International Journal of Environmental Research and Public Health

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224 KiB

Open AccessArticle

A Wicked Problem: Early Childhood Safety in the Dynamic, Interactive Environment of Home

by Jean Simpson, Geoff Fougere and Rob McGee

Int. J. Environ. Res. Public Health 2013, 10(5), 1647-1664; https://doi.org/10.3390/ijerph10051647 - 24 Apr 2013

Cited by 10 | Viewed by 7581

Abstract

Young children being injured at home is a perennial problem. When parents of young children and family workers discussed what influenced parents’ perceptions and responses to child injury risk at home, both “upstream” and “downstream” causal factors were identified. Among the former, complex [...] Read more.

Young children being injured at home is a perennial problem. When parents of young children and family workers discussed what influenced parents’ perceptions and responses to child injury risk at home, both “upstream” and “downstream” causal factors were identified. Among the former, complex and interactive facets of society and contemporary living emerged as potentially critical features. The “wicked problems” model arose from the need to find resolutions for complex problems in multidimensional environments and it proved a useful analogy for child injury. Designing dynamic strategies to provide resolutions to childhood injury, may address our over-dependence on ‘tame solutions’ that only deal with physical cause-and-effect relationships and which cannot address the complex interactive contexts in which young children are often injured. Full article

(This article belongs to the Special Issue Child Injury Prevention)

299 KiB

Open AccessArticle

A Comparison of Willingness to Pay to Prevent Child Maltreatment Deaths in Ecuador and the United States

by Phaedra S. Corso, Justin B. Ingels and M. Isabel Roldos

Int. J. Environ. Res. Public Health 2013, 10(4), 1342-1355; https://doi.org/10.3390/ijerph10041342 - 28 Mar 2013

Cited by 11 | Viewed by 6558

Abstract

Estimating the benefits of preventing child maltreatment (CM) is essential for policy makers to determine whether there are significant returns on investment from interventions to prevent CM. The aim of this study was to estimate the benefits of preventing CM deaths in an [...] Read more.

Estimating the benefits of preventing child maltreatment (CM) is essential for policy makers to determine whether there are significant returns on investment from interventions to prevent CM. The aim of this study was to estimate the benefits of preventing CM deaths in an Ecuadorian population, and to compare the results to a similar study in a US population. The study used the contingent valuation method to elicit respondents’ willingness to pay (WTP) for a 1 in 100,000 reduction in the risk of CM mortality. After adjusting for differences in purchasing power, the WTP to prevent the CM mortality risk reduction in the Ecuador population was $237 and the WTP for the same risk reduction in the US population was $175. In the pooled analysis, WTP for a reduction in CM mortality was significantly impacted by country (p = 0.03), history of CM (p = 0.007), payment mechanism (p < 0.001), confidence in response (p = 0.014), and appropriateness of the payment mechanism (p < 0.001). These findings suggest that estimating benefits from one culture may not be transferable to another, and that low- and middle-income countries, such as Ecuador, may be better served by developing their own benefits estimates for use in future benefit-cost analyses of interventions designed to prevent CM. Full article

(This article belongs to the Special Issue Child Injury Prevention)

235 KiB

Open AccessArticle

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

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

Int. J. Environ. Res. Public Health 2013, 10(3), 1113-1124; https://doi.org/10.3390/ijerph10031113 - 15 Mar 2013

Cited by 12 | Viewed by 7449

Abstract

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 [...] Read more.

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. Full article

(This article belongs to the Special Issue Child Injury Prevention)

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271 KiB

Open AccessArticle

A Multi-Site Study on Knowledge, Attitudes, Beliefs and Practice of Child-Dog Interactions in Rural China

by Jiabin Shen, Shaohua Li, Huiyun Xiang, Shulan Pang, Guozhang Xu and David C. Schwebel

Int. J. Environ. Res. Public Health 2013, 10(3), 950-962; https://doi.org/10.3390/ijerph10030950 - 7 Mar 2013

Cited by 27 | Viewed by 7794

Abstract

This study examines demographic, cognitive and behavioral factors that predict pediatric dog-bite injury risk in rural China. A total of 1,537 children (grades 4–6) in rural regions of Anhui, Hebei and Zhejiang Provinces, China completed self-report questionnaires assessing beliefs about and behaviors with [...] Read more.

