BC) have higher injury incidence than the general population. Our project describes variability among injury categories, time periods, and geographic, demographic and socio-economic groups. This report focuses on unintentional falls. Methods We used BC’s universal health care insurance plan as a population registry, linked to hospital separation and vital statistics databases. We identified Aboriginal people by insurance premium group and birth and death record notations. We identified residents of specific Aboriginal communities by postal code. We calculated crude incidence and Standardized Relative Risk (SRR) of hospitalization for unintentional fall injury, standardized for age, gender and Health Service Delivery Area (HSDA), relative to the total population of BC. We tested hypothesized associations of geographic, socio-economic, and employment-related characteristics with community SRR of injury by linear regression. Results During 1991 through 2010, the crude rate of hospitalization for unintentional fall injury in BC was 33.6 per 10,000 person-years. The Aboriginal rate was 49.9 per 10,000 and SRR was 1.89 (95% confidence interval 1.85-1.94). Among those living on reserves SRR was 2.00 (95% CI 1.93-2.07). Northern and non-urban HSDAs had higher SRRs, within both total and Aboriginal populations. In every age and gender category, the HSDA-standardized SRR was higher among the Aboriginal than among the total population. Between 1991 and 2010, crude rates and SRRs declined substantially, but proportionally more among the Aboriginal population, so the gap between the Aboriginal and total population is narrowing, particularly among females and older adults. These community characteristics were associated with higher risk: lower income, lower educational level, worse housing conditions, and more hazardous types of employment. Conclusions Over the years, as socio-economic conditions improve, risk of

Childhood Injuries in Maine: A Status Report.

ERIC Educational Resources Information Center

DiCara, Cheryl; And Others

Purposes of this report are to: (1) describe the extent of the childhood injury problem relative to diseases and other conditions affecting children in Maine who are 1 to 19 years of age; (2) give an overview of what is known about the incidence of childhood injuries in Maine; and (3) offer recommendations to improve the state's ability to control…

Children admitted to hospital following unintentional injury: perspectives of health service providers in Aotearoa/New Zealand

PubMed Central

2010-01-01

Background Unintentional injuries are the leading cause of death and hospitalisation among New Zealand children, with indigenous Māori and ethnic minority Pacific children significantly over represented in these statistics. International research has shown that many children hospitalised for injury, as well as their families experience high levels of stress, and ethnic disparities in the quality of trauma care are not uncommon. The research on which this paper is based sought to identify key issues and concerns for New Zealand's multi-ethnic community following hospitalisation for childhood injury in order to inform efforts to improve the quality of trauma services. This paper reports on service providers' perspectives complementing previously published research on the experiences of families of injured children. Methods A qualitative research design involving eleven in-depth individual interviews and three focus groups was used to elicit the views of 21 purposefully selected service provider key informants from a range of professional backgrounds involved in the care and support of injured children and their families in Auckland, New Zealand. Interviews were transcribed and data were analysed using thematic analysis. Results Key issues identified by service providers included limited ability to meet the needs of children with mild injuries, particularly their emotional needs; lack of psychological support for families; some issues related to Māori and Pacific family support services; lack of accessible and comprehensive information for children and families; poor staff continuity and coordination; and poor coordination of hospital and community services, including inadequacies in follow-up plans. There was considerable agreement between these issues and those identified by the participant families. Conclusions The identified issues and barriers indicate the need for interventions for service improvement at systemic, provider and patient levels. Of particular

Children admitted to hospital following unintentional injury: perspectives of health service providers in Aotearoa/New Zealand.

PubMed

Ameratunga, Shanthi; Abel, Sally; Tin Tin, Sandar; Asiasiga, Lanuola; Milne, Sharon; Crengle, Sue

2010-12-07

Unintentional injuries are the leading cause of death and hospitalisation among New Zealand children, with indigenous Māori and ethnic minority Pacific children significantly over represented in these statistics. International research has shown that many children hospitalised for injury, as well as their families experience high levels of stress, and ethnic disparities in the quality of trauma care are not uncommon. The research on which this paper is based sought to identify key issues and concerns for New Zealand's multi-ethnic community following hospitalisation for childhood injury in order to inform efforts to improve the quality of trauma services. This paper reports on service providers' perspectives complementing previously published research on the experiences of families of injured children. A qualitative research design involving eleven in-depth individual interviews and three focus groups was used to elicit the views of 21 purposefully selected service provider key informants from a range of professional backgrounds involved in the care and support of injured children and their families in Auckland, New Zealand. Interviews were transcribed and data were analysed using thematic analysis. Key issues identified by service providers included limited ability to meet the needs of children with mild injuries, particularly their emotional needs; lack of psychological support for families; some issues related to Māori and Pacific family support services; lack of accessible and comprehensive information for children and families; poor staff continuity and coordination; and poor coordination of hospital and community services, including inadequacies in follow-up plans. There was considerable agreement between these issues and those identified by the participant families. The identified issues and barriers indicate the need for interventions for service improvement at systemic, provider and patient levels. Of particular relevance are strategies that enable

Pattern of childhood injury presenting at General Hospital Aliero, Nigeria.

PubMed

Buowari, D Y

2010-01-01

Injuries are important causes of morbidity and mortality in childhood. Children are vulnerable to injuries of any kind. This is a prospective study of children with injuries who presented at General Hospital Aliero. Records were kept of injuries in children age fifteen years and below that occurred from February to November 2006 at General Hospital, Aliero. We aim to study the pattern of childhood injuries presenting at General Hospital Aliero, Nigeria. Most of the injuries occurred at home 31 (48.4%) and on the road 28 (43.8%). Road traffic accidents occurred when a moving vehicle or motorcycle hit children or children falling from moving trucks. Boys 39 (60.9%) were more involved in injuries than girls 25 (39.1%). Mortality occurred in three injured children. Childhood injuries occur more in the boys and commonly Parents and guardians should not leave children unattended even for a moment. Children should always be in company of an adult when outside the home. Childhood injury can lead to serious work and financial problems for families. Health promoting and injury preventive interventions should be instituted to reduce the rate of injuries and their effects on children.

Risk of unintentional injuries in children and adolescents with ADHD and the impact of ADHD medications: protocol for a systematic review and meta-analysis.

PubMed

Ruiz-Goikoetxea, Maite; Cortese, Samuele; Aznarez-Sanado, Maite; Magallon, Sara; Luis, Elkin O; Álvarez Zallo, Noelia; Castro-Manglano, Pilar de; Soutullo, Cesar; Arrondo, Gonzalo

2017-09-25

Attention-deficit hyperactivity disorder (ADHD) has been related to increased rates of unintentional injuries. However, the magnitude of the effect and to which extent variables such as sex, age or comorbidity can influence this relationship is unknown. Additionally, and importantly, it is unclear if, and to which degree, ADHD medications can decrease the number of unintentional injuries. Due to the amount of economic and social resources invested in the treatment of injuries, filling these gaps in the literature is highly relevant from a public health standpoint. Here, we present a protocol for a systematic review and meta-analysis to estimate the relationship between ADHD and unintentional injuries and assess the impact of pharmacological treatment for ADHD METHODS AND ANALYSIS: We will combine results from 114 bibliographic databases for studies relating ADHD and risk of injuries. Bibliographic searches and data extraction will be carried out independently by two researchers. The studies' risk of bias will be assessed using the Newcastle-Ottawa Scale. Articles reporting ORs or HRs of suffering an injury in ADHD compared with controls (or enough data to calculate them) will be combined using Robust Variance Estimation, a method that permits to include multiple non-independent outcomes in the analysis. All analyses will be carried out in Stata. Age, sex and comorbid conduct disorders will be considered as potential causes of variance and their effect analysed through meta-regression and subgroup analysis. Sensitivity analyses will exclude articles with longer follow-ups, non-stringent definitions of ADHD or controls and statistically uncontrolled/controlled outcomes. Studies implementing a self-controlled case series methodology to investigate if ADHD drugs reduce the risk of injuries will be combined with a generalised linear mixed model using the Poisson distribution and a log link function. PROSPERO-Prospective Register of Systematic Reviews (CRD42017064967). �

[Childhood traumatization, dissociation and nonsuicidal self-injurious behavior in borderline personality disorder].

PubMed

Merza, Katalin; Harmatta, János; Papp, Gábor; Kuritárné Szabó, Ildikó

2017-05-01

Childhood traumatization plays a significant role in the etiology of borderline personality disorder. Studies found a significant association between childhood traumatization, dissociation, and nonsuicidal self-injurious behavior. The aim of our study was to assess dissociation and nonsuicidal self-injury among borderline inpatients and to reveal the association between childhood traumatization, dissociation, and self-injurious behavior. The sample consisted of 80 borderline inpatients and 73 depressed control patients. Childhood traumatization, dissociation and self-injurious behavior were assessed by questionnaires. Borderline patients reported severe and multiplex childhood traumatization. Cumulative trauma score and sexual abuse were the strongest predictors of dissociation. Furthermore, we have found that cumulative trauma score and dissociation were highly predictive of self-injurious behavior. Our results suggest that self-injurious behavior and dissociation in borderline patients can be regarded as indicators of childhood traumatization. Orv Hetil. 2017; 158(19): 740-747.

Firework-related childhood injuries in Greece: a national problem.

PubMed

Vassilia, Konte; Eleni, Petridou; Dimitrios, Trichopoulos

2004-03-01

During a 5-year period, out of 110066 children with injuries recorded in the Greek Emergency Department Injury Surveillance System (EDISS), 91 had firework-related injuries. Descriptive analyses and the Barrell matrix were used to determine risk factors and extrapolated national firework childhood injury figures were calculated. The estimated annual incidence of childhood firework injuries treated in the emergency departments of hospitals countrywide, was 7 per 100000 children years. Seventy percent of injuries concerned older children (10-14 years), mostly boys with self-inflicted injuries, whereas girls suffered injuries as bystanders. A sharp peak in spring was noted, when the Greek Orthodox Easter is celebrated. Illicitly sold fireworks caused most injuries, but in eight instances homemade firecrackers were responsible.

Relationships between Sleep Behaviors and Unintentional Injury in Southern Chinese School-Aged Children: A Population-Based Study.

PubMed

Tan, Yafei; Ma, Di; Chen, Ying; Cheng, Fuyuan; Liu, Xiangxiang; Li, Liping

2015-10-16

The purpose of this study is to explore the relationships between sleep behaviors and injury occurrence among Chinese school-aged children. Data were collected with self-administered questionnaires of a cross-sectional survey which covered the school-aged children from southeastern Chinese urban and rural areas in April 2010. Information was collected on unintentional injury in the past year, sleep duration, napping and daytime fatigue, sleeping pill use, and social-demographic variables. Multivariable logistic regression analyses, controlling for confounding factors, were conducted to assess sleep-related variables that were associated with injuries. Students who slept for less than 8 h had a 30% increased risk of injury (OR: 1.30; 95%CI: 1.01-1.69) compared with those who slept for 8-9 h. Lack of napping, snoring and use of sleeping pills were significantly associated with injury. Among different genders, the slight difference in sleep behaviors predicted the occurrence of injury. Rural children displayed more sleep behaviors associated with injury than urban children. The sleep behaviors of primary school students were more negatively correlated with injury occurrence than junior/senior high school children. Consideration should be given to the prevention of problematic sleep behaviors as a potential risk factor in order to decrease injury rates and promote the health of school-aged children.

The feasibility of using a parenting programme for the prevention of unintentional home injuries in the under-fives: a cluster randomised controlled trial.

PubMed

Mytton, Julie; Ingram, Jenny; Manns, Sarah; Stevens, Tony; Mulvaney, Caroline; Blair, Peter; Powell, Jane; Potter, Barbara; Towner, Elizabeth; Emond, Alan; Deave, Toity; Thomas, James; Kendrick, Denise; Stewart-Brown, Sarah

2014-01-01

Unintentional injury is the leading cause of preventable death of children over the age of 1 year in the UK and a major cause of attendance at emergency departments. Children having one injury are at increased risk of further injuries. Parenting programmes can reduce injuries in preschool children if delivered in the home and on a one-to-one basis. It is not known if group-based programmes delivered outside the home are effective. To develop (1) a parenting programme to prevent recurrent unintentional home injuries in preschool children and (2) a tool for parents to report unintentional home injuries occurring to their preschool children. To assess the feasibility of delivering and evaluating the parenting programme through a cluster randomised controlled trial, specifically to (1) assess methods for the recruitment and retention of parents; (2) determine the training, equipment and facilities needed for the delivery of the programme; (3) establish appropriate primary and secondary outcome measures and methods for their collection; (4) determine how 'normal care' in a comparison arm should be defined; and (5) determine the resource utilisation and costing data that would need to be collected for the cost-effectiveness component of a future trial; and (6) produce estimates of effect sizes to inform sample size estimation for a main trial. Feasibility multicentre, cluster, randomised, unblinded trial. Eight children's centres in Bristol and Nottingham, UK. Ninety-six parents of preschool children who had sustained an unintentional injury requiring medical attention in the previous 12 months. The First-aid Advice and Safety Training (FAST) parent programme, comprising parenting support and skills combined with first aid and home safety advice. Parent-reported medically attended injuries in the index child and any preschool siblings sustained during a 6-month period of observation. An 8-week parenting programme was produced, designed with participant

Using the public health model to address unintentional injuries and TBI: A perspective from the Centers for Disease Control and Prevention (CDC).

PubMed

Baldwin, Grant; Breiding, Matt; Sleet, David

2016-06-30

Traumatic brain injury (TBI) can have long term effects on mental and physical health, and can disrupt vocational, educational, and social functioning. TBIs can range from mild to severe and their effects can last many years after the initial injury. CDC seeks to reduce the burden of TBI from unintentional injuries through a focus on primary prevention, improved recognition and management, and intervening to improve health outcomes after TBI. CDC uses a 4-stage public health model to guide TBI prevention, moving from 1) surveillance of TBI, 2) identification of risk and protective factors for TBI, 3) development and testing of evidence-based interventions, to 4) bringing effective intervention to scale through widespread adoption. CDC's unintentional injury prevention activities focus on the prevention of sports-related concussions, motor vehicle crashes, and older adult falls. For concussion prevention, CDC developed Heads Up - an awareness initiative focusing on ways to prevent a concussion in sports, and identifying how to recognize and manage potential concussions. In motor vehicle injury prevention, CDC has developed a tool (MV PICCS) to calculate the expected number of injuries prevented and lives saved using various evidence-based motor vehicle crash prevention strategies. To help prevent TBI related to older adult falls, CDC has developed STEADI, an initiative to help primary care providers identify their patients' falls risk and provide effective interventions. In the future, CDC is focused on advancing our understanding of the public health burden of TBI through improved surveillance in order to produce more comprehensive estimates of the public health burden of TBI.

Relationships between Sleep Behaviors and Unintentional Injury in Southern Chinese School-Aged Children: A Population-Based Study

PubMed Central

Tan, Yafei; Ma, Di; Chen, Ying; Cheng, Fuyuan; Liu, Xiangxiang; Li, Liping

2015-01-01

The purpose of this study is to explore the relationships between sleep behaviors and injury occurrence among Chinese school-aged children. Data were collected with self-administered questionnaires of a cross-sectional survey which covered the school-aged children from southeastern Chinese urban and rural areas in April 2010. Information was collected on unintentional injury in the past year, sleep duration, napping and daytime fatigue, sleeping pill use, and social-demographic variables. Multivariable logistic regression analyses, controlling for confounding factors, were conducted to assess sleep-related variables that were associated with injuries. Students who slept for less than 8 h had a 30% increased risk of injury (OR: 1.30; 95%CI: 1.01–1.69) compared with those who slept for 8–9 h. Lack of napping, snoring and use of sleeping pills were significantly associated with injury. Among different genders, the slight difference in sleep behaviors predicted the occurrence of injury. Rural children displayed more sleep behaviors associated with injury than urban children. The sleep behaviors of primary school students were more negatively correlated with injury occurrence than junior/senior high school children. Consideration should be given to the prevention of problematic sleep behaviors as a potential risk factor in order to decrease injury rates and promote the health of school-aged children. PMID:26501305

Unintentional firearm deaths: a comparison of other-inflicted and self-inflicted shootings.

PubMed

Hemenway, David; Barber, Catherine; Miller, Matthew

2010-07-01

This study compares other-inflicted and self-inflicted unintentional firearm fatalities. Data come from the National Violent Death Reporting System, a new surveillance system from the Centers for Disease Control and Prevention. Data are currently available from 16 states and parts of California for various years 2003-2006. Of the 363 unintentional firearm fatalities, about half (49%) were other-inflicted, ranging from 78% of child (aged 0-14) deaths to 19% of older adult (aged 55+) deaths. In other-inflicted shooting deaths, the shooters were overwhelmingly young (81% under age 25). The shooters in the other-inflicted deaths were primarily friends (43%) or family (47%); brothers were the most common family shooter. To learn how to prevent unintentional injuries, it is critical to have information not only on the victim, but also on the person who inflicted the injury. Copyright 2010 Elsevier Ltd. All rights reserved.

The association of social functioning, social relationships and the receipt of compensation with time to return to work following unintentional injuries to Victorian workers.

PubMed

Clay, Fiona J; Fitzharris, Michael; Kerr, Emily; McClure, Roderick J; Watson, Wendy L

2012-09-01

Understanding individual factors associated with return to work (RTW) post-injury is an important goal of compensation systems research. The aim of the present study was to determine factors associated with time to return to work following acute unintentional injuries. A prospective cohort study was conducted in Victoria, Australia. The cohort comprised 133 persons who were employed at the time they were admitted to one of three study hospitals. Baseline health status data was obtained retrospectively at one-week post-injury and participants were further surveyed at 1, 6, 12, 26 and 52 weeks post-injury to measure recovery. Multivariate Cox proportional hazards regression analysis was used to examine the association between potential prognostic factors and time to RTW during the 12 month study. At the end of 12 months follow-up, 81.2% of the study cohort had returned to work. Older age, increased injury severity, self reported symptomatic pain and poor mental health at 1 week post-injury were associated with extended time to RTW. A significant statistical interaction between the receipt of compensation and high social functioning as measured by the SF-36 or strong social relationships as measured by the Assessment of Quality of Life was associated with earlier RTW. Participants reporting strong social relationships and high social functioning at 1 week post-injury and entitled to injury compensation returned to work 2.05 and 3.66 times earlier respectively, than similar participants with no entitlement to compensation. Both injury-related and psychosocial factors were associated with the duration of time to RTW following acute unintentional injuries. This study replicated previously reported findings on social functioning and compensation from an independent acute trauma sample. Programs or policies to improve social functioning early post-injury may provide opportunities to improve the duration of time to RTW following injury.

Risk of unintentional injuries in children and adolescents with ADHD and the impact of ADHD medications: A systematic review and meta-analysis.

PubMed

Ruiz-Goikoetxea, Maite; Cortese, Samuele; Aznarez-Sanado, Maite; Magallón, Sara; Alvarez Zallo, Noelia; Luis, Elkin O; de Castro-Manglano, Pilar; Soutullo, Cesar; Arrondo, Gonzalo

2018-01-01

A systematic review with meta-analyses was performed to: 1) quantify the association between ADHD and risk of unintentional physical injuries in children/adolescents ("risk analysis"); 2) assess the effect of ADHD medications on this risk ("medication analysis"). We searched 114 databases through June 2017. For the risk analysis, studies reporting sex-controlled odds ratios (ORs) or hazard ratios (HRs) estimating the association between ADHD and injuries were combined. Pooled ORs (28 studies, 4,055,620 individuals without and 350,938 with ADHD) and HRs (4 studies, 901,891 individuals without and 20,363 with ADHD) were 1.53 (95% CI=1.40,1.67) and 1.39 (95% CI=1.06,1.83), respectively. For the medication analysis, we meta-analysed studies that avoided the confounding-by-indication bias [four studies with a self-controlled methodology and another comparing risk over time and groups (a "difference in differences" methodology)]. The pooled effect size was 0.879 (95% CI=0.838,0.922) (13,254 individuals with ADHD). ADHD is significantly associated with an increased risk of unintentional injuries and ADHD medications have a protective effect, at least in the short term, as indicated by self-controlled studies. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

A systematic review of the epidemiology of unintentional burn injuries in South Asia.

PubMed

Golshan, Ashkan; Patel, Cyra; Hyder, Adnan A

2013-09-01

Burns are a significant cause of mortality and morbidity in developing countries. We examined the epidemiology of unintentional burns in South Asia to identify trends and gaps in information. A MEDLINE/PUBMED search (1970-2011) was undertaken on empirical studies that focused on burns in India, Pakistan, Bangladesh and Sri Lanka. Data analyzed included demographics, injury details and risk factors. Twenty-seven studies were identified, mostly from India. Burns were more common among males at younger ages (0-12 years) and among females from adolescence onward (>14 years). Flame-related burns and scalds accounted for over 80% of burns in most cases, and were the most common types of injuries observed among children and women with most burns occurring in the home. Electrical burns occurred mostly among men. Important risk factors for burns included low socioeconomic status, being younger, wearing loose, flammable clothing and the use of kerosene. Data on care-seeking and treatment were limited. Preventing burns in the household in South Asia, particularly around kitchen activities, is essential. Children in South Asia are susceptible to burns and are an important target population. Future research should focus on filling the gaps in burn epidemiology found in this review.

Fatal and hospitalised childhood injuries in Fiji (TRIP Project-3).

PubMed

Naisaki, Asilika; Wainiqolo, Iris; Kafoa, Berlin; Kool, Bridget; Taoi, Mabel; McCaig, Eddie; Ameratunga, Shanthi

2013-01-01

Although childhood injury rates in low- and middle-income countries are known to be high, contemporary data on this topic from Pacific Island countries and territories are scant. We describe the epidemiology of childhood injuries resulting in death or hospital admission in Fiji using a population-based registry. A cross-sectional analysis of the Fiji Injury Surveillance in Hospitals system investigated the characteristics associated with childhood injuries (<15 years) in Viti Levu, resulting in death or hospital admission (≥12 h) from October 2005 to September 2006. The 496 children meeting the study eligibility criteria corresponded to annual injury-related hospitalisation and death rates of 265.4 and 15.3 per 100,000, respectively. Most (82%) deaths occurred prior to hospitalisation. The death and hospitalisation rates were highest among the <5- and 5- to 9-year groups, respectively. Males and indigenous Fijian children were at increased risk of injury. The leading causes of injury death were road traffic injury (29%), choking (25%) and drowning (18%). Major causes of hospital admission were falls (48%), burns (13%), road traffic injury (11%) and being hit by a person or object (10%). Fractures and head injuries were the most common types of injury. The findings support the need for a national strategy that builds capacity and mobilises resources to prevent childhood injuries in Fiji. Priority actions should include investment in technical support and research to identify local contextual and social determinants that inform the development and implementation of effective injury prevention interventions as a child health survival strategy. © 2012 The Authors. Journal of Paediatrics and Child Health © 2012 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Unintentional injury and its prevention in infant: knowledge and self-reported practices of main caregivers

PubMed Central

2014-01-01

Background Unintentional injuries are the major cause of morbidity and mortality in infants. Prevention of unintentional injuries has been shown to be effective with education. Understanding the level of knowledge and practices of caregivers in infant safety would be useful to identify gaps for improvement. Methods A cross-sectional study was conducted in an urban government health clinic in Malaysia among main caregivers of infants aged 11 to 15 months. Face-to-face interviews were conducted using a semi-structured self-designed questionnaire. Responses to the items were categorised by the percentage of correct answers: poor (<50%), moderate (50% – 70%) and good (>70%). Results A total of 403 caregivers participated in the study. Of the 21 items in the questionnaire on knowledge, 19 had good-to-moderate responses and two had poor responses. The two items on knowledge with poor responses were on the use of infant walkers (26.8%) and allowing infants on motorcycles as pillion riders (27.3%). Self-reported practice of infant safety was poor. None of the participants followed all 19 safety practices measured. Eight (42.1%) items on self-reported practices had poor responses. The worst three of these were on the use of baby cots (16.4%), avoiding the use of infant walkers (23.8%) and putting infants to sleep in the supine position (25.6%). Better knowledge was associated with self-reported safety practices in infants (p < 0.05). However, knowledge did not correspond to correct practice, particularly on the use of baby cots, infant walkers and sarong cradles. Conclusion Main caregivers’ knowledge on infant safety was good but self-reported practice was poor. Further research in the future is required to identify interventions that target these potentially harmful practices. PMID:24885332

Unintentional injury and its prevention in infant: knowledge and self-reported practices of main caregivers.

PubMed

Ramdzan, Siti Nurkamilla; Liew, Su May; Khoo, Ee Ming

2014-05-29

Unintentional injuries are the major cause of morbidity and mortality in infants. Prevention of unintentional injuries has been shown to be effective with education. Understanding the level of knowledge and practices of caregivers in infant safety would be useful to identify gaps for improvement. A cross-sectional study was conducted in an urban government health clinic in Malaysia among main caregivers of infants aged 11 to 15 months. Face-to-face interviews were conducted using a semi-structured self-designed questionnaire. Responses to the items were categorised by the percentage of correct answers: poor (<50%), moderate (50% - 70%) and good (>70%). A total of 403 caregivers participated in the study. Of the 21 items in the questionnaire on knowledge, 19 had good-to-moderate responses and two had poor responses. The two items on knowledge with poor responses were on the use of infant walkers (26.8%) and allowing infants on motorcycles as pillion riders (27.3%). Self-reported practice of infant safety was poor. None of the participants followed all 19 safety practices measured. Eight (42.1%) items on self-reported practices had poor responses. The worst three of these were on the use of baby cots (16.4%), avoiding the use of infant walkers (23.8%) and putting infants to sleep in the supine position (25.6%). Better knowledge was associated with self-reported safety practices in infants (p < 0.05). However, knowledge did not correspond to correct practice, particularly on the use of baby cots, infant walkers and sarong cradles. Main caregivers' knowledge on infant safety was good but self-reported practice was poor. Further research in the future is required to identify interventions that target these potentially harmful practices.

Translation of an Evidence-Based Tailored Childhood Injury Prevention Program

PubMed Central

Weaver, Nancy L.; Williams, Janice; Jacobsen, Heather A.; Botello-Harbaum, Maria; Glasheen, Cristie; Noelcke, Elizabeth; Nansel, Tonja R.

2008-01-01

This article describes the process of translating Safe n’ Sound, a computer-based program for parents of young children, for a general clinic environment. Safe n’ Sound is designed to reduce the risk of unintentional childhood injuries, the leading cause of death among children older than 1 year in the United States. The evidence-based program produces tailored information for parents and their healthcare provider about burns, falls, poisoning, drowning, suffocations, choking prevention, and car safety. To offer Safe n’ Sound to a broader audience, we translated the program from the form used for efficacy testing to a stand-alone application. Notable steps in this translation included (1) conducting an organizational assessment to determine the needs of the clinic staff and feasibility of implementation, (2) modifying the program to reduce length, prioritize risk areas, and update content, (3) repackaging the program to minimize cost and space requirements, and (4) developing promotional and instructional materials. Factors contributing to the success of this effort include strong collaborative partnerships, the relative advantage of Safe n’ Sound over traditional materials, the modifiable design of the program, and the support of the clinic staff and providers. Challenges and areas for future work are discussed. PMID:18287925

The association between adverse childhood experiences and adult traumatic brain injury/concussion: a scoping review.

PubMed

Ma, Zechen; Bayley, Mark T; Perrier, Laure; Dhir, Priya; Dépatie, Lana; Comper, Paul; Ruttan, Lesley; Lay, Christine; Munce, Sarah E P

2018-01-12

Adverse childhood experiences are significant risk factors for physical and mental illnesses in adulthood. Traumatic brain injury/concussion is a challenging condition where pre-injury factors may affect recovery. The association between childhood adversity and traumatic brain injury/concussion has not been previously reviewed. The research question addressed is: What is known from the existing literature about the association between adverse childhood experiences and traumatic brain injury/concussion in adults? All original studies of any type published in English since 2007 on adverse childhood experiences and traumatic brain injury/concussion outcomes were included. The literature search was conducted in multiple electronic databases. Arksey and O'Malley and Levac et al.'s scoping review frameworks were used. Two reviewers independently completed screening and data abstraction. The review yielded six observational studies. Included studies were limited to incarcerated or homeless samples, and individuals at high-risk of or with mental illnesses. Across studies, methods for childhood adversity and traumatic brain injury/concussion assessment were heterogeneous. A positive association between adverse childhood experiences and traumatic brain injury occurrence was identified. The review highlights the importance of screening and treatment of adverse childhood experiences. Future research should extend to the general population and implications on injury recovery. Implications for rehabilitation Exposure to adverse childhood experiences is associated with increased risk of traumatic brain injury. Specific types of adverse childhood experiences associated with risk of traumatic brain injury include childhood physical abuse, psychological abuse, household member incarceration, and household member drug abuse. Clinicians and researchers should inquire about adverse childhood experiences in all people with traumatic brain injury as pre-injury health conditions can

Barriers to, and facilitators of, the prevention of unintentional injury in children in the home: a systematic review and synthesis of qualitative research.

PubMed

Smithson, Janet; Garside, Ruth; Pearson, Mark

2011-04-01

This review considers barriers to, and facilitators of, success for interventions to reduce unintentional injury to children in the home through supply and/or installation of home safety equipment, and looks at risk assessments. A systematic review of qualitative research. Bibliographic databases were searched for studies on interventions to reduce unintentional child injury in the home, or on related attitudes and behaviours. Studies were quality appraised, findings extracted, and a conceptual framework was developed to assess factors affecting the success of interventions. Nine peer-reviewed journal articles were included. Barriers and facilitators were highlighted at organisational, environmental and personal levels. Effective provision of safety equipment involves ongoing support with installation and maintenance. Take up and success of interventions depends on adjusting interventions according to practical limitations and parents' cultural expectations. A particular barrier was parents' inability to modify rented or shared accommodation. The review highlights ways in which health inequalities affect the take up and success of home safety interventions, and how health workers can use this knowledge to facilitate future interventions.

Childhood injuries in Ilesa, South-Western Nigeria: causes, pattern, and outcome.

PubMed

Adegoke, S A; Ademola, A S; Dedeke, I O F; Oyelami, O A

2010-01-01

In Sub-Saharan Africa, infections and undernutrition are the leading causes of childhood death; however injuries are now contributing significantly to childhood morbidity and mortality. To determine the aetiology, morbidity and mortality associated with injuries in children in South-Western Nigeria. This was an observational cross-sectional study of consecutive childhood injury attendances and admissions into the hospital's Children Emergency Room (CHER) over a one-year period. Socio-demographic data as well as the data on the cause, site, and possible risks of injury; parts of the body affected and eventual outcome of the patients were documented. Injury accounted for 382 (10.6%) of the 3,604 attendances, 142 (11.9%) of 1193 admissions and 11 (20.4%) of 54 deaths in CHER. Their ages ranged from six weeks to 15 years, with a mean (SD) of 6.7 (3.9) years, and a male:female ratio of 1.6:1. Road traffic accidents, 130 (34.0%), were the most common cause, followed by falls 119 (31.2%), cuts 44 (11.5%), bits 26 (6.8%), and burns 24 (6.3%). Injuries occurred mostly at home 154 (40.1%), on the road 142 (37.4%), and at school 59 (15.2%). Lack of supervision and/or poor anticipation of potential dangers were the leading risks associated with childhood injuries. Injuries contribute significantly to childhood deaths in South-Western Nigeria. A well-orchestrated public enlightenment programme to improve home, school, and road supervision of children as well as concerted efforts to make these places safer could help ameliorate the situation.

Unintentional human exposure to tilmicosin (Micotil 300).

PubMed

Von Essen, Susanna; Spencer, Jonathan; Hass, Brian; List, Pam; Seifert, Steven A

2003-01-01

Tilmicosin phosphate is a macrolide antibiotic that is used to treat cattle for pathogens that cause Bovine Respiratory Disease. A 28-year-old man with no prior history of heart disease developed severe chest pain, inverted T waves, and intraventricular conduction delay on EKG and mild elevation of cardiac enzymes 5 hours after unintentional injection of less than half of a 12cc syringe filled with Micotil 300 (tilmicosin phosphate 300 mg/mL, propylene glycol 25%, phosphoric acid, water for injection). The patient made an uneventful recovery after hospitalization. This case provides evidence that unintentional injection of tilmicosin can cause cardiac symptoms and laboratory evidence of myocardial injury. Tilmicosin should always be administered by properly trained personnel who are using techniques designed to reduce the risk of accidental self-injection.

Childhood injuries in a tertiary institution in north east Nigeria.

PubMed

Esin, Issa Abdul Razaq; Alabi, Sikiru; Lawal, Oluwagbemiga Abdul Razzaq

2013-01-01

Injury has been recognised as a preventable cause of morbidity and mortality in children. The aim of this study was to determine the aetiology, pattern and location of childhood injuries in north east Nigeria. This is a 3-year retrospective hospital-based descriptive study. The study included 114 children (77 boys, 37 girls; mean age 6.4 ± 3.2 years; range 2 months to 15 years) who were admitted for various injuries in the female/paediatric surgical ward from January 2007 to December 2009. Information obtained from their case notes included demographic data, mechanism of injury, location of injury, anatomical site of injury and outcome of treatment. Records for 114 children (77 boys, 37 girls; mean age 6.2 years; range 2 months to 15 years) were available for analysis. The highest number of injuries occurred in the age group 6-10 years. Home was the most common location of injury among the age group 0-5 years while older children sustained most of their injuries outside the home on the street/highways. Burns from hot water was the most common injury among children aged 0-5 years while pedestrian accident accounted for the highest cause of injury among older children. Fall accounted for 20.2% of the injuries. The most common specific anatomic injury was head injury followed by limb fractures. Two mortalities were recorded (1.8%). This study provided useful information on the characteristics of childhood injuries in our environment. There is the need for parents and children education about the risks of injury and preventive measures in addition to legislation and policy on environmental modifications and enforcements to significantly reduce childhood injury.

School-based education programmes for the prevention of unintentional injuries in children and young people.

PubMed

Orton, Elizabeth; Whitehead, Jessica; Mhizha-Murira, Jacqueline; Clarkson, Mandy; Watson, Michael C; Mulvaney, Caroline A; Staniforth, Joy Ul; Bhuchar, Munish; Kendrick, Denise

2016-12-27

Unintentional injuries are the leading cause of death in children aged four to 18 years and are a major cause of ill health. The school setting offers the opportunity to deliver preventive interventions to a large number of children and has been used to address a range of public health problems. However, the effectiveness of the school setting for the prevention of different injury mechanisms in school-aged children is not well understood. To assess the effects of school-based educational programmes for the prevention of injuries in children and evaluate their impact on improving children's safety skills, behaviour and practices, and knowledge, and assess their cost-effectiveness. We ran the most recent searches up to 16 September 2016 for the following electronic databases: Cochrane Injuries Group Specialised Register; Cochrane Central Register of Controlled Trials; Ovid MEDLINE(R), Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations; Ovid MEDLINE(R) Daily and Ovid OLDMEDLINE(R); Embase and Embase Classic (Ovid); ISI Web of Science: Science Citation Index Expanded; ISI Web of Science Conference Proceedings Citation Index-Science; ISI Web of Science: Social Sciences Citation Index; ISI Web of Science: Conference Proceedings Citation Index - Social Sciences & Humanities; and the 14 October 2016 for the following electronic databases: Health Economics Evaluations Database (HEED); Health Technology Assessment Database (HTA); CINAHL Plus (EBSCO); ZETOC; LILACS; PsycINFO; ERIC; Dissertation Abstracts Online; IBSS; BEI; ASSIA; CSA Sociological Abstracts; Injury Prevention Web; SafetyLit; EconLit (US); PAIS; UK Clinical Research Network Study Portfolio; Open Grey; Index to Theses in the UK and Ireland; Bibliomap and TRoPHI. We included randomised controlled trials (RCTs), non-randomised controlled trials (non-RCTs), and controlled before-and-after (CBA) studies that evaluated school-based educational programmes aimed at preventing a range of injury mechanisms. The

Hospitalizations due to unintentional transport injuries among Aboriginal population of British Columbia, Canada: Incidence, changes over time and ecological analysis of risk markers.

PubMed

Brussoni, Mariana; George, M Anne; Jin, Andrew; Amram, Ofer; McCormick, Rod; Lalonde, Christopher E

2018-01-01

Worldwide, Indigenous people have disproportionately higher rates of transport injuries. We examined disparities in injury-related hospitalizations resulting from transport incidents for three population groups in British Columbia (BC): total population, Aboriginal off-reserve, and Aboriginal on-reserve populations. We also examined sociodemographic, geographic and ethnic risk markers for disparities. We identified Aboriginal people through BC's universal health care insurance plan insurance premium group and birth and death record notations. We calculated crude incidence rate and Standardized Relative Risk (SRR) of hospitalization for unintentional transport injury, standardized for age, gender and Health Service Delivery Area (HSDA), relative to the total population of BC. We tested hypothesized associations of geographic, socio-economic, and employment-related characteristics of Aboriginal communities with SRR of transport injury by multivariable linear regression. During the period 1991-2010, the SRR for the off-reserve Aboriginal population was 1.77 (95% CI: 1.71 to 1.83); and 2.00 (95% CI: 1.93 to 2.07) among those living on-reserve. Decline in crude rate and SRRs was observed over this period among both the Aboriginal and total populations of BC, but was proportionally greater among the Aboriginal population. The best-fitting multivariable risk marker model was an excellent fit (R2 = 0.912, p<0.001), predicted SRRs very close to observed values, and retained the following terms: urban residence, population per room, proportion of the population with a high school certificate, proportion of the population employed; and multiplicative interactions of Aboriginal ethnicity with population per room and proportion of the population employed. Disparities in risk of hospitalization due to unintentional transport injury have narrowed. Aboriginal ethnicity modifies the effects of socioeconomic risk factors. Continued improvement of socioeconomic conditions and

Hospitalizations due to unintentional transport injuries among Aboriginal population of British Columbia, Canada: Incidence, changes over time and ecological analysis of risk markers

PubMed Central

George, M. Anne; Jin, Andrew; Amram, Ofer; McCormick, Rod; Lalonde, Christopher E.

2018-01-01

Background Worldwide, Indigenous people have disproportionately higher rates of transport injuries. We examined disparities in injury-related hospitalizations resulting from transport incidents for three population groups in British Columbia (BC): total population, Aboriginal off-reserve, and Aboriginal on-reserve populations. We also examined sociodemographic, geographic and ethnic risk markers for disparities. Methods We identified Aboriginal people through BC’s universal health care insurance plan insurance premium group and birth and death record notations. We calculated crude incidence rate and Standardized Relative Risk (SRR) of hospitalization for unintentional transport injury, standardized for age, gender and Health Service Delivery Area (HSDA), relative to the total population of BC. We tested hypothesized associations of geographic, socio-economic, and employment-related characteristics of Aboriginal communities with SRR of transport injury by multivariable linear regression. Results During the period 1991–2010, the SRR for the off-reserve Aboriginal population was 1.77 (95% CI: 1.71 to 1.83); and 2.00 (95% CI: 1.93 to 2.07) among those living on-reserve. Decline in crude rate and SRRs was observed over this period among both the Aboriginal and total populations of BC, but was proportionally greater among the Aboriginal population. The best-fitting multivariable risk marker model was an excellent fit (R2 = 0.912, p<0.001), predicted SRRs very close to observed values, and retained the following terms: urban residence, population per room, proportion of the population with a high school certificate, proportion of the population employed; and multiplicative interactions of Aboriginal ethnicity with population per room and proportion of the population employed. Conclusions Disparities in risk of hospitalization due to unintentional transport injury have narrowed. Aboriginal ethnicity modifies the effects of socioeconomic risk factors. Continued

Mothers’ perspectives on the delivery of childhood injury messages: a qualitative study from the growing up in Wales, environments for healthy living study (EHL)

PubMed Central

2013-01-01

Background Childhood injury is the second leading cause of death for infants aged 1–5 years in the United Kingdom (UK) and most unintentional injuries occur in the home. We explored mothers’ knowledge and awareness of child injury prevention and sought to discover mothers’ views about the best method of designing interventions to deliver appropriate child safety messages to prevent injury in the home. Methods Qualitative study based on 21 semi-structured interviews with prospective mothers and mothers of young children. Mothers were selected according to neighbourhood deprivation status. Results There was no difference in awareness of safety devices according to mothers’ deprivation status. Social networks were important in raising awareness and adherence to child safety advice. Mothers who were recent migrants had not always encountered safety messages or safety equipment commonly used in the UK. Mothers’ recommended that safety information should be basic and concise, and include both written and pictorial information and case studies focus on proactive preventive messages. Messages should be delivered both by mass media and suitably trained individuals and be timed to coincide with pregnancy and repeated at age appropriate stages of child development. Conclusions The findings suggest that timely childhood injury-related risk messages should be delivered during pregnancy and in line with developmental milestones of the child, through a range of sources including social networks, mass media, face-to-face advice from health professionals and other suitably trained mothers. In addition information on the safe use of home appliances around children and use of child safety equipment should be targeted specifically at those who have recently migrated to the United Kingdom. PMID:24007442

Childhood injury: a status report, part 2.

PubMed

Crawley-Coha, Teri

2002-04-01

The October issue of The Journal of Pediatric Nursing carried the first of two parts on childhood injury. That article reviewed the importance of prevention, the short- and long-term effects of injury on the child and the family, and how to incorporate prevention strategies at home and at work. Also reviewed were three of the most common mechanisms of injury, motor vehicle crashes, bicycle crashes, and pool drowning, and prevention measures. In this second part, the remaining primary areas of concern for common pediatric injuries are addressed: poisoning, fires and burns, and firearms. Copyright 2002, Elsevier Science (USA). All rights reserved.

Prevalence and predictors of mental disorders in intentionally and unintentionally injured emergency centre patients

PubMed Central

van der Westhuizen, Claire; Wyatt, Gail; Williams, John K.; Stein, Dan J.; Sorsdahl, Katherine

2014-01-01

Little is known about the prevalence and predictors of mental disorders amongst injured emergency centre (EC) patients in low- and middle-income countries. Patients presenting with either an intentional or unintentional injury were recruited (n=200). Mental health, injury and psychological trauma histories were assessed. Descriptive statistics and logistic regressions were conducted and predictors for current mental disorder were identified. Diagnostic criteria for a current mental disorder, including substance use disorders, were met by 59.5% of participants. Compared to those with an unintentional injury, intentionally injured participants were more likely to be diagnosed with a current mental disorder (66.9% vs 48.8%; p=0.01). High frequencies of previous intentional injuries predicted for current mental disorder (OR = 1.460, 95% CI 1.08-1.98), while male gender and witnessed community violence predicted substance use disorder diagnoses. Findings indicate that injured EC patients, particularly those with intentional injuries, are at risk for mental disorders. Psychosocial interventions in the EC context can potentially make an important contribution in reducing the burden of mental disorders and injuries in low- and middle-income countries. PMID:25126754

Risk of Hospitalization Due to Unintentional Fall Injury in British Columbia, Canada, 1999-2008: Ecological Associations with Socioeconomic Status, Geographic Place, and Aboriginal Ethnicity.

