International Journal of Environmental Research and Public Health

Editorial

Jump to: Research, Review, Other

7 pages, 578 KiB

Open AccessEditorial

The Global Challenge of Child Injury Prevention

by David A. Sleet

Int. J. Environ. Res. Public Health 2018, 15(9), 1921; https://doi.org/10.3390/ijerph15091921 - 4 Sep 2018

Cited by 69 | Viewed by 12456

Abstract

n/a Full article

(This article belongs to the Special Issue Child Injury Prevention 2017)

► Show Figures

Figure 1

Research

Jump to: Editorial, Review, Other

19 pages, 47613 KiB

Open AccessArticle

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

by Michael F. Ballesteros, Dionne D. Williams, Karin A. Mack, Thomas R. Simon and David A. Sleet

Int. J. Environ. Res. Public Health 2018, 15(4), 616; https://doi.org/10.3390/ijerph15040616 - 28 Mar 2018

Cited by 56 | Viewed by 10126

Abstract

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 [...] Read more.

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. Full article

(This article belongs to the Special Issue Child Injury Prevention 2017)

► Show Figures

Figure 1

278 KiB

Open AccessArticle

A Comprehensive Approach to Motorcycle-Related Head Injury Prevention: Experiences from the Field in Vietnam, Cambodia, and Uganda

by Greig Craft, Truong Van Bui, Mirjam Sidik, Danielle Moore, David J. Ederer, Erin M. Parker, Michael F. Ballesteros and David A. Sleet

Int. J. Environ. Res. Public Health 2017, 14(12), 1486; https://doi.org/10.3390/ijerph14121486 - 30 Nov 2017

Cited by 15 | Viewed by 5842

Abstract

Motorcyclists account for 23% of global road traffic deaths and over half of fatalities in countries where motorcycles are the dominant means of transport. Wearing a helmet can reduce the risk of head injury by as much as 69% and death by 42%; [...] Read more.

Motorcyclists account for 23% of global road traffic deaths and over half of fatalities in countries where motorcycles are the dominant means of transport. Wearing a helmet can reduce the risk of head injury by as much as 69% and death by 42%; however, both child and adult helmet use are low in many countries where motorcycles are a primary mode of transportation. In response to the need to increase helmet use by all drivers and their passengers, the Global Helmet Vaccine Initiative (GHVI) was established to increase helmet use in three countries where a substantial portion of road users are motorcyclists and where helmet use is low. The GHVI approach includes five strategies to increase helmet use: targeted programs, helmet access, public awareness, institutional policies, and monitoring and evaluation. The application of GHVI to Vietnam, Cambodia, and Uganda resulted in four key lessons learned. First, motorcyclists are more likely to wear helmets when helmet use is mandated and enforced. Second, programs targeted to at-risk motorcyclists, such as child passengers, combined with improved awareness among the broader population, can result in greater public support needed to encourage action by decision-makers. Third, for broad population-level change, using multiple strategies in tandem can be more effective than using a single strategy alone. Lastly, the successful expansion of GHVI into Cambodia and Uganda has been hindered by the lack of helmet accessibility and affordability, a core component contributing to its success in Vietnam. This paper will review the development of the GHVI five-pillar approach in Vietnam, subsequent efforts to implement the model in Cambodia and Uganda, and lessons learned from these applications to protect motorcycle drivers and their adult and child passengers from injury. Full article

(This article belongs to the Special Issue Child Injury Prevention 2017)

1601 KiB

Open AccessArticle

Improving Pool Fencing Legislation in Queensland, Australia: Attitudes and Impact on Child Drowning Fatalities

by Richard C. Franklin and Amy E. Peden

Int. J. Environ. Res. Public Health 2017, 14(12), 1450; https://doi.org/10.3390/ijerph14121450 - 24 Nov 2017

Cited by 38 | Viewed by 7642

Abstract

Four-sided, non-climbable pool fencing is an effective strategy for preventing children from drowning in home swimming pools. In 2009, the Queensland Government introduced legislation to improve the effectiveness of pool fencing. This study explores community attitudes towards the effectiveness of these legislative changes [...] Read more.