This study examines demographic, cognitive and behavioral factors that predict pediatric dog-bite injury risk in rural China. A total of 1,537 children (grades 4–6) in rural regions of Anhui, Hebei and Zhejiang Provinces, China completed self-report questionnaires assessing beliefs about and behaviors with dogs. The results showed that almost 30% of children reported a history of dog bites. Children answered 56% of dog-safety knowledge items correctly. Regressions revealed both demographic and cognitive/behavioral factors predicted children’s risky interactions with dogs and dog-bite history. Boys behaved more riskily with dogs and were more frequently bitten. Older children reported greater risks with dogs and more bites. With demographics controlled, attitudes/beliefs of invulnerability, exposure frequency, and dog ownership predicted children’s self-reported risky practice with dogs. Attitudes/beliefs of invulnerability, dog exposure, and dog ownership predicted dog bites. In conclusion, both demographic and cognitive/behavioral factors influenced rural Chinese children’s dog-bite injury risk. Theory-based, empirically-supported intervention programs might reduce dog-bite injuries in rural China. Full article

(This article belongs to the Special Issue Child Injury Prevention)

106 KiB

Open AccessArticle

Correlates of Unsupervised Bathing of Infants: A Cross-Sectional Study

by Mirjam E. J. Van Beelen, Eduard F. Van Beeck, Paul Den Hertog, Tinneke M. J. Beirens and Hein Raat

Int. J. Environ. Res. Public Health 2013, 10(3), 856-866; https://doi.org/10.3390/ijerph10030856 - 4 Mar 2013

Cited by 5 | Viewed by 7156

Abstract

Drowning represents the third leading cause of fatal unintentional injury in infants (0–1 years). The aim of this study is to investigate correlates of unsupervised bathing. This cross-sectional study included 1,410 parents with an infant. Parents completed a questionnaire regarding supervision during bathing, [...] Read more.

Drowning represents the third leading cause of fatal unintentional injury in infants (0–1 years). The aim of this study is to investigate correlates of unsupervised bathing. This cross-sectional study included 1,410 parents with an infant. Parents completed a questionnaire regarding supervision during bathing, socio-demographic factors, and Protection Motivation Theory-constructs. To determine correlates of parents who leave their infant unsupervised, logistic regression analyses were performed. Of the parents, 6.2% left their child unsupervised in the bathtub. Parents with older children (OR 1.24; 95%CI 1.00–1.54) were more likely to leave their child unsupervised in the bathtub. First-time parents (OR 0.59; 95%CI 0.36–0.97) and non-Western migrant fathers (OR 0.18; 95%CI 0.05–0.63) were less likely to leave their child unsupervised in the bathtub. Furthermore, parents who perceived higher self-efficacy (OR 0.57; 95%CI 0.47–0.69), higher response efficacy (OR 0.34; 95%CI 0.24–0.48), and higher severity (OR 0.74; 95%CI 0.58–0.93) were less likely to leave their child unsupervised. Since young children are at great risk of drowning if supervision is absent, effective strategies for drowning prevention should be developed and evaluated. In the meantime, health care professionals should inform parents with regard to the importance of supervision during bathing. Full article

(This article belongs to the Special Issue Child Injury Prevention)

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197 KiB

Open AccessArticle

Characteristics and Trends of Hospitalized Pediatric Abuse Head Trauma in Wuhan, China: 2002–2011

by Xin Xia, Joe Xiang, Jianbo Shao, Gary A. Smith, Chuanhua Yu, Huiping Zhu and Huiyun Xiang

Int. J. Environ. Res. Public Health 2012, 9(11), 4187-4196; https://doi.org/10.3390/ijerph9114187 - 15 Nov 2012

Cited by 9 | Viewed by 8333

Abstract

This study investigated characteristics and trends of hospitalized abuse-related traumatic brain injuries (TBI) treated at a large pediatric medical center in Wuhan, China during the past 10 years. De-identified hospital discharge data for patients 0–4 years old hospitalized at the Wuhan Medical Care [...] Read more.

This study investigated characteristics and trends of hospitalized abuse-related traumatic brain injuries (TBI) treated at a large pediatric medical center in Wuhan, China during the past 10 years. De-identified hospital discharge data for patients 0–4 years old hospitalized at the Wuhan Medical Care Center for Women and Children were analyzed, and ICD-10 codes were used to identify cases of TBI. Medical notes provided by doctors in the medical record were used to identify TBI cases in which suspected child abuse was the cause. From 2002 to 2011, 3,061 pediatric TBI patients were hospitalized and 4.6% (140) of these cases were suspected child abuse-related. The majority of suspected child abuse cases involved children younger than 1 year of age (68.6%) and usually affected males (63.6%). Children with non-Abusive Head Trauma (AHT) were more likely to have full recovery outcome (68.4%, 95% CI: 66.6%–70.0%) than children with suspected AHT (44.3%, 95% CI: 36.1%–52.5%). The proportion of all childhood TBI attributable to abuse did not appear to have increased in the 10-year period at this medical center. This is the first comprehensive study highlighting the important role of suspected child abuse in causing TBIs among Chinese children. Child abuse as a major cause of TBIs among infants in China should be studied further, and there should be greater awareness of this important social and medical problem in China. Full article