PubMed

Jin, Andrew; Brussoni, Mariana; George, M Anne; Lalonde, Christopher E; McCormick, Rod

2017-08-01

Aboriginal people in British Columbia (BC), especially those residing on Indian reserves, have higher risk of unintentional fall injury than the general population. We test the hypothesis that the disparities are attributable to a combination of socioeconomic status, geographic place, and Aboriginal ethnicity. Within each of 16 Health Service Delivery Areas in BC, we identified three population groups: total population, Aboriginal off-reserve, and Aboriginal on-reserve. We calculated age and gender-standardized relative risks (SRR) of hospitalization due to unintentional fall injury (relative to the total population of BC), during time periods 1999-2003 and 2004-2008, and we obtained custom data from the 2001 and 2006 censuses (long form), describing income, education, employment, housing, proportions of urban and rural dwellers, and prevalence of Aboriginal ethnicity. We studied association of census characteristics with SRR of fall injury, by multivariable linear regression. The best-fitting model was an excellent fit (R 2  = 0.854, p < 0.001) and predicted SRRs very close to observed values for the total, Aboriginal off-reserve, and Aboriginal on-reserve populations of BC. After stepwise regression, the following terms remained: population per room, urban residence, labor force participation, income per capita, and multiplicative interactions of Aboriginal ethnicity with population per room and labor force participation. The disparities are predictable by the hypothesized risk markers. Aboriginal ethnicity is not an independent risk marker: it modifies the effects of socioeconomic factors. Closing the gap in fall injury risk between the general and Aboriginal populations is likely achievable by closing the gaps in socioeconomic conditions.

Preventing unintentional injuries to children under 15 years in the outdoors: a systematic review of the effectiveness of educational programs

PubMed Central

Hunt, Harriet; Garside, Ruth; Moxham, Tiffany; Peters, Jaime; Anderson, Rob

2011-01-01

Introduction Unintentional injuries to children in the outdoors have a significant impact on child mortality, development and healthcare costs. This paper presents the findings of a systematic review about the effectiveness of programs that provided information, advice or education about the prevention of unintentional injuries to children under 15 years during outdoor play and leisure. Methods A structured search strategy was conducted in a range of databases. All report titles and abstracts were screened using pre-defined criteria. Included reports were quality appraised using a modified Graphical Appraisal Tool for Epidemiological studies (GATE) tool. All quality appraisals and data extraction were checked by a second reviewer. If not provided in the original reports, ORs and mean differences were calculated, where sufficient data were available. Results Twenty-three studies met the inclusion criteria. There was a paucity of robust study designs. The majority of studies only reported a short-term follow-up of intermediate outcome measures. Only two studies measured injury rates; both reported a reduction, but both studies also had considerable methodological weaknesses. The five studies that measured the use of protective equipment reported mixed results, although there is some evidence that suggests that more extensive educational programs (such as health fairs and media campaigns) increase their use. The 20 studies that measured behaviour, attitude or knowledge outcomes reported highly mixed results. Discussion Methodological weaknesses of the included studies limit support for a particular course of action. To better inform policy and practice, future research should (1) use robust study designs and (2) not rely on short-term proxy outcome measures. PMID:21890579

Childhood and adolescent injuries in elementary schools in north-western Uganda: extent, risk and associated factors.

PubMed

Mutto, Milton; Lawoko, Stephen; Ovuga, Emilio; Svanstrom, Leif

2012-01-01

Childhood injuries remain understudied in Uganda. The objective of this study was to determine the extent, nature and determinants of school-related childhood injury risk in north-western Uganda. A cohort of 1000 grade fives from 13 elementary schools was followed-up for one term. Survival and multi-level modelling techniques compared the risk rates across gender, schools and locations. Childhood injuries are common in north-western Uganda. Most of them occur during travel, breaks, practical classes and gardening, while walking, playing, learning and digging. Most injuries result from collisions with objects, sports and falls. Two-thirds of children receive first aid and hospital care. Times to injury were 72.1 and 192.9 person days (p = 0.0000). Gender differences in time to event were significant (p = 0.0091). Girls had better survival rates: cumulative prevalence of childhood injury was 36.1%; with significant gender differences (p = 0.007). Injury rate was 12.3/1000 person days, with a hazard ratio of 1.4. Compared to girls, boys had a 37% higher injury rate (p = 0.004). Rates varied among schools. Associated factors include sex and school. Rural-urban location and school differences do influence childhood injury risk. Childhood injuries are common: the risk is high, gender- and school-specific. Determinants include gender and school. Location and school contexts influence injury risk.

Disseminating Childhood Home Injury Risk Reduction Information in Pakistan: Results from a Community-Based Pilot Study

PubMed Central

Chandran, Aruna; Khan, Uzma Rahim; Zia, Nukhba; Feroze, Asher; de Ramirez, Sarah Stewart; Huang, Cheng-Ming; Razzak, Junaid A.; Hyder, Adnan A.

2013-01-01

Background: Most childhood unintentional injuries occur in the home; however, very little home injury prevention information is tailored to developing countries. Utilizing our previously developed information dissemination tools and a hazard assessment checklist tailored to a low-income neighborhood in Pakistan, we pilot tested and compared the effectiveness of two dissemination tools. Methods: Two low-income neighborhoods were mapped, identifying families with a child aged between 12 and 59 months. In June and July 2010, all enrolled households underwent a home hazard assessment at the same time hazard reduction education was being given using an in-home tutorial or a pamphlet. A follow up assessment was conducted 4–5 months later. Results: 503 households were enrolled; 256 received a tutorial and 247 a pamphlet. The two groups differed significantly (p < 0.01) in level of maternal education and relationship of the child to the primary caregiver. However, when controlling for these variables, those receiving an in-home tutorial had a higher odds of hazard reduction than the pamphlet group for uncovered vats of water (OR 2.14, 95% CI: 1.28, 3.58), an open fire within reach of the child (OR 3.55, 95% CI: 1.80, 7.00), and inappropriately labeled cooking fuel containers (OR 1.86, 95% CI: 1.07, 3.25). Conclusions: This pilot project demonstrates the potential utility of using home-visit tutorials to decrease home hazards in a low-income neighborhood in Pakistan. A longer-term randomized study is needed to assess actual effectiveness of the use of allied health workers for home-based injury education and whether this results in decreased home injuries. PMID:23502323

The National Childhood Vaccine Injury Act: A Chance for Families.

ERIC Educational Resources Information Center

Gage, Jack; And Others

1989-01-01

The article describes the National Childhood Vaccine Injury Act which provides for recovery awards for vaccine-related injuries caused by diphtheria, pertussis, tetanus, polio, measles, mumps, and rubella vaccines. A Vaccine Injury Table lists types of disabilities covered and time periods for first symptoms. The claims process, legal assistance,…

Unintentional childhood poisoning in the Sharon area in Israel: a prospective 5-year study.

PubMed

Uziel, Y; Adler, A; Aharonowitz, G; Franco, S; Fainmesser, P; Wolach, B

2005-04-01

To study the epidemiology and risk factors for unintentional exposure to poisoning among the Jewish and the Arab population in the Sharon area in Israel. We prospectively evaluated visits to the pediatric emergency department because of unintentional poisoning exposure, at the Meir General Hospital. We collected demographic data, substance exposure data, and the clinical outcome of the poisoning. During the 5 years of the study, 502 children were evaluated for unintentional poisoning, 84% Jewish and 16% Arabs; 88.5% occurred in children younger than 5 years, with a peak incidence at the age of 2 years (39.5%). Medications including hormones, vitamins, and antibiotics were the most common cause of exposure. Most children (95%) had no symptoms or abnormal findings on physical examination (84%), and most (85%) were discharged after several hours of observation. However, children of Arab origin presented with severe clinical manifestations because of a high rate of pesticide poisoning. There was 1 death from organic phosphate poisoning. Exposure to poisoning is commonly encountered in children. Pesticides exposure is more common in the Arab community and is usually associated with more severe clinical manifestations. Educational preventive programs are mandatory.

The King's Outcome Scale for Childhood Head Injury and Injury Severity and Outcome Measures in Children with Traumatic Brain Injury

ERIC Educational Resources Information Center

Calvert, Sophie; Miller, Helen E.; Curran, Andrew; Hameed, Biju; McCarter, Renee; Edwards, Richard J.; Hunt, Linda; Sharples, Peta Mary

2008-01-01

The aim of this study was to relate discharge King's Outcome Scale for Childhood Head Injury (KOSCHI) category to injury severity and detailed outcome measures obtained in the first year post-traumatic brain injury (TBI). We used a prospective cohort study. Eighty-one children with TBI were studied: 29 had severe, 15 moderate, and 37 mild TBI. The…

Evaluation of playground injuries based on ICD, E codes, international classification of external cause of injury codes (ICECI), and abbreviated injury scale coding systems.

PubMed

Tan, N C; Ang, A; Heng, D; Chen, J; Wong, H B

2007-01-01

The survey is aimed to describe the epidemiology of playground related injuries in Singapore based on the ICD-9, AIS/ ISS and PTS scoring systems, and mechanisms and causes of such injuries according to E codes and ICECI codes. A cross-sectional questionnaire survey examined children (< 16 years old), who sought treatment for or died of unintentional injuries in the ED of three hospitals, two primary care centers and the sole Forensic Medicine Department of Singapore. A data dictionary was compiled using guidelines from CDC/WHO. The ISS, AIS and PTS, ICD-9, ICECI v1 and E codes were used to describe the details of the injuries. 19,094 childhood injuries were recorded in the database, of which 1617 were playground injuries (8.5%). The injured children (mean age=6.8 years, SD 2.9 years) were predo-minantly male (M:F ratio = 1.71:1). Falls were the most frequent in-juries (70.7%) using ICECI. 25.0% of injuries involved radial and ulnar fractures (ICD-9 code). 99.4% of these injuries were minor, with PTS scores of 9-12. Children aged 6-10 years, were prone to upper limb injuries (71.1%) based on AIS. The use of international coding systems in injury surveillance facilitated standardisation of description and comparison of playground injuries.

Alexithymia as a Mediator between Childhood Trauma and Self-Injurious Behaviors

ERIC Educational Resources Information Center

Paivio, Sandra C.; McCulloch, Chantal R.

2004-01-01

Objective: The aim of this study was to test whether alexithymia mediates the relationship between childhood maltreatment and self-injurious behaviors (SIB) in college women. Method: The sample was comprised of 100 female undergraduate students. Measures were the Childhood Trauma Questionnaire [D. Bernstein, L. Fink, Manual for the Childhood…

Risk factors associated with unintentional house fire incidents, injuries and deaths in high-income countries: a systematic review.

PubMed

Turner, Samantha L; Johnson, Rhodri D; Weightman, Alison L; Rodgers, Sarah E; Arthur, Geri; Bailey, Rowena; Lyons, Ronan A

2017-04-01

To identify the distinguishing risk factors associated with unintentional house fire incidents, injuries and deaths. Systematic review. A range of bibliographical databases and grey literature were searched from their earliest records to January 2016. To ensure the magnitude of risk could be quantified, only those study types which contained a control group, and undertook appropriate statistical analyses were included. A best evidence synthesis was conducted instead of a meta-analysis due to study heterogeneity. Eleven studies investigating a variety of risk factors and outcomes were identified. Studies ranged from medium to low quality with no high quality studies identified. Characteristics commonly associated with increased risk of house fire incidents, injuries and fatalities included: higher numbers of residents, male, children under the age of 5 years, non-working households, smoking, low income, non-privately owned properties, apartments and buildings in poor condition. Several risk factors were only associated with one outcome (eg, living alone was only associated with increased risk of injurious fires), and households with older residents were at increased risk of injurious fires, but significantly less likely to experience a house fire in the first place. This best evidence synthesis indicates that several resident and property characteristics are associated with risk of experiencing house fire incidents, injuries or death. These findings should be considered by the Fire and Rescue Services and others with a role in fire prevention. Future research should adopt robust, standardised study designs to permit meta-analyses and enable stronger conclusions to be drawn. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

46 CFR 28.580 - Unintentional flooding.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 1 2012-10-01 2012-10-01 false Unintentional flooding. 28.580 Section 28.580 Shipping... INDUSTRY VESSELS Stability § 28.580 Unintentional flooding. (a) Applicability. Except for an open boat that... survive the assumed damage and unintentional flooding described in paragraphs (d) and (e) of this section...

46 CFR 28.580 - Unintentional flooding.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 1 2011-10-01 2011-10-01 false Unintentional flooding. 28.580 Section 28.580 Shipping... INDUSTRY VESSELS Stability § 28.580 Unintentional flooding. (a) Applicability. Except for an open boat that... survive the assumed damage and unintentional flooding described in paragraphs (d) and (e) of this section...

46 CFR 28.580 - Unintentional flooding.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 1 2014-10-01 2014-10-01 false Unintentional flooding. 28.580 Section 28.580 Shipping... INDUSTRY VESSELS Stability § 28.580 Unintentional flooding. (a) Applicability. Except for an open boat that... survive the assumed damage and unintentional flooding described in paragraphs (d) and (e) of this section...

46 CFR 28.580 - Unintentional flooding.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 1 2013-10-01 2013-10-01 false Unintentional flooding. 28.580 Section 28.580 Shipping... INDUSTRY VESSELS Stability § 28.580 Unintentional flooding. (a) Applicability. Except for an open boat that... survive the assumed damage and unintentional flooding described in paragraphs (d) and (e) of this section...

The contribution of physicians to childhood injury prevention in France.

PubMed Central

Lévêque, B.; Baudier, F.; Janvrin, M. P.

1995-01-01

OBJECTIVES: The objective of this study was to determine what injury control interventions are currently carried out by physicians and to examine how these interventions could be more effective. SETTING: Surveys were conducted among the three main groups of physicians who provide primary care to children in France--private practice pediatricians (PPPs), well-child clinic pediatricians (WCCPs), and general practitioners (GPs). METHOD: A representative sample of each of the three groups of physicians were interviewed by telephone, using a computer assisted telephone interview system, in December 1993 or February 1994. RESULTS: Responses demonstrated that most physicians felt they could play an important part in injury prevention but that many had inadequate knowledge of injury related mortality rates in children. Most PPPs and WCCPs usually provided counseling on safety in relation to developmental changes in children. Few physicians gave recommendations about appropriate first responses to emergencies. Printed material, designed for parent education, was provided by many PPPs and WCCPs, but was usually absent from the offices of GPs. Participation in group education sessions was common among WCCPs but rare among PPPs and GPs. Many physicians expressed skepticism regarding the efficacy of their interventions in injury control. CONCLUSION: A number of recommendations are made to those in government agencies or elsewhere who could help physicians to improve childhood injury prevention, for instance by regular publication of data on childhood injury mortality, counseling about parent education on this subject, and first aid in emergencies. PMID:9346017

The Unintentional Procrastination Scale.

PubMed

Fernie, Bruce A; Bharucha, Zinnia; Nikčević, Ana V; Spada, Marcantonio M

2017-01-01

Procrastination refers to the delay or postponement of a task or decision and is often conceptualised as a failure of self-regulation. Recent research has suggested that procrastination could be delineated into two domains: intentional and unintentional. In this two-study paper, we aimed to develop a measure of unintentional procrastination (named the Unintentional Procrastination Scale or the 'UPS') and test whether this would be a stronger marker of psychopathology than intentional and general procrastination. In Study 1, a community sample of 139 participants completed a questionnaire that consisted of several items pertaining to unintentional procrastination that had been derived from theory, previous research, and clinical experience. Responses were subjected to a principle components analysis and assessment of internal consistency. In Study 2, a community sample of 155 participants completed the newly developed scale, along with measures of general and intentional procrastination, metacognitions about procrastination, and negative affect. Data from the UPS were subjected to confirmatory factor analysis and revised accordingly. The UPS was then validated using correlation and regression analyses. The six-item UPS possesses construct and divergent validity and good internal consistency. The UPS appears to be a stronger marker of psychopathology than the pre-existing measures of procrastination used in this study. Results from the regression models suggest that both negative affect and metacognitions about procrastination differentiate between general, intentional, and unintentional procrastination. The UPS is brief, has good psychometric properties, and has strong associations with negative affect, suggesting it has value as a research and clinical tool.

Closing the Aboriginal child injury gap: targets for injury prevention.

PubMed

Möller, Holger; Falster, Kathleen; Ivers, Rebecca; Falster, Michael O; Clapham, Kathleen; Jorm, Louisa

2017-02-01

To describe the leading mechanisms of hospitalised unintentional injury in Australian Aboriginal children and identify the injury mechanisms with the largest inequalities between Aboriginal and non-Aboriginal children. We used linked hospital and mortality data to construct a whole of population birth cohort including 1,124,717 children (1,088,645 non-Aboriginal and 35,749 Aboriginal) born in the state of New South Wales (NSW), Australia, between 1 July 2000 and 31 December 2012. Injury hospitalisation rates were calculated per person years at risk for injury mechanisms coded according to the ICD10-AM classification. The leading injury mechanisms in both groups of children were falls from playground equipment. For 66 of the 69 injury mechanisms studied, Aboriginal children had a higher rate of hospitalisation compared with non-Aboriginal children. The largest relative inequalities were observed for injuries due to exposure to fire and flame, and the largest absolute inequalities for injuries due to falls from playground equipment. Aboriginal children in NSW experience a significant higher burden of unintentional injury compared with their non-Aboriginal counterparts. Implications for Public Health: We suggest the implementation of targeted injury prevention measures aimed at injury mechanism and age groups identified in this study. © 2016 The Authors.

The incidence of injuries among 87,000 Massachusetts children and adolescents: results of the 1980-81 Statewide Childhood Injury Prevention Program Surveillance System.

PubMed Central

Gallagher, S S; Finison, K; Guyer, B; Goodenough, S

1984-01-01

This study describes the incidence of fatal and nonfatal injuries occurring in 87,022 Massachusetts children and adolescents during a one-year period. A surveillance system for injuries at 23 hospitals captured 93 per cent of all discharges for ages 0-19 in the 14 communities under study. Sample data were collected on emergency room visits, hospital admissions, and deaths for all but a few causes of unintentional injuries. The overall incidence was 2,239 per 10,000. The true incidence rates are probably higher than those reported. The ratio of emergency room visits to admissions to deaths was 1,300 to 45 to 1. Injury rates varied considerably by age, sex, cause, and level of severity. Age-specific injury rates were lowest for infants and elementary school age children and highest for toddlers and adolescents. The overall ratio of male to female injury rates was 1.66 to 1. Injuries from falls, sports, and cutting and piercing instruments had a high incidence and low severity. Injuries from motor vehicles, burns, and drownings had lower incidence, but greater severity. Results provide evidence that both morbidity and mortality must be considered when determining priorities for injury prevention. Current prevention efforts must be expanded to target injuries of higher incidence and within the adolescent population. PMID:6507685

Injuries in adolescents with childhood-onset epilepsy compared with sibling controls

PubMed Central

Baca, Christine B.; Vickrey, Barbara G.; Vassar, Stefanie D.; Cook, Aaron; Berg, Anne T.

2013-01-01

Objective To compare the occurrence of injuries in adolescents with childhood-onset epilepsy and matched sibling controls. Study design Retrospective case-control lifetime injury assessments were obtained from a community-based cohort of adolescents with childhood-onset epilepsy diagnosed 9-years earlier, and their siblings. Children with epilepsy (n=501; mean age 15.3 years) included children with complicated (abnormal neurological exam or IQ<80; n=133) and uncomplicated (normal neurological exam and IQ≥80; n=368) epilepsy. Children with uncomplicated epilepsy were matched to sibling controls (n=210 pairs). Children reported whether they had ever (before and after epilepsy diagnosis) experienced injuries, “serious enough to require medical attention” and the type of treatment required. Results 49.1% of children with epilepsy experienced any injury, of whom 8.9% required surgery/hospitalization and 17.1% had an injury due to a seizure; fewer children with uncomplicated epilepsy had seizure-related injuries versus those with complicated epilepsy (13.6% vs. 27.4%; p≤0.01). The proportion of children with epilepsy with any injury by types (not mutually exclusive) were: 25.2% (n=126) fractures, 24.4% (n=122) head, 10.2% (n=51) other, 8.4% (n=42) dental and 8% (n=40) burns/scalds. A similar proportion of children with uncomplicated epilepsy experienced any injury (overall and by type) compared with matched sibling controls, with the exception that more children with uncomplicated epilepsy had head injuries (30.0% vs. 19.5%; p<0.02). Conclusion With the exception of head injuries, in a representative cohort of children with epilepsy compared with siblings there was no evidence of an increased risk of injury. This may reflect that the sample was not biased to more severe cases or that safety precautions to prevent injury were widely employed. PMID:24054432

Developing Childhood Injury Prevention Programs: An Administrative Guide for State Maternal and Child Health (Title V) Programs.

ERIC Educational Resources Information Center

Birch & Davis Associates, Inc., Silver Spring, MD.

Based primarily on the experience of three childhood injury prevention demonstration projects, this manual provides state Title V program directors with an action guide for developing targeted childhood injury prevention programs. The manual is divided into four sections: background; program planning; program design; and program implementation and…

Retropharyngeal hematoma secondary to whiplash injury in childhood: a case report.

PubMed

Nurata, Hakan; Yilmaz, Muhammet Bahadır; Borcek, Alp Ozgun; Oner, Ali Yusuf; Baykaner, M Kemali

2012-01-01

Whiplash Associated Disorders (WAD) has been reported as an adult phenomenon. Whiplash injury has classically been described as a cervical soft tissue hyperextension- flexion injury after a trauma such as a rear end impact car crash, contact sport injuries, blows to the head from a falling object or a punch and shaken baby syndrome and is mostly seen in adults . It is important as it may cause severe disability due to spinal cord injury, decrease work productivity and even retropharyngeal hematoma resulting airway obstruction and mortality due to bleeding amongst deep cervical fascias. We describe a case of retropharyngeal hematoma after whiplash injury in a childhood.

Evaluation of a community based childhood injury prevention program.

PubMed Central

Bablouzian, L.; Freedman, E. S.; Wolski, K. E.; Fried, L. E.

1997-01-01

OBJECTIVES: This pilot study evaluates the effectiveness of a community based childhood injury prevention program on the reduction of home hazards. METHODS: High risk pregnant women, who were enrolled in a home visiting program that augments existing health and human services, received initial home safety assessments. Clients received education about injury prevention practices, in addition to receiving selected home safety supplies. Fourteen questions from the initial assessment tool were repeated upon discharge from the program. Matched analyses were conducted to evaluate differences from initial assessment to discharge. RESULTS: A significantly larger proportion of homes were assessed as safe at discharge, compared with the initial assessment, for the following hazards: children riding unbuckled in all auto travel, Massachusetts Poison Center sticker on the telephone, outlet plugs in all unused electrical outlets, safety latches on cabinets and drawers, and syrup of ipecac in the home. CONCLUSIONS: A community based childhood injury prevention program providing education and safety supplies to clients significantly reduced four home hazards for which safety supplies were provided. Education and promotion of the proper use of child restraint systems in automobiles significantly reduced a fifth hazard, children riding unbuckled in auto travel. This program appears to reduce the prevalence of home hazards and, therefore, to increase home safety. PMID:9113841

Educational professionals' understanding of childhood traumatic brain injury.

PubMed

Linden, Mark A; Braiden, Hannah-Jane; Miller, Sarah

2013-01-01

To determine the understanding of educational professionals around the topic of childhood brain injury and explore the factor structure of the Common Misconceptions about Traumatic Brain Injury Questionnaire (CM-TBI). Cross-sectional postal survey. The CM-TBI was posted to all educational establishments in one region of the UK. One representative from each school was asked to complete and return the questionnaire (n = 388). Differences were demonstrated between those participants who knew someone with a brain injury and those who did not, with a similar pattern being shown for those educators who had taught a child with brain injury. Participants who had taught a child with brain injury demonstrated greater knowledge in areas such as seatbelts/prevention, brain damage, brain injury sequelae, amnesia, recovery and rehabilitation. Principal components analysis suggested the existence of four factors and the discarding of half the original items of the questionnaire. In the first European study to explore this issue, it is highlighted that teachers are ill-prepared to cope with children who have sustained a brain injury. Given the importance of a supportive school environment in return to life following hospitalization, the lack of understanding demonstrated by teachers in this research may significantly impact on a successful return to school.

Childhood Obstructive Sleep Apnea Associates with Neuropsychological Deficits and Neuronal Brain Injury

PubMed Central

Halbower, Ann C; Degaonkar, Mahaveer; Barker, Peter B; Earley, Christopher J; Marcus, Carole L; Smith, Philip L; Prahme, M. Cristine; Mahone, E. Mark

2006-01-01

Background Childhood obstructive sleep apnea (OSA) is associated with neuropsychological deficits of memory, learning, and executive function. There is no evidence of neuronal brain injury in children with OSA. We hypothesized that childhood OSA is associated with neuropsychological performance dysfunction, and with neuronal metabolite alterations in the brain, indicative of neuronal injury in areas corresponding to neuropsychological function. Methods and Findings We conducted a cross-sectional study of 31 children (19 with OSA and 12 healthy controls, aged 6–16 y) group-matched by age, ethnicity, gender, and socioeconomic status. Participants underwent polysomnography and neuropsychological assessments. Proton magnetic resonance spectroscopic imaging was performed on a subset of children with OSA and on matched controls. Neuropsychological test scores and mean neuronal metabolite ratios of target brain areas were compared. Relative to controls, children with severe OSA had significant deficits in IQ and executive functions (verbal working memory and verbal fluency). Children with OSA demonstrated decreases of the mean neuronal metabolite ratio N-acetyl aspartate/choline in the left hippocampus (controls: 1.29, standard deviation [SD] 0.21; OSA: 0.91, SD 0.05; p = 0.001) and right frontal cortex (controls: 2.2, SD 0.4; OSA: 1.6, SD 0.4; p = 0.03). Conclusions Childhood OSA is associated with deficits of IQ and executive function and also with possible neuronal injury in the hippocampus and frontal cortex. We speculate that untreated childhood OSA could permanently alter a developing child's cognitive potential. PMID:16933960

[Frequency and prevention of childhood domestic injury according to age].

PubMed

Kanaizumi, Shiomi; Shibata, Mariko; Miyazaki, Yukiko; Nakashita, Tomiko; Sakou, Keiko; Hoshino, Yasue; Ichinohe, Shinko; Ohno, Ayako; Manabe, Shigeo

2009-04-01

This study aimed to: 1) obtain data about occurrence of childhood domestic injuries in Gunma prefecture according to children's age; 2) ascertain parental awareness of injury prevention; and 3) develop ideas for creating concrete strategies of childhood injury prevention. The participants were 551 parents of children living in 14 cities/towns in Gunma prefecture that showed interest in cooperating with this survey. A self-reported questionnaire was handed to parents when they took their children to health check-ups provided by the cities/towns either during the child's first year, at 18 months, or at 3 years. Parents completed the questionnaire asking whether their child had been injured at home during the past year, and if so, they were asked about the type of injury, the cause of injury, and what action they took. We also asked whether the parents took specific injury prevention measures at home. Data were analyzed statistically. The injury experienced most frequently during the first year of life was "fall" (30.8%), followed by "ingestion of a foreign body" (22.7%), and then "choking" (11.5%). For children around the age of 18 months, the most frequently experienced injury was "fall" (41.0%), followed by "burn" (20.3%), and "ingestion of a foreign body" (19.3%). At 3 years, "burn" was reported most frequently (32.3%), followed by "fall" (31.0%), and "choking" (14.5%). Chi2-test revealed significant correlations among the three age groups concerning the rate of burn injury, foreign body ingestion, and drowning. The rate of burn injury was higher at 3 years than at 18 months, and also higher at 18 months as compared to under the age of one. In contrast, the rate of foreign body ingestion was higher under the age of one than at 18 months, and also higher at 18 months as compared to the age of 3 years. Drowning was more common at 18 months and 3 years than under the age of one. As for prevention of domestic injury, investigation of preventive means taken according

Traumatic Brain Injury in Early Childhood: Developmental Effects and Interventions.

ERIC Educational Resources Information Center

Lowenthal, Barbara; Lowenthal, Barbara

1998-01-01

Describes the unique effects of traumatic brain injury (TBI) on development in early childhood and offers suggestions for interventions in the cognitive, language, social-emotional, motor, and adaptive domains. Urges more intensive, long-term studies on the immediate and long-term effects of TBI. (Author/DB)

How Useful Are Home Safety Behaviours for Predicting Childhood Injury? A Cohort Study

ERIC Educational Resources Information Center

Kendrick, Denise; Watson, Michael; Mulvaney, Caroline; Burton, Paul

2005-01-01

Little work has examined the utility of home safety behaviours in predicting childhood injury. This study examines the relationship between safety behaviours and child injury using a cohort of 1717 families, with 2357 children aged 0-7 years. Safety behaviours, and sociodemographic and family characteristics were measured using a validated…

Nocturnal awakenings and pediatric injury risk.

PubMed

Schwebel, David C; Brezausek, Carl M

2008-04-01

This study was designed to examine relations between nocturnal awakenings and unintentional injury risk among toddlers. A nationally representative sample of 799 children was followed longitudinally from birth through 36 months. Patterns of nocturnal awakening were assessed by parent-report at ages 6, 15, 24 and 36 months, and injury events were reported at quarterly intervals over the same time period. A range of external covariates, including positive and negative affect and externalizing behavior; maternal stress, maternal depression, and parenting style; and family socioeconomic status were measured. A persistent pattern of very mild nocturnal awakening was related to increased risk of injury during the toddler years, and that relation held after controlling for a range of potential covariates. A pattern of persistent nocturnal awakening appears to be related to unintentional injury risk in toddlers.

Determinants of Unintentional Leaks During CPAP Treatment in OSA.

PubMed

Lebret, Marius; Arnol, Nathalie; Martinot, Jean-Benoît; Lambert, Loïc; Tamisier, Renaud; Pepin, Jean-Louis; Borel, Jean-Christian

2018-04-01

Unintentional leakage from the mouth or around the mask may lead to cessation of CPAP treatment; however, the causes of unintentional leaks are poorly understood. The objectives of this study were (1) to identify determining factors of unintentional leakage and (2) to determine the effect of the type of mask (nasal/oronasal) used on unintentional leakage. Seventy-four polysomnograms from patients with OSA syndrome treated with auto-CPAP were analyzed (23 women; 56 ± 13 years; BMI, 32.9 kg/m 2 (range, 29.0-38.0 kg/m 2 ). Polysomnographic recordings were obtained under auto-CPAP, and mandibular behavior was measured with a magnetic sensor. After sleep and respiratory scoring, polysomnographic signals were computed as mean values over nonoverlapping 10-s intervals. The presence/absence of unintentional leakage was dichotomized for each 10-s interval (yes/no). Univariate and multivariate conditional regression models estimated the risk of unintentional leaks during an interval "T" based on the explanatory variables from the previous interval "T-1." A sensitivity analysis for the type of mask was then conducted. The univariate analysis showed that mandibular lowering (mouth opening), a high level of CPAP, body position (other than supine), and rapid eye movement (REM) sleep increased the risk of unintentional leaks and microarousal decreased it. In the multivariate analysis, the same variables remained independently associated with an increased risk of unintentional leakage. The sensitivity analysis showed that oronasal masks reduced the risk of unintentional leaks in cases of mouth opening and REM sleep. Mouth opening, CPAP level, sleep position, and REM sleep independently contribute to unintentional leakage. These results provide a strong rationale for the definition of phenotypes and the individual management of leaks during CPAP treatment. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Childhood onset of spinal cord injury: self-esteem and self-perception.

PubMed

Kennedy, P; Gorsuch, N; Marsh, N

1995-11-01

The effects of spinal cord injury in childhood upon later psychological adjustment were investigated by comparing a group of 86 people injured as children with a control group (matched for time since injury and level of injury) of people injured as adults. It was hypothesized that adolescence is a crucial period in psychological development and that the effect of spinal cord injury on body image, self-concept and social relationships during adolescence will have a long-term negative effect on psychological well-being. However, on overall measures of depression, self-esteem and self-perception, there were no significant differences between the experimental and control groups. Furthermore, there were no significant differences between paraplegics and tetraplegics, between men women, or between those who were involved in a significant intimate relationship and those who were not. These findings support previous research which has suggested that organic variables, such as age at injury and level of injury, are not predictive of long-term psychological adjustment.

3 CFR 8484 - Proclamation 8484 of March 15, 2010. National Poison Prevention Week, 2010

Code of Federal Regulations, 2011 CFR

2011-01-01

..., childhood death rates from unintentional poisonings have fallen considerably. However, adult death rates... senseless injuries and deaths. With nearly two million poison exposures reported each year, we must take...

The association between hospitalisation for childhood head injury and academic performance: evidence from a population e-cohort study.

PubMed

Gabbe, Belinda J; Brooks, Caroline; Demmler, Joanne C; Macey, Steven; Hyatt, Melanie A; Lyons, Ronan A

2014-05-01

Childhood head injury has the potential for lifelong disability and burden. This study aimed to establish the association between admission to hospital for childhood head injury and early academic performance. The Wales Electronic Cohort for Children (WECC) study is comprised of record-linked routinely collected data, on all children born or residing in Wales. Anonymous linking fields are used to link child and maternal health, environment and education records. Data from WECC were extracted for children born between September 1998 and August 2001. A Generalised Estimating Equation model, adjusted for clustering based on the maternal identifier as well as other key confounders, was used to establish the association between childhood head injury and performance on the Key Stage 1 (KS1) National Curriculum assessment administered to children aged 5-7 years. Head injury was defined as an emergency admission for >24 h for concussion, skull fracture or intracranial injury prior to KS1 assessment. Of the 101 892 eligible children, KS1 results were available for 90 661 (89%), and 290 had sustained a head injury. Children who sustained an intracranial injury demonstrated significantly lower adjusted odds of achieving a satisfactory KS1 result than children who had not been admitted to hospital for head injury (adjusted OR 0.46, 95% CI 0.30 to 0.72). The findings of this population e-cohort study quantify the impact of head injury on academic performance, highlighting the need for enhanced head injury prevention strategies. The results have implications for the care and rehabilitation of children admitted to hospital with head injury.

Injury-related visits and comorbid conditions among homeless persons presenting to emergency departments.

PubMed

Hammig, Bart; Jozkowski, Kristen; Jones, Ches

2014-04-01

The authors examined the clinical characteristics of homeless patients presenting to emergency departments (EDs) in the United States, with a focus on unintentional and intentional injury events and related comorbid conditions. The study included a nationally representative sample of patients presenting to EDs with data obtained from the 2007 through 2010 National Hospital Ambulatory Medical Care Survey (NHAMCS). Descriptive and analytical epidemiologic analyses were employed to examine injuries among homeless patients. Homeless persons made 603,000 visits annually to EDs, 55% of which were for injuries, with the majority related to unintentional (52%) and self-inflicted (23%) injuries. Multivariate logistic regression analyses revealed that homeless patients had a higher odds of presenting with injuries related to unintentional (odds ratio [OR]=1.4. 95% confidence interval [CI]=1.1 to 1.9), self-inflicted (OR=6.0, 95% CI=3.7 to 9.5), and assault (OR=3.0, 95% CI=1.5 to 5.9) injuries. A better understanding of the injuries affecting homeless populations may provide medical and public health professionals insight into more effective ways to intervene and limit further morbidity and mortality related to specific injury outcomes. © 2014 by the Society for Academic Emergency Medicine.

Adult cognitive outcomes following childhood mild traumatic brain injuries.

PubMed

Yumul, Joy Noelle; McKinlay, Audrey

2017-10-01

To investigate the adult cognitive outcomes of one versus multiple childhood mTBI and to examine the potential predictors of the outcomes. Review of neurosurgical files and hospital records, as well as community recruitment, yielded 169 participants, who were injured between ages 0-17 years and assessed between ages 18-30 years with at least five years post-injury. Each participant underwent a three-hour assessment. For data analysis, participants were grouped by type and number of injury. The mTBI group exhibited some cognitive deficits but their performance fell between the control and moderate/severe TBI groups as expected. Those with one and multiple mTBI performed comparably across all cognitive domains. Cognitive outcomes were significantly predicted by estimated IQ but not by number of mTBI and age at injury. Despite the detected cognitive deficits, those who sustained multiple mTBI did not exhibit worse or cumulative deficits compared to those with one mTBI.

Population-based epidemiology of non-fatal injuries in Tehran, Iran.

PubMed

Hashemi, Esmatolsadat; Zangi, Mahdi; Sadeghi-Bazargani, Homayoun; Soares, Joaquim; Viitasara, Eija; Mohammadi, Reza

2018-01-01

Background: Our aim in this survey was to explore descriptive epidemiology of injuries in Tehran in 2012 and to report the recalled estimates of injury incidence rates. Methods: A population survey was conducted in Tehran during 2012, within which a total of 8626 participants were enrolled. The cluster sampling was used to draw samples in 100 clusters with a pre-specified cluster size of 25 households per cluster. Data were collected on demographic features, accident and injury characteristics based on the International Classification of Diseases (ICD10). Results: A total of 618 injuries per 3 months were reported, within which 597 cases (96.6%)were unintentional injuries. More than 82% of all injuries were those caused by exposure to inanimate mechanical forces, traffic accidents, falls and burns. Above 80% of the traffic injuries happened among men (P<0.001). About 43% of the unintentional injuries were mild injuries.After the age of 40, women, unlike men, had higher risks for being injured. The estimated annual incidence rate for all types of injuries was 284.8 per 1000 (95% CI: 275.4-294.4) and for unintentional injuries was 275.2 per 1000. Conclusion: Injuries are major health problems in Tehran with a highly reported incidence. The status is not substantially improved over the recent years which urges the need to be adequately and emergently addressed. As the incidence rate was estimated based on participant recalls, the real incidence rate may even be higher than those reported in the current study.

Causes of unintentional deaths from carbon monoxide poisonings in California.

PubMed Central

Girman, J R; Chang, Y L; Hayward, S B; Liu, K S

1998-01-01

The purpose of this study was to determine the annual number and incidence of unintentional deaths from carbon monoxide (CO) poisonings in California and to identify specific factors that caused or contributed to the deaths. Unintentional CO deaths in California over a ten-year period (1979 to 1988) were identified from the database of the California Master Mortality File and coroners' investigation reports. Factors associated with unintentional CO deaths were determined based on the information from the investigation reports. The annual number of unintentional CO deaths varied from 27 to 58 over the ten years examined, with an average annual death incidence of 1.7 x 10(-6). Death rates were high among males and African-Americans. Alcohol appeared to be a factor in 31% of the cases. The types of combustion sources associated with unintentional CO deaths were: heating or cooking appliances; motor vehicles; charcoal grills and hibachis; small engines; and camping equipment. Factors associated with unintentional CO deaths interact in a complex way. To reduce the rate of unintentional CO deaths effectively, joint efforts involving several prevention methods are suggested. PMID:9549414

Borderline Symptoms and Suicidality/Self-injury in Late Adolescence: Prospectively Observed Relationship Correlates in Infancy and Childhood

PubMed Central

Lyons-Ruth, Karlen; Bureau, Jean-Francois; Holmes, Bjarne; Easterbrooks, Ann; Brooks, Nancy Hall

2012-01-01

The primary objective was to assess whether prospectively observed quality of parent-child interaction in infancy and middle childhood contributed to the prediction of borderline symptoms and recurrent suicidality/self-injury in late adolescence. Adolescents (mean 19.9 years) from 56 families participating in a longitudinal study since infancy (retention rate 74%) were assessed on the SCID-II for symptoms of borderline personality disorder, including suicidality/self-injury. Early clinical risk was indexed by clinical referral to parent-infant services. Attachment security and parent-child interaction were assessed from videotape at 18 months and 8 years. Severity of childhood abuse was rated from interview and self-report measures. Maternal withdrawal in infancy was a significant predictor of both borderline symptoms and suicidality/self-injury in late adolescence. Disorganizedcontrolling child behavior at age 8 contributed independently to the prediction of borderline symptoms. The effect of maternal withdrawal was independent of, and additive to, variability explained by severity of childhood abuse. Borderline symptoms and suicidality/self-injury may be preceded developmentally by disturbed interactions as early as 18 months of age. A parent-child transactional model is proposed to account for the findings. PMID:23123044

Practical applications of injury surveillance: a brief 25-year history of the Connecticut Injury Prevention Center.

PubMed

Lapidus, Garry; Borrup, Kevin; DiVietro, Susan; Campbell, Brendan T; Beebe, Rebecca; Grasso, Damion; Rogers, Steven; Joseph, D'Andrea; Banco, Leonard

2016-04-01

The mission of the Connecticut Injury Prevention Center (CIPC), jointly housed in Connecticut Children's Medical Center and Hartford Hospital, is to reduce unintentional injury and violence among Connecticut residents, with a special focus on translating research into injury prevention programmes and policy. The CIPC engages in four core activities: research, education and training, community outreach programmes and public policy. As surveillance is an essential element of injury prevention, the CIPC has developed a robust statewide fatal and non-fatal injury surveillance system that has guided our prior work and continues to inform our current projects. The purpose of this article is to review the projects, programmes, and collaborative relationships that have made the CIPC successful in reducing unintentional injury and violence in Connecticut throughout the course of its 25 years history. Retrospective review of the application of injury surveillance. We believe that the application of our surveillance system can serve as a model for others who wish to engage in collaborative, community-based, data-driven injury prevention programmes in their own communities. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Approaches to reduce urinary tract injury during management of placenta accreta, increta, and percreta: a systematic review.

PubMed

Tam Tam, Kiran Babu; Dozier, James; Martin, James Nello

2012-04-01

A systematic review of the literature was conducted to answer the following question: are there enhancements to standard peripartum hysterectomy technique that minimize unintentional urinary tract (UT) injury in pregnancies complicated by invasive placental attachment (INPLAT)? A PubMed search of English language articles on INPLAT published by June 2010 was conducted. Data regarding the following parameters was required for inclusion in the quantitative analysis of the review's objective: (1) type of INPLAT, (2) details pertaining to medical and surgical management of INPLAT, and (3) complications, if any, associated with management. An attempt was made to identify approaches that may lower the risk of unintentional UT injury. Most cases (285 of 292) were managed by hysterectomy. There were 83 (29%) cases of unintentional UT injury. Antenatal diagnosis of INPLAT lowered the rate of UT injury (39% vs. 63%; P = 0.04). Information regarding surgical technique or medical management was available for 90 cases; 14 of these underwent a standard hysterectomy technique. Methotrexate treatment and 11 modifications of the surgical technique were associated with 16% unintentional UT injury rate as opposed to 57% for standard hysterectomy (P = 0.002). The use of ureteral stents reduced risk of urologic injury (P = 0.01). Multiple logistic regression analysis identified antenatal diagnosis as the significant predictor of an intact UT. Antenatal diagnosis of INPLAT is paramount to minimize UT injury. Utilization of management modifications identified in this review may reduce urologic injury due to INPLAT.

Risk Factors for Acute Unintentional Poisoning among Children Aged 1–5 Years in the Rural Community of Sri Lanka

PubMed Central

Jayamanne, Shaluka F.; Jayasinghe, Chamilka Y.

2017-01-01

Background Acute poisoning in children is a major preventable cause of morbidity and mortality in both developed and developing countries. However, there is a wide variation in patterns of poisoning and related risk factors across different geographic regions globally. This hospital based case-control study identifies the risk factors of acute unintentional poisoning among children aged 1−5 years of the rural community in a developing Asian country. Methods This hospital based case-control study included 600 children. Each group comprised three hundred children and all children were recruited at Anuradhapura Teaching Hospital, Sri Lanka, over two years (from February 2012 to January 2014). The two groups were compared to identify the effect of 23 proposed risk factors for unintentional poisoning using multivariate analysis in a binary logistic regression model. Results Multivariate analysis identified eight risk factors which were significantly associated with unintentional poisoning. The strongest risk factors were inadequate supervision (95% CI: 15.4–52.6), employed mother (95% CI: 2.9–17.5), parental concern of lack of family support (95% CI: 3.65–83.3), and unsafe storage of household poisons (95% CI: 1.5–4.9). Conclusions Since inadequate supervision, unsafe storage, and unsafe environment are the strongest risk factors for childhood unintentional poisoning, the effect of community education to enhance vigilance, safe storage, and assurance of safe environment should be evaluated. PMID:28932247

Injuries, Death, and Disability Associated with 11 Years of Conflict in Baghdad, Iraq: A Randomized Household Cluster Survey.