Four-sided, non-climbable pool fencing is an effective strategy for preventing children from drowning in home swimming pools. In 2009, the Queensland Government introduced legislation to improve the effectiveness of pool fencing. This study explores community attitudes towards the effectiveness of these legislative changes and examines child (<5 years) drowning deaths in pools. Data from the 2011 Queensland Computer-Assisted Telephone Interviewing (CATI) Social Survey include results from questions related to pool ownership and pool fencing legislation. Fatal child drowning cases between 1 January 2005 and 31 December 2015 were sourced from coronial data. Of the 1263 respondents, 26/100 households had a pool. A total of 58% believed tightening legislation would be effective in reducing child drowning deaths. Pool owners were more likely to doubt the effectiveness of legislation (p < 0.001) when compared to non-pool owners. Perceptions of effectiveness did not differ by presence of children under the age of five. There were 46 children who drowned in Queensland home pools (7.8/100,000 pools with children residing in the residence/annum) between 2005 and 2015. While pool owners were less likely to think that tightening the legislation would be effective, the number of children drowning in home swimming pools declined over the study period. Drowning prevention agencies have more work to do to ensure that the most vulnerable (young children in houses with swimming pools) are protected. Full article

(This article belongs to the Special Issue Child Injury Prevention 2017)

► Show Figures

Figure 1

1359 KiB

Open AccessFeature PaperArticle

Fatal Pediatric Motor Vehicle Crashes on U.S. Native American Indian Lands Compared to Adjacent Non-Indian Lands: Restraint Use and Injury by Driver, Vehicle, Roadway and Crash Characteristics

by Shin Ah Oh, Chang Liu and Joyce C. Pressley

Int. J. Environ. Res. Public Health 2017, 14(11), 1287; https://doi.org/10.3390/ijerph14111287 - 25 Oct 2017

Cited by 4 | Viewed by 4228

Abstract

There are large disparities in American Indian pediatric motor vehicle (MV) mortality with reports that several factors may contribute. The Fatality Analysis Reporting System for 2000–2014 was used to examine restraint use for occupants aged 0–19 years involved in fatal MV crashes on [...] Read more.

There are large disparities in American Indian pediatric motor vehicle (MV) mortality with reports that several factors may contribute. The Fatality Analysis Reporting System for 2000–2014 was used to examine restraint use for occupants aged 0–19 years involved in fatal MV crashes on Indian lands (n = 1667) and non-Indian lands in adjacent states (n = 126,080). SAS GLIMMIX logistic regression with random effects was used to generate odds ratios (OR) with 95% confidence intervals (CI). Restraint use increased in both areas over the study period with restraint use on Indian lands being just over half that of non-Indian lands for drivers (36.8% vs. 67.8%, p < 0.0001) and for pediatric passengers (33.1% vs. 59.3%, p < 0.0001). Driver restraint was the strongest predictor of passenger restraint on both Indian and non-Indian lands exerting a stronger effect in ages 13–19 than in 0–12 year olds. Valid licensed driver was a significant predictor of restraint use in ages 0–12 years. Passengers in non-cars (SUVs, vans and pickup trucks) were less likely to be restrained. Restraint use improved over the study period in both areas, but disparities failed to narrow as restraint use remains lower and driver, vehicle and crash risk factors higher for MV mortality on Indian lands. Full article

(This article belongs to the Special Issue Child Injury Prevention 2017)

► Show Figures

Figure 1

307 KiB

Open AccessArticle

“He’s the Number One Thing in My World”: Application of the PRECEDE-PROCEED Model to Explore Child Car Seat Use in a Regional Community in New South Wales

by Kate Hunter, Lisa Keay, Kathleen Clapham, Julie Brown, Lynne E. Bilston, Marilyn Lyford, Celeste Gilbert and Rebecca Q. Ivers

Int. J. Environ. Res. Public Health 2017, 14(10), 1206; https://doi.org/10.3390/ijerph14101206 - 10 Oct 2017

Cited by 6 | Viewed by 5393

Abstract

We explored the factors influencing the use of age-appropriate car seats in a community with a high proportion of Aboriginal families in regional New South Wales. We conducted a survey and three focus groups with parents of children aged 3–5 years enrolled at [...] Read more.