(This article belongs to the Special Issue Child Injury Prevention)

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176 KiB

Open AccessArticle

Suicidal Expression among School-Attending Adolescents in a Middle-Income Sub-Saharan Country

by Michael L. Wilson, Andrea C. Dunlavy, Bharathi Viswanathan and Pascal Bovet

Int. J. Environ. Res. Public Health 2012, 9(11), 4122-4134; https://doi.org/10.3390/ijerph9114122 - 13 Nov 2012

Cited by 45 | Viewed by 8699

Abstract

We investigated correlates for suicidal expression among adolescents in the Seychelles. Data on 1,432 students (52% females) were derived from the Global School-based Health Survey. Participants were divided into three groups: those with no suicidal behavior (N = 1,199); those with suicide ideation/SI [...] Read more.

We investigated correlates for suicidal expression among adolescents in the Seychelles. Data on 1,432 students (52% females) were derived from the Global School-based Health Survey. Participants were divided into three groups: those with no suicidal behavior (N = 1,199); those with suicide ideation/SI (N = 89); and those reporting SI with a plan to carry out a suicide attempt/SISP (N = 139), each within a 12-month recall period. Using multinomial logistic regression, we examined the strength of associations with social, behavioral and economic indicators while adjusting for covariates. Sixteen percent of school-attending adolescents reported a suicidal expression (10% with a plan/6.2% without). Those reporting SI were younger (relative risk ratio RRR = 0.81; CI = 0.68–0.96), indicated signs of depression (RRR = 1.69; CI = 1.05–2.72) and loneliness (RRR=3.36; CI =1.93–5.84). Tobacco use (RRR = 2.34; CI = 1.32–4.12) and not having close friends (RRR = 3.32; CI = 1.54–7.15) were significantly associated with SI. Those with SISP were more likely to be female (RRR = 0.47; 0.30–0.74), anxious (RRR = 3.04; CI = 1.89–4.88) and lonely (RRR = 1.74; CI = 1.07–2.84). Having no close friends (RRR = 2.98; 1.56–5.69) and using tobacco (RRR = 2.41; 1.48–3.91) were also strongly associated. Having parents who were understanding was protective (RRR = 0.50; CI = 0.31–0.82). Our results suggest that school health promotion programs may benefit from targeting multiple factors associated with suicidal expression. More research, particularly multilevel designs are needed to identify peer and family influences which may modify associations with suicidality. Full article

(This article belongs to the Special Issue Child Injury Prevention)

177 KiB

Open AccessArticle

Scale-Up Approach in CATI Surveys for Estimating the Number of Foreign Body Injuries in the Aero-Digestive Tract in Children

by Silvia Snidero, Nicola Soriani, Ileana Baldi, Federica Zobec, Paola Berchialla and Dario Gregori

Int. J. Environ. Res. Public Health 2012, 9(11), 4056-4067; https://doi.org/10.3390/ijerph9114056 - 12 Nov 2012

Cited by 12 | Viewed by 6757

Abstract

Foreign body injuries are a well-known threat to children due to the high risk of ingestion of small objects and choking. In order to depict the epidemiological framework of such injuries, data are mostly available for hospitalizations and partially for emergency room visits. [...] Read more.

Foreign body injuries are a well-known threat to children due to the high risk of ingestion of small objects and choking. In order to depict the epidemiological framework of such injuries, data are mostly available for hospitalizations and partially for emergency room visits. The hidden part of the phenomenon consisting of minor self-resolved injuries is still unknown. The purpose of this paper is to provide an estimate of the overall burden of such injuries in children in Italy. Our paper proposes the use of the scale up technique to overcome most of the pitfalls of classical techniques in the estimation of the number of children aged 0–14 that suffered a foreign body injury in 2004. Our results, based on a CATI survey on 1,081 women, show that the estimated number of children under 15 years that incurred in a foreign body injury was 15,829 (95% CI: 14,376–17,282), of these 12,844 were treated in hospital or in emergency department (95% CI: 11,535–14,153). The scale-up method in conjunction with a CATI survey provides a reliable estimate of the size of hard-to-count populations as those of injured children at lower costs with respect to classical sampling schemes. Full article

(This article belongs to the Special Issue Child Injury Prevention)

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251 KiB

Open AccessArticle

Dog Bite Risk: An Assessment of Child Temperament and Child-Dog Interactions

by Aaron L. Davis, David C. Schwebel, Barbara A. Morrongiello, Julia Stewart and Melissa Bell

Int. J. Environ. Res. Public Health 2012, 9(8), 3002-3013; https://doi.org/10.3390/ijerph9083002 - 20 Aug 2012

Cited by 27 | Viewed by 10496

Abstract

Annually approximately 400,000 American children receive treatment for dog bites. Young children are at greatest risk and are frequently bitten following behavior that provokes familiar dogs. This study investigated the effects of child temperament on children’s interaction with dogs. Eighty-eight children aged 3.5–6 [...] Read more.