PubMed

Lafta, Riyadh; Al-Shatari, Sahar; Cherewick, Megan; Galway, Lindsay; Mock, Charles; Hagopian, Amy; Flaxman, Abraham; Takaro, Tim; Greer, Anna; Kushner, Adam; Burnham, Gilbert

2015-01-01

The objective of this study was to characterize injuries, deaths, and disabilities arising during 11 years of conflict in Baghdad. Using satellite imagery and administrative population estimated size for Baghdad, 30 clusters were selected, proportionate to population size estimates. Interviews were conducted during April and May 2014 in 900 households containing 5148 persons. Details about injuries and disabilities occurring from 2003 through May 2014 and resultant disabilities were recorded. There were 553 injuries reported by Baghdad residents, 225 of which were intentional, and 328 unintentional. For intentional injuries, the fatality rate was 39.1% and the disability rate 56.0%. Gunshots where the major cause of injury through 2006 when blasts/explosions became the most common cause and remained so through 2014. Among unintentional injuries, the fatality rate was 7.3% and the disability rate 77.1%. The major cause of unintentional injuries was falls (131) which have increased dramatically since 2008, followed by traffic related injuries (81), which have steadily increased. The proportion of injuries ending in disabilities remained fairly constant through the survey period. Intentional injuries added substantially to the burden of unintentional injuries for the population. For Baghdad, the phases of the Iraqi conflict are reflected in the patterns of injuries and consequent deaths reported. The scale of injuries during conflict is most certainly under-reported. Difficulties recalling injuries in a survey covering 11 years is a limitation, but it is likely that minor injuries were under-reported more than severe injuries. The in- and out-migration of Baghdad populations likely had effects on the events reported which we could not measure or estimate. Damage to the health infrastructure and the flight of health workers may have contributed to mortality and morbidity. Civilian injuries as well as mortality should be measured during conflicts, though not currently

Injuries, Death, and Disability Associated with 11 Years of Conflict in Baghdad, Iraq: A Randomized Household Cluster Survey

PubMed Central

Lafta, Riyadh; Al-Shatari, Sahar; Cherewick, Megan; Galway, Lindsay; Mock, Charles; Hagopian, Amy; Flaxman, Abraham; Takaro, Tim; Greer, Anna; Kushner, Adam; Burnham, Gilbert

2015-01-01

Background The objective of this study was to characterize injuries, deaths, and disabilities arising during 11 years of conflict in Baghdad. Methods Using satellite imagery and administrative population estimated size for Baghdad, 30 clusters were selected, proportionate to population size estimates. Interviews were conducted during April and May 2014 in 900 households containing 5148 persons. Details about injuries and disabilities occurring from 2003 through May 2014 and resultant disabilities were recorded. Findings There were 553 injuries reported by Baghdad residents, 225 of which were intentional, and 328 unintentional. For intentional injuries, the fatality rate was 39.1% and the disability rate 56.0%. Gunshots where the major cause of injury through 2006 when blasts/explosions became the most common cause and remained so through 2014. Among unintentional injuries, the fatality rate was 7.3% and the disability rate 77.1%. The major cause of unintentional injuries was falls (131) which have increased dramatically since 2008, followed by traffic related injuries (81), which have steadily increased. The proportion of injuries ending in disabilities remained fairly constant through the survey period. Interpretation Intentional injuries added substantially to the burden of unintentional injuries for the population. For Baghdad, the phases of the Iraqi conflict are reflected in the patterns of injuries and consequent deaths reported. The scale of injuries during conflict is most certainly under-reported. Difficulties recalling injuries in a survey covering 11 years is a limitation, but it is likely that minor injuries were under-reported more than severe injuries. The in- and out-migration of Baghdad populations likely had effects on the events reported which we could not measure or estimate. Damage to the health infrastructure and the flight of health workers may have contributed to mortality and morbidity. Civilian injuries as well as mortality should be

Underestimates of unintentional firearm fatalities: comparing Supplementary Homicide Report data with the National Vital Statistics System

PubMed Central

Barber, C; Hemenway, D; Hochstadt, J; Azrael, D

2002-01-01

Objective: A growing body of evidence suggests that the nation's vital statistics system undercounts unintentional firearm deaths that are not self inflicted. This issue was examined by comparing how unintentional firearm injuries identified in police Supplementary Homicide Report (SHR) data were coded in the National Vital Statistics System. Methods: National Vital Statistics System data are based on death certificates and divide firearm fatalities into six subcategories: homicide, suicide, accident, legal intervention, war operations, and undetermined. SHRs are completed by local police departments as part of the FBI's Uniform Crime Reports program. The SHR divides homicides into two categories: "murder and non-negligent manslaughter" (type A) and "negligent manslaughter" (type B). Type B shooting deaths are those that are inflicted by another person and that a police investigation determined were inflicted unintentionally, as in a child killing a playmate after mistaking a gun for a toy. In 1997, the SHR classified 168 shooting victims this way. Using probabilistic matching, 140 of these victims were linked to their death certificate records. Results: Among the 140 linked cases, 75% were recorded on the death certificate as homicides and only 23% as accidents. Conclusion: Official data from the National Vital Statistics System almost certainly undercount firearm accidents when the victim is shot by another person. PMID:12226128

Causes and Outcomes of Pediatric Injuries Occurring at School.

ERIC Educational Resources Information Center

Di Scala, Carla; Gallagher, Susan Scavo; Schneps, Sue E.

1997-01-01

Used the National Pediatric Trauma Registry, which collects data on child injuries requiring hospitalization, to examine causes and outcomes of injuries occurring at school. Analysis of 1,558 cases indicated that most injuries were unintentional and occurred among students age 10-14 years. Nearly half occurred in recreational areas. Falls and…

Violence related injuries, deaths and disabilities in the capital of Honduras.

PubMed

Yacoub, Sophie; Arellano, Sergio; Padgett-Moncada, Dennis

2006-05-01

Honduras has the second highest incidence of violence in the Americas. The aim of this study is to explore the number and mechanism of fatal injuries, non-fatal injuries and the sequelae of these injuries due to violence. This is compared with unintentional injuries, in the capital of Honduras for 2001, with a view to better-targeted prevention. Data for non-fatal injuries was retrospectively obtained from medical records of all admissions from the public Emergency Department in Tegucigalpa for 2001. Data on fatal injuries were obtained from the national forensic department. All injuries were reviewed for intention, mechanism and age group. There were 1631 (rate 138/100,000) fatal injuries recorded for 2001 in Tegucigalpa. Of these, 1149 (70.4%) were due to violence, compared to 355 (21.8%) due to unintentional injuries and 127 (7.8%) of unknown intent. Homicides accounted for 1044 (64%), suicides 105 (6.4%) and unintentional deaths 355 (22%). Firearms were the leading cause of death in the homicide group (84.3%). In addition 1592 (rate 235/100,000) non-fatal injuries were documented for people 15 years and above, with 1228 (77.1%) caused by violence, of which 640 (52.1%) were caused by firearms. The age group 15-24 years had the highest rates of fatal and non-fatal injuries due to violence. Twenty percent had permanent sequelae as a result of their injuries. Firearm injuries had the highest proportion of sequelae (28.8%). Violence in Tegucigalpa is a major cause of injury resulting in substantial morbidity, mortality and disability, particularly in young individuals. Firearms are the most common form of violence related injury mechanism and carry the highest associated mortality and permanent disability. Prevention programs are urgently needed to address this devastating problem.

Permanent hypopituitarism is rare after structural traumatic brain injury in early childhood.

PubMed

Heather, Natasha L; Jefferies, Craig; Hofman, Paul L; Derraik, José G B; Brennan, Christine; Kelly, Patrick; Hamill, James K M; Jones, Rhys G; Rowe, Deborah L; Cutfield, Wayne S

2012-02-01

We sought to determine the incidence of permanent hypopituitarism in a potentially high-risk group: young children after structural traumatic brain injury (TBI). We conducted a cross-sectional study with longitudinal follow-up. Dynamic tests of pituitary function (GH and ACTH) were performed in all subjects and potential abnormalities critically evaluated. Puberty was clinically staged; baseline thyroid function, prolactin, IGF-I, serum sodium, and osmolality were compared with age-matched data. Diagnosis of GH deficiency was based on an integrated assessment of stimulated GH peak (<5 μg/liter suggestive of deficiency), IGF-I, and growth pattern. ACTH deficiency was diagnosed based on a subnormal response to two serial Synacthen tests (peak cortisol <500 nmol/liter) and a metyrapone test. We studied 198 survivors of structural TBI sustained in early childhood (112 male, age at injury 1.7 ± 1.5 yr) 6.5 ± 3.2 yr after injury. Sixty-four of the injuries (33%) were inflicted and 134 (68%) accidental. Two participants had developed precocious puberty, which is within the expected background population rate. Peak stimulated GH was subnormal in 16 participants (8%), in the context of normal IGF-I and normal growth. Stimulated peak cortisol was low in 17 (8%), but all had normal ACTH function on follow-up. One participant had a transient low serum T(4). Therefore, no cases of hypopituitarism were recorded. Permanent hypopituitarism is rare after both inflicted and accidental structural TBI in early childhood. Precocious puberty was the only pituitary hormone abnormality found, but the prevalence did not exceed that of the normal population.

Corticobulbar tract changes as predictors of dysarthria in childhood brain injury.

PubMed

Liégeois, Frédérique; Tournier, Jacques-Donald; Pigdon, Lauren; Connelly, Alan; Morgan, Angela T

2013-03-05

To identify corticobulbar tract changes that may predict chronic dysarthria in young people who have sustained a traumatic brain injury (TBI) in childhood using diffusion MRI tractography. We collected diffusion-weighted MRI data from 49 participants. We compared 17 young people (mean age 17 years, 10 months; on average 8 years postinjury) with chronic dysarthria who sustained a TBI in childhood (range 3-16 years) with 2 control groups matched for age and sex: 1 group of young people who sustained a traumatic injury but had no subsequent dysarthria (n = 15), and 1 group of typically developing individuals (n = 17). We performed tractography from spherical seed regions within the precentral gyrus white matter to track: 1) the hand-related corticospinal tract; 2) the dorsal corticobulbar tract, thought to correspond to the lips/larynx motor representation; and 3) the ventral corticobulbar tract, corresponding to the tongue representation. Despite widespread white matter damage, radial (perpendicular) diffusivity within the left dorsal corticobulbar tract was the best predictor of the presence of dysarthria after TBI. Diffusion metrics in this tract also predicted speech and oromotor performance across the whole group of TBI participants, with additional significant contributions from ventral speech tract volume in the right hemisphere. An intact left dorsal corticobulbar tract seems crucial to the normal execution of speech long term after acquired injury. Examining the speech-related motor pathways using diffusion-weighted MRI tractography offers a promising prognostic tool for people with acquired, developmental, or degenerative neurologic conditions likely to affect speech.

Road traffic and other unintentional injuries among travelers to developing countries

PubMed Central

Stewart, Barclay; Yankson, Isaac Kofi; Afukaar, Francis; Medina, Martha Hijar; Cuong, Pham Viet; Mock, Charles

2015-01-01

Synopsis Injuries result in nearly 6 million deaths and incur 52 million disability-adjusted life years annually, comprising 15% of the global disease burden. More than 90% of this burden occurs in low- and middle-income countries (LMICs). Given this burden, it’s not unexpected that injuries are the leading cause of death among travelers to LMICs, namely from road traffic crashes and drowning. Opportunely, the majority of injuries are preventable. Therefore, pre-travel advice regarding foreseeable dangers and how to avoid them may significantly mitigate injury risk, such as: wearing seatbelts, helmets and personal flotation devices when appropriate; responsibly consuming alcohol; and closely supervising children. Upon return, travelers to LMICs are in a unique position; having shared injury risks while abroad, travelers can advocate for injury control initiatives that might make the world safer for travelers and local populations alike. PMID:26900117

Strategies for Playground Injury Prevention: An Overview of a Playground Project

ERIC Educational Resources Information Center

Olsen, Heather; Hudson, Susan D.; Thompson, Donna

2010-01-01

Preventing injuries to children, especially debilitating and life threatening, requires an awareness of where these types of injuries occur during the school days. This review examines falls from playground equipment, events that have been identified as the leading causes of nonfatal unintentional injuries for children. Thus, the issue of…

Prevention of Unintentional Islands in Power Systems with Distributed

Science.gov Websites

Islands in Power Systems with Distributed Resources Webinar Prevention of Unintentional Islands in Power Systems with Distributed Resources Webinar Learn about unintentional islanding in a webinar from NREL and following the presentation. Types of islands in power systems with distributed resources Issues with

Working hours associated with unintentional sleep at work among airline pilots

PubMed Central

Marqueze, Elaine Cristina; Nicola, Ana Carolina B; Diniz, Dag Hammarskjoeld M D; Fischer, Frida Marina

2017-01-01

ABSTRACT OBJECTIVE Tto identify factors associated with unintentional sleep at work of airline pilots. METHODS This is a cross-sectional epidemiological study conducted with 1,235 Brazilian airline pilots, who work national or international flights. Data collection has been performed online. We carried out a bivariate and multiple logistic regression analysis, having as dependent variable unintentional sleep at work. The independent variables were related to biodemographic data, characteristics of the work, lifestyle, and aspects of sleep. RESULTS The prevalence of unintentional sleep while flying the airplane was 57.8%. The factors associated with unintentional sleep at work were: flying for more than 65 hours a month, frequent technical delays, greater need for recovery after work, work ability below optimal, insufficient sleep, and excessive sleepiness. CONCLUSIONS The occurrence of unintentional sleep at work of airline pilots is associated with factors related to the organization of the work and health. PMID:28678902

Toward a taxonomy of the unintentional discharge of firearms in law enforcement.

PubMed

O'Neill, John; O'Neill, Dawn A; Lewinski, William J

2017-03-01

An unintentional discharge (UD) is an activation of the trigger mechanism that results in an unplanned discharge that is outside of the firearm's prescribed use. UDs can result in injury or death, yet have been understudied in scientific literature. Pre-existing (1974-2015) UD reports (N = 137) from seven law enforcement agencies in the United States of America were analyzed by context, officer behavior, type of firearm, and injuries. Over 50% of UDs occurred in contexts with low threat potential while engaged in routine firearm tasks. The remaining UDs occurred in contexts with elevated to high threat potential during muscle co-activation, unfamiliar firearm tasks, contact with inanimate objects, and a medical condition. An antecedent-behavior-consequence (A-B-C) taxonomy as well as a standardized reporting form, based on the current findings and the existing literature, are offered as tools for identifying the conditions under which UDs may be likely to occur. Copyright © 2016 Elsevier Ltd. All rights reserved.

Preventing Unintentional Injuries in the Home Using the Health Impact Pyramid

PubMed Central

Mack, Karin A.; Liller, Karen D.; Baldwin, Grant; Sleet, David

2015-01-01

Injuries continue to be the leading cause of death for the first four decades of life. These injuries result from a confluence of behavioral, physical, structural, environmental, and social factors. Taken together, these illustrate the importance of taking a broad and multileveled approach to injury prevention. Using examples from fall, fire, scald, and poisoning-related injuries, this article illustrates the utility of an approach that incorporates a social–environmental perspective in identifying and selecting interventions to improve the health and safety of individuals. Injury prevention efforts to prevent home injuries benefit from multilevel modifications of behavior, public policy, laws and enforcement, the environment, consumer products and engineering standards, as demonstrated with Frieden’s Health Impact Pyramid. A greater understanding, however, is needed to explain the associations between tiers. While interventions that include modifications of the social environment are being field-tested, much more work needs to be done in measuring social–environmental change and in evaluating these programs to disentangle what works best. PMID:25829110

Childhood abuse and neglect, attachment states of mind, and non-suicidal self-injury.

PubMed

Martin, Jodi; Raby, K Lee; Labella, Madelyn H; Roisman, Glenn I

2017-10-01

This investigation examined preoccupied attachment states of mind as both a risk factor for non-suicidal self-injury (NSSI) and as a mechanism by which prospectively assessed childhood experiences of abuse and neglect predicted the frequency/severity of NSSI behavior up to age 26 years in 164 individuals (83 females) who were followed from birth in the Minnesota Longitudinal Study of Risk and Adaptation. Preoccupied (but not dismissing) states of mind regarding both childhood caregivers and adult romantic partners were correlated with more frequent/severe NSSI. Furthermore, preoccupied states of mind regarding caregivers partially accounted for the association between childhood abuse/neglect and NSSI. This work represents a rare prospective test of a developmental psychopathology framework for understanding NSSI behavior, in which atypical caregiving experiences are carried forward through attachment representations of caregivers that reflect behavioral risk.

Preventing Unintentional Injuries in the Home Using the Health Impact Pyramid

ERIC Educational Resources Information Center

Mack, Karin A.; Liller, Karen D.; Baldwin, Grant; Sleet, David

2015-01-01

Injuries continue to be the leading cause of death for the first four decades of life. These injuries result from a confluence of behavioral, physical, structural, environmental, and social factors. Taken together, these illustrate the importance of taking a broad and multileveled approach to injury prevention. Using examples from fall, fire,…

Preventing unintentional injuries in the home using the Health Impact Pyramid.

PubMed

Mack, Karin A; Liller, Karen D; Baldwin, Grant; Sleet, David

2015-04-01

Injuries continue to be the leading cause of death for the first four decades of life. These injuries result from a confluence of behavioral, physical, structural, environmental, and social factors. Taken together, these illustrate the importance of taking a broad and multileveled approach to injury prevention. Using examples from fall, fire, scald, and poisoning-related injuries, this article illustrates the utility of an approach that incorporates a social-environmental perspective in identifying and selecting interventions to improve the health and safety of individuals. Injury prevention efforts to prevent home injuries benefit from multilevel modifications of behavior, public policy, laws and enforcement, the environment, consumer products and engineering standards, as demonstrated with Frieden's Health Impact Pyramid. A greater understanding, however, is needed to explain the associations between tiers. While interventions that include modifications of the social environment are being field-tested, much more work needs to be done in measuring social-environmental change and in evaluating these programs to disentangle what works best. © 2015 Society for Public Health Education.

Unintentional and undetermined firearm related deaths: a preventable death analysis for three safety devices.

PubMed

Vernick, J S; O'Brien, M; Hepburn, L M; Johnson, S B; Webster, D W; Hargarten, S W

2003-12-01

To determine the proportion of unintentional and undetermined firearm related deaths preventable by three safety devices: personalization devices, loaded chamber indicators (LCIs), and magazine safeties. A personalized gun will operate only for an authorized user, a LCI indicates when the gun contains ammunition, and a magazine safety prevents the gun from firing when the ammunition magazine is removed. Information about all unintentional and undetermined firearm deaths from 1991-98 was obtained from the Office of the Chief Medical Examiner for Maryland, and from the Wisconsin Firearm Injury Reporting System for Milwaukee. Data regarding the victim, shooter, weapon, and circumstances were abstracted. Coding rules to classify each death as preventable, possibly preventable, or not preventable by each of the three safety devices were also applied. There were a total of 117 firearm related deaths in our sample, 95 (81%) involving handguns. Forty three deaths (37%) were classified as preventable by a personalized gun, 23 (20%) by a LCI, and five (4%) by a magazine safety. Overall, 52 deaths (44%) were preventable by at least one safety device. Deaths involving children 0-17 (relative risk (RR) 3.3, 95% confidence interval (CI) 2.1 to 5.1) and handguns (RR 8.1, 95% CI 1.2 to 53.5) were more likely to be preventable. Projecting the findings to the entire United States, an estimated 442 deaths might have been prevented in 2000 had all guns been equipped with these safety devices. Incorporating safety devices into firearms is an important injury intervention, with the potential to save hundreds of lives each year.

Functional Magnetic Resonance Imaging of Chronic Dysarthric Speech after Childhood Brain Injury: Reliance on a Left-Hemisphere Compensatory Network

ERIC Educational Resources Information Center

Morgan, Angela T.; Masterton, Richard; Pigdon, Lauren; Connelly, Alan; Liegeois, Frederique J.

2013-01-01

Severe and persistent speech disorder, dysarthria, may be present for life after brain injury in childhood, yet the neural correlates of this chronic disorder remain elusive. Although abundant literature is available on language reorganization after lesions in childhood, little is known about the capacity of motor speech networks to reorganize…

"Trying to Get a Grip": Language Competence and Self-Reported Satisfaction With Social Relationships Three Decades Post-Childhood Traumatic Brain Injury.

PubMed

Atay, Christina; Ryan, Sarah J; Lewis, Fiona M

2016-01-01

(1) To investigate outcomes in language competence and self-reported satisfaction with social relationships in long-term survivors of childhood traumatic brain injury (TBI); and (2) to establish whether language competence contributes to self-reported satisfaction with social relationships decades after sustaining childhood TBI. Twelve females and 8 males aged 30 to 55 (mean = 39.80, standard deviation = 7.54) years who sustained a TBI during childhood and were on average 31 years postinjury (standard deviation = 9.69). An additional 20 participants matched for age, sex, handedness, years of education, and socioeconomic status constituted a control group. Test of Language Competence-Expanded Edition and the Quality of Life in Brain Injury questionnaire. Individuals with a history of childhood TBI performed significantly poorer than their non-injured peers on 2 (Ambiguous Sentences and Oral Expression: Recreating Sentences) out of the 4 Test of Language Competence-Expanded Edition subtests used and on the Quality of Life in Brain Injury subscale assessing satisfaction with social relationships. In the TBI group, scores obtained on the Ambiguous Sentences subtest were found to be a significant predictor of satisfaction with social relationships, explaining 25% of the variance observed. The implication of high-level language skills to self-reported satisfaction with social relationships many decades post-childhood TBI suggests that ongoing monitoring of emerging language skills and support throughout the school years and into adulthood may be warranted if adult survivors of childhood TBI are to experience satisfying social relationships.

[Epidemiology and risk factors in injuries due to fall in infants under one year-old].

PubMed

Jiménez de Domingo, Ana; Rubio García, Elena; Marañon Pardillo, Rafael; Arias Constanti, Vanessa; Frontado Haiek, Luis Alberto; Soriano Arola, Marta; Ripoll Oliveras, Francesc; Remón García, Cristina; Estopiña Ferrer, Gloria; Lorente Romero, Jorge

2017-06-01

To describe the epidemiological characteristics of unintentional injuries due to falls in children under one year and to analyse the risk factors associated with severe injuries. This multicentre, observational and cross-sectional study included all children less than one year treated for unintentional fall in the Emergency Departments of 8 Spanish Hospitals, belonging to the «Unintentional Paediatric Injury Workshop» of the Spanish Paediatric Emergency Society, between March 1st, 2014 and February 28th, 2015. Out of 289,887 emergency department cases, 1,022 were due to unintentional falls. The median age was 8 months and 52.5% were males. Fall injuries were more frequent among children aged 9-12 months (37.6%), and 83.5% occurred at home. The most common mechanism was fall from nursery equipment (69.4%), and 47.8% occurred from a height under 50cm. More than two-thirds (68%) of falls were witnessed, but in half of the cases (329) the caregiver was not in area. Serious injuries were seen in 12% of cases. In this study, a fall height greater than 50cm, falls in the street, from the arms of the carer, and from the stairs were identified as independent risk factors for worse outcomes. The most serious injuries occur in children <3 months and from a height of >50cm, though not related to unwitnessed falls. Because the most common serious injury mechanism is the fall from the arms of the carer, from stairs, and falls in the street, these facts should be highlighted in order to avoid morbidity. Copyright © 2015 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

Change in child mortality patterns after injuries in Sweden: a nationwide 14-year study.

PubMed

Bäckström, D; Steinvall, I; Sjöberg, F

2017-06-01

Sweden has one of the world's lowest child injury mortality rates, but injuries are still the leading cause of death among children. Child injury mortality in the country has been declining, but this decline seems to decrease recently. Our objective was therefore to further examine changes in the mortality of children's death from injury over time and to assess the contribution of various effects on mortality. The underlying hypothesis for this investigation is that the incidence of lethal injuries in children, still is decreasing and that this may be sex specific. We studied all deaths from injury in Sweden under-18-year-olds during the 14 years 1999-2012. We identified those aged under 18 whose underlying cause of death was recorded as International Classification of Diseases, 10th Revision (ICD-10) diagnosis from V01 to X39 in the Swedish cause of death, where all dead citizens are registered. From the 1 January 1999 to 31 December 2012, 1213 children under the age of 18 died of injuries in Sweden. The incidence declined during this period (r = -0.606, p = 0.02) to 3.3 deaths/100,000 children-years (95 % CI 2.6-4.2). Death from unintentional injury was more common than that after intentional injury (p < 0.0001). There was a reduction in the incidence of unintentional injuries during the study period (r = -0.757, p = 0.03). The most common causes of death were injury to the brain (n = 337, 41 %), followed by drowning (n = 109, 13 %). The number of deaths after intentional injury increased (r = 0.585, p = 0.03) and at the end of the period was 1.5 deaths/100,000 children-years. The most common causes of death after intentional injuries were asphyxia (n = 177, 45 %), followed by injury to the brain (n = 76, 19 %). Mortality patterns in injured children in Sweden have changed from being dominated by unintentional injuries to a more equal distribution between unintentional and intentional injuries as well as between sexes and the overall

Occupational injury mortality in New Mexico.

PubMed

Fullerton, L; Olson, L; Crandall, C; Sklar, D; Zumwalt, R

1995-10-01

To examine specific risks for occupational injury deaths in New Mexico. Retrospective review of state medical investigator reports from 1980 through 1991 with regard to industry, agent of death, gender, ethnicity, location, and alcohol and other drug involvement. New Mexico residents who were fatally injured while on the job. We identified 613 deaths: 87.1% unintentional, 10.6% homicides, and 2.3% suicides. Industries with the most fatalities were construction (11.8%), oil/gas (10.6%), and farming (8.6%). The primary agents of death were motor vehicles (41.7%), firearms (10.1%), and falling objects (10.0%). Almost all (95.6%) of the decedents were male. However, females were overrepresented among homicide deaths (P < .0001). Most unintentional injuries occurred in rural areas (69.1%), whereas most homicides (73.4%) and suicides (71.4%) occurred in urban areas. Drug or alcohol use was evident in 19.4% of cases. New Mexico has a high rate of occupational injury death, which appears to be associated with rural location and use of motor vehicles and alcohol.

Stereotype activation is unintentional: Behavioural and event-related potenials evidence.

PubMed

Wang, Pei; Yang, Ya-Ping; Tan, Chen-Hao; Zhao, Xiang-Xia; Liu, Yong-He; Lin, Chong-De

2016-04-01

In this study, a priming Stroop paradigm was used to determine whether stereotype activation is unintentional. Priming conditions (priming/no-priming) and the relationship between priming and target (consistent/inconsistent/no-relation) were the independent variables; accuracy, reaction time and N400 amplitude were used as dependent variables. The reaction time revealed that stereotype activation is, to some extent, unintentional. Furthermore, the event-related potenial (ERP) results showed that N400 amplitude was larger for inconsistent conditions than for consistent conditions. This result supported the notion that stereotype activation is an unintentional and automatic process. © 2015 International Union of Psychological Science.

Labelling of household products and prevention of unintentional poisoning.

PubMed

de Presgrave, Rosaura Farias; Alves, Eloisa Nunes; Camacho, Luiz Antônio Bastos; Bôas, Maria Helena Simões Villas

2008-04-01

Unintentional poisoning occurs mainly in childhood due to ingestion of common household products. A decisive factor is the lack of knowledge concerning the potential toxicity of these products. A random study of 158 labels of cleaning products was conducted at the National Institute of Quality Control in Health--Brazil. Health hazard warnings, first aid in case of poisoning and storage instructions were evaluated to assess the quality of information provided to the consumer regarding the risks inherent in these products. Among these labels, 75% were considered inadequate since they did not provide all cautionary information necessary to avoid the health hazards associated with these products. First aid instructions in the case of inhalation were missing on more than 50% of labels studied and 47% did not recommend taking the label to a health professional in case of accident. Furthermore, the labels did not provide other important warnings such as "read before use" and "keep in original container': The results indicate that the labelling of cleaning products does not provide all safety information recommended for consumers.

A comparison of two surveillance systems for deaths related to violent injury

PubMed Central

Comstock, R; Mallonee, S; Jordan, F

2005-01-01

Objective: To compare violent injury death reporting by the statewide Medical Examiner and Vital Statistics Office surveillance systems in Oklahoma. Methods: Using a standard study definition for violent injury death, the sensitivity and predictive value positive (PVP) of the Medical Examiner and Vital Statistics violent injury death reporting systems in Oklahoma in 2001 were evaluated. Results: Altogether 776 violent injury deaths were identified (violent injury death rate: 22.4 per 100 000 population) including 519 (66.9%) suicides, 248 (32.0%) homicides, and nine (1.2%) unintentional firearm deaths. The Medical Examiner system over-reported homicides and the Vital Statistics system under-reported homicides and suicides and over-reported unintentional firearm injury deaths. When compared with the standard, the Medical Examiner and Vital Statistics systems had sensitivities of 99.2% and 90.7% (respectively) and PVPs of 95.0% and 99.1% for homicide, sensitivities of 99.2% and 93.1% and PVPs of 100% and 99.0% for suicide, and sensitivities of 100% and 100% and PVPs of 100% and 31.0% for unintentional firearm deaths. Conclusions: Both the Vital Statistics and Medical Examiner systems contain valuable data and when combined can work synergistically to provide violent injury death information while also serving as quality control checks for each other. Preventable errors within both systems can be reduced by increasing training, addressing sources of human error, and expanding computer quality assurance programming. A standardized nationwide Medical Examiners' coding system and a national violent death reporting system that merges multiple public health and criminal justice datasets would enhance violent injury surveillance and prevention efforts. PMID:15691992

Unintentional fall-related mortality in the elderly: comparing patterns in two countries with different demographic structure

PubMed Central

Majdan, Marek; Mauritz, Walter

2015-01-01

Objectives Falls are among the major external causes of unintentional injury and injury-related mortality in the elderly. The aim of this study was to compare the patterns of unintentional fall-related mortalities in two countries with different demographic structure: Slovakia and Austria in 2003–2010. Methods A study was conducted using death certificate data, trends of fall-related mortality in the elderly (over 65 years) in Austria and Slovakia were compared. Crude and age-standardised mortality rates were calculated. Rate ratios were used to quantify differences based on age, sex and country. The role of demographic structure and population ageing was considered. Results The annual average crude mortality for Slovakia was 28.82, for Austria 54.19 per 100 000 person-years. Increasing rates were observed towards higher age in both countries. Males had higher mortality than females (1.18 times higher in Austria, 2.4 higher in Slovakia). In ages over 75 years rates were significantly higher in Austria, compared to Slovakia. Injuries to head (in males) and hip (in females) were most commonly the underlying cause of death. The proportion of populations over 65 and over 80 and rate of their increase were higher in Austria than in Slovakia. Conclusions We conclude that higher proportions of the elderly population of Austria could have contributed to the higher fall-related mortality rates compared to Slovakia, especially in females over 80 years. Our study quantified the differences between two countries with different structure of the elderly population and these findings could be used in planning future needs of health and social services and to plan prevention in countries where a rapid increase in age of the population can be foreseen. PMID:26270950

Trends in Unintentional Fall-Related Traumatic Brain Injury Death Rates in Older Adults in the United States, 1980-2010: A Joinpoint Analysis.

PubMed

Sung, Kuan-Chin; Liang, Fu-Wen; Cheng, Tain-Junn; Lu, Tsung-Hsueh; Kawachi, Ichiro

2015-07-15

Unintentional fall-related traumatic brain injury (TBI) death rate is high in older adults in the United States, but little is known regarding trends of these death rates. We sought to examine unintentional fall-related TBI death rates by age and sex in older adults from 1980 through 2010 in the United States. We used multiple-cause mortality data from 1980 through 2010 (31 years of data) to identify fall-related TBI deaths. Using a joinpoint regression program, we determined the joinpoints (years at which trends change significantly) and annual percentage changes (APCs) in mortality trends. The fall-related TBI death rates (deaths per 100,000 population) in older adults ages 65-74, 75-84, and 85 years and above were 2.7, 9.2, and 21.5 for females and 8.5, 18.2, and 40.8 for males, respectively, in 1980. The rate was about the same in 1992, yet increased markedly to 5.9, 23.4, and 68.9 for females and 11.6, 41.2, and 112.4 for males, respectively, in 2010. For males all 65 years years of age and above, we found the first joinpoint in 1992, when the APC for 1980 through 1992, -0.8%, changed to 6.2% for 1992-2005. The second joinpoint occurred in 2005, when the APC decreased to 3.7% for 2005-2010. For all females 65 years of age and above, the first joinpoint was in 1993 when the APC for 1980 through 1993, -0.2%, changed to 7.6% from 1993 to 2005. The second joinpoint occurred in 2005 when the APC decreased to 3.8% for 2005-2010. This descriptive epidemiological study suggests increasing fall-related TBI death rates from 1992 to 2005 and then a slowdown of increasing trends between 2005 and 2010. Continued monitoring of fall-related TBI death rate trends is needed to determine the burden of this public health problem among older adults in the United States.

Child development and pediatric sport and recreational injuries by age.

PubMed

Schwebel, David C; Brezausek, Carl M

2014-01-01

In 2010, 8.6 million children were treated for unintentional injuries in American emergency departments. Child engagement in sports and recreation offers many health benefits but also exposure to injury risks. In this analysis, we consider possible developmental risk factors in a review of age, sex, and incidence of 39 sport and recreational injuries. To assess (1) how the incidence of 39 sport and recreational injuries changed through each year of child and adolescent development, ages 1 to 18 years, and (2) sex differences. Design : Descriptive epidemiology study. Emergency department visits across the United States, as reported in the 2001-2008 National Electronic Injury Surveillance System database. Data represent population-wide emergency department visits in the United States. Main Outcome Measure(s) : Pediatric sport- and recreation-related injuries requiring treatment in hospital emergency departments. Almost 37 pediatric sport or recreational injuries are treated hourly in the United States. The incidence of sport- and recreation-related injuries peaks at widely different ages. Team-sport injuries tend to peak in the middle teen years, playground injuries peak in the early elementary ages and then drop off slowly, and bicycling injuries peak in the preteen years but are a common cause of injury throughout childhood and adolescence. Bowling injuries peaked at the earliest age (4 years), and injuries linked to camping and personal watercraft peaked at the oldest age (18 years). The 5 most common causes of sport and recreational injuries across development, in order, were basketball, football, bicycling, playgrounds, and soccer. Sex disparities were common in the incidence of pediatric sport and recreational injuries. Both biological and sociocultural factors likely influence the developmental aspects of pediatric sport and recreational injury risk. Biologically, changes in perception, cognition, and motor control might influence injury risk. Socioculturally

Symptoms from repeated intentional and unintentional head impact in soccer players

PubMed Central

Stewart, Walter F.; Kim, Namhee; Ifrah, Chloe S.; Lipton, Richard B.; Bachrach, Tamar A.; Zimmerman, Molly E.; Kim, Mimi

2017-01-01

Objective: To determine the rate and differential contribution of heading vs unintentional head impacts (e.g., head to head, goal post) to CNS symptoms in adult amateur soccer players. Methods: Amateur soccer players completed baseline and serial on-line 2-week recall questionnaires (HeadCount) and reported (1) soccer practice and games, (2) heading and unintentional soccer head trauma, and (3) frequency and severity (mild to very severe) of CNS symptoms. For analysis, CNS symptoms were affirmed if one or more moderate, severe, or very severe episodes were reported in a 2-week period. Repeated measures logistic regression was used to assess if 2-week heading exposure (i.e., 4 quartiles) or unintentional head impacts (i.e., 0, 1, 2+) were associated with CNS symptoms. Results: A total of 222 soccer players (79% male) completed 470 HeadCount questionnaires. Mean (median) heading/2 weeks was 44 (18) for men and 27 (9.5) for women. One or more unintentional head impacts were reported by 37% of men and 43% of women. Heading-related symptoms were reported in 20% (93 out of 470) of the HeadCounts. Heading in the highest quartile was significantly associated with CNS symptoms (odds ratio [OR] 3.17, 95% confidence interval [CI] 1.57–6.37) when controlling for unintentional exposure. Those with 2+ unintentional exposures were at increased risk for CNS symptoms (OR 6.09, 95% CI 3.33–11.17) as were those with a single exposure (OR 2.98, 95% CI 1.69–5.26) when controlling for heading. Conclusions: Intentional (i.e., heading) and unintentional head impacts are each independently associated with moderate to very severe CNS symptoms. PMID:28148633

Unintentional and undetermined firearm related deaths: a preventable death analysis for three safety devices

PubMed Central

Vernick, J; O'Brien, M; Hepburn, L; Johnson, S; Webster, D; Hargarten, S

2003-01-01

Objective: To determine the proportion of unintentional and undetermined firearm related deaths preventable by three safety devices: personalization devices, loaded chamber indicators (LCIs), and magazine safeties. A personalized gun will operate only for an authorized user, a LCI indicates when the gun contains ammunition, and a magazine safety prevents the gun from firing when the ammunition magazine is removed. Design: Information about all unintentional and undetermined firearm deaths from 1991–98 was obtained from the Office of the Chief Medical Examiner for Maryland, and from the Wisconsin Firearm Injury Reporting System for Milwaukee. Data regarding the victim, shooter, weapon, and circumstances were abstracted. Coding rules to classify each death as preventable, possibly preventable, or not preventable by each of the three safety devices were also applied. Results: There were a total of 117 firearm related deaths in our sample, 95 (81%) involving handguns. Forty three deaths (37%) were classified as preventable by a personalized gun, 23 (20%) by a LCI, and five (4%) by a magazine safety. Overall, 52 deaths (44%) were preventable by at least one safety device. Deaths involving children 0–17 (relative risk (RR) 3.3, 95% confidence interval (CI) 2.1 to 5.1) and handguns (RR 8.1, 95% CI 1.2 to 53.5) were more likely to be preventable. Projecting the findings to the entire United States, an estimated 442 deaths might have been prevented in 2000 had all guns been equipped with these safety devices. Conclusion: Incorporating safety devices into firearms is an important injury intervention, with the potential to save hundreds of lives each year. PMID:14693889

Firearm injuries in the United States.

PubMed

Fowler, Katherine A; Dahlberg, Linda L; Haileyesus, Tadesse; Annest, Joseph L

2015-10-01

This paper examines the epidemiology of fatal and nonfatal firearm violence in the United States. Trends over two decades in homicide, assault, self-directed and unintentional firearm injuries are described along with current demographic characteristics of victimization and health impact. Fatal firearm injury data were obtained from the National Vital Statistics System (NVSS). Nonfatal firearm injury data were obtained from the National Electronic Injury Surveillance System (NEISS). Trends were tested using Joinpoint regression analyses. CDC Cost of Injury modules were used to estimate costs associated with firearm deaths and injuries. More than 32,000 persons die and over 67,000 persons are injured by firearms each year. Case fatality rates are highest for self-harm related firearm injuries, followed by assault-related injuries. Males, racial/ethnic minority populations, and young Americans (with the exception of firearm suicide) are disproportionately affected. The severity of such injuries is distributed relatively evenly across outcomes from outpatient treatment to hospitalization to death. Firearm injuries result in over $48 billion in medical and work loss costs annually, particularly fatal firearm injuries. From 1993 to 1999, rates of firearm violence declined significantly. Declines were seen in both fatal and nonfatal firearm violence and across all types of intent. While unintentional firearm deaths continued to decline from 2000 to 2012, firearm suicides increased and nonfatal firearm assaults increased to their highest level since 1995. Firearm injuries are an important public health problem in the United States, contributing substantially each year to premature death, illness, and disability. Understanding the nature and impact of the problem is only a first step toward preventing firearm violence. A science-driven approach to understand risk and protective factors and identify effective solutions is key to achieving measurable reductions in firearm

Firearm injuries in the United States

PubMed Central

Fowler, Katherine A.; Dahlberg, Linda L.; Haileyesus, Tadesse; Annest, Joseph L.

2015-01-01

Objective This paper examines the epidemiology of fatal and nonfatal firearm violence in the United States. Trends over two decades in homicide, assault, self-directed and unintentional firearm injuries are described along with current demographic characteristics of victimization and health impact. Method Fatal firearm injury data were obtained from the National Vital Statistics System (NVSS). Nonfatal firearm injury data were obtained from the National Electronic Injury Surveillance System (NEISS). Trends were tested using Joinpoint regression analyses. CDC Cost of Injury modules were used to estimate costs associated with firearm deaths and injuries. Results More than 32,000 persons die and over 67,000 persons are injured by firearms each year. Case fatality rates are highest for self-harm related firearm injuries, followed by assault-related injuries. Males, racial/ethnic minority populations, and young Americans (with the exception of firearm suicide) are disproportionately affected. The severity of such injuries is distributed relatively evenly across outcomes from outpatient treatment to hospitalization to death. Firearm injuries result in over $48 billion in medical and work loss costs annually, particularly fatal firearm injuries. From 1993 to 1999, rates of firearm violence declined significantly. Declines were seen in both fatal and nonfatal firearm violence and across all types of intent. While unintentional firearm deaths continued to decline from 2000 to 2012, firearm suicides increased and nonfatal firearm assaults increased to their highest level since 1995. Conclusion Firearm injuries are an important public health problem in the United States, contributing substantially each year to premature death, illness, and disability. Understanding the nature and impact of the problem is only a first step toward preventing firearm violence. A science-driven approach to understand risk and protective factors and identify effective solutions is key to achieving

75 FR 21307 - Injury Prevention Program; Announcement Type: Cooperative Agreement

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-23

... effective will be considered. Motor vehicle related injuries and deaths impact AI/AN communities in... leading cause of death and disability for AI/AN communities. Injuries cause more deaths among AI/AN ages 1... AI/AN communities. Unintentional falls reduce independence and quality of life for adults ages 65 and...

On the Necessity of Distinguishing Between Unintentional and Intentional Mind Wandering.

PubMed

Seli, Paul; Risko, Evan F; Smilek, Daniel

2016-05-01

In recent years, there has been an enormous increase in the number of studies examining mind wandering. Although participants' reports of mind wandering are often assumed to largely reflect spontaneous, unintentional thoughts, many researchers' conceptualizations of mind wandering have left open the possibility that at least some of these reports reflect deliberate, intentional thought. Critically, however, in most investigations on the topic, researchers have not separately assessed each type of mind wandering; instead, they have measured mind wandering as a unitary construct, thereby conflating intentional and unintentional types. We report the first compelling evidence that an experimental manipulation can have qualitatively different effects on intentional and unintentional types of mind wandering. This result provides clear evidence that researchers interested in understanding mind wandering need to consider the distinction between unintentional and intentional occurrences of this phenomenon. © The Author(s) 2016.

The role of adverse childhood experiences as determinants of non-suicidal self-injury among children and adolescents referred to community and inpatient mental health settings.