We explored the factors influencing the use of age-appropriate car seats in a community with a high proportion of Aboriginal families in regional New South Wales. We conducted a survey and three focus groups with parents of children aged 3–5 years enrolled at three early learning centres on the Australian south-east coast. Survey data were triangulated with qualitative data from focus groups and analysed using the PRECEDE-PROCEED conceptual framework. Of the 133 eligible families, 97 (73%) parents completed the survey including 31% of parents who reported their children were Aboriginal. Use of age-appropriate car seats was reported by 80 (83%) of the participants, and awareness of the child car seat legislation was high (91/97, 94%). Children aged 2–3 years were less likely reported to be restrained in an age-appropriate car seat than were older children aged 4–5 years (60% versus 95%: χ² = 19.14, p < 0.001). Focus group participants highlighted how important their child’s safety was to them, spoke of the influence grandparents had on their use of child car seats and voiced mixed views on the value of authorised child car seat fitters. Future programs should include access to affordable car seats and target community members as well as parents with clear, consistent messages highlighting the safety benefits of using age-appropriate car seats. Full article

(This article belongs to the Special Issue Child Injury Prevention 2017)

658 KiB

Open AccessArticle

by Jagnoor Jagnoor, Shankar Prinja, Aliki Christou, Jannah Baker, Belinda Gabbe and Rebecca Ivers

Int. J. Environ. Res. Public Health 2017, 14(10), 1144; https://doi.org/10.3390/ijerph14101144 - 28 Sep 2017

Cited by 7 | Viewed by 4269

Abstract

Paediatric injuries can lead to long-term functional impairment and reduced health-related quality of life, and are a growing public health issue in India. To date, however, the burden has been poorly characterized. This study assessed the impact of non-fatal injuries on health-related quality [...] Read more.

Paediatric injuries can lead to long-term functional impairment and reduced health-related quality of life, and are a growing public health issue in India. To date, however, the burden has been poorly characterized. This study assessed the impact of non-fatal injuries on health-related quality of life in a prospective cohort study of 373 children admitted to three hospitals in Chandigarh and Haryana states in India. The Pediatric Quality of Life Inventory (PedsQL) and King’s Outcome Scale for Childhood Head Injury (KOSCHI) were administered at baseline (pre-injury) and at 1, 2, 4, and 12 months post-injury by telephone interview. Follow-up at all-time points was completed for 277 (77%) of all living participants. Less than one percent reported ongoing disability at 4 months, and no disability was reported at 12 months. PedsQL physical health scores were below healthy child norms (83.4) at 1 month in the cohort for ages 8–12 years and 13–16 years. Although injuries are prevalent, ongoing impact on functioning and disability from most childhood injuries at 12 months was reported to be low. The results raise questions about reliability of generic, Western-centric tools in low- and middle-income settings, and highlight the need for local context-specific tools. Full article

(This article belongs to the Special Issue Child Injury Prevention 2017)

► Show Figures

Figure 1

295 KiB

Open AccessArticle

Worsening Inequalities in Child Injury Deaths in the WHO European Region

by Dinesh Sethi, Emogene Aldridge, Ivo Rakovac and Akash Makhija

Int. J. Environ. Res. Public Health 2017, 14(10), 1128; https://doi.org/10.3390/ijerph14101128 - 26 Sep 2017

Cited by 17 | Viewed by 4642

Abstract

This article compares the mortality data for injuries in children aged 0–14 years in the World Health Organization WHO European region as estimated by the WHO Global Health Estimates for 2000 and 2015. While the region has seen a decline in child mortality [...] Read more.

This article compares the mortality data for injuries in children aged 0–14 years in the World Health Organization WHO European region as estimated by the WHO Global Health Estimates for 2000 and 2015. While the region has seen a decline in child mortality due to injuries over the years, inequality persists between the low- and middle-income countries and high-income countries in the region. The gap in child mortality due to unintentional injuries has widened over the years between these two socioeconomic regions, particularly in terms of road injuries. In contrast, mortality rate ratios due to intentional injuries have narrowed between 2000 and 2015. The low- and middle-income countries need to scale up their efforts in injury prevention by adopting stricter regulations and higher safety practices to narrow the East-West gap in unintentional injuries. Full article

(This article belongs to the Special Issue Child Injury Prevention 2017)

299 KiB

Open AccessArticle

Alcohol-Related Physical Abuse of Children in the Slums of Kampala, Uganda

by Monica H. Swahn, Rachel E. Culbreth, Catherine A. Staton, Shannon R. Self-Brown and Rogers Kasirye

Int. J. Environ. Res. Public Health 2017, 14(10), 1124; https://doi.org/10.3390/ijerph14101124 - 26 Sep 2017

Cited by 22 | Viewed by 4930

Abstract

This study examines the patterns of alcohol-related physical abuse and alcohol use and related behaviors among children living in the slums of Kampala, Uganda. The study is based on a cross-sectional survey, conducted in spring 2014, of service-seeking children ages 12 to 18 [...] Read more.