Annually approximately 400,000 American children receive treatment for dog bites. Young children are at greatest risk and are frequently bitten following behavior that provokes familiar dogs. This study investigated the effects of child temperament on children’s interaction with dogs. Eighty-eight children aged 3.5–6 years interacted with a live dog. Dog and child behaviors were assessed through observational coding. Four child temperament constructs—impulsivity, inhibitory control, approach and shyness—were assessed via the parent-report Children’s Behavioral Questionnaire. Less shy children took greater risks with the dog, even after controlling for child and dog characteristics. No other temperament traits were associated with risk-taking with the dog. Based on these results, children’s behavior with unfamiliar dogs may parallel behavior with other novel or uncertain situations. Implications for dog bite intervention programs include targeting at-risk children and merging child- and parent-oriented interventions with existing programs geared toward the physical environment and the dog. Full article

(This article belongs to the Special Issue Child Injury Prevention)

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62 KiB

Open AccessArticle

Injury and Social Correlates among in-School Adolescents in Four Southeast Asian Countries

by Karl Peltzer and Supa Pengpid

Int. J. Environ. Res. Public Health 2012, 9(8), 2851-2862; https://doi.org/10.3390/ijerph9082851 - 13 Aug 2012

Cited by 43 | Viewed by 7072

Abstract

The aim of this study was to determine estimates of the prevalence and social correlates of injury among adolescents in four Southeast Asian countries. Cross-sectional national data from the Global School-based Health Survey (GSHS) included 9,333 students at the ages from 13 to [...] Read more.

The aim of this study was to determine estimates of the prevalence and social correlates of injury among adolescents in four Southeast Asian countries. Cross-sectional national data from the Global School-based Health Survey (GSHS) included 9,333 students at the ages from 13 to 15 years inclusive from Indonesia, Myanmar, Sri Lanka and Thailand is chosen by a two-stage cluster sample design to represent all students in grades 6, 7, 8, 9, and 10 in each country. The percentage of adolescents reporting one or more serious injuries within the past 12 months was 42.2% for all countries, ranging from 27.0% in Myanmar to 46.8% in Thailand. By major activity, “fall” (14.6%) was the leading external cause of injury, followed by playing or training for a sport (9.9%) and vehicle accident (6.1%). In multivariate regression analysis Thailand and Indonesia, being male, substance use (smoking and drinking alcohol) and psychological distress were associated with annual injury prevalence. Risk factors of substance use and psychological distress should be considered in an integrated approach to injury etiology in planning injury prevention and safety promotion activities among school children. Full article

(This article belongs to the Special Issue Child Injury Prevention)

Review

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85 KiB

Open AccessReview

Risky Play and Children’s Safety: Balancing Priorities for Optimal Child Development

by Mariana Brussoni, Lise L. Olsen, Ian Pike and David A. Sleet

Int. J. Environ. Res. Public Health 2012, 9(9), 3134-3148; https://doi.org/10.3390/ijerph9093134 - 30 Aug 2012

Cited by 232 | Viewed by 104309

Abstract

Injury prevention plays a key role in keeping children safe, but emerging research suggests that imposing too many restrictions on children’s outdoor risky play hinders their development. We explore the relationship between child development, play, and conceptions of risk taking with the aim [...] Read more.

Injury prevention plays a key role in keeping children safe, but emerging research suggests that imposing too many restrictions on children’s outdoor risky play hinders their development. We explore the relationship between child development, play, and conceptions of risk taking with the aim of informing child injury prevention. Generational trends indicate children’s diminishing engagement in outdoor play is influenced by parental and societal concerns. We outline the importance of play as a necessary ingredient for healthy child development and review the evidence for arguments supporting the need for outdoor risky play, including: (1) children have a natural propensity towards risky play; and, (2) keeping children safe involves letting them take and manage risks. Literature from many disciplines supports the notion that safety efforts should be balanced with opportunities for child development through outdoor risky play. New avenues for investigation and action are emerging seeking optimal strategies for keeping children “as safe as necessary,” not “as safe as possible.” This paradigm shift represents a potential for epistemological growth as well as cross-disciplinary collaboration to foster optimal child development while preserving children’s safety. Full article

(This article belongs to the Special Issue Child Injury Prevention)

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