PubMed

Baiden, Philip; Stewart, Shannon L; Fallon, Barbara

2017-07-01

The objectives of this study were to examine the prevalence of, and determine the effect of adverse childhood experiences on non-suicidal self-injury among children and adolescents referred to community and inpatient mental health settings. Data for this study were obtained from the interRAI Child and Youth Mental Health dataset. A total of 2038 children and adolescents aged 8-18 years (M=12.49; SD=2.88, 61.1% males) were analyzed. Binary logistic regression was fitted to identify predictors of non-suicidal self-injury as a function of adverse childhood experiences, depression, and social support while simultaneously controlling for age, gender, type of patient, legal guardianship, marital status of parents/caregivers, history of foster family placement, and mental health diagnoses. Of the 2038 children and adolescents examined, 592 (29%) of this clinical sample engaged in non-suicidal self-injury. In the multivariate logistic regression model, children and adolescents who were physically abused had 49% higher odds of engaging in non-suicidal self-injury and children and adolescents who were sexually abused had 60% higher odds of engaging in non-suicidal self-injury, when compared to their non-abused counterparts. Other predictors of non-suicidal self-injury include: older age, female gender, inpatient status, depression, attention deficit-hyperactivity disorder, disruptive behavior disorder, and mood disorders. Children and adolescents who had some form of social support had a 26% decrease in the odds of engaging in non-suicidal self-injury. Assessment procedures for indicators of mental health, particularly among children and adolescents with a history of adverse childhood experiences, should also take into account non-suicidal self-injury. In addition to bolstering social support networks, addressing depression and related emotion regulation skills in childhood may help prevent future non-suicidal self-injury behaviors. Copyright © 2017 Elsevier Ltd. All rights

Electrical injury from subway third rails: serious injury associated with intermediate voltage contact.

PubMed

Rabban, J; Adler, J; Rosen, C; Blair, J; Sheridan, R

1997-09-01

Railway and subway-associated electrical trauma is rare and typically involves high voltage (> 20,000) arc injuries. Not all rail systems utilize such high voltage. We report 16 cases of electrical trauma due to 600 V direct contact with subway 'third' rails. A case series of injured patients presenting to Shriners Burns Institute, Boston or Massachusetts General Hospital between 1970 and 1995 was retrospectively analyzed. A total of 16 cases was identified. Among seven subway workers, the mechanism of rail contact was unintentional by a tool, a hand or by falling; no deaths occurred. Among nine non-occupational victims, injuries involved suicide attempts, unintentional falls, or risk-taking behavior. This group suffered greater burn severity, operative procedures, and complications; three deaths occurred. This is the largest report series of direct electrical trauma from a subway third rail. The high morbidity and mortality from this 600 V contact suggests that the traditional classification of low voltage (< 1000 V) exposure can be subdivided to reflect the serious and lethal potential of intermediate range exposures compared to household range exposures (0-220 V).

Re-interpreting: Narratives of childhood language brokering over time.

PubMed

Orellana, Marjorie Faulstich; Phoenix, Ann

2017-05-01

This article probes how childhood experiences are actively taken into adult lives and thus challenges the unwitting and unintentional reproduction of an adult-child binary in childhood studies. We do this by analyzing interviews with one adult daughter of immigrants from Mexico to the United States at four points in time (ages 19, 26, 27, and 33). Using narrative analysis to examine the mutability of memory, we consider how Eva oriented herself to her childhood story, what was salient and invisible in each recount, the values she associated with the practice, and the meanings she took from her experiences. We show how Eva re-interpreted her experiences as an immigrant child language broker in relation to unfolding life events, showing her childhood to be very much alive in her adult life. Language brokering serves as one way in which to examine the interpenetration of childhood into adulthood, rather than being the focus per se.

Trends and Divergences in Childhood Income Dynamics, 1970-2010.

PubMed

Hill, Heather D

2018-01-01

Earnings and income variability have increased since the 1970s, particularly at the bottom of the income distribution. Considerable evidence suggests that childhood income levels-captured as average or point-in-time yearly income-are associated with numerous child and adult outcomes. The importance to child development of stable proximal processes during childhood suggests that income variability may also be important, particularly if it is unpredictable, unintentional, or does not reflect an upward trend in family income. Using the Panel Study of Income Dynamics, this study documents trends since the 1970s in three dimensions of childhood income dynamics: level, variability, and growth (n=7991). The analysis reveals that income variability during childhood has grown over time, while income growth rates have not. In addition, the economic context of childhood has diverged substantially by socioeconomic status, race, and family structure, with the most disadvantaged children facing a double-whammy of low income and high variability. © 2018 Elsevier Inc. All rights reserved.

Re-interpreting: Narratives of childhood language brokering over time

PubMed Central

Orellana, Marjorie Faulstich; Phoenix, Ann

2016-01-01

This article probes how childhood experiences are actively taken into adult lives and thus challenges the unwitting and unintentional reproduction of an adult–child binary in childhood studies. We do this by analyzing interviews with one adult daughter of immigrants from Mexico to the United States at four points in time (ages 19, 26, 27, and 33). Using narrative analysis to examine the mutability of memory, we consider how Eva oriented herself to her childhood story, what was salient and invisible in each recount, the values she associated with the practice, and the meanings she took from her experiences. We show how Eva re-interpreted her experiences as an immigrant child language broker in relation to unfolding life events, showing her childhood to be very much alive in her adult life. Language brokering serves as one way in which to examine the interpenetration of childhood into adulthood, rather than being the focus per se. PMID:28503031

Competency‐based strategies for injury control and prevention curriculums in undergraduate medical education

PubMed Central

Phelan, Mary Beth; Falimirski, Mark E; Simpson, Deborah E; Czinner, Mary L; Hargarten, Stephen W

2007-01-01

Injury, including unintentional injury and intentional injury, is the leading cause of death in people aged ⩽44 years. Doctors often treat acute injuries, assist in the rehabilitation process and provide injury prevention guidance to patients. Current undergraduate medical school curriculums lack content and consistency in providing training in this area. A matrix to show the integration of injury control and prevention principles into existing undergraduate medical school curriculums is proposed. PMID:17296681

Risk factors for unintentional poisoning in children aged 1-3 years in NSW Australia: a case-control study.

PubMed

Schmertmann, Marcia; Williamson, Ann; Black, Deborah; Wilson, Leigh

2013-05-24

Unintentional poisoning in young children is an important public health issue. Age pattern studies have demonstrated that children aged 1-3 years have the highest levels of poisoning risk among children aged 0-4 years, yet little research has been conducted regarding risk factors specific to this three-year age group and the methodologies employed varied greatly. The purpose of the current study is to investigate a broad range of potential risk factors for unintentional poisoning in children aged 1-3 years using appropriate methodologies. Four groups of children, one case group (children who had experienced a poisoning event) and three control groups (children who had been 'injured', 'sick' or who were 'healthy'), and their mothers (mother-child dyads) were enrolled into a case-control study. All mother-child dyads participated in a 1.5-hour child developmental screening and observation, with mothers responding to a series of questionnaires at home. Data were analysed as three case-control pairs with multivariate analyses used to control for age and sex differences between child cases and controls. Five risk factors were included in the final multivariate models for one or more case-control pairs. All three models found that children whose mothers used more positive control in their interactions during a structured task had higher odds of poisoning. Two models showed that maternal psychiatric distress increased poisoning risk (poisoning-injury and poisoning-healthy). Individual models identified the following variables as risk factors: less proximal maternal supervision during risk taking activities (poisoning-injury), medicinal substances stored in more accessible locations in bathrooms (poisoning-sick) and lower total parenting stress (poisoning-healthy). The findings of this study indicate that the nature of the caregiver-child relationship and caregiver attributes play an important role in influencing poisoning risk. Further research is warranted to explore the

Reptilian behavioural patterns in childhood autism.

PubMed

Thong, Y H

1984-04-01

Childhood autism may be caused by damage to three phylogenetically distinct regions of the brain, or their major pathways and connections. Injury to the neocortex results in loss of language and cognitive function, while injury to the limbic cortex results in autistic withdrawal and abolition of play behaviour. Injury to the more primitive striatal complex, mammalian counterpart of the brain of reptiles, results in a bizarre and truncated form of stereotyped and ritualistic behaviour. The causes of brain injury in childhood autism could be those common in the perinatal period including cerebral anoxia, haemorrhage, phenylketonuria, neurolipidoses , meningitis, toxoplasmosis, and congenital rubella. All these conditions have previously been shown to be associated with childhood autism.

Unintentional falls mortality among elderly in the United States: time for action.

PubMed

Alamgir, Hasanat; Muazzam, Sana; Nasrullah, Muazzam

2012-12-01

Fall injury is a leading cause of death and disability among older adults. The objective of this study is to identify the groups among the ≥ 65 population by age, gender, race, ethnicity and state of residence which are most vulnerable to unintentional fall mortality and report the trends in falls mortality in the United States. Using mortality data from the Centers for Disease Control and Prevention, the age specific and age-adjusted fall mortality rates were calculated by gender, age, race, ethnicity and state of residence for a five year period (2003-2007). Annual percentage changes in rates were calculated and linear regression using natural logged rates were used for time-trend analysis. There were 79,386 fall fatalities (rate: 40.77 per 100,000 population) reported. The annual mortality rate varied from a low of 36.76 in 2003 to a high of 44.89 in 2007 with a 22.14% increase (p=0.002 for time-related trend) during 2003-2007. The rates among whites were higher compared to blacks (43.04 vs. 18.83; p=0.01). While comparing falls mortality rate for race by gender, white males had the highest mortality rate followed by white females. The rate was as low as 20.19 for Alabama and as high as 97.63 for New Mexico. The relative attribution of falls mortality among all unintentional injury mortality increased with age (23.19% for 65-69 years and 53.53% for 85+ years), and the proportion of falls mortality was significantly higher among females than males (46.9% vs. 40.7%: p<0.001) and among whites than blacks (45.3% vs. 24.7%: p<0.001). The burden of fall related mortality is very high and the rate is on the rise; however, the burden and trend varied by gender, age, race and ethnicity and also by state of residence. Strategies will be more effective in reducing fall-related mortality when high risk population groups are targeted. Copyright © 2011 Elsevier Ltd. All rights reserved.

Adolescent assault injury: risk and protective factors and locations of contact for intervention.

PubMed

Cheng, Tina L; Schwarz, Donald; Brenner, Ruth A; Wright, Joseph L; Fields, Cheryl B; O'Donnell, Regina; Rhee, Peter; Scheidt, Peter C

2003-10-01

Violence is a large contributor to morbidity and mortality among adolescents. Most studies assessing markers for violent injury are cross-sectional. To guide intervention, we conducted a case-control study to explore factors associated with assault injury and locations to reach at-risk adolescents. 1) To assess risk and protective factors for adolescent assault injury compared with 2 control groups of youth with unintentional injuries and noninjury complaints presenting to the emergency department and 2) to assess locations of contact with assault-injured youth for prevention programs. Face-to-face and phone interviews were conducted with systematic samples of youth aged 12 to 19 years presenting to the emergency department with assault injury, unintentional injury, and noninjury complaints. Youth with intentional injuries were matched to youth in the 2 control groups on age +/-1 year, gender, race, and residency. One hundred forty-seven 147 assault-injured youth completed interviews. One hundred thirty-three assault-injured youth were matched to 133 unintentionally injured and 133 noninjured youth presenting to the emergency department. Compared with the 2 control groups, assault-injured youth were more likely to have had more fights in the past year (odds ratio [OR]: 3.91; 95% confidence interval [CI]: 2.02, 7.58; OR: 4.00; 95% CI: 2.23, 7.18) and fights requiring medical treatment (OR: 35.49; 95% CI: 8.71, 144.68; OR: 80.00; 95% CI: 11.13, 574.80). Eighty percent of assault-injured youth had been in 1 or more fights in the last 12 months compared with 55% and 46% in unintentional and noninjured controls, respectively. Assault-injured youth were more likely to have had previous weapon injuries (OR: 9.50; 95% CI: 3.39, 26.6; OR: 8.50; 95% CI: 3.02, 23.95) and have seen someone shot (OR: 2.00; 95% CI 1.12, 3.58; OR: 2.00; 95% CI: 1.12, 3.58). Eighty-six percent of assault-injured youth had a regular health care provider with 82% reporting a visit within the last

Child injury control: trends, themes, and controversies.

PubMed

Johnston, Brian D; Ebel, Beth E

2013-01-01

Injury is a major cause of morbidity and mortality among US children, and an important driver of health status globally. Despite its enormous burden, injury is preventable. Over the last 10 years, significant progress has been made in the reduction of unintentional injury among US children. However, aggregate trends mask important disparities by age group, region, and injury mechanism. Basic and translation research is needed to develop and test prevention strategies to address these new or recalcitrant problems. Motor vehicle occupant injury has fallen to historic lows, but challenges remain in protecting novice drivers and managing the distraction of new technologies. Injury to pedestrians has also declined, but likely as a result of decreased exposure as fewer children walk. This calls for a broader public health perspective to promote activity while enhancing safety. Deaths due to drowning are common and illustrate the difficulty in measuring and promoting appropriate supervision. Environmental modification and use of protective products may be a more appropriate response. Concussion in sport is another challenging issue: public health laws promote identification and appropriate management of concussed athletes, but less progress has been made on primary prevention of these injuries. Unintentional poisoning is on the rise, attributable to misuse of, and overdose with, prescription opioids. Injury deaths to infants are also increasing. This trend is driven in part by better death investigation that classifies more sleep-related deaths as suffocation events. Finally, we examine a sample of cross-cutting themes and controversies in injury control that might be amenable to empiric evaluation. Copyright © 2013 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Unintentional child neglect: literature review and observational study.

PubMed

Friedman, Emily; Billick, Stephen B

2015-06-01

Child abuse is a problem that affects over six million children in the United States each year. Child neglect accounts for 78% of those cases. Despite this, the issue of child neglect is still not well understood, partially because child neglect does not have a consistent, universally accepted definition. Some researchers consider child neglect and child abuse to be one in the same, while other researchers consider them to be conceptually different. Factors that make child neglect difficult to define include: (1) Cultural differences; motives must be taken into account because parents may believe they are acting in the child's best interests based on cultural beliefs (2) the fact that the effect of child abuse is not always immediately visible; the effects of emotional neglect specifically may not be apparent until later in the child's development, and (3) the large spectrum of actions that fall under the category of child abuse. Some of the risk factors for increased child neglect and maltreatment have been identified. These risk factors include socioeconomic status, education level, family composition, and the presence of dysfunction family characteristics. Studies have found that children from poorer families and children of less educated parents are more likely to sustain fatal unintentional injuries than children of wealthier, better educated parents. Studies have also found that children living with adults unrelated to them are at increased risk for unintentional injuries and maltreatment. Dysfunctional family characteristics may even be more indicative of child neglect. Parental alcohol or drug abuse, parental personal history of neglect, and parental stress greatly increase the odds of neglect. Parental depression doubles the odds of child neglect. However, more research needs to be done to better understand these risk factors and to identify others. Having a clearer understanding of the risk factors could lead to prevention and treatment, as it would allow

Trends in childhood injury mortality in a developing country: United Arab Emirates.

PubMed

Bener, Abdulbari; Hyder, Adnan A; Schenk, Ellen

2007-10-01

To describe the epidemiology of a leading cause of childhood mortality in Al-Ain, United Arab Emirates (UAE)--injury. To examine trends across types of injury, as well as the mechanisms of injury leading to death, by age groups, gender, citizenship, and explore mortality rates and make global comparisons. This is a retrospective, descriptive, statistical analysis of unlinked hospital data. Al-Ain and Tawam Hospitals, and Preventive Medicine Department, Al-Ain, United Arab Emirates. All cases that met the conditions established for the study: fell within the age group of 0 to 14 years, suffered from injuries, and were admitted to either Al-Ain or Tawam hospitals and subsequently died within the studied time period of 1 January 1995 to 31 December 2004. A total of 7204 deaths were reported in children below 15 years during the studied time period. Of these cases, 2150 children died due to injury, comprising 29.8% of total deaths. Further analysis showed that road traffic injuries were the most frequent cause of injury leading to death (68.3%). Overall injury death rates were higher in non-citizens (54.5%) than in citizens (45.5%); and males had a higher incidence, specifically a 2.1:1 ratio, than females. Children 5 to 14 years had the highest frequency of injury deaths. Overall, injury mortality rates exhibited a decreasing, though fluctuating, trend during the studied period at a rate that is comparable to those in other developed nations such as New Zealand and USA. The present study reveals that the burden of injury deaths among children below 15 years is significant; and injuries exist in every form and affect every age group, and gender. The high burden of injuries on children in the UAE demands the attention of the health community, including policy makers. An understanding of the trends such as those presented in this study, for instance that injuries from road traffic are prominent, will assist in the development of interventions to address this growing

The jungle book of neuropsychology: Disentangling the influence of feral childhood from adult brain injury in order to provide effective rehabilitation.

PubMed

McIntosh, C J; James, A I W

2018-03-01

This article considers the complexities of neuropsychological assessment and rehabilitation in brain injury when the client is illiterate, is from a foreign culture with English as a second language, and reports highly atypical childhood feral experiences prior to injury. MC was a 63-year-old woman referred for neuropsychological rehabilitation with a diagnosis of suspected St Louis encephalitis and global cognitive impairment. In formulating her clinical presentation, consideration was given to a reported history of feral childhood living with monkeys in the Colombian jungle and subsequent physical and emotional abuse. MC participated in comprehensive neuropsychological assessment and then targeted rehabilitation. Neuroimaging documented relatively focal damage in the right temporal lobe. MC's family described her as "the same but worse"; assessment and formulation indicated an exacerbation of attentional, pragmatic, arousal and executive weaknesses but with new memory and emotion recognition impairments. Rehabilitation techniques for communication and executive difficulties were successful despite the complexities of the case. The importance of carefully considered assessment and formulation in understanding MC's presentation is discussed. To the authors' knowledge, this is the only case of neuropsychological assessment and rehabilitation in brain injury involving a history of feral childhood.

Functional magnetic resonance imaging of chronic dysarthric speech after childhood brain injury: reliance on a left-hemisphere compensatory network.

PubMed

Morgan, Angela T; Masterton, Richard; Pigdon, Lauren; Connelly, Alan; Liégeois, Frédérique J

2013-02-01

Severe and persistent speech disorder, dysarthria, may be present for life after brain injury in childhood, yet the neural correlates of this chronic disorder remain elusive. Although abundant literature is available on language reorganization after lesions in childhood, little is known about the capacity of motor speech networks to reorganize after injury. Here, we examine the structural and functional neural correlates associated with chronic dysarthria after childhood-onset traumatic brain injury. Forty-nine participants aged 12 years 3 months to 24 years 11 months were recruited to the study: (i) a group with chronic dysarthria (n = 17); matched for age and sex with two control groups of (ii) healthy control subjects (n = 17); and (iii) individuals without dysarthria after traumatic brain injury (n = 15). A high-resolution 3D T(1)-weighted whole-brain data set was acquired for voxel-based morphometry analyses of group differences in grey matter. Functional magnetic resonance imaging was used to localize activation associated with speaking single words (baseline: listening to words). Group differences on voxel-based morphometry revealed widespread grey matter reductions in the dysarthric group compared with healthy control subjects, including in numerous speech motor regions bilaterally, such as the cerebellum, the basal ganglia and primary motor cortex representation of the articulators. Relative to the non-dysarthric traumatic brain injury group, individuals with dysarthria showed reduced grey matter bilaterally in the ventral sensorimotor cortex, but this reduction was concomitant with increased functional activation only in the left-hemisphere cluster during speech. Finally, increased recruitment of Broca's area (Brodmann area 45, pars triangularis) but not its right homologue, correlated with better speech outcome, suggesting that this 'higher-level' area may be more critically involved with production when associated motor speech regions are damaged. We

Analysis of Prior Health System Contacts as a Harbinger of Subsequent Fatal Injury in American Indians

ERIC Educational Resources Information Center

Sanddal, Teri L.; Upchurch, James; Sanddal, Nels D.; Esposito, Thomas J.

2005-01-01

Many American Indian nations, tribes, and bands are at an elevated risk for premature death from unintentional injury. Previous research has documented a relationship between alcohol-related injury and subsequent injury death among predominately urban samples. The presence or nature of such a relationship has not been documented among American…

Effects of visual and verbal interaction on unintentional interpersonal coordination.

PubMed

Richardson, Michael J; Marsh, Kerry L; Schmidt, R C

2005-02-01

Previous research has demonstrated that people's movements can become unintentionally coordinated during interpersonal interaction. The current study sought to uncover the degree to which visual and verbal (conversation) interaction constrains and organizes the rhythmic limb movements of coactors. Two experiments were conducted in which pairs of participants completed an interpersonal puzzle task while swinging handheld pendulums with instructions that minimized intentional coordination but facilitated either visual or verbal interaction. Cross-spectral analysis revealed a higher degree of coordination for conditions in which the pairs were visually coupled. In contrast, verbal interaction alone was not found to provide a sufficient medium for unintentional coordination to occur, nor did it enhance the unintentional coordination that emerged during visual interaction. The results raise questions concerning differences between visual and verbal informational linkages during interaction and how these differences may affect interpersonal movement production and its coordination.

Risk factors for unintentional poisoning in children aged 1–3 years in NSW Australia: a case–control study

PubMed Central

2013-01-01

Background Unintentional poisoning in young children is an important public health issue. Age pattern studies have demonstrated that children aged 1–3 years have the highest levels of poisoning risk among children aged 0–4 years, yet little research has been conducted regarding risk factors specific to this three-year age group and the methodologies employed varied greatly. The purpose of the current study is to investigate a broad range of potential risk factors for unintentional poisoning in children aged 1–3 years using appropriate methodologies. Methods Four groups of children, one case group (children who had experienced a poisoning event) and three control groups (children who had been ‘injured’, ‘sick’ or who were ‘healthy’), and their mothers (mother-child dyads) were enrolled into a case–control study. All mother-child dyads participated in a 1.5-hour child developmental screening and observation, with mothers responding to a series of questionnaires at home. Data were analysed as three case–control pairs with multivariate analyses used to control for age and sex differences between child cases and controls. Results Five risk factors were included in the final multivariate models for one or more case–control pairs. All three models found that children whose mothers used more positive control in their interactions during a structured task had higher odds of poisoning. Two models showed that maternal psychiatric distress increased poisoning risk (poisoning-injury and poisoning-healthy). Individual models identified the following variables as risk factors: less proximal maternal supervision during risk taking activities (poisoning-injury), medicinal substances stored in more accessible locations in bathrooms (poisoning-sick) and lower total parenting stress (poisoning-healthy). Conclusions The findings of this study indicate that the nature of the caregiver-child relationship and caregiver attributes play an important role in

[Recommendations for the prevention of poisoning].

PubMed

Mintegi, S; Esparza, M J; González, J C; Rubio, B; Sánchez, F; Vila, J J; Yagüe, F; Benítez, M T

2015-12-01

Poisoning is the fifth leading cause of death from unintentional injury in the WHO European region, while Spain is in the group with a lower rate. Most involuntary poisonings occur in young children while they are at the home, due to unintentional ingestion of therapeutic drugs or household products. Of these, a large percentage is stored in non-original containers and/or within reach of children. In this article, the Committee on Safety and Non-Intentional Injury Prevention in Childhood of the Spanish Association of Pediatrics provides a series of recommendations, educational as well as legal, to prevent such cases. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

Impact of Childhood Abuse on the Risk of Non-Suicidal Self-Injury in Mainland Chinese Adolescents

PubMed Central

Wan, Yuhui; Chen, Jing; Sun, Ying; Tao, Fangbiao

2015-01-01

Background Childhood abuse has been associated with significant increases in non-suicidal self-injury (NSSI) behaviors in adolescents; however, only general definitions of this risk indicator have been examined. This study identified relationships between specific forms of childhood abuse and NSSI in mainland Chinese adolescents. Method A total of 14,221 cases were retained from an epidemiological study involving adolescents from junior and senior middle schools. Information relating to the perpetrator, perceived harm, timing of exposure to different types of childhood abuse, and NSSI were obtained. Logistic regression was used to analyze relationships between each form of childhood abuse and NSSI. Results Approximately 51.0% of the students reported at least one abusive childhood experience. Nearly one in four students (24.9%) reported that they had engaged in NSSI in the past 12 months. Each type of childhood abuse, occurring at any time within the first 16 years of life, especially in situations of continuous exposure, was significantly associated with NSSI. A significant graded relationship was found between number of abusive childhood experiences and NSSI. Students maltreated by parents or others were at high risk of engaging in NSSI, the risk was greater in students maltreated by both; students who had been exposed to childhood abuse with no perceived harm still demonstrated an elevated risk for NSSI. The pattern of associations did not vary by gender. Conclusions These findings suggest that experiencing any of various forms of childhood abuse should be considered a risk factor for NSSI during adolescence. Further research should focus upon psychosocial, neural, and genetic factors that might moderate or mediate the onset of NSSI in adolescents who have experienced childhood abuse. PMID:26114574

Pattern of injury mortality by age-group in children aged 0-14 years in Scotland, 2002-2006, and its implications for prevention.

PubMed

Pearson, Janne; Stone, David H

2009-04-07

Knowledge of the epidemiology of injuries in children is essential for the planning, implementation and evaluation of preventive measures but recent epidemiological information on injuries in children both in general and by age-group in Scotland is scarce. This study examines the recent pattern of childhood mortality from injury by age-group in Scotland and considers its implications for prevention. Routine mortality data for the period 2002-2006 were obtained from the General Register Office for Scotland and were analysed in terms of number of deaths, mean annual mortality rates per 100,000 population, leading causes of death, and causes of injury death. Mid-year population estimates were used as the denominator. Chi-square tests were used to determine statistical significance. 186 children aged 0-14 died from an injury in Scotland during 2002-06 (MR 4.3 per 100,000). Injuries were the leading cause of death in 1-14, 5-9 and 10-14 year-olds (causing 25%, 29% and 32% of all deaths respectively). The leading individual causes of injury death (0-14 years) were pedestrian and non-pedestrian road-traffic injuries and assault/homicide but there was variation by age-group. Assault/homicide, fire and suffocation caused most injury deaths in young children; road-traffic injuries in older ones. Collectively, intentional injuries were a bigger threat to the lives of under-15s than any single cause of unintentional injury. The mortality rate from assault/homicide was highest in infants (<1 year) and decreased with increasing age. Children aged 5-9 were significantly less likely to die from an injury than 0-4 or 10-14 year-olds (p < 0.05). Suicide was an important cause of injury mortality in 10-14 year-olds. Injuries continue to be a leading cause of death in childhood in Scotland. Variation in causes of injury death by age-group is important when targeting preventive efforts. In particular, the threats of assault/homicide in infants, fire in 1-4 year-olds, pedestrian injury

Child Development and Pediatric Sport and Recreational Injuries by Age

PubMed Central

Schwebel, David C.; Brezausek, Carl M.

2014-01-01

Context: In 2010, 8.6 million children were treated for unintentional injuries in American emergency departments. Child engagement in sports and recreation offers many health benefits but also exposure to injury risks. In this analysis, we consider possible developmental risk factors in a review of age, sex, and incidence of 39 sport and recreational injuries. Objective: To assess (1) how the incidence of 39 sport and recreational injuries changed through each year of child and adolescent development, ages 1 to 18 years, and (2) sex differences. Design Descriptive epidemiology study. Setting: Emergency department visits across the United States, as reported in the 2001–2008 National Electronic Injury Surveillance System database. Patients or Other Participants: Data represent population-wide emergency department visits in the United States. Main Outcome Measure(s) Pediatric sport- and recreation-related injuries requiring treatment in hospital emergency departments. Results: Almost 37 pediatric sport or recreational injuries are treated hourly in the United States. The incidence of sport- and recreation-related injuries peaks at widely different ages. Team-sport injuries tend to peak in the middle teen years, playground injuries peak in the early elementary ages and then drop off slowly, and bicycling injuries peak in the preteen years but are a common cause of injury throughout childhood and adolescence. Bowling injuries peaked at the earliest age (4 years), and injuries linked to camping and personal watercraft peaked at the oldest age (18 years). The 5 most common causes of sport and recreational injuries across development, in order, were basketball, football, bicycling, playgrounds, and soccer. Sex disparities were common in the incidence of pediatric sport and recreational injuries. Conclusions: Both biological and sociocultural factors likely influence the developmental aspects of pediatric sport and recreational injury risk. Biologically, changes in

Configural approaches to temperament assessment: implications for predicting risk of unintentional injury in children.

PubMed

Berry, Jack W; Schwebel, David C

2009-10-01

This study used two configural approaches to understand how temperament factors (surgency/extraversion, negative affect, and effortful control) might predict child injury risk. In the first approach, clustering procedures were applied to trait dimensions to identify discrete personality prototypes. In the second approach, two- and three-way trait interactions were considered dimensionally in regression models predicting injury outcomes. Injury risk was assessed through four measures: lifetime prevalence of injuries requiring professional medical attention, scores on the Injury Behavior Checklist, and frequency and severity of injuries reported in a 2-week injury diary. In the prototype analysis, three temperament clusters were obtained, which resembled resilient, overcontrolled, and undercontrolled types found in previous research. Undercontrolled children had greater risk of injury than children in the other groups. In the dimensional interaction analyses, an interaction between surgency/extraversion and negative affect tended to predict injury, especially when children lacked capacity for effortful control.

Fatal occupational injuries in a southern state.

PubMed

Loomis, D P; Richardson, D B; Wolf, S H; Runyan, C W; Butts, J D

1997-06-15

Fatal occupational injuries were studied using data from medical examiners' reports in North Carolina for the years 1977-1991. Cases were defined as deaths due to accidents or homicide at the workplace, and populations at risk were estimated from the 1980 and 1990 US Censuses. Mortality rate ratios and proportionate mortality ratios were used as measures of association, and the population attributable risk percentage was used as an indicator of the burden of injury. Standard weights for direct age-adjustment of rates were obtained from the total state workforce. There were 2,524 eligible deaths-83 percent from unintentional traumatic injuries, 14 percent from homicide, and the remainder from other causes. This report focuses on unintentional trauma deaths, which were strongly associated with the wood production, fishing, and transportation industries. Elderly, African-American, and self-employed workers had higher fatality rates than members of other groups. Among male workers, motor vehicle crashes were the principal cause of death on the job, followed by falling objects, machinery, and falls. The industries contributing the largest proportions of these deaths were construction, trucking, agriculture, and logging (population attributable risk percentages were 16.8%, 8.8%, 7.9%, and 6.9%, respectively). The fatality patterns of female workers were different: Numbers of deaths from homicide and unintentional trauma were equal, and 27% of the latter deaths occurred in one catastrophic fire. Decentralized and rural industries were the most hazardous, but many deaths were outside the current jurisdiction of occupational safety and health agencies. These patterns suggest that greater scrutiny of such industries, through both research and intervention, is warranted.

41 CFR 50-201.104 - Protection against unintentional employment of underage minors.

Code of Federal Regulations, 2011 CFR

2011-07-01

... unintentional employment of underage minors. 50-201.104 Section 50-201.104 Public Contracts and Property... REGULATIONS § 50-201.104 Protection against unintentional employment of underage minors. An employer shall not be deemed to have knowingly employed an underage minor in the performance of contracts subject to the...

Injuries are not accidents

PubMed Central

Gutiérrez, María Isabel

2014-01-01

Injuries are the result of an acute exposure to exhort of energy or a consequence of a deficiency in a vital element that exceeds physiological thresholds resulting threatens life. They are classified as intentional or unintentional. Injuries are considered a global health issue because they cause more than 5 million deaths per year worldwide and they are an important contributor to the burden of disease, especially affecting people of low socioeconomic status in low- and middle-income countries. A common misconception exists where injuries are thought to be the same as accidents; however, accidents are largely used as chance events, without taken in consideration that all these are preventable. This review discusses injuries and accidents in the context of road traffic and emphasizes injuries as preventable events. An understanding of the essence of injuries enables the standardization of terminology in public use and facilitates the development of a culture of prevention among all of us. PMID:25386040

Slipping and tripping: fall injuries in adults associated with rugs and carpets

PubMed Central

Rosen, Tony; Mack, Karin A.; Noonan, Rita K.

2013-01-01

Abstract: Background: Falls are a leading cause of unintentional injury among adults age 65 years and older. Loose, unsecured rugs and damaged carpets with curled edges, are recognized environmental hazards that may contribute to falls. To characterize nonfatal, unintentional fall-related injuries associated with rugs and carpets in adults aged 65 years and older. Methods: We conducted a retrospective analysis of surveillance data of injuries treated in hospital emergency departments (EDs) during 2001–2008. We used the National Electronic Injury Surveillance System-All Injury Program, which collects data from a nationally representative stratified probability sample of 66 U.S. hospital EDs. Sample weights were used to make national estimates. Results: Annually, an estimated 37,991 adults age 65 years or older were treated in U.S. EDs for falls associated with carpets (54.2%) and rugs (45.8%). Most falls (72.8%) occurred at home. Women represented 80.2% of fall injuries. The most common location for fall injuries in the home was the bathroom (35.7%). Frequent fall injuries occurred at the transition between carpet/rug and non-carpet/rug, on wet carpets or rugs, and while hurrying to the bathroom. Conclusions: Fall injuries associated with rugs and carpets are common and may cause potentially severe injuries. Older adults, their caregivers, and emergency and primary care physicians should be aware of the significant risk for fall injuries and of environmental modifications that may reduce that risk. PMID:22868399

Falls and Fall-Related Injuries among Community-Dwelling Adults in the United States

PubMed Central

Verma, Santosh K.; Willetts, Joanna L.; Corns, Helen L.; Marucci-Wellman, Helen R.; Lombardi, David A.; Courtney, Theodore K.

2016-01-01

Introduction Falls are the leading cause of unintentional injuries in the U.S.; however, national estimates for all community-dwelling adults are lacking. This study estimated the national incidence of falls and fall-related injuries among community-dwelling U.S. adults by age and gender and the trends in fall-related injuries across the adult life span. Methods Nationally representative data from the National Health Interview Survey (NHIS) 2008 Balance and Dizziness supplement was used to develop national estimates of falls, and pooled data from the NHIS was used to calculate estimates of fall-related injuries in the U.S. and related trends from 2004–2013. Costs of unintentional fall-related injuries were extracted from the CDC’s Web-based Injury Statistics Query and Reporting System. Results Twelve percent of community-dwelling U.S. adults reported falling in the previous year for a total estimate of 80 million falls at a rate of 37.2 falls per 100 person-years. On average, 9.9 million fall-related injuries occurred each year with a rate of 4.38 fall-related injuries per 100 person-years. In the previous three months, 2.0% of older adults (65+), 1.1% of middle-aged adults (45–64) and 0.7% of young adults (18–44) reported a fall-related injury. Of all fall-related injuries among community-dwelling adults, 32.3% occurred among older adults, 35.3% among middle-aged adults and 32.3% among younger adults. The age-adjusted rate of fall-related injuries increased 4% per year among older women (95% CI 1%–7%) from 2004 to 2013. Among U.S. adults, the total lifetime cost of annual unintentional fall-related injuries that resulted in a fatality, hospitalization or treatment in an emergency department was 111 billion U.S. dollars in 2010. Conclusions Falls and fall-related injuries represent a significant health and safety problem for adults of all ages. The findings suggest that adult fall prevention efforts should consider the entire adult lifespan to ensure a

Implementing parallel spreadsheet models for health policy decisions: The impact of unintentional errors on model projections.

PubMed

Bailey, Stephanie L; Bono, Rose S; Nash, Denis; Kimmel, April D

2018-01-01

Spreadsheet software is increasingly used to implement systems science models informing health policy decisions, both in academia and in practice where technical capacity may be limited. However, spreadsheet models are prone to unintentional errors that may not always be identified using standard error-checking techniques. Our objective was to illustrate, through a methodologic case study analysis, the impact of unintentional errors on model projections by implementing parallel model versions. We leveraged a real-world need to revise an existing spreadsheet model designed to inform HIV policy. We developed three parallel versions of a previously validated spreadsheet-based model; versions differed by the spreadsheet cell-referencing approach (named single cells; column/row references; named matrices). For each version, we implemented three model revisions (re-entry into care; guideline-concordant treatment initiation; immediate treatment initiation). After standard error-checking, we identified unintentional errors by comparing model output across the three versions. Concordant model output across all versions was considered error-free. We calculated the impact of unintentional errors as the percentage difference in model projections between model versions with and without unintentional errors, using +/-5% difference to define a material error. We identified 58 original and 4,331 propagated unintentional errors across all model versions and revisions. Over 40% (24/58) of original unintentional errors occurred in the column/row reference model version; most (23/24) were due to incorrect cell references. Overall, >20% of model spreadsheet cells had material unintentional errors. When examining error impact along the HIV care continuum, the percentage difference between versions with and without unintentional errors ranged from +3% to +16% (named single cells), +26% to +76% (column/row reference), and 0% (named matrices). Standard error-checking techniques may not

Childhood Abuse, Nonsuicidal Self-Injury, and Suicide Attempts: An Exploration of Gender Differences in Incarcerated Adults.

PubMed

Power, Jenelle; Gobeil, Renee; Beaudette, Janelle N; Ritchie, Mary B; Brown, Shelley L; Smith, Hayden P

2016-12-01

The relationship between types of childhood abuse, suicide attempts, and nonsuicidal self-injury (NSSI) was examined in a sample of 415 incarcerated adults (268 men, 147 women). Men and women were equally likely to experience childhood abuse, although women were more likely to report sexual abuse and men were more likely to report emotional neglect. Sexual abuse was the only type of abuse found to predict NSSI and suicide attempts in women. For men, physical abuse and physical neglect were significant predictors of NSSI and suicide attempts, respectively. Gender differences exist and should be examined in future research in this area. © 2016 The American Association of Suicidology.

Implicit versus explicit attitude to doping: Which better predicts athletes' vigilance towards unintentional doping?

PubMed

Chan, Derwin King Chung; Keatley, David A; Tang, Tracy C W; Dimmock, James A; Hagger, Martin S

2018-03-01

This preliminary study examined whether implicit doping attitude, explicit doping attitude, or both, predicted athletes' vigilance towards unintentional doping. A cross-sectional correlational design. Australian athletes (N=143;M age =18.13, SD=4.63) completed measures of implicit doping attitude (brief single-category implicit association test), explicit doping attitude (Performance Enhancement Attitude Scale), avoidance of unintentional doping (Self-Reported Treatment Adherence Scale), and behavioural vigilance task of unintentional doping (reading the ingredients of an unfamiliar food product). Positive implicit doping attitude and explicit doping attitude were negatively related to athletes' likelihood of reading the ingredients table of an unfamiliar food product, and positively related to athletes' vigilance towards unintentional doping. Neither attitude measures predicted avoidance of unintentional doping. Overall, the magnitude of associations by implicit doping attitude appeared to be stronger than that of explicit doping attitude. Athletes with positive implicit and explicit doping attitudes were less likely to read the ingredients table of an unknown food product, but were more likely to be aware of the possible presence of banned substances in a certain food product. Implicit doping attitude appeared to explain athletes' behavioural response to the avoidance of unintentional doping beyond variance explained by explicit doping attitude. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Personal Injury and Property Damage in the Moral Judgments of Children

ERIC Educational Resources Information Center

Elkind, David; Dabek, Ruth F.

1977-01-01

A total of 72 elementary school students responded to six moral judgment story pairs which corresponded to all the possible combinations of intentionality (intentional/unintentional) and type of damage (personal injury/property damage). (Author/JMB)

Long-term classroom functioning and its association with neuropsychological and academic performance following traumatic brain injury during early childhood.

PubMed

Treble-Barna, Amery; Schultz, Hanna; Minich, Nori; Taylor, H Gerry; Yeates, Keith Owen; Stancin, Terry; Wade, Shari L

2017-07-01

The present study utilized ecobehavioral assessment to examine classroom functioning several years following early childhood traumatic brain injury (TBI) or orthopedic injury (OI) and its association with injury factors, neuropsychological abilities, and academic performance. Participants included 39 children with moderate to severe TBI and 51 children with OI sustained between ages 3 and 7 years. At 7.2 (± 1.3) years post injury, ecobehavioral assessment was used to examine classroom functioning. Additional outcomes included neuropsychological tests, parent and teacher ratings of dysexecutive behavior, and teacher ratings of academic performance. Groups were compared on measures controlling for demographic characteristics, and associations among outcomes were examined using linear regression. Children with TBI showed lower academic engagement relative to children with OI, as well as more frequent individual teacher attention for children with more severe injuries. For children with TBI, difficulties in classroom functioning were associated with lower cognitive flexibility and higher parent and teacher ratings of dysexecutive behavior. Lower scores on a test of fluid reasoning and a greater frequency of individual teacher attention were also associated with lower academic performance in children with TBI. Difficulties in classroom functioning are evident several years after early childhood TBI and were associated with greater injury severity, neuropsychological weaknesses, and poorer academic performance. Children with impaired cognitive flexibility and fluid reasoning skills were at greatest risk for these difficulties and associated weaknesses in academic performance. Instructional interactions may be a potential target for intervention to promote academic progress in at-risk children. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Differences in Poisoning Mortality in the United States, 2003–2007: Epidemiology of Poisoning Deaths Classified as Unintentional, Suicide or Homicide

PubMed Central

Muazzam, Sana; Swahn, Monica H.; Alamgir, Hasanat; Nasrullah, Muazzam

2012-01-01

Introduction Poisoning, specifically unintentional poisoning, is a major public health problem in the United States (U.S.). Published literature that presents epidemiology of all forms of poisoning mortalities (i.e., unintentional, suicide, homicide) together is limited. This report presents data and summarizes the evidence on poisoning mortality by demographic and geographic characteristics to describe the burden of poisoning mortality and the differences among sub-populations in the U.S. for a 5-year period. Methods Using mortality data from the Center for Disease Control and Prevention's Web-based Injury Statistics Query and Reporting System, we presented the age-specific and age-adjusted unintentional and intentional (suicide, homicide) poisoning mortality rates by sex, age, race, and state of residence for the most recent years (2003–2007) of available data. Annual percentage changes in deaths and rates were calculated, and linear regression using natural log were used for time-trend analysis. Results There were 121,367 (rate=8.18 per 100,000) unintentional poisoning deaths. Overall, the unintentional poisoning mortality rate increased by 46.9%, from 6.7 per 100,000 in 2003 to 9.8 per100.000 in 2007, with the highest mortality rate among those aged 40–59 (rate=15.36), males (rate=11.02) and whites (rate=8.68). New Mexico (rate=18.2) had the highest rate. Unintentional poisoning mortality rate increased significantly among both sexes, and all racial groups except blacks (p<0.05 time-related trend for rate). Among a total of 29,469 (rate=1.97) suicidal poisoning deaths, the rate increased by 9.9%, from 1.9 per 100,000 in 2003 to 2.1 per 100,000 in 2007, with the highest rate among those aged 40–59 (rate=3.92), males (rate=2.20) and whites (rate=2.24). Nevada (rate=3.9) had the highest rate. Mortality rate increased significantly among females and whites only (p<0.05 time-related trend for rate). There were 463 (rate=0.03) homicidal poisoning deaths and the

Trampoline-related injuries in childhood.