This study examines the patterns of alcohol-related physical abuse and alcohol use and related behaviors among children living in the slums of Kampala, Uganda. The study is based on a cross-sectional survey, conducted in spring 2014, of service-seeking children ages 12 to 18 years (n = 1134) attending Uganda Youth Development Link drop-in centers for vulnerable children in the slums. Descriptive statistics, chi-squares, and bivariate and multivariable logistic regression analyses were conducted to determine patterns of children’s alcohol-related behaviors, based on alcohol-related physical abuse and neglect. Nearly 34% of children (n = 380) reported experiencing physical abuse, and 12.4% (n = 140) reported experiencing alcohol-related physical abuse. Alcohol-related neglect was reported among 19.6% (n = 212) of the children. Past year alcohol use was significantly more prevalent among children who reported experiencing alcohol-related neglect (

χ^{2}

= 79.18, df = 1, p < 0.0001) and alcohol-related physical abuse (

χ^{2}

= 62.02, df = 1, p < 0.0001). Reporting physical abuse was also associated with parental alcohol use (OR: 1.85; 95% CI: 1.38, 2.48) and parental partner violence (OR: 5.51; 95% CI: 4.09, 7.43), after adjusting for other variables in the model. Given the high levels of alcohol-related abuse and neglect reported in this population, both primary and secondary prevention initiatives are needed to improve parenting strategies and to reduce alcohol-related harm. Similarly, strategies to reduce and delay alcohol use among these vulnerable children are also needed. Full article

(This article belongs to the Special Issue Child Injury Prevention 2017)

298 KiB

Open AccessArticle

Are mHealth Interventions to Improve Child Restraint System Installation of Value? A Mixed Methods Study of Parents

by Linda Fleisher, Danielle Erkoboni, Katherine Halkyard, Emily Sykes, Marisol S. Norris, Lorrie Walker and Flaura Winston

Int. J. Environ. Res. Public Health 2017, 14(10), 1122; https://doi.org/10.3390/ijerph14101122 - 26 Sep 2017

Cited by 8 | Viewed by 4142

Abstract

Childhood death from vehicle crashes and the delivery of information about proper child restraint systems (CRS) use continues to be a critical public health issue. Safe Seat, a sequential, mixed-methods study identified gaps in parental knowledge about and perceived challenges in the use [...] Read more.

Childhood death from vehicle crashes and the delivery of information about proper child restraint systems (CRS) use continues to be a critical public health issue. Safe Seat, a sequential, mixed-methods study identified gaps in parental knowledge about and perceived challenges in the use of appropriate CRS and insights into the preferences of various technological approaches to deliver CRS education. Focus groups (eight groups with 21 participants) and a quantitative national survey (N = 1251) using MTurk were conducted. Although there were differences in the age, racial/ethnic background, and educational level between the focus group participants and the national sample, there was a great deal of consistency in the need for more timely and personalized information about CRS. The majority of parents did not utilize car seat check professionals although they expressed interest in and lack of knowledge about how to access these resources. Although there was some interest in an app that would be personalized and able to push just-in-time content (e.g., new guidelines, location and times of car seat checks), content that has sporadic relevance (e.g., initial installation) seemed more appropriate for a website. Stakeholder input is critical to guide the development and delivery of acceptable and useful child safety education. Full article

(This article belongs to the Special Issue Child Injury Prevention 2017)

1353 KiB

Open AccessArticle

The Canadian Atlas of Child and Youth Injury: Mobilizing Injury Surveillance Data to Launch a National Knowledge Translation Tool

by Ian Pike, Jennifer Smith, Samar Al-Hajj, Pamela Fuselli and Alison Macpherson

Int. J. Environ. Res. Public Health 2017, 14(9), 982; https://doi.org/10.3390/ijerph14090982 - 30 Aug 2017

Cited by 7 | Viewed by 4480

Abstract

Child and youth injury prevention research in Canada has lagged behind other Organisation for Economic Co-operation and Development nations, despite existing surveillance systems and longitudinal data. A critical need to improve access to the available data, as well as need to tailor its [...] Read more.