PubMed

Eberl, Robert; Schalamon, Johannes; Singer, Georg; Huber, Sarah S; Spitzer, Peter; Höllwarth, Michael E

2009-10-01

Recommendations to prevent trampoline injuries were given since the 1970s. However, despite these educational efforts, safety recommendations seem to be ignored and the number of trampoline injuries is increasing. All children referred to our department for injuries related to trampolines over a period of 3 years were included. The patients' records were reviewed and a questionnaire was sent out in order to gain additional information. Injuries were classified as severe and mild. A total of 265 children (46% m, 54% f) with a median age of 8.2 years (range 1 to 14) were included. The injury rate was continuously growing from the year 2005 (10.6%) to 2007 (58.1%). Most of the injuries were recorded between April and September with a peak of injuries in August. Seventy-five percent of all accidents happened in the afternoon; 40% of the injuries were classified as severe, 60% as mild. Nets or equal security devices were used in 56.6%. Trampolining is associated with a significant risk for bodily harm at any age and results in severe injuries in 40% of cases. Though there may be still room for improvement in safety recommendations, all attempts over a period of more than 30 years to reduce the number of trampoline-related backyard injuries failed and the incidence is still increasing. At present, trampolines cannot be made safe for recreational activities and are of an unacceptable risk even under supervision.

46 CFR 28.580 - Unintentional flooding.

Code of Federal Regulations, 2010 CFR

2010-10-01

... INDUSTRY VESSELS Stability § 28.580 Unintentional flooding. (a) Applicability. Except for an open boat that... means to rapidly make it watertight which is operable from a location aft of the collision bulkhead; (4... penetration must be assumed: (1) Longitudinal extent—L/10, or 10 feet (3.05 meters) plus 0.03L, whichever is...

Injury prevention and other international public health initiatives.

PubMed

Razzak, Junaid A; Sasser, Scott M; Kellermann, Arthur L

2005-02-01

Injuries, whether caused by unintentional or intentional events, area significant public health problem. The burden of injury is greatest in low-and middle-income countries and among individuals of low socioeconomic status living in high-income countries. Most of these injuries are prevent-able. Emergency physicians can play an important role in reducing the global burden of injuries by providing expert care and by identifying, implementing, and evaluating population-based countermeasures to prevent and control injuries. The strategy used in a particular country depends in large part on the nature of the local problem, the concerns of the population, the availability of resources, and competing demands. Even simple countermeasures may have a big impact in reducing the global burden of death and disability due to injury.

Photoreflectance measurements of unintentional impurity concentrations in undoped GaAs

NASA Astrophysics Data System (ADS)

Sydor, Michael; Angelo, James; Mitchel, William; Haas, T. W.; Yen, Ming-Yuan

1989-07-01

Modulated photoreflectance is used to measure the unintentional impurity concentrations in undoped epitaxial GaAs. A photoreflectance signal above the band gap spreads with the unintentional impurity concentrations and shows well-defined Franz-Keldysh peaks whose separation provide a good measure of the current carrier concentrations. In samples less than 3-micron thick, a photoreflectance signal at the band edge contains a substrate-epilayer interface effect which precludes the analysis of the data by using the customary third derivative functional fits for low electric fields.

Injury and violence prevention: a primer.

PubMed

Gielen, Andrea Carlson

2002-03-01

Unintentional and intentional injuries cause a great deal of human suffering throughout the world. They exact a huge toll on societies in terms of mortality, years of potential life lost, disability, and health care costs. The good news is that great strides have been made in understanding the causes of injuries and how to prevent them. Using seat belts and car seats, installing air bags in cars, replacing dangerous playground equipment, enforcing drinking and driving laws are but a few examples of modifying behavior, products, and environments to reduce injury risk. This paper provides an overview of the science of injury control and selected examples of how professionals in the field of patient education and counseling can contribute to enhancing the safety of the public.

Injury Control for Children and Youth.

ERIC Educational Resources Information Center

American Academy of Pediatrics, Elk Grove Village, IL.

This book begins with a progress report on preventing childhood injuries. Settings for pediatric care are discussed as well as The Injury Prevention Program (TIPP). Child abuse is also addressed in the first section. In section two, specific childhood injuries and interventions are discussed. Each chapter begins with an overview of the problem,…

Implementing parallel spreadsheet models for health policy decisions: The impact of unintentional errors on model projections

PubMed Central

Bailey, Stephanie L.; Bono, Rose S.; Nash, Denis; Kimmel, April D.

2018-01-01

Background Spreadsheet software is increasingly used to implement systems science models informing health policy decisions, both in academia and in practice where technical capacity may be limited. However, spreadsheet models are prone to unintentional errors that may not always be identified using standard error-checking techniques. Our objective was to illustrate, through a methodologic case study analysis, the impact of unintentional errors on model projections by implementing parallel model versions. Methods We leveraged a real-world need to revise an existing spreadsheet model designed to inform HIV policy. We developed three parallel versions of a previously validated spreadsheet-based model; versions differed by the spreadsheet cell-referencing approach (named single cells; column/row references; named matrices). For each version, we implemented three model revisions (re-entry into care; guideline-concordant treatment initiation; immediate treatment initiation). After standard error-checking, we identified unintentional errors by comparing model output across the three versions. Concordant model output across all versions was considered error-free. We calculated the impact of unintentional errors as the percentage difference in model projections between model versions with and without unintentional errors, using +/-5% difference to define a material error. Results We identified 58 original and 4,331 propagated unintentional errors across all model versions and revisions. Over 40% (24/58) of original unintentional errors occurred in the column/row reference model version; most (23/24) were due to incorrect cell references. Overall, >20% of model spreadsheet cells had material unintentional errors. When examining error impact along the HIV care continuum, the percentage difference between versions with and without unintentional errors ranged from +3% to +16% (named single cells), +26% to +76% (column/row reference), and 0% (named matrices). Conclusions

Educational, vocational, psychosocial, and quality-of-life outcomes for adult survivors of childhood traumatic brain injury.

PubMed

Anderson, Vicki; Brown, Sandra; Newitt, Heidi; Hoile, Hannah

2009-01-01

To examine long-term outcomes from child traumatic brain injury (TBI) and relevance of injury severity. A retrospective cross-sectional design. One hundred and twenty-four young adult survivors of childhood TBI (81 men), aged 18 to 30 years at evaluation (mean = 23.5, SD = 2.9), with injury on average 13.7 years prior to evaluation divided according to injury severity: mild (n = 60), moderate (n = 27), and severe (n = 37). Questionnaires assessed educational and employment status, psychosocial function, and quality-of-life issues. Functional difficulties persisted into adulthood. Injury severity was a particularly strong predictor of long-term outcomes, with environmental factors playing a less consistent role. Survivors of severe TBI were particularly vulnerable, demonstrating global impairment: poorer school performance, employment difficulties, poor quality of life, and increased risk of mental health problems. Mild and moderate TBI were more benign, although lower educational attainment and employment status were identified, and moderate TBI was associated with late developing mental health issues. Traumatic brain injury is a lifelong problem, compromising the individual's capacity to meet developmental expectations across a wide range of functional domains.

Work organisation and unintentional sleep: results from the WOLF study

PubMed Central

Akerstedt, T; Knutsson, A; Westerholm, P; Theorell, T; Alfredsson, L; Kecklund, G

2002-01-01

Background: Falling asleep at work is receiving increasing attention as a cause of work accidents. Aims: To investigate which variables (related to work, lifestyle, or background) are related to the tendency to fall asleep unintentionally, either during work hours, or during leisure time. Methods: 5589 individuals (76% response rate) responded to a questionnaire. A multiple logistic regression analysis of the cross sectional data was used to estimate the risk of falling asleep. Results: The prevalence for falling asleep unintentionally at least once a month was 7.0% during work hours and 23.1% during leisure time. The risk of unintentional sleep at work was related to disturbed sleep, having shift work, and higher socioeconomic group. Being older, being a woman, and being a smoker were associated with a reduced risk of unintentionally falling asleep at work. Work demands, decision latitude at work, physical load, sedentary work, solitary work, extra work, and overtime work were not related to falling asleep at work. Removing "disturbed sleep" as a predictor did not change the odds ratios of the other predictors in any significant way. With respect to falling asleep during leisure time, disturbed sleep, snoring, high work demands, being a smoker, not exercising, and higher age (>45 years) became risk indicators. Conclusion: The risk of involuntary sleep at work is increased in connection with disturbed sleep but also with night work, socioeconomic group, low age, being a male, and being a non-smoker. PMID:12205231

Unintentional Exposure to Online Sexual Content and Sexual Behavior Intentions Among College Students in China.

PubMed

Zhang, Jingwen; Jemmott, John B

2015-07-01

This study examined the relations of unintentional exposure to Internet sexual content to intentions for sex and condom use and potential mediators of these relations, including attitudes, norms, and self-efficacy, among college students in China. A sample of 524 Chinese college students completed an online questionnaire. Mediation path analyses were conducted to test the theory of planned behavior as a model of the relations between unintentional exposure and intentions to have sex and use condoms. On average, students reported being unintentionally exposed to Internet sexual content about 3 to 4 times during the past month. Unintentional exposure was indirectly associated with intention to have sex, mediated through descriptive and injunctive norms. Descriptive norm was a stronger mediator for females than males. In contrast, unintentional exposure was unrelated to condom-use intention and mediators. The theory of planned behavior provides a model for the development of Internet-based interventions with these students. © 2014 APJPH.

Affect and State Dysregulation as Moderators of the Relationship between Childhood Sexual Abuse and Nonsuicidal Self-Injury

ERIC Educational Resources Information Center

Bolen, Rebecca M.; Ramseyer Winter, Virginia; Hodges, Liz

2013-01-01

Nonsuicidal self-injury (NSSI) is a significant problem in both clinical and nonclinical populations. Affect and state dysregulation are frequently observed in survivors of childhood sexual abuse and in those who engage in NSSI. Both have been found to predict NSSI, and affect regulation has also been modeled as a mediator of NSSI. This study…

Father-Child Interactions and Children's Risk of Injury

ERIC Educational Resources Information Center

StGeorge, Jennifer; Fletcher, Richard; Freeman, Emily; Paquette, Daniel; Dumont, Caroline

2015-01-01

Unintentional injury is an important cause of infant and child hospitalisation and parents play a key role in reducing children's risk-taking behaviour. Studies show that maternal and paternal parenting and supervision of children differ, but there is little research showing how fathers' parenting may influence children's tendency to engage in…

Childhood injury in Tower Hamlets: Audit of children presenting with injury to an inner city A&E department in London.

PubMed

Smith, Dianna; Kirkwood, Graham; Pott, Jason; Kourita, Lida; Jessop, Vanessa; Pollock, Allyson M

2015-01-01

Childhood injury is a leading cause of mortality and morbidity worldwide with the most socio-economically deprived children at greatest risk. Current routine NHS hospital data collection in England is inadequate to inform or evaluate prevention strategies. A pilot study of enhanced data collection was conducted to assess the feasibility of collecting accident and emergency data for national injury surveillance. To evaluate the reliability and feasibility of supplementary data collection using a paper-based questionnaire and to assess the potential relationship between income deprivation and incidence of paediatric injury. Clinical staff conducted an audit of injuries in all patients under 16 years between June and December 2012 through completion of a questionnaire while taking the medical history. Descriptive statistics were produced for age, sex, time of arrival, activity at time of injury, mechanism and location of injuries. The association between known injury incidence and area level income deprivation (2010 English Index of Multiple Deprivation [IMD] Income Deprivation Domain from home postcode) was assessed using Spearman's rank correlation. Representativeness of the audit was measured using z-test statistics for time of arrival, age, sex and ethnicity. The paper audit captured 414 (6.5%) of the 6358 under-16 injury-related attendances recorded on the NHS Care Record Service Dataset. Comparison of the audit dataset with NHS records showed that the audit was not representative of the larger dataset except for sex of the patient. There was a positive correlation between injury incidence and income deprivation measured using IMD score where data were available (n = 384, p < 0.001). Nearly half of the attendances were due to falls, slips or trips (49.8%) and more than half were due to either leisure (32.9%) or sport (18.1%) activities. There is evidence of area level income inequalities in injury incidence among children attending the Royal London Hospital. The

What did you have in mind? Examining the content of intentional and unintentional types of mind wandering

PubMed Central

Seli, Paul; Ralph, Brandon C. W.; Konishi, Mahiko; Smilek, Daniel; Schacter, Daniel L.

2017-01-01

It has recently been argued that researchers should distinguish between mind wandering (MW) that is engaged with and without intention. Supporting this argument, studies have found that intentional and unintentional MW have behavioral/neural differences, and that they are differentially associated with certain variables of theoretical interest. Although there have been considerable inroads made into the distinction between intentional/unintentional MW, possible differences in their content remain unexplored. To determine whether these two types of MW differ in content, we had participants complete a task during which they categorized their MW as intentional or unintentional, and then provided responses to questions about the content of their MW. Results indicated that intentional MW was more frequently rated as being future-oriented and less vague than unintentional MW. These findings shed light on the nature of intentional and unintentional MW and provide support for the argument that researchers should distinguish between intentional and unintentional types. PMID:28371688

Child injury surveillance capabilities in NSW: informing policy and practice.

PubMed

Mitchell, Rebecca; Testa, Luke

2017-10-11

Injury is one of the most common reasons why a child is hospitalised. Information gained from injury surveillance activities provides an estimate of the injury burden, describes injury event circumstances, can be used to monitor injury trends over time, and is used to design and evaluate injury prevention activities. This perspective article provides an overview of child injury surveillance capabilities within New South Wales (NSW), Australia, following a stocktake of population-based injury-related data collections using the Evaluation Framework for Injury Surveillance Systems. Information about childhood injury in NSW is obtained from multiple administrative data collections that were not specifically designed to conduct injury surveillance. Obtaining good information for child injury surveillance in NSW will involve better coordination of information from agencies that record information about childhood injury. Regular reporting about childhood injury to provide a comprehensive profile of injuries of children and young people in the state should be considered, along with the provision and/or linkage of child injury information from multiple data collections. This could support the development of a suite of injury performance indicators to monitor childhood injury reduction strategies across NSW.

Prediction of Multidimensional Fatigue After Childhood Brain Injury.

PubMed

Crichton, Alison J; Babl, Franz; Oakley, Ed; Greenham, Mardee; Hearps, Stephen; Delzoppo, Carmel; Hutchison, Jamie; Beauchamp, Miriam; Anderson, Vicki A

To determine (1) the presence of fatigue symptoms and predictors of fatigue after childhood brain injury and examine (2) the feasibility, reliability, and validity of a multidimensional fatigue measure (PedsQL Multidimensional Fatigue Scale [MFS]) obtained from parent and child perspectives. Emergency and intensive care units of a hospital in Melbourne, Australia. Thirty-five families (34 parent-proxies and 32 children) aged 8 to 18 years (mean child age = 13.29 years) with traumatic brain injury (TBI) of all severities (27 mild, 5 moderate, and 3 severe) admitted to the Royal Children's Hospital. Longitudinal prospective study. Fatigue data collected at 6-week follow-up (mean = 6.9 weeks). Postinjury child- and parent-rated fatigue (PedsQL MFS), mood, sleep, and pain based on questionnaire report: TBI severity (mild vs moderate/severe TBI). A score greater than 2 standard deviations below healthy control data indicated the presence of abnormal fatigue, rates of which were higher compared with normative data for both parent and child reports (47% and 29%). Fatigue was predicted by postinjury depression and sleep disturbance for parent, but not child ratings. Fatigue, as rated by children, was not significantly predicted by TBI severity or other symptoms. The PedsQL MFS demonstrated acceptable measurement properties in child TBI participants, evidenced by good feasibility and reliability (Cronbach α values >0.90). Interrater reliability between parent and child reports was poor to moderate. Results underscore the need to assess fatigue and associated sleep-wake disturbance and depression after child TBI from both parent and child perspectives.

Preventing gun injuries in children.

PubMed

Crossen, Eric J; Lewis, Brenna; Hoffman, Benjamin D

2015-02-01

Firearms are involved in the injury and death of a large number of children each year from both intentional and unintentional causes. Gun ownership in homes with children is common, and pediatricians should incorporate evidence-based means to discuss firearms and protect children from gun-related injuries and violence. Safe storage of guns, including unloaded guns locked and stored separately from ammunition, can decrease risks to children, and effective tools are available that pediatricians can use in clinical settings to help decrease children's access to firearms. Furthermore, several community-based interventions led by pediatricians have effectively reduced firearm-related injury risks to children. Educational programs that focus on children's behavior around guns have not proven effective. © American Academy of Pediatrics, 2015. All rights reserved.

Teenager injury panorama in northern Sweden.

PubMed

Johansson, L; Eriksson, A; Björnstig, U

2001-08-01

To study non-fatal unintentional injuries among teenagers and to suggest preventive measures. The emergency care unit of the University Hospital, Umeå, Sweden. All injured teenagers (N = 1044) attending the emergency care unit during 1991 were asked to answer a questionnaire focusing on when, where and how the injury occurred. All available medical records were examined. Data were coded according to the Nordic Medico-Statistical Committees Classification for Accident Monitoring, NOMESCO, and to the Abbreviated Injury Scale, AIS. 1,043 teenagers were treated with sports and transportation related injuries as the most common ones. Most injuries were minor (AIS 1), transportation related injuries had the highest proportion of non-minor injuries (AIS > or = 2), 139 teenagers were admitted for in-patient care. Most injuries occurred during leisure/school time. Sports and transportation related injuries were most frequent. Body weight and length differs among teenagers, we suggest that teenagers should exercise and play together, not only by age, but also to some extent, to height and weight. Curfew laws, a compulsory bicycle helmet law are other injury reducing measures suggested.

Caregiver Ratings of Long-term Executive Dysfunction and Attention Problems After Early Childhood Traumatic Brain Injury: Family Functioning Is Important

PubMed Central

Kurowski, Brad G.; Taylor, H. Gerry; Yeates, Keith Owen; Walz, Nicolay C.; Stancin, Terry; Wade, Shari L.

2013-01-01

Objective To evaluate the relationship of family and parenting factors to long-term executive dysfunction and attention problems after early childhood traumatic brain injury (TBI). We hypothesized that the magnitude of executive dysfunction and attention problems would be moderated by family and parenting factors. Design A multicenter, prospective cohort study that included an orthopedic injury (OI) reference group. Setting Three tertiary academic children’s hospital medical centers and one general medical center. Participants Children, ages 3–7 years, hospitalized for OI, moderate TBI, or severe TBI. Methods and Outcome Measurements Parental ratings of family functioning and parenting styles were obtained 18 months after the injury occurred. The main outcome measurements, which were parental ratings of children’s executive function and attention, were performed at least 24 months after the injury occurred (mean, 39 months; range, 25–63 months). Analysis Group comparisons were conducted with use of t-tests, χ2 analysis, analysis of variance, and Pearson and Spearman correlations. Regression analysis was used to examine associations of the outcomes with family functioning and parenting styles and to test moderating effects of these factors on group differences. Results Participants with severe TBI demonstrated increased executive dysfunction and attention problems compared with those who sustained moderate TBI or OI. Lower levels of family dysfunction were associated with better executive function and attention across groups but did not moderate group differences. However, attention deficits after severe TBI were exacerbated under conditions of more permissive parenting relative to attention deficits after OIs. Conclusions Executive function and attention problems persisted on a long-term basis (>24 months) after early childhood TBI, and positive global family functioning and nonpermissive parenting were associated with better outcomes. Better

Caregiver ratings of long-term executive dysfunction and attention problems after early childhood traumatic brain injury: family functioning is important.

PubMed

Kurowski, Brad G; Taylor, H Gerry; Yeates, Keith Owen; Walz, Nicolay C; Stancin, Terry; Wade, Shari L

2011-09-01

To evaluate the relationship of family and parenting factors to long-term executive dysfunction and attention problems after early childhood traumatic brain injury (TBI). We hypothesized that the magnitude of executive dysfunction and attention problems would be moderated by family and parenting factors. A multicenter, prospective cohort study that included an orthopedic injury (OI) reference group. Three tertiary academic children's hospital medical centers and one general medical center. Children, ages 3-7 years, hospitalized for OI, moderate TBI, or severe TBI. METHODS AND OUTCOME MEASUREMENTS: Parental ratings of family functioning and parenting styles were obtained 18 months after the injury occurred. The main outcome measurements, which were parental ratings of children's executive function and attention, were performed at least 24 months after the injury occurred (mean, 39 months; range, 25-63 months). Group comparisons were conducted with use of t-tests, χ(2) analysis, analysis of variance, and Pearson and Spearman correlations. Regression analysis was used to examine associations of the outcomes with family functioning and parenting styles and to test moderating effects of these factors on group differences. Participants with severe TBI demonstrated increased executive dysfunction and attention problems compared with those who sustained moderate TBI or OI. Lower levels of family dysfunction were associated with better executive function and attention across groups but did not moderate group differences. However, attention deficits after severe TBI were exacerbated under conditions of more permissive parenting relative to attention deficits after OIs. Executive function and attention problems persisted on a long-term basis (>24 months) after early childhood TBI, and positive global family functioning and nonpermissive parenting were associated with better outcomes. Better characterization of the optimal family environment for recovery from early childhood

The Anals of History: Unintentional Humor from Freshman Compositions.

ERIC Educational Resources Information Center

Hansen, Kristine

1983-01-01

Presents examples of unintentional humor from college freshman composition courses. Suggests that by pointing out miscommunications, teachers can persuade students to use standard English more effectively. (MM)

Elevated depressive symptoms and adolescent injury: examining associations by injury frequency, injury type, and gender

PubMed Central

2014-01-01

Background Key risk factors for adolescent injury have been well documented, and include structural, behavioural, and psychosocial indicators. While psychiatric distress has been associated with suicidal behaviour and related self-harm, very little research has examined the role of depression in shaping adolescent injury. This study examines the association of elevated depressive symptoms with injury, including total number of injuries and injury type. Gender differences are also considered. Methods Data were drawn in 2010–11 from a representative sample of 2,989 high school students (14 to18 years of age) from Nova Scotia, Canada. Self-reported injury outcomes were examined using the 17-item Adolescent Injury Checklist, which captures past six-month injuries. Elevated depressive symptoms were assessed using the Centers for Epidemiological Studies Depression scale. Associations of elevated depressive symptoms with total number of injuries were estimated with negative binomial regression, while associations with specific injury types were estimated with logistic regression. Analyses were conducted in 2012. Results Adolescents with elevated depressive symptoms experienced a 40% increase in the total number of injury events occurring in the past six months. The association of elevated depressive symptoms with injury was consistent across injury type; violence-related (OR 2.21, 95% CI 1.61 to 3.03), transport-related (OR 1.53, 95% CI 1.10 to 2.13), and unintentional injuries (OR 1.65, 95% CI 1.20 to 2.27). Gender differences were also observed. Conclusion Elevated depressive symptoms play a role in shaping adolescent injury. Interventions aimed at reducing adolescent injury should look to minimize psychosocial antecedents, such as poor mental health, that put adolescents at an elevated risk. PMID:24555802

New Zealand Teachers' Understanding of Childhood Mild Traumatic Brain Injury: Investigating and Enhancing Teacher Knowledge and Practice

ERIC Educational Resources Information Center

Case, Rosalind Jane Leamy; Starkey, Nicola J.; Jones, Kelly; Barker-Collo, Suzanne; Feigin, Valery

2017-01-01

This two-phase study investigated New Zealand primary school teachers' knowledge and perceptions of childhood mild Traumatic Brain Injury (mTBI), and evaluated the effectiveness of a professional development workshop for enhancing teacher knowledge regarding mTBI. In phase one, 19 teachers from schools in the Waikato and Bay of Plenty engaged in…

Availability and quality of cause-of-death data for estimating the global burden of injuries

PubMed Central

Harrison, James E; Shahraz, Saeid; Fingerhut, Lois A

2010-01-01

Abstract Objective To assess the availability and quality of global death registration data used for estimating injury mortality. Methods The completeness and coverage of recent national death registration data from the World Health Organization mortality database were assessed. The quality of data on a specific cause of injury death was judged high if fewer than 20% of deaths were attributed to any of several partially specified causes of injury, such as “unspecified unintentional injury”. Findings Recent death registration data were available for 83 countries, comprising 28% of the global population. They included most high-income countries, most countries in Latin America and several in central Asia and the Caribbean. Categories commonly used for partially specified external causes of injury resulting in death included “undetermined intent,” “unspecified mechanism of unintentional injury,” “unspecified road injury” and “unspecified mechanism of homicide”. Only 20 countries had high-quality data. Nevertheless, because the partially specified categories do contain some information about injury mechanisms, reliable estimates of deaths due to specific external causes of injury, such as road injury, suicide and homicide, could be derived for many more countries. Conclusion Only 20 countries had high-quality death registration data that could be used for estimating injury mortality because injury deaths were frequently classified using imprecise partially specified categories. Analytical methods that can derive national estimates of injury mortality from alternative data sources are needed for countries without reliable death registration systems. PMID:21076564

Cognitive aging and the distinction between intentional and unintentional mind wandering

PubMed Central

Seli, Paul; Maillet, David; Smilek, Daniel; Oakman, Jonathan M.; Schacter, Daniel L.

2017-01-01

A growing number of studies have reported age-related reductions in the frequency of mind wandering. Here, at both the trait (Study 1) and state (Study 2) levels, we re-examined this association while distinguishing between intentional (deliberate) and unintentional (spontaneous) mind wandering. Based on research demonstrating age-accompanied deficits in executive functioning, we expected to observe increases in unintentional mind wandering with increasing age. Moreover, because aging is associated with increased task motivation, we reasoned that older adults might be more engaged in their tasks, and hence, show a more pronounced decline in intentional mind wandering relative to young adults. In both studies, we found that older adults did indeed report lower rates of intentional mind wandering compared with young adults. However, contrary to our expectations, we also found that older adults reported lower rates of unintentional mind wandering (Studies 1 and 2). We discuss the implications of these findings for theories of age-related declines in mind wandering. PMID:28471215

Social and Behavioral Outcomes following Childhood Traumatic Brain Injury: What Predicts Outcome at 12 Months Post-Insult?

PubMed

Catroppa, Cathy; Hearps, Stephen; Crossley, Louise; Yeates, Keith; Beauchamp, Miriam; Fusella, Jessica; Anderson, Vicki

2017-04-01

This study sought to investigate social and behavioral outcomes 12 months following childhood traumatic brain injury (TBI) and to identify predictors of these outcomes. The study also compared rates of impairment in social and behavioral outcomes at 12 months post-injury between children with TBI and a typically developing (TD) control group. The study comprised 114 children ages 5.5 to 16.0 years, 79 with mild, moderate, or severe TBI and 35 TD children, group-matched for age, sex and socio-economic status. Children with TBI were recruited via consecutive hospital admissions and TD children from the community. Social and behavioral outcomes were measured via parent-rated questionnaires. Analysis of covariance models identified a significant mean difference between the mild and moderate groups for social problems only, but the moderate and severe TBI groups showed a higher rate of impairment, particularly in externalizing problems. Pre-injury function, injury severity, parent mental health, and child self-esteem all contributed significantly to predicting social and behavioral outcomes. Both injury and non-injury factors should be considered when identifying children at risk for long-term difficulties in social and behavioral domains.

The Role of Context in Risk for Pediatric Injury: Influences from the Home and Child Care Environments

ERIC Educational Resources Information Center

Schwebel, David C.; Brezausek, Carl M.

2007-01-01

Unintentional injury is the leading cause of pediatric mortality among American children, but the role of environmental context remains poorly understood as a risk for child injury. Couched in Bronfenbrenner's (1977) ecological theory, this study analyzed data from a sample of almost 900 children to identify relations between the home and…

Temporal trends, gender, and geographic distributions in child and youth injury rates in Sweden.

PubMed

Ekman, R; Svanström, L; Långberg, B

2005-02-01

Sweden has the lowest child injury mortality rate in the world, 5.2/100 000 for children under 15. This paper describes temporal trends in Sweden, as well as gender related and geographic differences. The Swedish Cause-of-Death Register (1987-2001) and the Hospital Patient Register (1987-2002) were used to compare rates for the country as a whole and for discharges aged 0-20 by municipality, using the SEATS time series analysis program. There was a decrease in the rate of fatal unintentional injuries from 7 to 4 per 100 000 for girls and from 16 to 10 per 100 000 for boys since 1987. The gap between girls and boys was reduced and boys now have almost the same mortality rate as girls for violence related deaths. Road and other unintentional injuries show a general decrease whereas the pattern for falls varies by age and sex. Self inflicted injuries increased for both sexes, but more for girls. Substantial differences in injury rates between municipalities were also found-up to six times for girls and eight times for boys. Substantial declines in injury fatalities over time were found, but these were different for boys and girls. There remain substantial differences between municipalities. These data, published in a child injury atlas, have prompted substantial interest among media and the authorities.

Unintentional Infusion of Phenylephrine into the Epidural Space.

PubMed

Townley, Kress R; Lane, Jason; Packer, Robyn; Gupta, Rajnish K

2016-03-01

We describe a patient who received an unintentionally prolonged epidural infusion of phenylephrine. The patient experienced no major morbidity. However, this case highlights the continuing problem of wrong-route drug administration and the urgent need to adopt route-specific connections.

Neural correlates of verbal associative memory and mnemonic strategy use following childhood traumatic brain injury

PubMed Central

Kramer, Megan E.; Chiu, C.-Y. Peter; Shear, Paula K.; Wade, Shari L.

2010-01-01

Children with traumatic brain injury (TBI) often experience memory deficits, although the nature, functional implication, and recovery trajectory of such difficulties are poorly understood. The present fMRI study examined the neural activation patterns in a group of young children who sustained moderate TBI in early childhood (n = 7), and a group of healthy control children (n = 13) during a verbal paired associate learning (PAL) task that promoted the use of two mnemonic strategies differing in efficacy. The children with TBI demonstrated intact memory performance and were able to successfully utilize the mnemonic strategies. However, the TBI group also demonstrated altered brain activation patterns during the task compared to the control children. These findings suggest early childhood TBI may alter activation within the network of brain regions supporting associative memory even in children who show good behavioral performance. PMID:21188286

Posttraumatic cerebral infarction due to progressive occlusion of the internal carotid artery after minor head injury in childhood: a case report.

PubMed

Matsumoto, Hiroaki; Kohno, Kanehisa

2011-07-01

Although minor head injury in childhood is a common occurrence and usually no complications, posttraumatic cerebral infarction has rarely been reported. Such infarction is characterized by occlusion of the lateral lenticulostriate artery. The authors report an atypical case of posttraumatic occlusion of the internal carotid artery (ICA) after minor head injury in childhood. A healthy 16-year-old boy was hit on the head by a pitch while playing baseball. He developed a transient ischemic attack involving the left extremities 15 min after the accident. Initial magnetic resonance imaging revealed neither hemorrhage nor infarction, and MR angiography demonstrated mild stenosis of the right carotid fork. Conservative therapy was started. However, 24 h after the accident, he suddenly developed left hemiparesis. Emergent neuroimaging demonstrated progressive occlusion of the supraclinoid portion of the right ICA and cerebral infarction of the deep white matter in the right frontal lobe. The hemiparesis deteriorated and the infarction area continued to expand on a daily. The patient underwent emergent superficial temporally artery-middle cerebral artery (STA-MCA) bypass. Intraoperative observation demonstrated that the supraclinoid portion of the right ICA was not thrombosed but pale with low tension and did not appear dissected. He fully recovered by 2 weeks after the operation. Postoperative investigations showed gradual improvement of the ICA occlusion. Minor head injury can cause cerebral infarction in childhood, although this is rare. If conservative therapy cannot prevent progressive cerebral infarction, STA-MCA bypass should be considered in case of the ICA occlusion.

Substance use, criminal behaviour and psychiatric symptoms following childhood traumatic brain injury: findings from the ALSPAC cohort.

PubMed

Kennedy, Eleanor; Heron, Jon; Munafò, Marcus

2017-10-01

Recent research suggests a link between traumatic brain injury (TBI) in youth and later risk behaviour. We explored the association between mild TBI and psychiatric symptoms, substance use and criminal behaviour using data from a longitudinal birth cohort. Participants with mild TBI (n = 800), orthopaedic injuries (n = 2305) and no injuries (n = 8307) were identified from self and parent reports up to age 16 years. Self-report measures of substance use (alcohol, tobacco and cannabis) and criminal behaviours, and parent-reported psychiatric symptoms were collected at age 17 years. Analyses were adjusted for pre-birth and early childhood confounders. Participants with a TBI showed increased odds of hazardous alcohol use compared to those with no injury and those with an orthopaedic injury. Relative to those with no injury, participants with a TBI showed increased odds of problematic use of tobacco and cannabis, being in trouble with the police and having more parent-reported conduct problems. Sustaining either a TBI or an orthopaedic injury increased the odds of offending behaviour compared to having no injuries. There was no clear evidence of association between orthopaedic injury and the other risk outcomes. The increased odds of risk behaviour associated with TBI relative to no injury replicated previous research. However, the inclusion of a non-brain-related injury group adds evidence for a possible causal pathway between mild TBI in youth and later hazardous alcohol use only. This highlights the importance of including an additional negative control injury group in mild TBI research.

Legislation coverage for child injury prevention in China

PubMed Central

Li, Li; Scherpbier, Robert; Wu, Jing; Zhu, Xu; Zhang, Wei; Zhang, Lin; Gao, Xin; Luo, Jiesi

2015-01-01

Abstract Objective To examine the extent to which effective interventions to prevent unintentional child injury are reflected in the laws and regulations of China. Methods We focused on the six common causes of fatal child injuries – drowning, road traffic injury, falls, poisoning, burns and suffocation. We investigated 27 interventions recommended by the United Nations Children’s Fund, the World Health Organization or the European Child Safety Alliance. We searched China National Knowledge Infrastructure and Lawyee for Chinese legislations using keywords and synonyms for the 27 interventions. We reviewed the identified legislations for statements specifying the responsible implementation department. Findings Seven national laws, nine regulations of the State Council and 46 departmental regulations were found to relate to at least one of the interventions. Although seven of the 27 internationally recommended interventions were covered by Chinese laws, 10 were not covered by any current Chinese law or regulation. None of the interventions against drowning and falls that we investigated was covered by national laws. The implementation responsibilities for effective interventions were either not specified or were assigned to multiple governmental departments in 11 or 20 legislative documents, respectively. Conclusion In Chinese laws and regulations, interventions proven to prevent major causes of unintentional child injuries are underrepresented and the associated implementation responsibilities are often poorly defined. China should include all such interventions in laws and regulations, and assign implementation responsibility for each to a single department of the national government. PMID:25838612

Intentional and unintentional poisoning in Pakistan: a pilot study using the Emergency Departments surveillance project.

PubMed

Khan, Nadeem; Pérez-Núñez, Ricardo; Shamim, Nudrat; Khan, Uzma; Naseer, Naureen; Feroze, Asher; Razzak, Junaid; Hyder, Adnan A

2015-01-01

Acute poisoning is one of the most common reasons for emergency department visits around the world. In Pakistan, the epidemiological data on poisoning is limited due to an under developed poison information surveillance system. We aim to describe the characteristics associated with intentional and unintentional poisoning in Pakistan presenting to emergency departments. The data was extracted from the Pakistan National Emergency Department Surveillance (Pak-NEDS) which was an active surveillance conducted between November 2010 and March 2011. All patients, regardless of age, who presented with poisoning to any of Pakistan's seven major tertiary care centers' emergency departments, were included. Information about patient demographics, type of poisoning agent, reason for poisoning and outcomes were collected using a standard questionnaire. Acute poisoning contributed to 1.2% (n = 233) of patients with intentional and unintentional injuries presenting to EDs of participating centers. Of these, 68% were male, 54% were aged 19 to 44 and 19% were children and adolescents (<18 years). Types of poisoning included chemical/gas (43.8%), drug/medicine (27%), alcohol (16.7%) and food/plant (6%). In half of all patients the poisoning was intentional. A total of 11.6% of the patients were admitted and 6.6% died. Poisoning causes more morbidity and mortality in young adults in Pakistan compared to other age groups, half of which is intentional. Improving mental health, regulatory control for hazardous chemicals and better access to care through poison information centers and emergency departments will potentially help control the problem.

Dissociation as a mediator of the relationship between childhood trauma and nonsuicidal self-injury in females: a path analytic approach.

PubMed

Franzke, Iris; Wabnitz, Pascal; Catani, Claudia

2015-01-01

New theoretical models of nonsuicidal self-injury (NSSI) postulate that symptoms subsequent to childhood maltreatment rather than childhood maltreatment itself may lead to engagement in NSSI. However, little is known concerning which specific syndromes serve as underlying mechanisms. In this study we sought to examine the mediating effects of dissociative, posttraumatic, and depressive symptoms, 3 often comorbid syndromes following childhood trauma. In addition, we aimed to assess differences between women with and without NSSI. A sample of 87 female inpatients with a history of childhood abuse and neglect was divided into 2 subgroups (NSSI: n = 42, no NSSI: n = 45). The assessment included measures of NSSI characteristics; adverse childhood experiences; and posttraumatic, dissociative, and depressive symptoms. The NSSI group reported significantly more cases of childhood maltreatment and higher levels of current dissociative, posttraumatic, and depressive symptoms than patients without NSSI. The results of a path analysis showed that only dissociation mediated the relationship between a history of child maltreatment and NSSI when all 3 psychopathological variables were included in the model. The findings point toward a strong and rather specific association between dissociative experiences and NSSI and therefore have important implications for clinical practice.

National estimates of non-fatal firearm related injuries other than gunshot wounds

PubMed Central

Hootman, J; Annest, J; Mercy, J; Ryan, G; Hargarten, S

2000-01-01

Objective—To characterize non-fatal firearm related injuries other than gunshot wounds (non-GSWs) treated in hospital emergency departments in the United States that occur during routine gun handling and recreational use as well as violence related use of a firearm. Methods—Cases were identified through the National Electronic Injury Surveillance System (NEISS). During the study period, 1 January 1993 through 31 December 1996, NEISS consisted of a nationally representative sample of 91 hospitals in the United States having at least six beds and providing 24 hour emergency services. Results—An estimated 65 374, or an average of 16 300 per year, non-fatal, non-GSWs were treated in American hospital emergency departments during the four year study period. Fifty seven per cent of all the non-fatal, non-GSWs were violence related, most of which involved being struck by a firearm. The majority of unintentional non-fatal, non-GSWs were self inflicted and occurred during routine gun handling or recreational use of a firearm; 43% of these injuries resulted from gun recoils. Conclusions—Non-fatal, non-GSWs make a notable contribution to the public health burden of firearm related injuries. Firearm related injury prevention programs should focus on not only the reduction of gunshot wounds but also the reduction of unintentional and violence related non-GSWs. PMID:11144625

The empathy impulse: A multinomial model of intentional and unintentional empathy for pain.

PubMed

Cameron, C Daryl; Spring, Victoria L; Todd, Andrew R

2017-04-01

Empathy for pain is often described as automatic. Here, we used implicit measurement and multinomial modeling to formally quantify unintentional empathy for pain: empathy that occurs despite intentions to the contrary. We developed the pain identification task (PIT), a sequential priming task wherein participants judge the painfulness of target experiences while trying to avoid the influence of prime experiences. Using multinomial modeling, we distinguished 3 component processes underlying PIT performance: empathy toward target stimuli (Intentional Empathy), empathy toward prime stimuli (Unintentional Empathy), and bias to judge target stimuli as painful (Response Bias). In Experiment 1, imposing a fast (vs. slow) response deadline uniquely reduced Intentional Empathy. In Experiment 2, inducing imagine-self (vs. imagine-other) perspective-taking uniquely increased Unintentional Empathy. In Experiment 3, Intentional and Unintentional Empathy were stronger toward targets with typical (vs. atypical) pain outcomes, suggesting that outcome information matters and that effects on the PIT are not reducible to affective priming. Typicality of pain outcomes more weakly affected task performance when target stimuli were merely categorized rather than judged for painfulness, suggesting that effects on the latter are not reducible to semantic priming. In Experiment 4, Unintentional Empathy was stronger for participants who engaged in costly donation to cancer charities, but this parameter was also high for those who donated to an objectively worse but socially more popular charity, suggesting that overly high empathy may facilitate maladaptive altruism. Theoretical and practical applications of our modeling approach for understanding variation in empathy are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Glasgow Coma Scale and Outcomes after Structural Traumatic Head Injury in Early Childhood

PubMed Central

Heather, Natasha L.; Derraik, José G. B.; Beca, John; Hofman, Paul L.; Dansey, Rangi; Hamill, James; Cutfield, Wayne S.

2013-01-01

Objective To assess the association of the Glasgow Coma Scale (GCS) with radiological evidence of head injury (the Abbreviated Injury Scale for the head region, AIS-HR) in young children hospitalized with traumatic head injury (THI), and the predictive value of GCS and AIS-HR scores for long-term impairment. Methods Our study involved a 10-year retrospective review of a database encompassing all patients admitted to Starship Children’s Hospital (Auckland, New Zealand, 2000–2010) with THI. Results We studied 619 children aged <5 years at the time of THI, with long-term outcome data available for 161 subjects. Both GCS and AIS-HR scores were predictive of length of intensive care unit and hospital stay (all p<0.001). GCS was correlated with AIS-HR (ρ=-0.46; p<0.001), although mild GCS scores (13–15) commonly under-estimated the severity of radiological injury: 42% of children with mild GCS scores had serious–critical THI (AIS-HR 3–5). Increasingly severe GCS or AIS-HR scores were both associated with a greater likelihood of long-term impairment (neurological disability, residual problems, and educational support). However, long-term impairment was also relatively common in children with mild GCS scores paired with structural THI more severe than a simple linear skull fracture. Conclusion Severe GCS scores will identify most cases of severe radiological injury in early childhood, and are good predictors of poor long-term outcome. However, young children admitted to hospital with structural THI and mild GCS scores have an appreciable risk of long-term disability, and also warrant long-term follow-up. PMID:24312648

Pediatric falls ages 0-4: understanding demographics, mechanisms, and injury severities.

PubMed

Chaudhary, Sofia; Figueroa, Janet; Shaikh, Salah; Mays, Elizabeth Williams; Bayakly, Rana; Javed, Mahwish; Smith, Matthew Lee; Moran, Tim P; Rupp, Jonathan; Nieb, Sharon

2018-04-10

Pediatric unintentional falls are the leading cause of injury-related emergency visits for children < 5 years old. The purpose of this study was to identify population characteristics, injury mechanisms, and injury severities and patterns among children < 5 years to better inform age-appropriate falls prevention strategies. This retrospective database study used trauma registry data from the lead pediatric trauma system in Georgia. Data were analyzed for all patients < 5 years with an international classification of disease, 9th revision, clinical modification (ICD-9 CM) external cause of injury code (E-code) for unintentional falls between 1/1/2013 and 12/31/2015. Age (months) was compared across categories of demographic variables, injury mechanisms, and emergency department (ED) disposition using Kruskal-Wallis ANOVA and the Mann Whitney U test. The relationships between demographic variables, mechanism of injury (MOI), and Injury Severity Score (ISS) were evaluated using multinomial logistic regression. Inclusion criteria were met by 1086 patients (median age = 28 months; 59.7% male; 53.8% White; 49.1% <  1 m fall height). Younger children, < 1-year-old, primarily fell from caregiver's arms, bed, or furniture, while older children sustained more falls from furniture and playgrounds. Children who fell from playground equipment were older (median = 49 months, p < 0.01) than those who fell from the bed (median = 10 months), stairs (median = 18 months), or furniture (median = 19 months). Children < 1 year had the highest proportion of head injuries including skull fracture (63.1%) and intracranial hemorrhage (65.5%), 2-year-old children had the highest proportion of femur fractures (32.9%), and 4-year-old children had the highest proportion of humerus fractures (41.0%). Medicaid patients were younger (median = 24.5 months, p < 0.01) than private payer (median = 34 months). Black patients were younger

Unintentional Pediatric Cocaine Exposures Result in Worse Outcomes than Other Unintentional Pediatric Poisonings.