Child and youth injury prevention research in Canada has lagged behind other Organisation for Economic Co-operation and Development nations, despite existing surveillance systems and longitudinal data. A critical need to improve access to the available data, as well as need to tailor its display and interpretation, was identified by injury prevention stakeholders involved in research, policy, and practice. The Canadian Atlas of Child and Youth Injury Prevention (“the Atlas”) was developed to address this need. Following a series of iterative consultation meetings and a pilot testing session, the Atlas was scaled up with national data. Two testing sessions were held to evaluate the tools. The Atlas is comprised of three main components: data, indicators, and visualizations. The accessibility of the dashboard is enhanced by customization of data visualizations and data outputs to suit the user’s needs. Overall feedback indicated that the tools were easy to use, and that the interface was intuitive and visually appealing. The Canadian Atlas of Child and Youth Injury Prevention provides readily accessible information to injury prevention practitioners, policy makers and researchers, helping to chart pathways to success in improving the child and youth injury prevention system in Canada. Full article

(This article belongs to the Special Issue Child Injury Prevention 2017)

► Show Figures

Figure 1

597 KiB

Open AccessArticle

Perceived Injury Risk among Junior Cricketers: A Cross Sectional Survey

by Prasanna J. Gamage, Lauren V. Fortington and Caroline F. Finch

Int. J. Environ. Res. Public Health 2017, 14(8), 946; https://doi.org/10.3390/ijerph14080946 - 22 Aug 2017

Cited by 8 | Viewed by 6358

Abstract

Understanding how junior athletes perceive injury risks when participating in sport and the environment they play in is an important component of injury prevention. This study investigates how Sri Lankan junior cricketers (n = 365, aged 11–14 years, boys) perceive injury risks [...] Read more.

Understanding how junior athletes perceive injury risks when participating in sport and the environment they play in is an important component of injury prevention. This study investigates how Sri Lankan junior cricketers (n = 365, aged 11–14 years, boys) perceive injury risks associated with playing cricket. The study used a Sri Lankan modification of an Australian junior cricket injury risk perception survey that considered playing cricket versus other sports, different cricket playing positions and roles, and different ground conditions. The risk of playing cricket was considered to be greater than that for cycling, but lower than that for rugby and soccer. Fast-bowlers, batters facing fast-bowlers, fielding close in the field, and wicket-keeping without a helmet were perceived to pose greater risks of injury than other scenarios. Playing on hard, bumpy and/or wet ground conditions were perceived to have a high risk opposed to playing on a grass field. Fielding in the outfield and wicket-keeping to fast-bowlers whilst wearing a helmet were perceived as low risk actions. The risk perceptions of junior cricketers identified in this study, do not necessarily reflect the true injury risk in some instances. This information will inform the development of injury prevention education interventions to address these risk perceptions in junior cricketers. Full article

(This article belongs to the Special Issue Child Injury Prevention 2017)

► Show Figures

Figure 1

4056 KiB

Open AccessArticle

Unintentional Child and Adolescent Drowning Mortality from 2000 to 2013 in 21 Countries: Analysis of the WHO Mortality Database

by Yue Wu, Yun Huang, David C. Schwebel and Guoqing Hu

Int. J. Environ. Res. Public Health 2017, 14(8), 875; https://doi.org/10.3390/ijerph14080875 - 4 Aug 2017

Cited by 29 | Viewed by 6847

Abstract

Limited research considers change over time for drowning mortality among individuals under 20 years of age, or the sub-cause (method) of those drownings. We assessed changes in under-20 drowning mortality from 2000 to 2013 among 21 countries. Age-standardized drowning mortality data were obtained [...] Read more.

Limited research considers change over time for drowning mortality among individuals under 20 years of age, or the sub-cause (method) of those drownings. We assessed changes in under-20 drowning mortality from 2000 to 2013 among 21 countries. Age-standardized drowning mortality data were obtained through the World Health Organization (WHO) Mortality Database. Twenty of the 21 included countries experienced a reduction in under-20 drowning mortality rate between 2000 and 2013, with decreases ranging from −80 to −13%. Detailed analysis by drowning method presented large variations in the cause of drowning across countries. Data were missing due to unspecified methods in some countries but, when known, drowning in natural bodies of water was the primary cause of child and adolescent drowning in Poland (56–92%), Cuba (53–81%), Venezuela (43–56%), and Japan (39–60%), while drowning in swimming pools and bathtubs was common in the United States (26–37%) and Japan (28–39%), respectively. We recommend efforts to raise the quality of drowning death reporting systems and discuss prevention strategies that may reduce child and adolescent drowning risk, both in individual countries and globally. Full article

(This article belongs to the Special Issue Child Injury Prevention 2017)

► Show Figures

Figure 1

295 KiB

Open AccessArticle

Child Supervision and Burn Outcome among Admitted Patients at Major Trauma Hospitals in the Gambia

by Edrisa Sanyang, Corinne Peek-Asa, Tracy Young and Laurence Fuortes

Int. J. Environ. Res. Public Health 2017, 14(8), 856; https://doi.org/10.3390/ijerph14080856 - 30 Jul 2017

Cited by 12 | Viewed by 4632

Abstract

Burn-related injuries are a significant burden in children, particularly in low- and middle-income countries (LMICs), where more than 90% of burn-related pediatric deaths occur. Lack of adult supervision of children is a major risk for pediatric burn injuries. The goal of this paper [...] Read more.

Burn-related injuries are a significant burden in children, particularly in low- and middle-income countries (LMICs), where more than 90% of burn-related pediatric deaths occur. Lack of adult supervision of children is a major risk for pediatric burn injuries. The goal of this paper was to examine the general characteristics of burns and identify burn injury outcomes among adult-supervised children compared to those who were not supervised. The study examined burn injury and clinical characteristics among all burn patients admitted to two trauma hospitals in The Gambia, West Africa. At intake in the emergency room, the treating physician or nurse determined the need for admission based on body surface area burned (BSAB), depth of burn, and other clinical considerations such as co-occurring injuries and co-morbidities. During the study period of 1 April 2014 through 31 October 2016, 105 burn patients were admitted and data were collected by the treating physician for all of them. Information about supervision was only asked for children aged five years or less. More than half (51%) of the burn patients were children under 18 years, and 22% were under 5 years. Among children under five, most (86.4%) were supervised by an adult at the time of burn event. Of the 19 supervised children, 16 (84.2%) had body area surface burned (BSAB) of less than 20%. Two of the three children without adult supervision at the time of burn event had BSAB ≥ 20%. Overall, 59% of the patients had 20% + BSAB. Females (aOR = 1.25; 95% CI = 0.43–3.62), those burned in rural towns and villages (aOR = 2.29; 95% CI = 0.69–7.57), or burned by fire or flames (aOR = 1.47; 95% CI = 0.51–4.23) had increased odds of having a BSAB ≥ 20%, although these differences were not statistically significant. Children 0–5 years or 5–18 years (aOR = 0.04, 95% CI = 0.01–0.17; aOR = 0.07, 95% CI = 0.02–0.23, respectively) were less likely to have BSAB ≥ 20% than adults. Those burned in a rural location (aOR = 9.23, 95% CI = 2.30–37.12) or by fire or flames (aOR = 6.09, 95% CI = 1.55–23.97) were more likely to die. Children 0–5 years or 5–18 years (aOR = 0.2, 95% CI = 0.03–1.18; aOR = 0.38; 95% CI = 0.11–1.570, respectively) were less likely to die. Children constitute a significant proportion of admitted burn patients, and most of them were supervised at the time of the burn event. Supervised children (compared to unsupervised children) had less severe burns. Programs that focus on burn prevention at all levels including child supervision could increase awareness and reduce burns or their severity. Programs need to be designed and evaluated with focus on the child development stage and the leading causes of burns by age group. Full article

(This article belongs to the Special Issue Child Injury Prevention 2017)

465 KiB

Open AccessArticle

Evaluating Otto the Auto: Does Engagement in an Interactive Website Improve Young Children’s Transportation Safety?

by David C. Schwebel, Anna Johnston, Jiabin Shen and Peng Li

Int. J. Environ. Res. Public Health 2017, 14(7), 804; https://doi.org/10.3390/ijerph14070804 - 19 Jul 2017

Cited by 1 | Viewed by 4009

Abstract

Transportation-related injuries are a leading cause of pediatric death, and effective interventions are limited. Otto the Auto is a website offering engaging, interactive activities. We evaluated Otto among a sample of sixty-nine 4- and 5-year-old children, who participated in a randomized parallel group [...] Read more.