PubMed

Armenian, Patil; Fleurat, Michelle; Mittendorf, George; Olson, Kent R

2017-06-01

Unintentional pediatric cocaine exposures are rare but concerning due to potentially serious complications such as seizures, dysrhythmias, and death. The objectives were to assess the demographic and clinical characteristics of pediatric cocaine exposures reported to the California Poison Control System. This is a retrospective study of all confirmed pediatric (< 6 years of age) cocaine exposures reported to the California Poison Control System from January 1, 1997-September 30, 2010. Case narratives were reviewed for patient demographics, exposure details, clinical effects, therapy, hospitalization, and final outcome. Of the 86 reported pediatric cocaine exposures, 36 had positive urine drug testing and were included in the study cohort. The median age at presentation was 18 months (range: 0-48 months), and 56% were male (n = 20). The most common clinical manifestations were tachycardia and seizures. The most common disposition was admission to an intensive care unit (n = 14; 39%). Eleven cases (31%) were classified as having a major effect as per American Association of Poison Control Centers case coding guidelines. One child presented in asystole with return of spontaneous circulation after cardiopulmonary resuscitation and multiple vasoactive medications. The proportion of cocaine exposures with serious (moderate or major) outcomes (66.7%; 95% confidence interval 50.3-79.8%) was higher than other pediatric poisonings reported to the American Association of Poison Control Centers during the study period (0.88%; 95% confidence interval 0.87-0.88). Although pediatric cocaine exposures are rare, they result in more severe outcomes than most unintentional pediatric poisonings. Practitioners need to be aware of the risk of recurrent seizures and cardiovascular collapse associated with cocaine poisoning. Copyright © 2017 Elsevier Inc. All rights reserved.

Approaches used by parents to keep their children safe at home: a qualitative study to explore the perspectives of parents with children aged under five years.

PubMed

Ablewhite, Joanne; McDaid, Lisa; Hawkins, Adrian; Peel, Isabel; Goodenough, Trudy; Deave, Toity; Stewart, Jane; Watson, Michael; Kendrick, Denise

2015-09-29

Childhood unintentional injury represents an important global health problem. Many unintentional injuries experienced by children aged under 5 years occur within the home and are preventable. The aim of this study was to explore the approaches used by parents of children under five in order to help prevent unintentional injuries in the home and the factors which influence their use. Understanding how parents approach risk-management in the home has important implications for injury practitioners. A multi-centre qualitative study using semi-structured interviews. A thematic approach was used to analyse the data. Sixty five parents of children aged under 5 years, from four study areas were interviewed: Bristol, Newcastle, Norwich and Nottingham. Three main injury prevention strategies used by parents were: a) Environmental such as removal of hazards, and use of safety equipment; b) parental supervision; and c) teaching, for example, teaching children about safety and use of rules and routine. Strategies were often used in combination due to their individual limitations. Parental assessment of injury risk, use of strategy and perceived effectiveness were fluid processes dependent on a child's character, developmental age and the prior experiences of both parent and child. Some parents were more proactive in their approach to home safety while others only reacted if their child demonstrated an interest in a particular object or activity perceived as being an injury risk. Parents' injury prevention practices encompass a range of strategies that are fluid in line with the child's age and stage of development; however, parents report that they still find it challenging to decide which strategy to use and when.

Constructing Model of Relationship among Behaviors and Injuries to Products Based on Large Scale Text Data on Injuries

NASA Astrophysics Data System (ADS)

Nomori, Koji; Kitamura, Koji; Motomura, Yoichi; Nishida, Yoshifumi; Yamanaka, Tatsuhiro; Komatsubara, Akinori

In Japan, childhood injury prevention is urgent issue. Safety measures through creating knowledge of injury data are essential for preventing childhood injuries. Especially the injury prevention approach by product modification is very important. The risk assessment is one of the most fundamental methods to design safety products. The conventional risk assessment has been carried out subjectively because product makers have poor data on injuries. This paper deals with evidence-based risk assessment, in which artificial intelligence technologies are strongly needed. This paper describes a new method of foreseeing usage of products, which is the first step of the evidence-based risk assessment, and presents a retrieval system of injury data. The system enables a product designer to foresee how children use a product and which types of injuries occur due to the product in daily environment. The developed system consists of large scale injury data, text mining technology and probabilistic modeling technology. Large scale text data on childhood injuries was collected from medical institutions by an injury surveillance system. Types of behaviors to a product were derived from the injury text data using text mining technology. The relationship among products, types of behaviors, types of injuries and characteristics of children was modeled by Bayesian Network. The fundamental functions of the developed system and examples of new findings obtained by the system are reported in this paper.

Working hours associated with unintentional sleep at work among airline pilots.

PubMed

Marqueze, Elaine Cristina; Nicola, Ana Carolina B; Diniz, Dag Hammarskjoeld M D; Fischer, Frida Marina

2017-06-26

Tto identify factors associated with unintentional sleep at work of airline pilots. This is a cross-sectional epidemiological study conducted with 1,235 Brazilian airline pilots, who work national or international flights. Data collection has been performed online. We carried out a bivariate and multiple logistic regression analysis, having as dependent variable unintentional sleep at work. The independent variables were related to biodemographic data, characteristics of the work, lifestyle, and aspects of sleep. The prevalence of unintentional sleep while flying the airplane was 57.8%. The factors associated with unintentional sleep at work were: flying for more than 65 hours a month, frequent technical delays, greater need for recovery after work, work ability below optimal, insufficient sleep, and excessive sleepiness. The occurrence of unintentional sleep at work of airline pilots is associated with factors related to the organization of the work and health. Identificar fatores associados aos cochilos não intencionais durante as jornadas de trabalho de pilotos da aviação regular. Estudo epidemiológico transversal conduzido com 1.235 pilotos brasileiros de avião do transporte aéreo regular, que realizavam voos nacionais ou internacionais, sendo a coleta de dados realizada on-line. Foi realizada análise de regressão logística bivariada e múltipla, tendo como variável dependente o cochilo não intencional durante o horário de trabalho. As variáveis independentes foram relacionadas a dados biodemográficos, características do trabalho, estilo de vida e aspectos do sono. A prevalência do cochilo não intencional enquanto pilotava o avião foi de 57,8%. Os fatores associados ao cochilo não intencional foram: voar por mais de 65 horas por mês, atrasos técnicos frequentes, maior necessidade de recuperação após o trabalho, capacidade para o trabalho inferior à ótima, sono insuficiente e sonolência excessiva. A ocorrência do cochilo n

Intentional and unintentional poisoning in Pakistan: a pilot study using the Emergency Departments surveillance project

PubMed Central

2015-01-01

Background Acute poisoning is one of the most common reasons for emergency department visits around the world. In Pakistan, the epidemiological data on poisoning is limited due to an under developed poison information surveillance system. We aim to describe the characteristics associated with intentional and unintentional poisoning in Pakistan presenting to emergency departments. Methods The data was extracted from the Pakistan National Emergency Department Surveillance (Pak-NEDS) which was an active surveillance conducted between November 2010 and March 2011. All patients, regardless of age, who presented with poisoning to any of Pakistan's seven major tertiary care centers' emergency departments, were included. Information about patient demographics, type of poisoning agent, reason for poisoning and outcomes were collected using a standard questionnaire. Results Acute poisoning contributed to 1.2% (n = 233) of patients with intentional and unintentional injuries presenting to EDs of participating centers. Of these, 68% were male, 54% were aged 19 to 44 and 19% were children and adolescents (<18 years). Types of poisoning included chemical/gas (43.8%), drug/medicine (27%), alcohol (16.7%) and food/plant (6%). In half of all patients the poisoning was intentional. A total of 11.6% of the patients were admitted and 6.6% died. Conclusion Poisoning causes more morbidity and mortality in young adults in Pakistan compared to other age groups, half of which is intentional. Improving mental health, regulatory control for hazardous chemicals and better access to care through poison information centers and emergency departments will potentially help control the problem. PMID:26691609

Perceptual analysis of speech following traumatic brain injury in childhood.

PubMed

Cahill, Louise M; Murdoch, Bruce E; Theodoros, Deborah G

2002-05-01

To investigate perceptually the speech dimensions, oromotor function, and speech intelligibility of a group of individuals with traumatic brain injury (TBI) acquired in childhood. The speech of 24 children with TBI was analysed perceptually and compared with that of a group of non-neurologically impaired children matched for age and sex. The 16 dysarthric TBI subjects were significantly less intelligible than the control subjects, and demonstrated significant impairment in 12 of the 33 speech dimensions rated. In addition, the eight non-dysarthric TBI subjects were significantly impaired in many areas of oromotor function on the Frenchay Dysarthria Assessment, indicating some degree of pre-clinical speech impairment. The results of the perceptual analysis are discussed in terms of the possible underlying pathophysiological bases of the deviant speech features identified, and the need for a comprehensive instrumental assessment, to more accurately determine the level of breakdown in the speech production mechanism in children following TBI.

Supervision of Children with an Autism Spectrum Disorder in the Context of Unintentional injury

ERIC Educational Resources Information Center

Cavalari, Rachel N. S.; Romanczyk, Raymond G.

2012-01-01

Despite high rates of severe medically attended injuries, a thorough understanding of the correlates of injury for children with an autism spectrum disorder (ASD) is currently lacking. The present study sought to determine the effect of an ASD diagnosis, self-reported supervision styles, and supervisor characteristics on behavioral supervisory…

[Negative experiences in childhood, stress and self-injurious behavior and suicidal tendencies in people with borderline personality].

PubMed

Blasczyk-Schiep, Sybilla; Jaworska-Andryszewska, Paulina

2014-06-01

In the bordeline personality disorder (BPD) a large role ascribe to psychological and psychosocial factors. Studies have shown that more than 70% patients BPD reported experiencing traumatic events in childhood. These people compare with patients with other psychiatric disorders often report history of sexual abuse and experience of violence or neglect. Making self-harming can be a reaction to negative experiences in childhood. The findings are confirming that making self-harming is a frequent symptom of BPD and 70-75% patients show at least one act self-harming. Moreover a lowered tolerance level is characteristic of them to the stress and determined course learning dysfunctional patterns of behavior. The aim of this study is to determine the childhood trauma such as sexual, psychological and physical abuse, emotional and physical neglect and to investigate their relation to stress, self-harming and suicidal behavior. In study participated 41 persons with emotionally unstable borderline personality diagnosis. In the group was 32 women and 9 men in age 19-43. The Polish adaptation of standardized questionnaires was used to measure childhood trauma (CTQ), stress (SSI-K), self-injurious behavior (SHI) and suicidal tendencies (RFL-I). In patients with BPD the level of childhood trauma and stress are predictors of self-harming behavior and suicidal tendencies. The mediation analyze showed, that self-harming was an important mediator between sexual abuse and suicidal tendencies. The high stress is the next mediator between sexual abuse and the level of self-harming behavior. A high level of childhood trauma correlates positively with stress, self-harming and suicidal behavior in patients with BPD.

Unintentional Cannabis Ingestion in Children: A Systematic Review.

PubMed

Richards, John R; Smith, Nishelle E; Moulin, Aimee K

2017-11-01

To analyze published reports of unintentional cannabis ingestions in children to determine presenting signs and symptoms, route of exposure, treatment, and outcome. PubMed, OpenGrey, and Google Scholar were systematically searched. Articles were selected, reviewed, and graded using Oxford Center for Evidence-Based Medicine guidelines. Of 3316 articles, 44 were included (3582 children age ≤12 years). We found no high quality (Oxford Center for Evidence-Based Medicine level I or II) studies and 10 level III studies documenting lethargy as the most common presenting sign and confirming increasing incidence of unintentional ingestion in states having decriminalized medical and recreational cannabis. We identified 16 level IV case series, and 28 level V case reports with 114 children, mean age 25.2 ± 18.7 months, range 8 months to 12 years, and 50 female children (44%). The most common ingestion (n = 43, 38%) was cannabis resin, followed by cookies and joints (both n = 15, 13%). Other exposures included passive smoke, medical cannabis, candies, beverages, and hemp oil. Lethargy was the most common presenting sign (n = 81, 71%) followed by ataxia (n = 16, 14%). Tachycardia, mydriasis, and hypotonia were also commonly observed. All cases were cared for in the emergency department or admitted, and mean length of stay was 27.1 ± 27.0 hours. Twenty (18%) were admitted to the pediatric intensive care unit, and 7 (6%) were intubated. Unintentional cannabis ingestion by children is a serious public health concern and is well-documented in numerous studies and case reports. Clinicians should consider cannabis toxicity in any child with sudden onset of lethargy or ataxia. Copyright © 2017 Elsevier Inc. All rights reserved.

Prevention and Control of Injuries.

ERIC Educational Resources Information Center

Tuchfarber, Barbara S.; Zins, Joseph E.; Jason, Leonard A.

Childhood injury continues to be a major public health crisis in the United States, with a large percentage of injuries being preventable and controllable. This chapter provides information related to understanding child and youth injury. Studies have shown that injuries affect identifiable high-risk groups. Such host factors that put children at…

The moderating effect of ANKK1 on the association of family environment with longitudinal executive function following traumatic brain injury in early childhood: A preliminary study.

PubMed

Smith-Paine, Julia; Wade, Shari L; Treble-Barna, Amery; Zhang, Nanhua; Zang, Huaiyu; Martin, Lisa J; Yeates, Keith Owen; Taylor, H Gerry; Kurowski, Brad G

2018-05-02

This study examined whether the ankyrin repeat and kinase domain containing 1 gene (ANKK1) C/T single-nucleotide polymorphism (SNP) rs1800497 moderated the association of family environment with long-term executive function (EF) following traumatic injury in early childhood. Caregivers of children with traumatic brain injury (TBI) and children with orthopedic injury (OI) completed the Behavior Rating Inventory of Executive Function (BRIEF) at post injury visits. DNA was collected to identify the rs1800497 genotype in the ANKK1 gene. General linear models examined gene-environment interactions as moderators of the effects of TBI on EF at two times post injury (12 months and 7 years). At 12 months post injury, analyses revealed a significant 3-way interaction of genotype with level of permissive parenting and injury type. Post-hoc analyses showed genetic effects were more pronounced for children with TBI from more positive family environments, such that children with TBI who were carriers of the risk allele (T-allele) had significantly poorer EF compared to non-carriers only when they were from more advantaged environments. At 7 years post injury, analyses revealed a significant 2-way interaction of genotype with level of authoritarian parenting. Post-hoc analyses found that carriers of the risk allele had significantly poorer EF compared to non-carriers only when they were from more advantaged environments. These results suggest a gene-environment interaction involving the ANKK1 gene as a predictor of EF in a pediatric injury population. The findings highlight the importance of considering environmental influences in future genetic studies on recovery following TBI and other traumatic injuries in childhood.

Social Environmental Moderators of Long-term Functional Outcomes of Early Childhood Brain Injury

PubMed Central

Wade, Shari L.; Zhang, Nanhua; Yeates, Keith Owen; Stancin, Terry; Taylor, H. Gerry

2017-01-01

IMPORTANCE Pediatric traumatic brain injury (TBI) contributes to impairments in behavior and academic performance. However, the long-term effects of early childhood TBI on functioning across settings remain poorly understood. OBJECTIVE To examine the long-term functional outcomes of early childhood TBI relative to early childhood orthopedic injuries (OIs). We also examine the moderating role of the social environment as defined by parent report and observational measures of family functioning, parenting practices, and home environment. DESIGN, SETTING, AND PARTICIPANTS A prospective, longitudinal, observational cohort study conducted at each child’s home, school, and hospital, including 3 children’s hospitals and 1 general hospital in the Midwest. Patients were enrolled in the initial study between January 2003 and October 2006. Follow-ups were completed between January 2010 and April 2015. Fifty-eight children who sustained a TBI (67%of original enrolled cohort) and 72 children who sustained an OI (61% of the original enrolled cohort) were prospectively followed up from shortly after injury (between the ages of 3 and 7 years at enrollment) to an average of 6.7 years after injury, with assessments occurring at multiple points. MAIN OUTCOMES AND MEASURES Long-term functional outcomes in everyday settings, as assessed through the Child and Adolescent Functional Assessment Scale (CAFAS). RESULTS Of the 130 children included, the median age for those with OIs was 11.72 years and 11.97, 12.21, and 11.72 years for those with complicated mild, moderate, and severe TBIs, respectively. Children with moderate and severe TBI were rated as having more functional impairments in multiple domains than those with OIs (P < .05). Children with complicated mild TBI had greater impairments in school (odds ratio = 2.93; 95%CI = 1.10–7.82) and with thinking (odds ratio = 15.72; 95%CI = 3.31–74.73) than those with OIs. Functional impairments in children with TBI were more

Child injuries in Ethiopia: A review of the current situation with projections.

PubMed

Li, Qingfeng; Alonge, Olakunle; Lawhorn, Collene; Ambaw, Yirga; Kumar, Smita; Jacobs, Troy; Hyder, Adnan A

2018-01-01

Heavy burden of child injuries and lack of policy response in Ethiopia call for an improved understanding of the situation and development of action plans from multiple governmental agencies and stakeholders. A consortium of international and Ethiopian researchers and stakeholders used extensive literature review and mixed analytical methods to estimate and project the burden of fatal and non-fatal child unintentional injuries in Ethiopia from 2015 to 2030. Estimates were derived for children aged 0-14 years. Data sources include a longitudinal study conducted by the Central Statistics Agency of Ethiopia and the World Bank as well as model-based estimates from World Health Organization 2017 and Global Burden of Disease 2016 project. Injuries caused about 25 thousand deaths among 0-14-year olds in Ethiopia in 2015. The leading cause of fatal child unintentional injuries in Ethiopia was road-traffic injuries, followed by fire, heat and hot substances and drowning. The death rate due to injuries among 0-14 years olds was about 50 percent higher in males than females. Rural children were exposed to a greater risk of injury than their urban peers. The longitudinal survey suggests that the incidence rate of child injuries increased during the period 2011-2014. The annual mortality caused by injuries is projected to increase from 10,697 in 2015 to 11,279 in 2020 and 11,989 in 2030 among children under 5 years, an increase of 12 percentage points in 15 years. The number of deaths among 0-14-year olds will be 26,463, 27,807, and 30,364 respectively in 2015, 2020, and 2030. As the first multisectoral collaboration on child injuries in Ethiopia, this study identified gaps in understanding of the burden of child injuries in Ethiopia. In consultation with Ethiopian government and other stakeholders, we propose starting an injury surveillance system at health clinics and hospitals and building an intervention package based on existing platforms.

Child injuries in Ethiopia: A review of the current situation with projections

PubMed Central

Alonge, Olakunle; Lawhorn, Collene; Ambaw, Yirga; Kumar, Smita; Hyder, Adnan A.

2018-01-01

Background Heavy burden of child injuries and lack of policy response in Ethiopia call for an improved understanding of the situation and development of action plans from multiple governmental agencies and stakeholders. Methods A consortium of international and Ethiopian researchers and stakeholders used extensive literature review and mixed analytical methods to estimate and project the burden of fatal and non-fatal child unintentional injuries in Ethiopia from 2015 to 2030. Estimates were derived for children aged 0–14 years. Data sources include a longitudinal study conducted by the Central Statistics Agency of Ethiopia and the World Bank as well as model-based estimates from World Health Organization 2017 and Global Burden of Disease 2016 project. Results Injuries caused about 25 thousand deaths among 0-14-year olds in Ethiopia in 2015. The leading cause of fatal child unintentional injuries in Ethiopia was road-traffic injuries, followed by fire, heat and hot substances and drowning. The death rate due to injuries among 0–14 years olds was about 50 percent higher in males than females. Rural children were exposed to a greater risk of injury than their urban peers. The longitudinal survey suggests that the incidence rate of child injuries increased during the period 2011–2014. The annual mortality caused by injuries is projected to increase from 10,697 in 2015 to 11,279 in 2020 and 11,989 in 2030 among children under 5 years, an increase of 12 percentage points in 15 years. The number of deaths among 0-14-year olds will be 26,463, 27,807, and 30,364 respectively in 2015, 2020, and 2030. Conclusions As the first multisectoral collaboration on child injuries in Ethiopia, this study identified gaps in understanding of the burden of child injuries in Ethiopia. In consultation with Ethiopian government and other stakeholders, we propose starting an injury surveillance system at health clinics and hospitals and building an intervention package based on existing

The History of Injury Control and the Epidemiology of Child and Adolescent Injuries.

ERIC Educational Resources Information Center

Grossman, David C.

2000-01-01

Presents a historical overview of injury control and prevention in the United States and offers a summary of current knowledge about the importance of different causes of childhood injury, looking at risk and protective factors that have a bearing on preventive efforts. Injury remains the most important cause of death and disability for children…

Extending systematic reviews to include evidence on implementation: methodological work on a review of community-based initiatives to prevent injuries.

PubMed

Roen, Katrina; Arai, Lisa; Roberts, Helen; Popay, Jennie

2006-08-01

Unintentional injury is a leading cause of mortality and disability among young and old. While evidence about the effectiveness of interventions in reducing injuries is accumulating, reviews of this evidence frequently fail to include details of implementation processes. Our research, of which the work reported here formed a part, had two main objectives: (1) to identify evidence about the implementation of interventions aimed at reducing unintentional injuries amongst children and young people; and (2) to explore methods for systematically reviewing evidence on implementation. Existing systematic reviews of the effectiveness of interventions aiming to reduce unintentional injuries in children and young people formed the starting point for the work reported here. In summary, many of the published papers we identified contained little information on implementation processes and, even when these were discussed, the extent to which authors' claims were based on research evidence was unclear. On the basis of the studies we reviewed implementation data were insufficiently strong to provide a sound evidence base for practitioners and policymakers. Notwithstanding this, we identified valuable data about the context in which such initiatives are implemented and the type of factors that might impinge on implementation. This work has implications in three areas: (1) researchers with an interest in evidence-based public health could be encouraged to consider implementation issues in the design of intervention studies; (2) funding bodies could be encouraged to prioritise intervention studies using mixed methods that will enable researchers to consider effectiveness and implementation; (3) journal editors could work towards increasing the quality of reporting on implementation issues through the development of guidelines.

Injury patterns among various age and gender groups of trauma patients in southern Iran

PubMed Central

Bolandparvaz, Shahram; Yadollahi, Mahnaz; Abbasi, Hamid Reza; Anvar, Mehrdad

2017-01-01

Abstract Administrative data from trauma referral centers are useful sources while studying epidemiologic aspects of injuries. We aimed to provide a hospital-based view of injuries in Shiraz considering victims’ age and gender, using administrative data from trauma research center. A cross-sectional registry-based study of adult trauma patients (age ≥15 years) sustaining injury through traffic accidents, violence, and unintentional incidents was conducted. Information was retrieved from 3 hospital administrative databases. Data on demographics, injury mechanisms, injured body regions, and injury descriptions; outcomes of hospitalization; and development of nosocomial infections were recorded. Injury Severity Score (ISS) was calculated by crosswalking from ICD-10 (International Classification of Diseases) injury diagnosis codes to AIS-98 (Abbreviated Injury Scale) severity codes. Patients were compared based on age groups and gender differences. A total of 47,295 trauma patients with a median age of 30 (interquartile range: 24–44 years) were studied, of whom 73.1% were male and the remaining 26.9% were female (M/F = 2.7:1.0). The most common injury mechanisms in the male group were car and motorcycle accidents whereas females were mostly victims of falls and pedestrian accidents (P < .01). As age increased, a shift from transportation-related to unintentionally caused injuries occurred. Overall, young men had their most severe injuries on head, whereas elderly women suffered more severe extremity injuries. Injury severity was similar between men and women; however, elderly had a significantly higher ISS. Although incidence of nosocomial infections was independent of victims’ age and gender, elderly men had a significantly higher mortality rate. Based on administrative data from our trauma center, male gender and age >65 years are associated with increased risk of injury incidence, prolonged hospitalizations, and in-hospital death following trauma

Lawn mower-related injuries to children.

PubMed

Bull, M J; Agran, P; Gardner, H G; Laraque, D; Pollack, S H; Smith, G A; Spivak, H R; Tenebein, M; Brenner, R A; Bryn, S; Neverman, C; Schieber, R A; Stanwick, R; Tinsworth, D; Garcia, V; Tanz, R; Katcher, M L; Newland, H

2001-06-01

Lawn mower-related injuries to children are relatively common and can result in severe injury or death. Many amputations during childhood are caused by power mowers. Pediatricians have an important role as advocates and educators to promote the prevention of these injuries.

Disentangling Environmental and Anthropogenic Impacts on the Distribution of Unintentionally Introduced Invasive Alien Insects in Mainland China

PubMed Central

Zhao, Cai-Yun; Xu, Jing; Liu, Xiao-Yan

2017-01-01

Abstract Globalization increases the opportunities for unintentionally introduced invasive alien species, especially for insects, and most of these species could damage ecosystems and cause economic loss in China. In this study, we analyzed drivers of the distribution of unintentionally introduced invasive alien insects. Based on the number of unintentionally introduced invasive alien insects and their presence/absence records in each province in mainland China, regression trees were built to elucidate the roles of environmental and anthropogenic factors on the number distribution and similarity of species composition of these insects. Classification and regression trees indicated climatic suitability (the mean temperature in January) and human economic activity (sum of total freight) are primary drivers for the number distribution pattern of unintentionally introduced invasive alien insects at provincial scale, while only environmental factors (the mean January temperature, the annual precipitation and the areas of provinces) significantly affect the similarity of them based on the multivariate regression trees. PMID:28973576

Interventions to reduce accidents in childhood: a systematic review.

PubMed

Barcelos, Raquel S; Del-Ponte, Bianca; Santos, Iná S

2017-12-30

To review the literature on interventions planned to prevent the incidence of injuries in childhood. The PubMed, Web of Science, and Bireme databases were searched by two independent reviewers, employing the single terms accidents, accident, injuries, injury, clinical trial, intervention, educational intervention, and multiple interventions, and their combinations, present in the article title or abstract, with no limits except period of publication (2006-2016) and studies in human subjects. Initially, 11,097 titles were located. Fifteen articles were selected for the review. Eleven were randomized trials (four carried out at the children's households, five in pediatric healthcare services, and two at schools), and four were non-randomized trials carried out at the children's households. Four of the randomized trials were analyzed by intention-to-treat and a protective effect of the intervention was observed: decrease in the number of risk factors, decrease in the number of medical consultations due to injuries, decrease in the prevalence of risk behaviors, and increase of the parents' knowledge regarding injury prevention in childhood. Traumatic injuries in childhood are amenable to primary prevention through strategies that consider the child's age and level of development, as well as structural aspects of the environment. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Injury patterns among various age and gender groups of trauma patients in southern Iran: A cross-sectional study.

PubMed

Bolandparvaz, Shahram; Yadollahi, Mahnaz; Abbasi, Hamid Reza; Anvar, Mehrdad

2017-10-01

Administrative data from trauma referral centers are useful sources while studying epidemiologic aspects of injuries. We aimed to provide a hospital-based view of injuries in Shiraz considering victims' age and gender, using administrative data from trauma research center.A cross-sectional registry-based study of adult trauma patients (age ≥15 years) sustaining injury through traffic accidents, violence, and unintentional incidents was conducted. Information was retrieved from 3 hospital administrative databases. Data on demographics, injury mechanisms, injured body regions, and injury descriptions; outcomes of hospitalization; and development of nosocomial infections were recorded. Injury Severity Score (ISS) was calculated by crosswalking from ICD-10 (International Classification of Diseases) injury diagnosis codes to AIS-98 (Abbreviated Injury Scale) severity codes. Patients were compared based on age groups and gender differences.A total of 47,295 trauma patients with a median age of 30 (interquartile range: 24-44 years) were studied, of whom 73.1% were male and the remaining 26.9% were female (M/F = 2.7:1.0). The most common injury mechanisms in the male group were car and motorcycle accidents whereas females were mostly victims of falls and pedestrian accidents (P < .01). As age increased, a shift from transportation-related to unintentionally caused injuries occurred. Overall, young men had their most severe injuries on head, whereas elderly women suffered more severe extremity injuries. Injury severity was similar between men and women; however, elderly had a significantly higher ISS. Although incidence of nosocomial infections was independent of victims' age and gender, elderly men had a significantly higher mortality rate.Based on administrative data from our trauma center, male gender and age >65 years are associated with increased risk of injury incidence, prolonged hospitalizations, and in-hospital death following trauma. Development of a

The family environment predicts long-term academic achievement and classroom behavior following traumatic brain injury in early childhood.

PubMed

Durber, Chelsea M; Yeates, Keith Owen; Taylor, H Gerry; Walz, Nicolay Chertkoff; Stancin, Terry; Wade, Shari L

2017-07-01

This study examined how the family environment predicts long-term academic and behavioral functioning in school following traumatic brain injury (TBI) in early childhood. Using a concurrent cohort, prospective design, 15 children with severe TBI, 39 with moderate TBI, and 70 with orthopedic injury (OI) who were injured when they were 3-7 years of age were compared on tests of academic achievement and parent and teacher ratings of school performance and behavior on average 6.83 years postinjury. Soon after injury and at the longer term follow-up, families completed measures of parental psychological distress, family functioning, and quality of the home environment. Hierarchical linear regression analyses examined group differences in academic outcomes and their associations with measures of the early and later family environment. The severe TBI group, but not the moderate TBI group, performed worse than did the OI group on all achievement tests, parent ratings of academic performance, and teacher ratings of internalizing problems. Higher quality early and late home environments predicted stronger academic skills and better classroom behavior for children with both TBI and OI. The early family environment more consistently predicted academic achievement, whereas the later family environment more consistently predicted classroom functioning. The quality of the home environment predicted academic outcomes more strongly than did parental psychological distress or family functioning. TBI in early childhood has long-term consequences for academic achievement and school performance and behavior. Higher quality early and later home environments predict better school outcomes for both children with TBI and children with OI. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Trends in fatal occupational injuries and industrial restructuring in North Carolina in the 1980s.

PubMed Central

Richardson, D; Loomis, D

1997-01-01

OBJECTIVES: This study examined the relationship between changes in employment in North Carolina in the 1980s and fatal occupational injury rates. METHODS: Unintentional fatal occupational injuries (n = 1989) in North Carolina between 1978 and 1991 were identified via the medical examiner's system. RESULTS: Overall fatal injury rates declined during the 1980s, but rates increased 9.6% per year among manufacturing industries that declined in employment size; rates fell among service sector and manufacturing industries that grew. CONCLUSIONS: Increasing occupational fatal injury rates accompanied the decline in workforce in North Carolina's traditional, labor-intensive manufacturing industries during the 1980s, while service sector and expanding manufacturing industries have experienced declining fatal injury rates. PMID:9224194

A Model Process for Setting Military Injury Prevention Priorities and Making Evidence-Based Recommendations for Interventions

DTIC Science & Technology

2005-08-01

physical training, and sports emerge as more important causes of injuries. Data such as these clearly indicate a need to shift the focus of military...5 Table 2. 25 Causes of Unintentional Injury Hospitalization* 1. Accidents with own instruments of war 14. Machinery/tools 2. Athletics/ sports ...Physical Training – 308 2. Privately Owned Motor Vehicles – 271 3. Athletics and Sports – 261 4. Excessive Heat – 255 5. Military Vehicles – 252

Missed Opportunities to Keep Children Safe? National Survey of Injury Prevention Activities of Children's Centres

ERIC Educational Resources Information Center

Watson, Michael Craig; Mulvaney, Caroline; Timblin, Clare; Stewart, Jane; Coupland, Carol A.; Deave, Toity; Hayes, Mike; Kendrick, Denise

2016-01-01

Objective: To ascertain the activities undertaken by children's centres to prevent unintentional injuries in the under-fives and, in particular, the prevention of falls, poisoning and scalds. Design: A questionnaire was posted to managers of 851 children's centres, using stratified cluster sampling. The questionnaire included questions on injury…

Running Injuries During Adolescence and Childhood.

PubMed

Krabak, Brian J; Snitily, Brian; Milani, Carlo J E

2016-02-01

The popularity of running among young athletes has significantly increased over the past few decades. As the number of children who participate in running increases, so do the potential number of injuries to this group. Proper care of these athletes includes a thorough understanding of the unique physiology of the skeletally immature athlete and common injuries in this age group. Treatment should focus on athlete education, modification of training schedule, and correction of biomechanical deficits contributing to injury. Early identification and correction of these factors will allow a safe return to running sports. Copyright © 2016 Elsevier Inc. All rights reserved.

Prevalence of driver physical factors leading to unintentional lane departure crashes.

PubMed

Cicchino, Jessica B; Zuby, David S

2017-07-04

Some lane-keeping assist systems in development and production provide autonomous braking and steering to correct unintentional lane drift but otherwise require drivers to fully control their vehicles. The goal of this study was to quantify the proportion of drivers involved in unintentional lane drift crashes who would be unable to regain control of their vehicles to inform the design of such systems. The NHTSA's National Motor Vehicle Crash Causation Survey collected in-depth, on-scene data for a nationally representative sample of 5,470 U.S. police-reported passenger vehicle crashes during 2005-2007 that occurred between 6 a.m. and midnight and for which emergency medical services were dispatched. The physical states of drivers involved in the 631 lane drift crashes in the sample, which represented 259,034 crashes nationally, were characterized. Thirty-four percent of drivers who crashed because they drifted from their lanes were sleeping or otherwise incapacitated. These drivers would be unlikely to regain full control of their vehicles if an active safety system prevented their initial drift. An additional 13% of these drivers had a nonincapacitating medical issue, blood alcohol concentration (BAC) ≥ 0.08%, or other physical factor that may not allow them to regain full vehicle control. When crashes involved serious or fatal injuries, 42% of drivers who drifted were sleeping or otherwise incapacitated, and an additional 14% were impacted by a nonincapacitating medical issue, BAC ≥ 0.08%, or other physical factor. Designers of active safety systems that provide autonomous lateral control should consider that a substantial proportion of drivers at risk of lane drift crashes are incapacitated. Systems that provide only transient corrective action may not ultimately prevent lane departure crashes for these drivers, and drivers who do avoid lane drift crashes because of these systems may be at high risk of other types of crashes when they attempt to regain

Prevalence of preventable household risk factors for childhood burn injury in semi-urban Ghana: A population-based survey.

PubMed

Gyedu, Adam; Stewart, Barclay; Mock, Charles; Otupiri, Easmon; Nakua, Emmanuel; Donkor, Peter; Ebel, Beth E

2016-05-01

Childhood burns are a leading cause of injury in low- and middle-income countries; most of which are preventable. We aimed to describe the prevalence of household risk factors for childhood burn injury (CBI) in semi-urban Ghana to inform prevention strategies for this growing population. We conducted a population-based survey of 200 households in a semi-urban community in Ghana. Households were randomly selected from a list of 6520 households with children aged <18 years. Caregivers were interviewed about CBI within the past 6 months and potentially modifiable household risk factors. Of 6520 households, 3856 used charcoal for cooking (59%) and 3267 cooked indoors (50%). In 4544 households (70%), the stove/cooking surface was within reach of children under-five (i.e., <1m). Higher household wealth quintiles (OR 0.95; 95%CI 0.61-1.49) and increasing age (OR 0.82; 95%CI 0.68-0.99) were associated with lower odds of CBI. Living in uncompleted accommodation (OR 11.29; 95%CI 1.48-86.18 vs rented room) and cooking outside the house (OR 1.13; 95%CI 0.60-2.14 vs cooking indoors) were also predictive of CBI. This study identified a high prevalence of CBI risk factors in semi-urban households that may benefit from targeted community-based prevention initiatives. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Influence of changing travel patterns on child death rates from injury: trend analysis.

PubMed Central

DiGuiseppi, C.; Roberts, I.; Li, L.

1997-01-01

OBJECTIVES: To examine trends in child mortality from unintentional injury between 1985 and 1992 and to find how changes in modes of travel contributed to these trends. DESIGN: Poisson regression modelling using data from death certificates, censuses, and national travel surveys. SETTING: England and Wales. SUBJECTS: Resident children aged 0-14. MAIN OUTCOME MEASURES: Deaths from unintentional injury and poisoning. RESULTS: Child deaths from injury declined by 34% (95% confidence interval 28% to 40%) per 100,000 population between 1985 and 1992. Substantial decreases in each of the leading causes of death from injury contributed to this overall decline. On average, children walked and cycled less distance and travelled substantially more miles by car in 1992 compared with 1985. Deaths from road traffic accidents declined for pedestrians by 24% per mile walked and for cyclists by 20% per mile cycled, substantially less than the declines per 100,000 population of 37% and 38% respectively. In contrast, deaths of occupants of motor vehicles declined by 42% per mile travelled by car compared with a 21% decline per 100,000 population. CONCLUSIONS: If trends in child mortality from injury continue the government's target to reduce the rate by 33% by the year 2005 will be achieved. A substantial proportion of the decline in pedestrian traffic and pedal cycling deaths, however, seems to have been achieved at the expense of children's walking and cycling activities. Changes in travel patterns may exact a considerable price in terms of future health problems. PMID:9116546

Benzodiazepines: a major component in unintentional prescription drug overdoses with opioid analgesics.

PubMed

Jann, Michael; Kennedy, William Klugh; Lopez, Gaylord

2014-02-01

The misuse and abuse of prescription medications in the United States continues to increase despite interventions by health care professionals, regulatory, and law enforcement agencies. Opioid analgesics are the leading class of prescription drugs that have caused unintentional overdose deaths. Benzodiazepines when taken alone are relatively safe agents in overdose. However, a 5-fold increase in deaths attributed to benzodiazepines occurred from 1999 to 2009. Emergency department visits related to opioid analgesics increased by 111% followed by benzodiazepines 89%. During 2003 to 2009, the 2 prescriptions drugs with the highest increase in death rates were oxycodone 264.6% and alprazolam 233.8%. Therefore, benzodiazepines have a significant impact on prescription drug unintentional overdoses second only to the opioid analgesics. The combination prescribing of benzodiazepines and opioid analgesics commonly takes place. The pharmacokinetic drug interactions between benzodiazepines and opioid analgesics are complex. The pharmacodynamic actions of these agents differ as their combined effects produce significant respiratory depression. Physician and pharmacy shopping by patients occurs, and prescription drug-monitoring programs can provide important information on benzodiazepine and opioid analgesic prescribing patterns and patient usage. Health care professionals need to inform patients and work closely with regulatory agencies and legislatures to stem the increasing fatalities from prescription drug unintentional overdoses.

Active electrode monitoring. How to prevent unintentional thermal injury associated with monopolar electrosurgery at laparoscopy.

PubMed

Vancaillie, T G

1998-08-01

In recent years, the use of minimally invasive surgery (MIS) has expanded to a wide variety of surgical specialties. The increased popularity of the procedure, however, has been accompanied by its share of complications, including trocar lacerations and inadvertent thermal injuries to nontargeted tissues during monopolar electrosurgery. A survey on electrosurgical thermal injuries and three case studies are presented. The new technology of active electrode monitoring (AEM) is described. AEM eliminates stray currents generated by insulation failure and capacitive coupling. To reduce the incidence of injury by monopolar electrosurgery at laparoscopy, there is a need for advanced technology, such as AEM. In addition, laparoscopic surgeons should be encouraged to study the basic concepts of the biophysics of electrosurgery.

Disentangling Environmental and Anthropogenic Impacts on the Distribution of Unintentionally Introduced Invasive Alien Insects in Mainland China.

PubMed

Zhao, Cai-Yun; Li, Jun-Sheng; Xu, Jing; Liu, Xiao-Yan

2017-05-01

Globalization increases the opportunities for unintentionally introduced invasive alien species, especially for insects, and most of these species could damage ecosystems and cause economic loss in China. In this study, we analyzed drivers of the distribution of unintentionally introduced invasive alien insects. Based on the number of unintentionally introduced invasive alien insects and their presence/absence records in each province in mainland China, regression trees were built to elucidate the roles of environmental and anthropogenic factors on the number distribution and similarity of species composition of these insects. Classification and regression trees indicated climatic suitability (the mean temperature in January) and human economic activity (sum of total freight) are primary drivers for the number distribution pattern of unintentionally introduced invasive alien insects at provincial scale, while only environmental factors (the mean January temperature, the annual precipitation and the areas of provinces) significantly affect the similarity of them based on the multivariate regression trees. © The Authors 2017. Published by Oxford University Press on behalf of Entomological Society of America.

Effects of Visual and Verbal Interaction on Unintentional Interpersonal Coordination

ERIC Educational Resources Information Center

Richardson, Michael J.; Marsh, Kerry L.; Schmidt, R. C.

2005-01-01

Previous research has demonstrated that people's movements can become unintentionally coordinated during interpersonal interaction. The current study sought to uncover the degree to which visual and verbal (conversation) interaction constrains and organizes the rhythmic limb movements of coactors. Two experiments were conducted in which pairs of…

Maternal kisses are not effective in alleviating minor childhood injuries (boo-boos): a randomized, controlled and blinded study.

PubMed

2015-12-01

The practice of maternal kissing of minor injuries of childhood (boo-boos), though widely endorsed and practised, has never been demonstrated to be of benefit to children. To determine the efficacy, if any, of maternal kissing of boo-boos in toddlers. Randomized, controlled and double-blinded study of children with experimentally induced minor injuries. Control arms included both no intervention group and 'sham' (non-maternal) kissing. Children were blinded to the identity of the kisser in both the maternal and sham control groups. Outpatient research clinics in Ottawa, Canada. 943 maternal-toddler pairs recruited from the community. Toddler Discomfort Index (TDI) pre-injury, 1 and 5 minutes post-injury. One-minute and 5-minute TDI scores did not differ significantly between the maternal and sham kiss groups. Both of these groups had significantly higher TDI scores at 5 minutes compared to the no intervention group. Maternal kissing of boo-boos confers no benefit on children with minor traumatic injuries compared to both no intervention and sham kissing. In fact, children in the maternal kissing group were significantly more distressed at 5 minutes than were children in the no intervention group. The practice of maternal kissing of boo-boos is not supported by the evidence and we recommend a moratorium on the practice. © 2015 John Wiley & Sons, Ltd.

Epidemiology of Fall Injury in Rural Bangladesh

PubMed Central

Wadhwaniya, Shirin; Alonge, Olakunle; Ul Baset, Md. Kamran; Chowdhury, Salim; Bhuiyan, Al-Amin; Hyder, Adnan A.

2017-01-01

Globally, falls are the second leading cause of unintentional injury deaths, with 80% occurring in low-and middle-income countries. The overall objective of this study is to describe the burden and risk factors of falls in rural Bangladesh. In 2013, a large household survey covering a population of 1,169,593 was conducted in seven rural sub-districts of Bangladesh to assess the burden of all injuries, including falls. The recall periods for non-fatal and fatal injuries were six and 12 months, respectively. Descriptive, bivariate and multiple logistic regression analyses were conducted. The rates of non-fatal and fatal falls were 36.3 per 1000 and 5 per 100,000 population, respectively. The rates of both fatal and non-fatal falls were highest among the elderly. The risk of non-fatal falls was higher at extremes of age. Lower limb and waist injuries were frequent following a fall. Head injuries were frequent among infants (35%), while lower limb and waist injuries were frequent among the elderly (>65 years old). Injuries to all body parts (except the waist) were most frequent among men. More than half of all non-fatal falls occurred in a home environment. The injury patterns and risk factors of non-fatal falls differ by sociodemographic factors. PMID:28796160

Epidemiology of Fall Injury in Rural Bangladesh.