Transportation-related injuries are a leading cause of pediatric death, and effective interventions are limited. Otto the Auto is a website offering engaging, interactive activities. We evaluated Otto among a sample of sixty-nine 4- and 5-year-old children, who participated in a randomized parallel group design study. Following baseline evaluation, children engaged with either Otto or a control website for 2 weeks and then were re-evaluated. Children who used Otto failed to show increases in transportation safety knowledge or behavior compared to the control group, although there was a dosage effect whereby children who engaged in the website more with parents gained safer behavior patterns. We conclude Otto may have some efficacy when engaged by children with their parents, but continued efforts to develop and refine engaging, effective, theory-driven strategies to teach children transportation safety, including via internet, should be pursued. Full article

(This article belongs to the Special Issue Child Injury Prevention 2017)

► Show Figures

Figure 1

577 KiB

Open AccessArticle

Adherence to Referral Criteria at Admission and Patient Management at a Specialized Burns Centre: The Case of the Red Cross War Memorial Children’s Hospital in Cape Town, South Africa

by Constance Boissin, Marie Hasselberg, Emil Kronblad, So-Mang Kim, Lee Wallis, Heinz Rode and Lucie Laflamme

Int. J. Environ. Res. Public Health 2017, 14(7), 732; https://doi.org/10.3390/ijerph14070732 - 6 Jul 2017

Cited by 6 | Viewed by 6495

Abstract

Referral guidelines for burn care are meant to assist in decision-making as regards patient transfer and admissions to specialized units. Little is known, however, concerning how closely they are followed and whether they are linked to patient care. This is the object of [...] Read more.

Referral guidelines for burn care are meant to assist in decision-making as regards patient transfer and admissions to specialized units. Little is known, however, concerning how closely they are followed and whether they are linked to patient care. This is the object of the current study, focused on the paediatric burns centre of the Red Cross War Memorial Children’s Hospital in Cape Town, South Africa. All patients admitted to the centre during the winters of 2011–2015 (n = 1165) were included. The patient files were scrutinized to clarify whether the referral criteria in place were identified (seven in total) and to compile data on patient and injury characteristics. A case was defined as adherent to the criteria when at least one criterion was fulfilled and adherence was expressed as a percentage with 95% confidence intervals, for all years aggregated as well as by year and by patient or injury characteristics. The association between adherence to any individual criterion and hospital care (surgery or longer length of stay) was measured using logistic regressions. The overall adherence was 93.4% (100% among children under 2 years of age and 86% among the others) and it did not vary remarkably over time. The two criteria of “injury sustained at a specific anatomical site” (85.2%) and “young age” (51.9%) were those most often identified. Children aged 2 years or older were more likely to undergo surgery or to stay longer than those of young age (although a referral criterion) and so were those with higher injury severity (a referral criterion). In this specialized paediatric burns centre, children are admitted mainly according to the guidelines. However, given the high prevalence of paediatric burns in the region and the limited resources at the burns centre, adherence to the guidelines need to be further studied at all healthcare levels in the province. Full article

(This article belongs to the Special Issue Child Injury Prevention 2017)

► Show Figures

Figure 1

426 KiB

Open AccessArticle

Trends in Pediatric and Adolescent Anterior Cruciate Ligament Injuries in Victoria, Australia 2005–2015

by Louise Shaw and Caroline F. Finch

Int. J. Environ. Res. Public Health 2017, 14(6), 599; https://doi.org/10.3390/ijerph14060599 - 5 Jun 2017

Cited by 94 | Viewed by 8733

Abstract

Anterior cruciate ligament (ACL) injuries in children and adolescents have been the focus of recent media attention and parental concern, given their potential for adverse long-term health outcomes and healthcare costs. However, there is limited formal evidence on trends in the incidence of [...] Read more.