PubMed

Wadhwaniya, Shirin; Alonge, Olakunle; Ul Baset, Md Kamran; Chowdhury, Salim; Bhuiyan, Al-Amin; Hyder, Adnan A

2017-08-10

Globally, falls are the second leading cause of unintentional injury deaths, with 80% occurring in low-and middle-income countries. The overall objective of this study is to describe the burden and risk factors of falls in rural Bangladesh. In 2013, a large household survey covering a population of 1,169,593 was conducted in seven rural sub-districts of Bangladesh to assess the burden of all injuries, including falls. The recall periods for non-fatal and fatal injuries were six and 12 months, respectively. Descriptive, bivariate and multiple logistic regression analyses were conducted. The rates of non-fatal and fatal falls were 36.3 per 1000 and 5 per 100,000 population, respectively. The rates of both fatal and non-fatal falls were highest among the elderly. The risk of non-fatal falls was higher at extremes of age. Lower limb and waist injuries were frequent following a fall. Head injuries were frequent among infants (35%), while lower limb and waist injuries were frequent among the elderly (>65 years old). Injuries to all body parts (except the waist) were most frequent among men. More than half of all non-fatal falls occurred in a home environment. The injury patterns and risk factors of non-fatal falls differ by sociodemographic factors.

Prevalence and outcome of injury in patients visiting the emergency Department of Yirgalem General Hospital, Southern Ethiopia.

PubMed

Negussie, Abel; Getie, Andarge; Manaye, Elias; Tekle, Tamrat

2018-05-22

Traumatic injuries continue to be an important cause of morbidity and mortality in the developing world. Despite the high burden of injury in Ethiopia, the occurrence and health impact have not received due attention. The aim of the study was to assess the prevalence and outcome of injury among patients visiting the Emergency Department (ED) of Yirgalem General Hospital, southern Ethiopia. A facility-based prospective cross sectional study was conducted from March, 27 - April, 30/2017. The final calculated sample size was 353 and all eligible trauma patients who visited the ED of Yirgalem General Hospital during the study period were included in the study. Data was collected using a checklist which was adapted from the WHO injury surveillance guideline. The data were entered and analyzed using SPSS version 19. A total of 346 patients, who visited the ED during the study period, participated in the study and of them, 171 (49.4%) were injury cases. Unintentional injuries accounted 123 (71.9%) of the total injuries and the age group ≤24 years (48.2%) was the most commonly affected age group. More than half (51.4%) of unintentional injury cases were due to Road Traffic Injuries (RTIs) and 48 (28%) of the cases were attributed to interpersonal violence (assault). The majority of patients, 97 (56.7%), had a minor or superficial injury (like bruises and minor cuts), 44 (25.7%) had a moderate injury and 16 (9.3%) had severe type of injury requiring intensive medical/surgical management; and RTIs accounted for 11 (68%) of all severe injuries. The prevalence of injury was considerably high in Yirgalem General Hospital. Road Traffic Injuries (RTIs) accounted for the majority of severe injury cases; therefore, appropriate prevention strategies should be strengthened and implemented against RTIs. We also suggest that children and young adults should be educated in schools and work environments to prevent injuries/accidents.

Influence of Dopamine-Related Genes on Neurobehavioral Recovery after Traumatic Brain Injury during Early Childhood.

PubMed

Treble-Barna, Amery; Wade, Shari L; Martin, Lisa J; Pilipenko, Valentina; Yeates, Keith Owen; Taylor, H Gerry; Kurowski, Brad G

2017-06-01

The present study examined the association of dopamine-related genes with short- and long-term neurobehavioral recovery, as well as neurobehavioral recovery trajectories over time, in children who had sustained early childhood traumatic brain injuries (TBI) relative to children who had sustained orthopedic injuries (OI). Participants were recruited from a prospective, longitudinal study evaluating outcomes of children who sustained a TBI (n = 68) or OI (n = 72) between the ages of 3 and 7 years. Parents completed ratings of child executive function and behavior at the immediate post-acute period (0-3 months after injury); 6, 12, and 18 months after injury; and an average of 3.5 and 7 years after injury. Thirty-two single nucleotide polymorphisms (SNPs) in dopamine-related genes (dopamine receptor D2 [DRD2], solute carrier family 6 member 3 [SLC6A3], solute carrier family 18 member A2 [SLC18A2], catechol-o-methyltransferase [COMT], and ankyrin repeat and kinase domain containing 1 [ANKK1]) were examined in association with short- and long-term executive function and behavioral adjustment, as well as their trajectories over time. After controlling for premorbid child functioning, genetic variation within the SLC6A3 (rs464049 and rs460000) gene was differentially associated with neurobehavioral recovery trajectories over time following TBI relative to OI, with rs464049 surviving multiple testing corrections. In addition, genetic variation within the ANKK1 (rs1800497 and rs2734849) and SLC6A3 (rs464049, rs460000, and rs1042098) genes was differentially associated with short- and long-term neurobehavioral recovery following TBI, with rs460000 and rs464049 surviving multiple testing corrections. The findings provide preliminary evidence that genetic variation in genes involved in DRD2 expression and density (ANKK1) and dopamine transport (SLC6A3) plays a role in neurobehavioral recovery following pediatric TBI.

Biosocial variables and auditory acuity as risk factors for non-fatal childhood injuries in Greece.

PubMed Central

Petridou, E.; Zervos, I.; Christopoulos, G.; Revinthi, K.; Papoutsakis, G.; Trichopoulos, D.

1995-01-01

OBJECTIVES: To examine whether biosocial variables and auditory acuity are risk factors for injuries among children. SETTING: Children with injuries who presented at the emergency clinics of one of the two university hospitals for children in Athens, Greece between December 1993 and April 1994. METHODS: 144 children aged 5-14 years, residents of Athens, were brought to the emergency clinics for a moderate to severe injury. For each of these children one hospital control, matched for age and sex, and one classmate control similarly matched were identified. A standard interview form was completed for all 432 children and acouometric and tympanometric examinations were performed in each of them. Analysis was done through conditional logistic regression. RESULTS: The likelihood of an accident was higher in children of younger fathers (odds ratio (OR) = 0.7, p = 0.04), children of mothers with non-professional jobs (OR = 1.9, p = 0.03) as well as in children of higher birth order (OR = 1.7, p = 0.01), in those with predominantly other than parental daily supervision (OR = 2.6, p = 0.001), and those with a history of previous accident (OR = 1.3, p = 0.002). Somatometric factors, school performance, use of corrective eyeglasses and subnormal auditory acuity were not found to be risk factors, but auditory imbalance and abnormal tympanograms were positively related to the risk of childhood injury (OR = 2.6, p = 0.02; and OR = 2.3, p = 0.08 respectively). CONCLUSIONS: the findings of this study underline the importance of attentive supervision and safety training of children living in modern cities; they also suggest that children with auditory imbalance and history of an accident are at higher injury risk and they should be targeted with specific intervention programs. PMID:9346003

Catechol-O-Methyltransferase Genotypes and Parenting Influence on Long-Term Executive Functioning After Moderate to Severe Early Childhood Traumatic Brain Injury: An Exploratory Study.

PubMed

Kurowski, Brad G; Treble-Barna, Amery; Zang, Huaiyu; Zhang, Nanhua; Martin, Lisa J; Yeates, Keith Owen; Taylor, H Gerry; Wade, Shari L

To examine catechol-O-methyltransferase (COMT) rs4680 genotypes as moderators of the effects of parenting style on postinjury changes in parent behavior ratings of executive dysfunction following moderate to severe early childhood traumatic brain injury. Research was conducted in an outpatient setting. Participants included children admitted to hospital with moderate to severe traumatic brain injury (n = 55) or orthopedic injuries (n = 70) between ages 3 and 7 years. Prospective cohort followed over 7 years postinjury. Parenting Practices Questionnaire and the Behavior Rating Inventory of Executive Functioning obtained at baseline, 6, 12, and 18 months, and 3.5 and 6.8 years postinjury. DNA was collected from saliva samples, purified using the Oragene (DNA Genotek, Ottawa, Ontario, Canada) OG-500 self-collection tubes, and analyzed using TaqMan (Applied Biosystems, Thermo Fisher Scientific, Waltham, Massachusetts) assay protocols to identify the COMT rs4680 polymorphism. Linear mixed models revealed a significant genotype × parenting style × time interaction (F = 5.72, P = .02), which suggested that the adverse effects of authoritarian parenting on postinjury development of executive functioning were buffered by the presence of the COMT AA genotype (lower enzyme activity, higher dopamine levels). There were no significant associations of executive functioning with the interaction between genotype and authoritative or permissive parenting ratings. The lower activity COMT rs4680 genotype may buffer the negative effect of authoritarian parenting on long-term executive functioning following injury in early childhood. The findings provide preliminary evidence for associations of parenting style with executive dysfunction in children and for a complex interplay of genetic and environmental factors as contributors to decreases in these problems after traumatic injuries in children. Further investigation is warranted to understand the interplay among genetic and

Understanding children's injury-risk behaviors: the independent contributions of cognitions and emotions.

PubMed

Morrongiello, Barbara A; Lasenby-Lessard, Jennifer; Matheis, Shawn

2007-09-01

Unintentional injuries are a leading threat to the health of elementary-school children, with many injuries happening when children are left to make their own decisions about risk taking during play. The present study sought to identify determinants of children's physical taking. An ecologically valid task that posed some threat of injury was used (i.e., highest height of a balance beam they would walk across). Ratings of cognitions (extent of danger, perceived vulnerability for personal injury, potential severity of injury) and emotional reactions (fear, excitement) were taken when on the beam, just before the children walked across. Regression analysis, controlling for age and sex, revealed that risk taking was predicted from ratings of danger, fear, and excitement. Both cognitive and emotional factors independently contribute to predict children's physical risk taking. Theoretical and practical implications of these findings are discussed.

Occupational ladder fall injuries - United States, 2011.

PubMed

Socias, Christina M; Chaumont Menéndez, Cammie K; Collins, James W; Simeonov, Peter

2014-04-25

Falls remain a leading cause of unintentional injury mortality nationwide [corrected].Among workers, approximately 20% of fall injuries involve ladders. Among construction workers, an estimated 81% of fall injuries treated in U.S. emergency departments (EDs) involve a ladder. To fully characterize fatal and nonfatal injuries associated with ladder falls among workers in the United States, CDC's National Institute for Occupational Safety and Health (NIOSH) analyzed data across multiple surveillance systems: 1) the Census of Fatal Occupational Injuries (CFOI), 2) the Survey of Occupational Injuries and Illnesses (SOII), and 3) the National Electronic Injury Surveillance System-occupational supplement (NEISS-Work). In 2011, work-related ladder fall injuries (LFIs) resulted in 113 fatalities (0.09 per 100,000 full-time equivalent [FTE] workers), an estimated 15,460 nonfatal injuries reported by employers that involved ≥1 days away from work (DAFW), and an estimated 34,000 nonfatal injuries treated in EDs. Rates for nonfatal, work-related, ED-treated LFIs were higher (2.6 per 10,000 FTE) than those for such injuries reported by employers (1.2 per 10,000 FTE). LFIs represent a substantial public health burden of preventable injuries for workers. Because falls are the leading cause of work-related injuries and deaths in construction, NIOSH, the Occupational Safety and Health Administration, and the Center for Construction Research and Training are promoting a national campaign to prevent workplace falls. NIOSH is also developing innovative technologies to complement safe ladder use.

What Can I Do to Help Prevent Traumatic Brain Injury?

MedlinePlus

... terrain vehicle; Playing a contact sport, such as football, ice hockey, or boxing; Using in-line skates ... Brain Injury Awareness Additional Pevention Resources Childhood Injuries Concussion in Children and Teens Injuries from Violence Injuries ...

Occupational Carbon Monoxide Fatalities in the US From Unintentional Non-Fire Related Exposures, 1992–2008

PubMed Central

Henn, Scott A.; Bell, Jennifer L.; Sussell, Aaron L.; Konda, Srinivas

2015-01-01

Objective To analyze characteristics of, and trends in, work-related carbon monoxide (CO) fatalities in the US. Methods Records of unintentional, non-fire related fatalities from CO exposure were extracted from the Bureau of Labor Statistics’ Census of Fatal Occupational Injuries and the Occupational Safety and Health Administration’s Integrated Management Information System for years 1992–2008 and analyzed separately. Results The average number of annual CO fatalities was 22 (standard deviation = 8). Fatality rates were highest among workers aged ≥65, males, Hispanics, winter months, the Midwest, and the Fishing, Hunting, and Trapping industry subsector. Self-employed workers accounted for 28% of all fatalities. Motor vehicles were the most frequent source of fatal CO exposure, followed by heating systems and generators. Conclusions CO has been the most frequent cause of occupational fatality due to acute inhalation, and has shown no significant decreasing trend since 1992. The high number of fatalities from motor vehicles warrants further investigation. PMID:23868822

Life-threatening methemoglobinemia after unintentional ingestion of antifreeze admixtures containing sodium nitrite in the construction sites.

PubMed

Sohn, C H; Seo, D W; Ryoo, S M; Lee, J H; Kim, W Y; Lim, K S; Oh, B J

2014-01-01

Construction workers are exposed to a wide variety of health hazards such as poisoning at the construction sites. Various forms of poisoning incidents in construction workers have been reported. However, studies on methemoglobinemia caused by unintentional ingestion of antifreeze admixtures containing sodium nitrite at the construction sites have not been reported yet. The aim of this study was to evaluate life-threatening methemoglobinemia after unintentional ingestion of antifreeze admixtures containing sodium nitrite at the construction sites and describe similar incidents involving ingestion of antifreeze admixtures in Korea. Retrospective observational case series study on patients with methemoglobinemia after unintentional ingestion of antifreeze admixtures containing sodium nitrite admitted to the emergency department (ED) from January 1, 2010 to December 31, 2012 and cases reported to the Korea Occupational Safety and Health Agency (KOSHA) was performed. Results. Six victims were admitted to our ED. They had methemoglobin levels ranging from 32.4% to 71.5% and all of them recovered after receiving one (2 mg/kg) or two doses infusion of methylene blue. From the data of the KOSHA, six incidents that caused 27 victims were identified. Of 27 victims, five were included in the ED cases. For all incidents, antifreeze admixtures were not contained in their original containers and all new containers did not have a new label. All workers mistook antifreeze admixtures for water. Among the 28 victims included in this study, four died. Unintentional ingestion of antifreeze admixtures containing sodium nitrite at the construction sites can cause life-threatening methemoglobinemia. There is a need to store and label potentially hazardous materials properly to avoid unintentional ingestion at the construction sites.

The Lidköping Accident Prevention Programme--a community approach to preventing childhood injuries in Sweden.

PubMed

Svanström, L; Ekman, R; Schelp, L; Lindström, A

1995-09-01

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

Root causes, clinical effects, and outcomes of unintentional exposures to buprenorphine by young children.

PubMed

Lavonas, Eric J; Banner, William; Bradt, Pamela; Bucher-Bartelson, Becki; Brown, Kimberly R; Rajan, Pradeep; Murrelle, Lenn; Dart, Richard C; Green, Jody L

2013-11-01

To characterize the rates, root causes, and clinical effects of unintentional exposures to buprenorphine sublingual formulations among young children and to determine whether exposure characteristics differ between formulations. Unintentional exposures to buprenorphine-containing products among children 28 days to less than 6 years old were collected from the Researched Abuse, Diversion, and Addiction-Related Surveillance System Poison Center Program and Reckitt Benckiser Pharmaceuticals' pharmacovigilance system from October 2009-March 2012. After adjustment for drug availability, negative binomial regression was used to estimate average exposure rates. Root cause assessment was conducted, and an expert clinician panel adjudicated causality and severity of moderate to severe adverse events (AEs). A total of 2380 cases were reviewed, including 4 deaths. Exposures to buprenorphine-naloxone combination film were significantly less frequent than exposures to buprenorphine tablets (rate ratio 3.5 [95% CI, 2.7-4.5]) and buprenorphine-naloxone combination tablets (rate ratio 8.8 [7.2-10.6]). The most commonly identified root causes were medication stored in sight, accessed from a bag or purse, and not stored in the original packaging. Among 536 panel review cases, the most common AEs reported for all formulations were lethargy, respiratory depression, miosis, and vomiting. The highest level AE severity did not differ significantly by formulation. Unintentional exposure to buprenorphine can cause central nervous system depression, respiratory depression, and death in young children. Exposure rates to film formulations are significantly less than to tablet formulations. Package and storage deficiencies contribute to unintentional exposures in young children. Copyright © 2013 Mosby, Inc. All rights reserved.

Prevalence of injuries among high school students in Eastern and Western parts of Cairo, Egypt.

PubMed

Wahdan, Maha M; Sayed, Amany M; Abd Elaziz, Khaled M; El-Hoseiny, Mostafa M; Al-Gwaily, Mohamed M

2016-12-01

Injury is the leading cause of death and long term disability and a significant contributor to healthcare costs among children worldwide especially those aged 15-19 years. To determine the prevalence of injuries among secondary school students in Cairo, Egypt and to explore the associated risk factors for sustaining injury. A Cross-sectional study was conducted on secondary school students in eastern and western part of Cairo; self-administered questionnaire was used for assessing injuries sustained in previous 12 months and the associated risk factors for injury. The overall prevalence of injuries was 68.5%. Unintentional injuries were the most common injuries falls (50%) and burns (38.6%). Significant factors associated with sustaining injury were truancy, smoking, alcohol use, quarreling behavior, carrying weapon, threatened by weapon and verbal bullying. This study showed a high prevalence of injuries among high school students in Egypt which necessitates raising public awareness about the magnitude and burden of injuries among adolescents. Copyright © 2016 Elsevier Ltd. All rights reserved.

A profile of Injury in Fiji: findings from a population-based injury surveillance system (TRIP-10)

PubMed Central

2012-01-01

Background Over 90% of injury deaths occur in low-and middle-income countries. However, the epidemiological profile of injuries in Pacific Islands has received little attention. We used a population-based-trauma registry to investigate the characteristics of all injuries in Viti Levu, Fiji. Method The Fiji Injury Surveillance in Hospitals (FISH) database prospectively collected data on all injury-related deaths and primary admissions to hospital (≥12 hours stay) in Viti Levu during 12 months commencing October 2005. Results The 2167 injury-related deaths and hospitalisations corresponded to an annual incidence rate of 333 per 100,000, with males accounting for twice as many cases as females. Almost 80% of injuries involved people aged less than 45 years, and 74% were deemed unintentional. There were 244 fatalities (71% died before admission) and 1994 hospitalisations corresponding to crude annual rates of 37.5 per 100,000 and 306 per 100,000 respectively. The leading cause of fatal injury was road traffic injury (29%) and the equivalent for injury admissions was falls (30%). The commonest type of injury resulting in death and admission to hospital was asphyxia and fractures respectively. Alcohol use was documented as a contributing factor in 13% of deaths and 12% of admissions. In general, indigenous Fijians had higher rates of injury admission, especially for interpersonal violence, while those of Indian ethnicity had higher rates of fatality, especially from suicide. Conclusions Injury is an important public health problem that disproportionately affects young males in Fiji, with a high proportion of deaths prior to hospital presentation. This study highlights key areas requiring priority attention to reduce the burden of potentially life-threatening injuries in Fiji. PMID:23234597

A profile of injury in Fiji: findings from a population-based injury surveillance system (TRIP-10).

PubMed

Wainiqolo, Iris; Kafoa, Berlin; Kool, Bridget; Herman, Josephine; McCaig, Eddie; Ameratunga, Shanthi

2012-12-12

Over 90% of injury deaths occur in low-and middle-income countries. However, the epidemiological profile of injuries in Pacific Islands has received little attention. We used a population-based-trauma registry to investigate the characteristics of all injuries in Viti Levu, Fiji. The Fiji Injury Surveillance in Hospitals (FISH) database prospectively collected data on all injury-related deaths and primary admissions to hospital (≥ 12 hours stay) in Viti Levu during 12 months commencing October 2005. The 2167 injury-related deaths and hospitalisations corresponded to an annual incidence rate of 333 per 100,000, with males accounting for twice as many cases as females. Almost 80% of injuries involved people aged less than 45 years, and 74% were deemed unintentional. There were 244 fatalities (71% died before admission) and 1994 hospitalisations corresponding to crude annual rates of 37.5 per 100,000 and 306 per 100,000 respectively. The leading cause of fatal injury was road traffic injury (29%) and the equivalent for injury admissions was falls (30%). The commonest type of injury resulting in death and admission to hospital was asphyxia and fractures respectively. Alcohol use was documented as a contributing factor in 13% of deaths and 12% of admissions. In general, indigenous Fijians had higher rates of injury admission, especially for interpersonal violence, while those of Indian ethnicity had higher rates of fatality, especially from suicide. Injury is an important public health problem that disproportionately affects young males in Fiji, with a high proportion of deaths prior to hospital presentation. This study highlights key areas requiring priority attention to reduce the burden of potentially life-threatening injuries in Fiji.

Fall injuries in Baghdad from 2003 to 2014: Results of a randomised household cluster survey.

PubMed

Stewart, Barclay T; Lafta, Riyadh; Esa Al Shatari, Sahar A; Cherewick, Megan; Flaxman, Abraham; Hagopian, Amy; Burnham, Gilbert; Kushner, Adam L

2016-01-01

Falls incur nearly 35 million disability-adjusted life-years annually; 75% of which occur in low- and middle-income countries. The epidemiology of civilian injuries during conflict is relatively unknown, yet important for planning prevention initiatives, health policy and humanitarian assistance. This study aimed to determine the death and disability and household consequences of fall injuries in post-invasion Baghdad. A two-stage, cluster randomised, community-based household survey was performed in May of 2014 to determine the civilian burden of injury from 2003 to 2014 in Baghdad. In addition to questions about household member death, households were interviewed regarding injury specifics, healthcare required, disability, relatedness to conflict and resultant financial hardship. Nine hundred households totaling 5148 individuals were interviewed. There were 138 fall injuries (25% of all injuries reported); fall was the most common mechanism of civilian injury in Baghdad. The rate of serious fall injuries increased from 78 to 466 per 100,000 persons in 2003 and 2013, respectively. Fall was the most common mechanism among the injured elderly (i.e. ≥65 years; 15/24 elderly unintentional injuries; 63%). However, 46 fall injuries were children aged <15 years (49% of unintentional injuries) and 77 were respondents aged 15-64 years (36%). Respondents who spent significant time within the home (i.e. unemployed, retired, homemaker) had three times greater odds of having suffered a fall injury than student referents (aOR 3.34; 95%CI 1.30-8.60). Almost 80% of fall injured were left with life-limiting disability. Affected households often borrowed substantial sums of money (34 households; 30% of affected households) and/or suffered food insecurity after a family member's fall (52; 46%). Falls were the most common cause of civilian injury in Baghdad. In part due to the effect of prolonged insecurity on a fragile health system, many injuries resulted in life

Fall injuries in Baghdad from 2003 to 2014: results of a randomized household cluster survey

PubMed Central

Stewart, Barclay T; Lafta, Riyadh; Shatari, Sahar A Esa Al; Cherewick, Megan; Flaxman, Abraham; Hagopian, Amy; Burnham, Gilbert; Kushner, Adam L

2015-01-01

Introduction Falls incur nearly 35 million disability-adjusted life-years annually; 75% of which occur in low- and middle-income countries. The epidemiology of civilian injuries during conflict is relatively unknown, yet important for planning prevention initiatives, health policy and humanitarian assistance. This study aimed to determine the death and disability and household consequences of fall injuries in post-invasion Baghdad. Methods A two-stage, cluster randomized, community-based household survey was performed in May of 2014 to determine the civilian burden of injury from 2003 to 2014 in Baghdad. In addition to questions about household member death, households were interviewed regarding injury specifics, healthcare required, disability, relatedness to conflict and resultant financial hardship. Results Nine hundred households totaling 5,148 individuals were interviewed. There were 138 fall injuries (25% of all injuries reported); fall was the most common mechanism of civilian injury in Baghdad. The rate of serious fall injuries increased from 78 to 466 per 100,000 persons in 2003 and 2013, respectively. Fall was the most common mechanism among the injured elderly (i.e. ≥65 years; 15/24 elderly unintentional injuries; 63%). However, 46 fall injuries were children aged <15 years (49% of unintentional injuries) and 77 were respondents aged 15 - 64 years (36%). Respondents who spent significant time within the home (i.e. unemployed, retired, homemaker) had three times greater odds of having suffered a fall injury than student referents (aOR 3.34; 95%CI 1.30 – 8.60). Almost 80% of fall injured were left with life-limiting disability. Affected households often borrowed substantial sums of money (34 households; 30% of affected households) and/or suffered food insecurity after a family member's fall (52; 46%). Conclusion Falls were the most common cause of civilian injury in Baghdad. In part due to the effect of prolonged insecurity on a fragile health system

Epidemiology and intermediate-term outcomes of open- and closed-globe injuries in traumatic childhood cataract.

PubMed

Khokhar, Sudarshan; Gupta, Shikha; Yogi, Rohit; Gogia, Varun; Agarwal, Tushar

2014-01-01

To study epidemiology and intermediate-term outcomes of open- and closed-globe injuries (CGI) in traumatic childhood cataract. In this retrospective interventional case series, demographic parameters and history including type of injury of 57 children younger than 16 years with traumatic cataract were recorded; ocular examination included best-corrected visual acuity (BCVA), slit-lamp biomicroscopy, and posterior segment evaluation. Patients underwent cataract surgery with or without intraocular lens (IOL) implantation. Main surgical outcomes at 6 months comprised BCVA, residual refractive spherical error (SE), and postoperative complications, namely visual axis opacification (VAO) and amblyopia. Bow and arrow was the most common causal agent. Open-globe injury (OGI) was 3 times more frequent than CGI. There was a significant visual gain from baseline in both groups after cataract surgery (p<0.001); residual SE was greater in OGI (1.6 ± 0.95 SD) compared to blunt trauma (0.8 ± 0.55 SD; p = 0.001). Incidence of corneal scarring, iris distortion, posterior synechiae, and intraoperative posterior capsular tear was greater with OGI (p<0.05). A total of 86% of patients were rehabilitated with a primary/secondary IOL. Single-piece IOL implantation rate (p = 0.004) was significantly greater in CGI, with no statistical difference for in-the-bag IOL (p = 0.053) and IOL implantation rate (p = 0.16). Final BCVA was significantly better for in-the-bag IOL implantation compared to sulcus fixation. Postoperative complications included amblyopia (51%) and VAO (12%). Bow and arrow injury caused the maximum cases of traumatic cataract; cataract extraction resulted in significant visual improvement; and CGI tended to have better prognosis in pediatric traumatic cataracts.

[Analysis of road traffic injuries in Mexican cyclists].

PubMed

Muro-Báez, Victoria Alejandra; Mendoza-García, M Eulalia; Vera-López, Juan Daniel; Pérez-Núñez, Ricardo

2017-01-01

With the objective of analyzing fatal and non-fatal road traffic injuries in cyclists and to document helmet use in this road user to inform sustainable mobility policies, a descriptive analysis of four secondary official information sources was conducted at the national level: mortality, Ministry of Health's hospital discharges, Unintentional and Violence Registry System (SIS-SS-17-P) and the 2012 National Health and Nutrition Survey (ENSANUT). Only SIS-SS-17-P and ENSANUT document helmet use. Except for ENSANUT information analyzed is of 2014.A total of 190 cyclists died in Mexico during 2014 and 392 were hospitalized; head was the anatomical region most frequently affected (63% and 32%, respectively). Only 0.75% of the 667 cases registered in SIS-17 reported helmet use and 24% suffered head injuries. Of the 165,348 non-fatally injured cyclists from ENSANUT <10% used helmet, 24% had head injuries and more than 16,000 suffered permanent injuries. Whereas cyclist-friendly infrastructure is an effective intervention to prevent injuries in the long term, helmet use could potentially reduce the frequency and severity of head injuries in the short run while bicycle use widespread as a means of transportation providing "safety in numbers".

Unintentional non-traffic injury and fatal events: Threats to children in and around vehicles.

PubMed

Zonfrillo, Mark R; Ramsay, Mackenzie L; Fennell, Janette E; Andreasen, Amber

2018-02-17

There have been substantial reductions in motor vehicle crash-related child fatalities due to advances in legislation, public safety campaigns, and engineering. Less is known about non-traffic injuries and fatalities to children in and around motor vehicles. The objective of this study was to describe the frequency of various non-traffic incidents, injuries, and fatalities to children using a unique surveillance system and database. Instances of non-traffic injuries and fatalities in the United States to children 0-14 years were tracked from January 1990 to December 2014 using a compilation of sources including media reports, individual accounts from families of affected children, medical examiner reports, police reports, child death review teams, coroner reports, medical professionals, legal professionals, and other various modes of publication. Over the 25-year period, there were at least 11,759 events resulting in 3,396 deaths. The median age of the affected child was 3.7 years. The incident types included 3,115 children unattended in hot vehicles resulting in 729 deaths, 2,251 backovers resulting in 1,232 deaths, 1,439 frontovers resulting in 692 deaths, 777 vehicles knocked into motion resulting in 227 deaths, 415 underage drivers resulting in 203 deaths, 172 power window incidents resulting in 61 deaths, 134 falls resulting in 54 deaths, 79 fires resulting in 41 deaths, and 3,377 other incidents resulting in 157 deaths. Non-traffic injuries and fatalities present an important threat to the safety and lives of very young children. Future efforts should consider complementary surveillance mechanisms to systematically and comprehensively capture all non-traffic incidents. Continued education, engineering modifications, advocacy, and legislation can help continue to prevent these incidents and must be incorporated in overall child vehicle safety initiatives.

Unintentional Power Plays: Interpersonal Contextual Impacts in Child-Centred Participatory Research

ERIC Educational Resources Information Center

Gillett-Swan, Jenna K.; Sargeant, Jonathon

2018-01-01

Background: Approaches to conducting research with children afford them varying degrees of participatory power. Despite children's varying roles within research, more needs to be understood about the influences of unintentional power plays and, in particular, interactions between participant and non-participants on children's participation in…

Community-based Injury Prevention Interventions.

ERIC Educational Resources Information Center

Klassen, Terry P.; MacKay, J. Morag; Moher, David; Walker, Annie; Jones, Alison L.

2000-01-01

Reviewed 32 studies that evaluated the impact of community-based injury prevention efforts on childhood injuries, safety behaviors, and adoption of safety devices. Interventions targeted schools, municipalities, and cities. This approach effectively increased some safety practices (e.g, bicycle helmet and car seat use) but not others. Common…

Eye injuries from laser exposure: a review.

PubMed

Hudson, S J

1998-05-01

Lasers pose a significant threat to vision in modern military operations. Anti-personnel lasers have been designed that can cause intentional blindness in large numbers of personnel. Although the use of blinding laser weapons during combat has been prohibited by international legislation, research and development of these weapons have not been prohibited, and significant controversy remains. Unintentional blinding can also result from other types of lasers used on the battlefield, such as range-finders and anti-material lasers. Lasers that are capable of producing blindness operate within specific wavelength parameters and include visible and near infrared lasers. Patients who suffer from laser eye injuries usually complain of flash blindness, followed by transient or permanent visual loss. Laser retinal damage should be suspected in any patient with visual complaints in an operational setting. The treatment for laser retinal injuries is extremely limited, and prevention is essential. Improved protective eyeware and other countermeasures to laser eye injury are necessary as long as the threat remains.

State Firearm Legislation and Nonfatal Firearm Injuries.

PubMed

Simonetti, Joseph A; Rowhani-Rahbar, Ali; Mills, Brianna; Young, Bessie; Rivara, Frederick P

2015-08-01

We investigated whether stricter state-level firearm legislation was associated with lower hospital discharge rates for nonfatal firearm injuries. We estimated discharge rates for hospitalized and emergency department-treated nonfatal firearm injuries in 18 states in 2010 and used negative binomial regression to determine whether strength of state firearm legislation was independently associated with total nonfatal firearm injury discharge rates. We identified 26 744 discharges for nonfatal firearm injuries. The overall age-adjusted discharge rate was 19.0 per 100 000 person-years (state range = 3.3-36.6), including 7.9 and 11.1 discharges per 100 000 for hospitalized and emergency department-treated injuries, respectively. In models adjusting for differences in state sociodemographic characteristics and economic conditions, states in the strictest tertile of legislative strength had lower discharge rates for total (incidence rate ratio [IRR] = 0.60; 95% confidence interval [CI] = 0.44, 0.82), assault-related (IRR = 0.58; 95% CI = 0.34, 0.99), self-inflicted (IRR = 0.18; 95% CI = 0.14, 0.24), and unintentional (IRR = 0.53; 95% CI = 0.34, 0.84) nonfatal firearm injuries. There is significant variation in state-level hospital discharge rates for nonfatal firearm injuries, and stricter state firearm legislation is associated with lower discharge rates for such injuries.

Individual and Neighborhood Characteristics of Children Seeking Emergency Department Care for Firearm Injuries Within the PECARN Network.

PubMed

Carter, Patrick M; Cook, Lawrence J; Macy, Michelle L; Zonfrillo, Mark R; Stanley, Rachel M; Chamberlain, James M; Fein, Joel A; Alpern, Elizabeth R; Cunningham, Rebecca M

2017-07-01

The objective was to describe the characteristics of children seeking emergency care for firearm injuries within the PECARN network and assess the influence of both individual and neighborhood factors on firearm-related injury risk. This was a retrospective, multicenter cross-sectional analysis of children (<19 years old) presenting to 16 pediatric EDs (2004-2008). ICD-9-CM E-codes were used to identify and categorize firearm injuries by mechanism/intent. Neighborhood variables were derived from home address data. Multivariable analysis examined the influence of individual and neighborhood factors on firearm-related injuries compared to nonfirearm ED visits. Injury recidivism was assessed. A total of 1,758 pediatric ED visits for firearm-related injuries were analyzed. Assault (51.4%, n = 904) and unintentional injury (33.2%, n = 584) were the most common injury mechanisms. Among children with firearm injuries, 68.3% were older adolescents (15-19 years old), 82.3% were male, 68.2% were African American, and 76.3% received public insurance/were uninsured. Extremity injuries were most common (75.9%), with 20% sustaining injuries to multiple body regions, 48.1% requiring admission and 1% ED mortality. Multivariable analysis identified firearm injury risk factors, including adolescent age (p < 0.001), male sex (p < 0.001), non-Caucasian race/ethnicity (p < 0.001), public payer/uninsured status (p < 0.001), and higher levels of neighborhood disadvantage (p < 0.001). Among children with firearm injuries, 12-month ED recidivism for any reason was 22.4%, with < 1% returning for another firearm injury. Among children receiving ED treatment within the PECARN network, there are distinct demographic and neighborhood factors associated with firearm injuries. Among younger children (<10 years old), unintentional injuries predominate, while assault-type injuries were most common among older adolescents. Overall, among this PECARN patient population, male adolescents living in

Characteristics of farm injuries in Greece.

PubMed

Alexe, D M; Petridou, E; Dessypris, N; Skenderis, N; Trichopoulos, D

2003-08-01

To assess the characteristics of occupational and leisure farm injuries in Greece. During a five-year period (1996-2000), 4,326 unintentional farm injuries have been recorded by the Emergency Department Injury Surveillance System in Greece. Data concerning demographic variables, accident conditions, and injury characteristics were collected by in person interviews. The data were analyzed by simple cross-tabulation and hierarchical cluster analysis. Injuries from falls on the same level are mainly lower-limb fractures and occur during the winter among older women. Falls from higher level concern migrant workers, who also tend to suffer severe multiple injuries, including concussions, particularly during autumn. Injuries resulting from cutting and piercing instruments, as well as from machinery, are generally open wounds in the upper-limbs, suffered by young migrant workers. Head injuries resulting from striking against an object are more generally spread across socio-demographic variables. Overexertion is the dominant mechanism for dislocations and sprains in the lower limbs. Snake and insect bites are common among younger migrant workers during summer, and they affect the upper limbs during manual work close to the ground. Non-traffic injuries from vehicles are frequently severe, involving head concussion of generally young individuals. In Greece, farm injuries are frequently serious and require hospitalization. These injuries show distinct patterns among older women (lower-limb fractures), young individuals (non-traffic vehicle-related injuries) and migrant workers (injuries from cutting and piercing instruments, falls from high level, and bites). Prevention strategies should give priority to these population groups. These prevention strategies should include guidance for poorly educated workers, including migrants, enforcement of safety regulations concerning farming machinery, and discouragement of risky farming activities among elderly individuals, particularly

Traditional Chinese Medicine and Herb-induced Liver Injury: Comparison with Drug-induced Liver Injury.

PubMed

Jing, Jing; Teschke, Rolf

2018-03-28

Cases of suspected herb-induced liver injury (HILI) caused by herbal Traditional Chinese Medicines (TCMs) and of drug-induced liver injury (DILI) are commonly published in the scientific literature worldwide. As opposed to the multiplicity of botanical chemicals in herbal TCM products, which are often mixtures of several herbs, conventional Western drugs contain only a single synthetic chemical. It is therefore of interest to study how HILI by TCM and DILI compare with each other, and to what extent results from each liver injury type can be transferred to the other. China is among the few countries with a large population using synthetic Western drugs as well as herbal TCM. Therefore, China is well suited to studies of liver injury comparing drugs with TCM herbs. Despite some concordance, recent analyses of liver injury cases with verified causality, using the Roussel Uclaf Causality Assessment Method, revealed major differences in HILI caused by TCMs as compared to DILI with respect to the following features: HILI cases are less frequently observed as compared to DILI, have a smaller proportion of females and less unintentional rechallenge events, and present a higher rate of hepatocellular injury features. Since many results were obtained among Chinese residents who had access to and had used Western drugs and TCM herbs, such ethnic homogeneity supports the contention that the observed differences of HILI and DILI in the assessed population are well founded.

Traditional Chinese Medicine and Herb-induced Liver Injury: Comparison with Drug-induced Liver Injury

PubMed Central

Jing, Jing; Teschke, Rolf

2017-01-01

Abstract Cases of suspected herb-induced liver injury (HILI) caused by herbal Traditional Chinese Medicines (TCMs) and of drug-induced liver injury (DILI) are commonly published in the scientific literature worldwide. As opposed to the multiplicity of botanical chemicals in herbal TCM products, which are often mixtures of several herbs, conventional Western drugs contain only a single synthetic chemical. It is therefore of interest to study how HILI by TCM and DILI compare with each other, and to what extent results from each liver injury type can be transferred to the other. China is among the few countries with a large population using synthetic Western drugs as well as herbal TCM. Therefore, China is well suited to studies of liver injury comparing drugs with TCM herbs. Despite some concordance, recent analyses of liver injury cases with verified causality, using the Roussel Uclaf Causality Assessment Method, revealed major differences in HILI caused by TCMs as compared to DILI with respect to the following features: HILI cases are less frequently observed as compared to DILI, have a smaller proportion of females and less unintentional rechallenge events, and present a higher rate of hepatocellular injury features. Since many results were obtained among Chinese residents who had access to and had used Western drugs and TCM herbs, such ethnic homogeneity supports the contention that the observed differences of HILI and DILI in the assessed population are well founded. PMID:29577033

Home safety measures and the risk of unintentional injury among young children: a multicentre case–control study

PubMed Central

LeBlanc, John C.; Pless, I. Barry; King, W. James; Bawden, Harry; Bernard-Bonnin, Anne-Claude; Klassen, Terry; Tenenbein, Milton

2006-01-01

Background Young children may sustain injuries when exposed to certain hazards in the home. To better understand the relation between several childproofing strategies and the risk of injuries to children in the home, we undertook a multicentre case–control study in which we compared hazards in the homes of children with and without injuries. Methods We conducted this case-control study using records from 5 pediatric hospital emergency departments for the 2-year period 1995–1996. The 351 case subjects were children aged 7 years and less who presented with injuries from falls, burns or scalds, ingestions or choking. The matched control subjects were children who presented during the same period with acute non-injury-related conditions. A home visitor, blinded to case-control status, assessed 19 injury hazards at the children's homes. Results Hazards found in the homes included baby walkers (21% of homes with infants), no functioning smoke alarm (17% of homes) and no fire extinguisher (51% of homes). Cases did not differ from controls in the mean proportion of home hazards. After controlling for siblings, maternal education and employment, we found that cases differed from controls for 5 hazards: the presence of a baby walker (odds ratio [OR] 9.0, 95% confidence interval [CI] 1.1–71.0), the presence of choking hazards within a child's reach (OR 2.0, 95% CI 1.0–3.7), no child-resistant lids in bathroom (OR 1.6, 95% CI 1.0–2.5), no smoke alarm (OR 3.2, 95% CI 1.4–7.7) and no functioning smoke alarm (OR 1.7, 95% CI 1.0–2.8). Interpretation Homes of children with injuries differed from those of children without injuries in the proportions of specific hazards for falls, choking, poisoning and burns, with a striking difference noted for the presence of a baby walker. In addition to counselling parents about specific hazards, clinicians should consider that the presence of some hazards may indicate an increased risk for home injuries beyond those directly

Booster seat or seat belt? Motor vehicle injuries and child restraint laws in preschool and early school-age children.

PubMed

Angulo-Vazquez, Vicki; De Santis, Joseph P

2005-01-01

Despite numerous interventions to reduce motor vehicle injuries and deaths in children living in the United States, unintentional motor vehicle injuries continue to be the leading cause of death of U.S. children. Even though child restraint laws have been enacted, many children 5 to 9 years of age continue to be injured in motor vehicle crashes. These injuries are related to the improper use of child restraints. Reasons for injuries in this age group were explored by a review of the current literature. Nurses have a unique role in educating families about proper restraint and in contributing to the evidence base for practice.

"The empathy impulse: A multinomial model of intentional and unintentional empathy for pain": Correction.

PubMed

2018-04-01

Reports an error in "The empathy impulse: A multinomial model of intentional and unintentional empathy for pain" by C. Daryl Cameron, Victoria L. Spring and Andrew R. Todd ( Emotion , 2017[Apr], Vol 17[3], 395-411). In this article, there was an error in the calculation of some of the effect sizes. The w effect size was manually computed incorrectly. The incorrect number of total observations was used, which affected the final effect size estimates. This computing error does not change any of the results or interpretations about model fit based on the G² statistic, or about significant differences across conditions in process parameters. Therefore, it does not change any of the hypothesis tests or conclusions. The w statistics for overall model fit should be .02 instead of .04 in Study 1, .01 instead of .02 in Study 2, .01 instead of .03 for the OIT in Study 3 (model fit for the PIT remains the same: .00), and .02 instead of .03 in Study 4. The corrected tables can be seen here: http://osf.io/qebku at the Open Science Framework site for the article. (The following abstract of the original article appeared in record 2017-01641-001.) Empathy for pain is often described as automatic. Here, we used implicit measurement and multinomial modeling to formally quantify unintentional empathy for pain: empathy that occurs despite intentions to the contrary. We developed the pain identification task (PIT), a sequential priming task wherein participants judge the painfulness of target experiences while trying to avoid the influence of prime experiences. Using multinomial modeling, we distinguished 3 component processes underlying PIT performance: empathy toward target stimuli (Intentional Empathy), empathy toward prime stimuli (Unintentional Empathy), and bias to judge target stimuli as painful (Response Bias). In Experiment 1, imposing a fast (vs. slow) response deadline uniquely reduced Intentional Empathy. In Experiment 2, inducing imagine-self (vs. imagine

78 FR 67369 - National Vaccine Injury Compensation Program: Addition to the Vaccine Injury Table to Include All...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-12

... Vaccine Injury Compensation Program: Addition to the Vaccine Injury Table to Include All Vaccines Against...) announces that all FDA- approved vaccines against seasonal influenza are covered under the National Vaccine... individuals who have been injured by covered childhood vaccines. Prior to this publication, trivalent...

Trends in hepatic injury associated with unintentional overdose of paracetamol (Acetaminophen) in products with and without opioid: an analysis using the National Poison Data System of the American Association of Poison Control Centers, 2000-7.

PubMed

Bond, G Randall; Ho, Mona; Woodward, Randall W

2012-02-01

more than one paracetamol-containing product. Abuse and misuse accounted for 34% of cases but 58% of the severe injuries. Paracetamol without opioid: A total of 126 830 cases were identified, increasing 44%, and 15 706 cases merited acetylcysteine (70% increase). A total of 4674 patients (3.7%) experienced some hepatic injury (134% increase). [corrected] Use of more than one non-opioid paracetamol product occurred in 7.3% of patients and was associated with a lower injury rate. Hepatic injury associated with paracetamol use is increasing significantly faster than population, paracetamol product sales and poison centre use. This suggests a growing portion of consumers is self-dosing paracetamol beyond the toxic threshold. This is true for paracetamol with and without opioids, but the increase in hepatic injury is greater when paracetamol is taken with an opioid. This disproportionate rise is greatest with misuse and abuse of paracetamol products in combination with opioids. Increasing self-dosage of the opioid combination products for the opioid effect is likely to result in more cases of toxic exposure to paracetamol. In contrast, cases of exposure to paracetamol-containing cough and cold products are underrepresented among those injured. In the absence of opioid-containing products, consumption of more than one paracetamol-containing product did not contribute to injury. Efforts to modulate unintentional paracetamol-related hepatic injury should consider these associations.

Multicentre study of acute alcohol use and non-fatal injuries: data from the WHO collaborative study on alcohol and injuries.

PubMed Central

Borges, Guilherme; Cherpitel, Cheryl; Orozco, Ricardo; Bond, Jason; Ye, Yu; Macdonald, Scott; Rehm, Jürgen; Poznyak, Vladimir

2006-01-01

OBJECTIVES: To study the risk of non-fatal injury at low levels and moderate levels of alcohol consumption as well as the differences in risk across modes of injury and differences among alcoholics. METHODS: Data are from patients aged 18 years and older collected in 2001-02 by the WHO collaborative study on alcohol and injuries from 10 emergency departments around the world (n = 4320). We used a case-crossover method to compare the use of alcohol during the 6 hours prior to the injury with the use of alcohol during same day of the week in the previous week. FINDINGS: The risk of injury increased with consumption of a single drink (odds ratio (OR) = 3.3; 95% confidence interval = 1.9-5.7), and there was a 10-fold increase for participants who had consumed six or more drinks during the previous 6 hours. Participants who had sustained intentional injuries were at a higher risk than participants who had sustained unintentional injuries. Patients who had no symptoms of alcohol dependence had a higher OR. CONCLUSION: Since low levels of drinking were associated with an increased risk of sustaining a non-fatal injury, and patients who are not dependent on alcohol may be at higher risk of becoming injured, comprehensive strategies for reducing harm should be implemented for all drinkers seen in emergency departments. PMID:16799729

Heading Frequency Is More Strongly Related to Cognitive Performance Than Unintentional Head Impacts in Amateur Soccer Players.

PubMed

Stewart, Walter F; Kim, Namhee; Ifrah, Chloe; Sliwinski, Martin; Zimmerman, Molly E; Kim, Mimi; Lipton, Richard B; Lipton, Michael L

2018-01-01

Compared to heading, unintentional head impacts (e.g., elbow to head, head to head, head to goalpost) in soccer are more strongly related to risk of moderate to very severe Central Nervous System (CNS) symptoms. But, most head impacts associated with CNS symptoms that occur in soccer are mild and are more strongly related to heading. We tested for a differential relation of heading and unintentional head impacts with neuropsychological (NP) test performance. Active adult amateur soccer players were recruited in New York City and the surrounding areas for this repeated measures longitudinal study of individuals who were enrolled if they had 5+ years of soccer play and were active playing soccer 6+ months/year. All participants completed a baseline validated questionnaire ("HeadCount-2w"), reporting 2-week recall of soccer activity, heading and unintentional head impacts. In addition, participants also completed NP tests of verbal learning, verbal memory, psychomotor speed, attention, and working memory. Most participants also completed one or more identical follow-up protocols (i.e., HeadCount-2w and NP tests) at 3- to 6-month intervals over a 2-year period. Repeated measures General Estimating Equations (GEE) linear models were used to determine if variation in NP tests at each visit was related to variation in either heading or unintentional head impacts in the 2-week period before testing. 308 players (78% male) completed 741 HeadCount-2w. Mean (median) heading/2-weeks was 50 (17) for men and 26 (7) for women. Heading was significantly associated with poorer performance on psychomotor speed ( p  < 0.001) and attention ( p  = 0.02) tasks and was borderline significant with poorer performance on the working memory ( p  = 0.06) task. Unintentional head impacts were not significantly associated with any NP test. Results did not differ after excluding 22 HeadCount-2w with reported concussive or borderline concussive symptoms. Poorer NP test performance was

Neonatal encephalopathic cerebral injury in South India assessed by perinatal magnetic resonance biomarkers and early childhood neurodevelopmental outcome.

PubMed

Lally, Peter J; Price, David L; Pauliah, Shreela S; Bainbridge, Alan; Kurien, Justin; Sivasamy, Neeraja; Cowan, Frances M; Balraj, Guhan; Ayer, Manjula; Satheesan, Kariyapilly; Ceebi, Sreejith; Wade, Angie; Swamy, Ravi; Padinjattel, Shaji; Hutchon, Betty; Vijayakumar, Madhava; Nair, Mohandas; Padinharath, Krishnakumar; Zhang, Hui; Cady, Ernest B; Shankaran, Seetha; Thayyil, Sudhin

2014-01-01

Although brain injury after neonatal encephalopathy has been characterised well in high-income countries, little is known about such injury in low- and middle-income countries. Such injury accounts for an estimated 1 million neonatal deaths per year. We used magnetic resonance (MR) biomarkers to characterise perinatal brain injury, and examined early childhood outcomes in South India. We recruited consecutive term or near term infants with evidence of perinatal asphyxia and a Thompson encephalopathy score ≥6 within 6 h of birth, over 6 months. We performed conventional MR imaging, diffusion tensor MR imaging and thalamic proton MR spectroscopy within 3 weeks of birth. We computed group-wise differences in white matter fractional anisotropy (FA) using tract based spatial statistics. We allocated Sarnat encephalopathy stage aged 3 days, and evaluated neurodevelopmental outcomes aged 3½ years using Bayley III. Of the 54 neonates recruited, Sarnat staging was mild in 30 (56%); moderate in 15 (28%) and severe in 6 (11%), with no encephalopathy in 3 (6%). Six infants died. Of the 48 survivors, 44 had images available for analysis. In these infants, imaging indicated perinatal rather than established antenatal origins to injury. Abnormalities were frequently observed in white matter (n = 40, 91%) and cortex (n = 31, 70%) while only 12 (27%) had abnormal basal ganglia/thalami. Reduced white matter FA was associated with Sarnat stage, deep grey nuclear injury, and MR spectroscopy N-acetylaspartate/choline, but not early Thompson scores. Outcome data were obtained in 44 infants (81%) with 38 (79%) survivors examined aged 3½ years; of these, 16 (42%) had adverse neurodevelopmental outcomes. No infants had evidence for established brain lesions, suggesting potentially treatable perinatal origins. White matter injury was more common than deep brain nuclei injury. Our results support the need for rigorous evaluation of the efficacy of rescue hypothermic

Neonatal Encephalopathic Cerebral Injury in South India Assessed by Perinatal Magnetic Resonance Biomarkers and Early Childhood Neurodevelopmental Outcome

PubMed Central

Pauliah, Shreela S.; Bainbridge, Alan; Kurien, Justin; Sivasamy, Neeraja; Cowan, Frances M.; Balraj, Guhan; Ayer, Manjula; Satheesan, Kariyapilly; Ceebi, Sreejith; Wade, Angie; Swamy, Ravi; Padinjattel, Shaji; Hutchon, Betty; Vijayakumar, Madhava; Nair, Mohandas; Padinharath, Krishnakumar; Zhang, Hui; Cady, Ernest B.; Shankaran, Seetha; Thayyil, Sudhin

2014-01-01

Although brain injury after neonatal encephalopathy has been characterised well in high-income countries, little is known about such injury in low- and middle-income countries. Such injury accounts for an estimated 1 million neonatal deaths per year. We used magnetic resonance (MR) biomarkers to characterise perinatal brain injury, and examined early childhood outcomes in South India. Methods We recruited consecutive term or near term infants with evidence of perinatal asphyxia and a Thompson encephalopathy score ≥6 within 6 h of birth, over 6 months. We performed conventional MR imaging, diffusion tensor MR imaging and thalamic proton MR spectroscopy within 3 weeks of birth. We computed group-wise differences in white matter fractional anisotropy (FA) using tract based spatial statistics. We allocated Sarnat encephalopathy stage aged 3 days, and evaluated neurodevelopmental outcomes aged 3½ years using Bayley III. Results Of the 54 neonates recruited, Sarnat staging was mild in 30 (56%); moderate in 15 (28%) and severe in 6 (11%), with no encephalopathy in 3 (6%). Six infants died. Of the 48 survivors, 44 had images available for analysis. In these infants, imaging indicated perinatal rather than established antenatal origins to injury. Abnormalities were frequently observed in white matter (n = 40, 91%) and cortex (n = 31, 70%) while only 12 (27%) had abnormal basal ganglia/thalami. Reduced white matter FA was associated with Sarnat stage, deep grey nuclear injury, and MR spectroscopy N-acetylaspartate/choline, but not early Thompson scores. Outcome data were obtained in 44 infants (81%) with 38 (79%) survivors examined aged 3½ years; of these, 16 (42%) had adverse neurodevelopmental outcomes. Conclusions No infants had evidence for established brain lesions, suggesting potentially treatable perinatal origins. White matter injury was more common than deep brain nuclei injury. Our results support the need for rigorous evaluation of the efficacy of

Source, Managemnt and Quantification of Unintentional POPs (PCDDD/Fs) in Nepal

NASA Astrophysics Data System (ADS)

Charitra Sah, Ram

2010-05-01

The aim to prepare and present this paper is to highlight the source, management and quantification of the unintentional POPs in an unindustrialized least developing landlocked small country Nepal. The methodology adopted for this is the review of the relevant research documents and national initiative towards addressing this issues complemented with sharing of the first hand experience from the implementation of the POPs management activities undertaken by our organization. Nepal is a small country of size 147181 sq.km but having large sources of POPs including unintentional POPs (PCDD/Fs) mainly because of weak enforcement of the existing environment related laws, standards and international commitment including POPs Convention. Country became homes to about 75 tons of Obsolete Pesticide since last 30 years including about 44 percent (33 tons out of 75) are of known POPs. These obsolete pesticides including identified POPs have been poorly stored in some about 25 locations throughout the country. The major warehouse accommodating about 50 tons at Amlekhgunj has been located just in front of a high school where about 1000 children are being studying and found to have some health related problem due to the gasses emission from the warehouse as well as school playground field contaminated with these POPs pesticides. The playground soil contamination has been found from routine examination of the soil samples. In addition to pesticides including POPs were used in the agriculture and public health field in the past, there are several other practices as well as anthropogenic activities producing PCDD/Fs. The annual inventory of countrywide emission of unintentional POPs was estimated to be 312.55 g TEQ for Nepal (MOE 2004). This is very high for a country like Nepal least developing in terms of industrial and economy. This estimation was based on the UNEP Toolkit which has included the broad categories of waste such as waste incineration, ferrous and non ferrous metal

Childhood Maltreatment, Public Service System Contact, and Preventable Death in Young Adulthood.

PubMed

Jonson-Reid, Melissa; Drake, Brett; Kohl, Patricia L

2017-02-01

Data from a longitudinal cohort study of low-income children reported for maltreatment matched to similarly poor nonreported children were used to examine intentional and unintentional injury deaths in young adulthood. The goal was to examine the unique contribution of maltreatment history and identify other potential systems for preventive efforts. Maltreatment reports were associated with increased risk of injury-related death per 6-month intervals (hazard ratio [HR] = 1.09, p < .05). Young adults with histories of both status offenses and delinquent offenses were at greater risk for later death (HR = 2.24, p < .05) as were those with histories of emergency room (ER) treatment for intentional injury prior to age 18 years (HR =3.95, p < .05). More than 50% of the deaths were firearm-related; nearly all firearm deaths occurred among Black youth. Implications for prevention within at-risk populations are discussed.

[Monitoring on injuries in Jiangsu sentinel hospitals, from 2006 to 2013].

PubMed

Du, Wencong; Yang, Jie; Zhou, Jinyi; Zhang, Yongqing; Shi, Zhan; Zhao, Lixia; Wu, Ming

2015-08-01

To analyze the characteristics on injuries, using data from the Jiangsu sentinel hospitals, from 2006 to 2013, to develop a injury prevention strategy. Data was collected from the 'National Injury Monitoring Report Card' of six sentinel hospitals from two surveillance points from 2006 to 2013. Information from 448 778 cases was analyzed. The numbers of male cases outnumbered the females, with sex ratio as 1.72:1. The top five causes of injuries were as follows: falls (27.21%), traffic-related (26.23%), blunt (17.50%), knife/sharp instrument (13.87%) and animal injury (6.59%). Injuries mainly occurred in June, July and August, at 8 to 10 O'clock in the morning. The major places where injuries occurred were road/street (31.58%), home (23.47%), industries and construction sites (21.38%). Recreation activities (36.12%), driving vehicle (25.26%), and at work (24.78%) were the major activities when injuries took place. Most injury cases were unintentional (92.65%) and deliberately (violence/attack) (6.36%). All the injuries showed an yearly increase, from 2006 to 2013, with main causes as falls and traffic-related ones. Injuries among teenagers and the elderly should be paid special attention to, with targeted interventions taken.

Incidence and determinants of severity of unintentional injuries among students of private schools in Dubai: a cross-sectional study.

PubMed

Altheeb, Ayesha; Hussein, Hamid; Al Faisal, Waleed; AlBehandy, Nusaiba; Alshareef, Nouf; Wasfy, Ahmed

2017-02-21

A cross-sectional study was performed on a student population in grades 7-12 in 10 private schools in Dubai in the academic year 2012/13. The study was in two phases. The first was used to estimate incidence rate of injuries, where the total injuries that took place in the schools in 2012 was divided by the total student population in the studied schools in the same year multiplied by 1000. The second was to study the determinants of severity through randomly selecting 1000 cases of injuries. A self-administered questionnaire was given to the participants after obtaining verbal consent. Sociodemographic characteristics showed that most (74.2%) of the students in this study were male and about half (57.3%) were aged 12-14 years. The incidence rate of injuries was 297.7/1000, and most of the injuries (88.9%) were mild. Poor school safety was blamed for most of the injuries, and falls were the most frequent type of injury.

State Firearm Legislation and Nonfatal Firearm Injuries

PubMed Central

Rowhani-Rahbar, Ali; Mills, Brianna; Young, Bessie; Rivara, Frederick P.

2015-01-01

Objectives. We investigated whether stricter state-level firearm legislation was associated with lower hospital discharge rates for nonfatal firearm injuries. Methods. We estimated discharge rates for hospitalized and emergency department–treated nonfatal firearm injuries in 18 states in 2010 and used negative binomial regression to determine whether strength of state firearm legislation was independently associated with total nonfatal firearm injury discharge rates. Results. We identified 26 744 discharges for nonfatal firearm injuries. The overall age-adjusted discharge rate was 19.0 per 100 000 person-years (state range = 3.3–36.6), including 7.9 and 11.1 discharges per 100 000 for hospitalized and emergency department–treated injuries, respectively. In models adjusting for differences in state sociodemographic characteristics and economic conditions, states in the strictest tertile of legislative strength had lower discharge rates for total (incidence rate ratio [IRR] = 0.60; 95% confidence interval [CI] = 0.44, 0.82), assault-related (IRR = 0.58; 95% CI = 0.34, 0.99), self-inflicted (IRR = 0.18; 95% CI = 0.14, 0.24), and unintentional (IRR = 0.53; 95% CI = 0.34, 0.84) nonfatal firearm injuries. Conclusions. There is significant variation in state-level hospital discharge rates for nonfatal firearm injuries, and stricter state firearm legislation is associated with lower discharge rates for such injuries. PMID:26066935

A qualitative secondary data analysis of intentional and unintentional medication nonadherence in adults with chronic heart failure.

PubMed

Riegel, Barbara; Dickson, Victoria Vaughan

To explore factors contributing to intentional and unintentional medication nonadherence in adults with chronic heart failure (HF). Medication nonadherence is prevalent in HF but the factors contributing to it are not well understood. This secondary data analysis of qualitative data explored narrative accounts about medication adherence from four previous studies (N = 112). The Necessity-Concerns-Framework derived from the Common Sense Model (CSM) of Self-Regulation guided the interpretation of themes. In this diverse sample (39% Black, 6% Hispanic, 63% male; mean age 59 ± 15 years), 90% reported at least intermittent nonadherence. For many (60%), missing medication was unintentional but 27% reported intentional nonadherence. Four interconnected patterns of behavior emerged: 1) rarely nonadherent, 2) frequently nonadherent, 3) intentionally nonadherent, and 4) reformed nonadherent. Misperceptions about HF, beliefs, concerns, and contextual factors contributed to both intentional and unintentional nonadherence. Medication nonadherence is prevalent in HF and influenced by modifiable factors. Copyright © 2016 Elsevier Inc. All rights reserved.

Association of traumatic brain injury in childhood and attention-deficit/hyperactivity disorder: a population-based study.

PubMed

Yang, Ling-Yu; Huang, Chao-Ching; Chiu, Wen-Ta; Huang, Li-Tung; Lo, Wei-Cheng; Wang, Jia-Yi

2016-09-01

We evaluated the risk of attention-deficit hyperactivity disorder (ADHD) following childhood traumatic brain injury (TBI). Using Taiwan's National Health Insurance Research Database, we included 10,416 newly diagnosed TBI children (aged ≤12 y) between 2001 and 2002 and 41,664 children without TBI, who were frequency matched by sex, age, and year of the index medical service with each TBI child, as controls. Children who had been diagnosed with ADHD prior to their medical service index were excluded. Each individual was followed for 9 y to identify ADHD diagnosis. We also compared the ADHD risk in children who were treated for fractures but not TBI as sensitivity analysis. During the 9-y follow-up period, children with TBI had a higher ADHD risk (adjusted hazard ratio (AHR) = 1.32, 95% confidence interval (CI) = 1.19, 1.45) than did those without TBI. Furthermore, children with mild and severe TBI had higher AHRs for ADHD than did those without TBI (AHR = 1.30; 95% CI = 1.10, 1.53; and AHR = 1.37; 95% CI = 1.22, 1.55). However, no significant association was observed between fractures and ADHD. TBI in childhood is associated with a greater likelihood of developing ADHD.

Unintentional recurrent laryngeal nerve injuries following thyroidectomy: Is it the surgeon who pays the bill?

PubMed

Gambardella, C; Polistena, A; Sanguinetti, A; Patrone, R; Napolitano, S; Esposito, D; Testa, D; Marotta, V; Faggiano, A; Calò, P G; Avenia, N; Conzo, G

2017-05-01

Thyroidectomy is one of the most common intervention in general surgery and, after the turn of the century, its rate has sharply increased, along with a worldwide increased incidence of differentiated thyroid cancers. Therefore, injuries of the recurrent laryngeal nerve have become one of the most frequent cause of surgical malpractice claims, mostly following surgery for benign pathology. Even if the incidence of definitive paralysis is generally lower than 3%, during the last 20 years in Italy, the number of claims for damages has sharply raised. As a consequence, a lot of defensive medicine has been caused by this issue, and a witch-hunt has been accordingly triggered, so determining mostly a painful and lasting frustration for the surgeons, who sometimes are compelled to pay a lot of money for increasing insurance premiums and lawyers fees. Recurrent laryngeal nerve injury should be considered as a potentially catastrophic predictable but not preventable event, rather than the result of a surgical mistake. Purposes of the Authors are analyzing incidence, conditions of risk, and mechanisms of recurrent laryngeal nerve injuries, underlining notes of surgical technique and defining medical practice recommendations useful to reduce the risk of malpractice lawsuits and judgments against surgeons. Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

Cardiorespiratory Fitness and Unintentional Nonfatal Injury Among the United States Air Force Active Duty

DTIC Science & Technology

2005-10-01

it follows that a sedentary lifestyle contributes to the decline in cardiorespiratory function characterized by decreases in VO2max, muscle mass and...to the musculoskeletal region of the spinal column as these injuries have been found to be associated with a sedentary lifestyle (Garg A and Moore JS

41 CFR 50-201.104 - Protection against unintentional employment of underage minors.

Code of Federal Regulations, 2010 CFR

2010-07-01

... REGULATIONS § 50-201.104 Protection against unintentional employment of underage minors. An employer shall not be deemed to have knowingly employed an underage minor in the performance of contracts subject to the... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Protection against...

Activating Endogenous Neural Precursor Cells Using Metformin Leads to Neural Repair and Functional Recovery in a Model of Childhood Brain Injury.

PubMed

Dadwal, Parvati; Mahmud, Neemat; Sinai, Laleh; Azimi, Ashkan; Fatt, Michael; Wondisford, Fredric E; Miller, Freda D; Morshead, Cindi M

2015-08-11

The development of cell replacement strategies to repair the injured brain has gained considerable attention, with a particular interest in mobilizing endogenous neural stem and progenitor cells (known as neural precursor cells [NPCs]) to promote brain repair. Recent work demonstrated metformin, a drug used to manage type II diabetes, promotes neurogenesis. We sought to determine its role in neural repair following brain injury. We find that metformin administration activates endogenous NPCs, expanding the size of the NPC pool and promoting NPC migration and differentiation in the injured neonatal brain in a hypoxia-ischemia (H/I) injury model. Importantly, metformin treatment following H/I restores sensory-motor function. Lineage tracking reveals that metformin treatment following H/I causes an increase in the absolute number of subependyma-derived NPCs relative to untreated H/I controls in areas associated with sensory-motor function. Hence, activation of endogenous NPCs is a promising target for therapeutic intervention in childhood brain injury models. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Storage and disposal of medical cannabis among patients with cancer: Assessing the risk of diversion and unintentional digestion.

PubMed

Sznitman, Sharon R; Goldberg, Victoria; Sheinman-Yuffe, Hedva; Flechter, Ezequiel; Bar-Sela, Gil

2016-11-15

Increasingly more jurisdictions worldwide are legalizing medical cannabis. Major concerns related to such policies are that improper storage and disposal arrangements may lead to the diversion and unintentional digestion of cannabis. These concerns are particularly acute among patients with cancer because they take home medical cannabis for extended periods and have high rates of treatment termination and mortality shortly after the onset of treatment with medical cannabis. Therefore, leftover cannabis is potentially particularly prevalent, and potentially improperly stored, in households of current and deceased patients with cancer. The current study investigated the risk of medical cannabis diversion and unintentional digestion among oncology patients treated with medical cannabis and caregivers of recently deceased patients who were treated with medical cannabis. A total of 123 oncology patients treated with medical cannabis and 37 caregivers of deceased oncology patients treated with medical cannabis were interviewed regarding practices and the information received concerning the safe storage and disposal of medical cannabis, as well as experiences of theft, diversion, and unintentional digestion. High rates of suboptimal storage were reported and caregivers were found to be particularly unlikely to have received information regarding the safe storage and disposal of medical cannabis. Few incidences of theft, diversion, and unintentional digestion were reported. Oncologists and other health care providers have an important, yet unfilled, role to play with regard to educating patients and caregivers of the importance of the safe storage and disposal of medical cannabis. Interventions designed to alert patients treated with medical cannabis and their caregivers to the problem of diversion, along with strategies to limit it, have the potential to limit diversion and unintentional exposure to medical cannabis. Cancer 2016;122:3363-3370. © 2016 American Cancer

Pancreatic stent insertion after an unintentional guidewire cannulation of the pancreatic duct during ERCP.

PubMed

García-Cano, Jesús; Viñuelas Chicano, Miriam; Del Moral Martínez, María; Muñiz Muñoz, Marta; Murillo Matamoros, Claudio; Suárez Matías, Miguel; Valiente González, Laura; Martínez Pérez, Teresa; Martínez Fernández, Raquel; Gómez Ruiz, Carmen Julia; Pérez García, José Ignacio; Morillas Ariño, Julia

2018-04-24

the guidewire (GW) may enter the pancreatic duct during common bile duct (CBD) cannulation attempts in endoscopic retrograde cholangiopancreatography (ERCP). After GW passage into the pancreas, the most effective maneuver for CBD cannulation and pancreatitis prevention has not been determined. to study CBD cannulation and post-ERCP pancreatitis rates when a pancreatic stent is inserted after an unintentional GW cannulation of the pancreatic duct. a retrospective analysis of patients undergoing ERCP for biliary drainage that were included prospectively into a database. After unintentional GW cannulation of the pancreatic duct, a straight 5-Fr and 4-cm long plastic stent was inserted. The stents had no internal flaps to facilitate expulsion. CBD cannulation attempts were made above the stent. A pancreatic sphincterotomy was performed in patients older than 60 years before stent insertion. a total of 46 pancreatic stents were inserted during 154 ERCP (29.8%) procedures. In the stent group, CBD cannulation was accomplished in 44/46 (95.6%) subjects. A total of 21/46 (45.6%) pancreatic sphincterotomies were performed. Only 1/46 (2.17%) mild pancreatitis cases were observed and most stents were spontaneously expelled. in this study, the CBD was eventually reached with the insertion of a plastic pancreatic stent after an unintentional GW passage into the pancreatic duct while attempting a CBD cannulation. No adverse events were observed following pancreatic stent insertion.

[Sports injuries and their prevention in childhood and adolescence].

PubMed

Lascombes, Pierre; Mainard, Laurence; Haumont, Thierry; Journeau, Pierre

2010-10-01

Sports injuries are common in children and adolescents. Typical musculoskeletal disorders include overuse injuries such as stress fractures and apophyseal avulsions. Gymnastics has one of the highest injury rates of all girls' sports. Intensive gymnastics can cause chronic spine and wrist trauma. Prevention of sport injuries should be a priority for parents, coaches and children themselves. Protection (helmet, padding) is mandatory for some activities. Proper education and preparation are necessary for all sports activities.

Injury Deaths Among U.S. Females: CDC Resources and Programs

PubMed Central

Mack, Karin A.; Peterson, Cora; Zhou, Chao; MacConvery, Elliane; Wilkins, Natalie

2017-01-01

Injury death rates are lower for women than for men at all ages, but we have a long way to go in understanding the circumstances of injury fatalities among females. This article presents resources that can be used to examine the most recent data on injury fatalities among females and highlights activities of CDC’s Injury Center. The National Center for Injury Prevention and Control’s (NCIPC’s) Web-based Injury Statistics Query and Reporting System, an online surveillance database, can be used to examine injury deaths. We present examples that show the 2015 number of female fatal injuries by age group and injury cause and method, as well as a 2008–2014 county-level map of female fatal injury rates. In 2015, there were 68,572 injury fatalities of females of age ≥1 year, equivalent to 1 death every 7 minutes. Injuries were the leading cause of death for females of ages 1–41 years and the sixth-ranked cause of female death overall. Falls were the leading cause of injury death overall (and for women ≥70 years), unintentional poisonings were second, and motor vehicle traffic injuries were third. NCIPC funds national organizations, state health agencies, and other groups to develop, implement, and promote effective injury and violence prevention and control practices. Five key programs are discussed. Presenting data on injury fatalities is an essential element in identifying meaningful prevention efforts. Further investigation of the causes and impact of female injury fatalities can refine the public health approach to reduce this injury burden. PMID:28294691

Injury deaths among Finnish residents travelling abroad.

PubMed

Lunetta, Philippe

2010-09-01

The increasing international mobility raises the possibility of foreign nationals dying abroad. Here, a descriptive, retrospective and population-based study of deaths abroad among Finnish residents from 1969 to 2007 is presented. The data were collected from the Statistics Finland data based on certificates of cause of death issued after repatriation of the corpse and after review of medical documents or a medico-legal autopsy. The frequency of injury deaths, proportional mortality rates (PMRs) and mortality risk estimates (MREs) were measured. During the study period, 6894 Finnish residents died abroad. Spain, Sweden and Thailand were the top three destination countries for number of deaths, accounting together for 40.3% of all the deaths. Cardiovascular diseases were the most common cause of deaths. The overall injury deaths represented 26.7% of all deaths abroad and occurred at a higher proportion than in Finland (PMR: 3.3). The most common injury deaths were traffic accident and drowning, which together represented more than 50% of all unintentional injury deaths. High PMRs were found for traffic accidents in Russia, Germany and the US and for drowning in Spain, Portugal, Greece and Turkey. The MRE for injury deaths was 73.5 per 100,000 person-years of exposure. Finnish travellers abroad are a population subgroup with a high risk of injury death. Common travel health interventions must be backed by actions to prevent injuries abroad, particularly traffic accident and drowning.

What Do We Know About the Association Between Firearm Legislation and Firearm-Related Injuries?

PubMed

Santaella-Tenorio, Julian; Cerdá, Magdalena; Villaveces, Andrés; Galea, Sandro

2016-01-01

Firearms account for a substantial proportion of external causes of death, injury, and disability across the world. Legislation to regulate firearms has often been passed with the intent of reducing problems related to their use. However, lack of clarity around which interventions are effective remains a major challenge for policy development. Aiming to meet this challenge, we systematically reviewed studies exploring the associations between firearm-related laws and firearm homicides, suicides, and unintentional injuries/deaths. We restricted our search to studies published from 1950 to 2014. Evidence from 130 studies in 10 countries suggests that in certain nations the simultaneous implementation of laws targeting multiple firearms restrictions is associated with reductions in firearm deaths. Laws restricting the purchase of (e.g., background checks) and access to (e.g., safer storage) firearms are also associated with lower rates of intimate partner homicides and firearm unintentional deaths in children, respectively. Limitations of studies include challenges inherent to their ecological design, their execution, and the lack of robustness of findings to model specifications. High quality research on the association between the implementation or repeal of firearm legislation (rather than the evaluation of existing laws) and firearm injuries would lead to a better understanding of what interventions are likely to work given local contexts. This information is key to move this field forward and for the development of effective policies that may counteract the burden that firearm injuries pose on populations. © The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Implied functional crossed cerebello-cerebral diaschisis and interhemispheric compensation during hand grasping more than 20 years after unilateral cerebellar injury in early childhood.

PubMed

Nakahachi, Takayuki; Ishii, Ryouhei; Canuet, Leonides; Iwase, Masao

2015-01-01

Crossed cerebello-cerebral diaschisis (CCCD) conventionally refers to decreased resting cerebral activity caused by injury to the contralateral cerebellum. We investigated whether functional activation of a contralesional cerebral cortical region controlling a specific task is reduced during task performance in a patient with a unilateral cerebellar lesion. We also examined functional compensation by the corresponding ipsilesional cerebral cortex. It was hypothesized that dysfunction of the primary sensorimotor cortex (SM1) contralateral to the cerebellar lesion would be detected together with a compensatory increase in neural activity of the ipsilesional SM1. To test these possibilities, we conducted non-invasive functional neuroimaging techniques for bilateral SM1 during hand grasping, a task known to activate predominantly the SM1 contralateral to the grasping hand. Activity in SM1 during hand grasping was measured electrophysiologically by magnetoencephalography and hemodynamically by near-infrared spectroscopy in an adult with mild right hemiataxia associated with a large injury of the right cerebellum due to resection of a tumor in early childhood. During left hand grasping, increased neural activity was detected predominantly in the right SM1, the typical developmental pattern. In contrast, neural activity increased in the bilateral SM1 with slight right-side dominance during right (ataxic) hand grasping. This study reported a case that implied functional CCCD and compensatory neural activity in the SM1 during performance of a simple hand motor task in an adult with unilateral cerebellar injury and mild hemiataxia 24 years prior to the study without rehabilitative interventions. This suggests that unilateral cerebellar injuries in early childhood may result in persistent functional abnormalities in the cerebrum into adulthood. Therapeutic treatments that target functional CCCD and interhemispheric compensation might be effective for treating ataxia due to

Addressing prehospital patient safety using the science of injury prevention and control.

PubMed

Meisel, Zachary F; Hargarten, Stephen; Vernick, Jon

2008-01-01

There is inadequate information about the scope and character of adverse events in prehospital care. However, there is ample evidence to suggest that prehospital patient safety hazards are often unique and underrecognized. We first summarize what is currently understood about prehospital patient safety and identify the specific aspects of emergency medical services (EMS) care that may make conventional approaches to the evaluation and improvement of patient safety more difficult. Next we introduce the concept of using injury prevention and control science to analyze prehospital adverse events and to help develop EMS patient safety solutions. Injury prevention and control is a proven public health approach for the study and reduction of both intentional and unintentional injuries. It includes the use of a Haddon phase-factor matrix to identify possible interventions, especially environmental modifications that provide automatic protection. We demonstrate how this method can be used as a complementary approach in efforts to prevent injuries caused by prehospital adverse medical events.

Quantitative genetic analysis of injury liability in infants and toddlers

DOE Office of Scientific and Technical Information (OSTI.GOV)

Phillips, K.; Matheny, A.P. Jr.

1995-02-27

A threshold model of latent liability was applied to infant and toddler twin data on total count of injuries sustained during the interval from birth to 36 months of age. A quantitative genetic analysis of estimated twin correlations in injury liability indicated strong genetic dominance effects, but no additive genetic variance was detected. Because interpretations involving overdominance have little research support, the results may be due to low order epistasis or other interaction effects. Boys had more injuries than girls, but this effect was found only for groups whose parents were prompted and questioned in detail about their children`s injuries.more » Activity and impulsivity are two behavioral predictors of childhood injury, and the results are discussed in relation to animal research on infant and adult activity levels, and impulsivity in adult humans. Genetic epidemiological approaches to childhood injury should aid in targeting higher risk children for preventive intervention. 30 refs., 4 figs., 3 tabs.« less

Unintentional transfer of vaccinia virus associated with smallpox vaccines: ACAM2000(®) compared with Dryvax(®).

PubMed

Tack, Danielle M; Karem, Kevin L; Montgomery, Jay R; Collins, Limone; Bryant-Genevier, Marthe G; Tiernan, Rosemary; Cano, Maria; Lewis, Paige; Engler, Renata J M; Damon, Inger K; Reynolds, Mary G

2013-07-01

Routine vaccination against smallpox (variola) ceased in the US in 1976. However, in 2002 limited coverage for military personnel and some healthcare workers was reinstituted. In March 2008, ACAM2000® replaced Dryvax® as the vaccine used in the United States against smallpox. Unintentional transfer of vaccinia virus from a vaccination site by autoinoculation or contact transmission, can have significant public health implications. We summarize unintentional virus transfer AEs associated with ACAM2000® since March 2008 and compare with Dryvax®. We identified 309 reports for ACAM2000® with skin or ocular involvement, of which 93 were autoinoculation cases and 20 were contact transmission cases. The rate for reported cases of autoinoculation was 20.6 per 100,000 vaccinations and for contact transmission was 4.4 per 100,000 vaccinations. Eighteen contact transmission cases could be attributed to contact during a sporting activity (45%) or intimate contact (45%). Of the 113 unintentional transfer cases, 6 met the case definition for ocular vaccinia. The most common locations for all autoinoculation and contact cases were arm/elbow/shoulder (35/113; 31%) and face (24/113; 21%). Methods We reviewed 753 reports associated with smallpox in the Vaccine Adverse Event Reporting System and CDC Poxvirus consultation log, reported from March 2008 to August 2010. Reports were classified into categories based upon standard case definitions. Overall, unintentional transfer events for ACAM2000® and Dryvax® are similar. We recommend continued efforts to prevent transfer events and continuing education for healthcare providers focused on recognition of vaccinia lesions, proper sample collection, and laboratory testing to confirm diagnosis.

Violence and its injury consequences in American movies

PubMed Central

McArthur, David L; Peek-Asa, Corinne; Webb, Theresa; Fisher, Kevin; Cook, Bernard; Browne, Nick; Kraus, Jess

2000-01-01

Objectives To evaluate the seriousness and frequency of violence and the degree of associated injury depicted in the 100 top-grossing American films of 1994. Methods Each scene in each film was examined for the presentation of violent actions on persons and coded by a systematic context-sensitive analytic scheme. Specific degrees of violence and indices of injury severity were abstracted. Only actually depicted, not implied, actions were coded, although both explicit and implied consequences were examined. Results The median number of violent actions per film was 16 (range, 0-110). Intentional violence outnumbered unintentional violence by a factor of 10. Almost 90% of violent actions showed no consequences to the recipient's body, although more than 80% of the violent actions were executed with lethal or moderate force. Fewer than 1% of violent actions were accompanied by injuries that were then medically attended. Conclusions Violent force in American films of 1994 was overwhelmingly intentional and in 4 of 5 cases was executed at levels likely to cause significant bodily injury. Not only action films but movies of all genres contained scenes in which the intensity of the action was not matched by correspondingly severe injury consequences. Many American films, regardless of genre, tend to minimize the consequences of violence to human beings. PMID:10986175

"Violence" in medicine: necessary and unnecessary, intentional and unintentional.

PubMed

Shapiro, Johanna

2018-06-11

We are more used to thinking of medicine in relation to the ways that it alleviates the effects of violence. Yet an important thread in the academic literature acknowledges that medicine can also be responsible for perpetuating violence, albeit unintentionally, against the very individuals it intends to help. In this essay, I discuss definitions of violence, emphasizing the importance of understanding the term not only as a physical perpetration but as an act of power of one person over another. I next explore the paradox of a healing profession that is permeated with violence sometimes necessary, often unintentional, and almost always unrecognized. Identifying the construct of "physician arrogance" as contributory to violence, I go on to identify different manifestations of violence in a medical context, including violence to the body; structural violence; metaphoric violence; and the practice of speaking to or about patients (and others in the healthcare system in ways that minimize or disrespect their full humanity. I further suggest possible explanations for the origins of these kinds of violence in physicians, including the fear of suffering and death in relation to vicarious trauma and the consequent concept of "killing suffering"; as well as why patients might be willing to accept such violence directed toward them. I conclude with brief recommendations for attending to root causes of violence, both within societal and institutional structures, and within ourselves, offering the model of the wounded healer.

78 FR 69699 - Advisory Commission on Childhood Vaccines; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-20

... Commission on Childhood Vaccines; Notice of Meeting In accordance with section 10(a)(2) of the Federal... Commission on Childhood Vaccines (ACCV). Date and Time: December 5, 2013, 10:00 a.m. to 4:00 p.m. (EDT... Division of Vaccine Injury Compensation (DVIC), Department of Justice, National Vaccine Program Office...

Intellectual functioning of childhood leukemia survivors--relation to Tau protein--a marker of white matter injury.

PubMed

Krawczuk-Rybak, M; Grabowska, A; Protas, P T; Muszynska-Roslan, K; Holownia, A; Braszko, J

2012-01-01

Chemo- and radiotherapy used in acute lymphoblastic leukemia (ALL) can influence on brain functioning in the future. In a prospective study we analysed the cognitive functions of ALL survivors in relation to Tau protein as a marker of white matter injury. Thirty-one survivors of childhood ALL (6.3 years after diagnosis); without the signs of CNS involvement, treated with chemotherapy alone, rested in first remission; underwent Intelligence tests- Wechsler Intelligence Scales (WISC-R, WAIS-R). Their results were analyzed in relation to the levels of Tau in cerebrospinal fluid (CSF) obtained during the treatment. The analysis showed that all survivors attained the average scores in intelligence tests. A negative correlation was found between methotrexate (MTX) doses and Freedom from Distractibility (FFD). Females had higher values of Performance Intelligence Quotient (PIQ) than males. A negative correlation was noted of Tau protein levels obtained from the last CSF with: Total and Verbal Intelligence Quotient, PIQ, Perceptual Organisation Index and FFD but not with Verbal Comprehension Index. Our results suggest the possibility of white matter injury during the treatment for ALL with chemotherapy alone. Elevated Tau protein level in CSF at the end of treatment might indicate future difficulties in neurocognitive functioning.

Retrospective case series analysis of characteristics and trends in unintentional pharmaceutical drug poisoning by methadone, opioid analgesics, antidepressants and benzodiazepines in Clark County, NV 2009-13.

PubMed

Bruno, Tamara; Pharr, Jennifer R

2017-06-01

Poisoning has become the leading cause of injury death in the USA-with opioid analgesic involved in more fatal poisonings than any other drug, including cocaine and heroin. The epidemic of prescription drug poisonings is a public health concern. This study aimed to define potential high-risk groups for unintentional prescription drug poisoning by methadone, opioid analgesics, antidepressants or benzodiazepines. A hospital-based retrospective case series analysis of admissions related to prescription drug poisonings associated with methadone, opioid analgesics, antidepressants or benzodiazepines for hospitals in Clark County, Nevada between 2009 and 2013 was employed. There were 7414 admissions with a primary diagnosis of an unintentional poisoning due to methadone, opioid analgesics, antidepressants or benzodiazepines. Women had the highest rate of admissions particularly in the 45-54 age group. Higher rates of admissions were also found among non-Hispanic whites, single and uninsured populations. There were concerning increases in admissions among 65+ and Native American/Alaskan Native subgroups in 2013. Benzodiazepines and opioid analgesics were the most prevalent drug categories for prescription drug poisoning admissions. Public health professionals can utilize hospital data to identify populations at risk and in need of targeted interventions. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

75 FR 61768 - Advisory Commission on Childhood Vaccines; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-06

... Commission on Childhood Vaccines; Notice of Meeting In accordance with section 10(a)(2) of the Federal... Commission on Childhood Vaccines (ACCV). Date and Time: October 28, 2010, 9 a.m. to 5 p.m. EDT. Place... meeting will include, but are not limited to: Updates from the Division of Vaccine Injury Compensation...

78 FR 29143 - Advisory Commission on Childhood Vaccines; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-17

... Commission on Childhood Vaccines; Notice of Meeting In accordance with section 10(a)(2) of the Federal... Commission on Childhood Vaccines (ACCV). Date and Time: June 07, 2013, 10:00 a.m. to 4:00 p.m. EDT. Place... Division of Vaccine Injury Compensation (DVIC), Department of Justice (DOJ), National Vaccine Program...

78 FR 49275 - Advisory Commission on Childhood Vaccines; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-13

... Commission on Childhood Vaccines; Notice of Meeting In accordance with section 10(a)(2) of the Federal... Commission on Childhood Vaccines (ACCV). Date and Time: September 5, 2013, 10:00 a.m. to 4:00 p.m. EDT. Place... Division of Vaccine Injury Compensation (DVIC); Department of Justice (DOJ); National Vaccine Program...

77 FR 70169 - Advisory Commission on Childhood Vaccines; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014