Anterior cruciate ligament (ACL) injuries in children and adolescents have been the focus of recent media attention and parental concern, given their potential for adverse long-term health outcomes and healthcare costs. However, there is limited formal evidence on trends in the incidence of ACL injuries in children. This study utilizes the Victorian Admitted Episodes Dataset (VAED) to characterize epidemiologic trends of hospital-admitted ACL injuries in those aged 5 to 14 years over a period of 10 years from 2005 to 2015. There was a total of 320 cases and the overall annual rate of ACL injuries increased by 147.8% from 2.74 per 100,000 population in 2005/2006 to 6.79 per 100,000 in 2014/2015. The majority (96.9%) of these injuries were in 10- to 14-year-olds. The main in-hospital procedure provided to over 80% of the hospitalized cases involved ACL reconstruction. Sporting activities accounted for 56.6% of ACL injuries. For females, over half (52.4%) of ACL injuries occurred whilst playing ball sports, compared to 35.4% of males. The large increase in ACL injuries in 5- to 14-year-olds in the state of Victoria, Australia over a 10-year period indicates they are a significant and emerging health burden. Population-wide ACL prevention policies are required to halt these trends. Cost effective prevention programs that involve neuromuscular training must be implemented in schools and junior sports teams. Full article

(This article belongs to the Special Issue Child Injury Prevention 2017)

► Show Figures

Figure 1

586 KiB

Open AccessArticle

U.S. Trends of ED Visits for Pediatric Traumatic Brain Injuries: Implications for Clinical Trials

by Cheng Chen, Junxin Shi, Rachel M. Stanley, Eric A. Sribnick, Jonathan I. Groner and Henry Xiang

Int. J. Environ. Res. Public Health 2017, 14(4), 414; https://doi.org/10.3390/ijerph14040414 - 13 Apr 2017

Cited by 36 | Viewed by 5407

Abstract

Our goal in this paper was to use the 2006–2013 Nationwide Emergency Department Sample (NEDS) database to describe trends of annual patient number, patient demographics and hospital characteristics of pediatric traumatic brain injuries (TBI) treated in U.S. emergency departments (EDs); and to use [...] Read more.

Our goal in this paper was to use the 2006–2013 Nationwide Emergency Department Sample (NEDS) database to describe trends of annual patient number, patient demographics and hospital characteristics of pediatric traumatic brain injuries (TBI) treated in U.S. emergency departments (EDs); and to use the same database to estimate the available sample sizes for various clinical trials of pediatric TBI cases. National estimates of patient demographics and hospital characteristics were calculated for pediatric TBI. Simulation analyses assessed the potential number of pediatric TBI cases from randomly selected hospitals for inclusion in future clinical trials under different scenarios. Between 2006 and 2013, the NEDS database estimated that of the 215,204,932 children who visited the ED, 6,089,930 (2.83%) had a TBI diagnosis. During the study period in the US EDs, pediatric TBI patients increased by 34.1%. Simulation analyses suggest that hospital EDs with annual TBI ED visits >1000, Levels I and II Trauma Centers, pediatric hospitals, and teaching hospitals will likely provide ample cases for pediatric TBI studies. However, recruiting severe pediatric TBI cases for clinical trials from a limited number of hospital EDs will be challenging due to small sample sizes. Pediatric TBI-related ED visits in the U.S. increased by over 30% from 2006 to 2013. Including unspecified head injury cases with ICD-9-CM code 959.01 would significantly change the national estimates and demographic patterns of pediatric TBI cases. Future clinical trials of children with TBI should conduct a careful feasibility assessment to estimate their sample size and study power in selected study sites. Full article

(This article belongs to the Special Issue Child Injury Prevention 2017)

► Show Figures

Figure 1

270 KiB

Open AccessArticle

Nonfatal Injuries and Psychosocial Correlates among Middle School Students in Cambodia and Vietnam

by Karl Peltzer and Supa Pengpid

Int. J. Environ. Res. Public Health 2017, 14(3), 280; https://doi.org/10.3390/ijerph14030280 - 8 Mar 2017

Cited by 15 | Viewed by 4548

Abstract

The aim of the study was to estimate the prevalence and psychosocial correlates of nonfatal injury among middle school students in Cambodia and Vietnam. Cross-sectional data from 7137 school children (mean age 15.5 years, SD = 1.4) who were randomly sampled for participation [...] Read more.

The aim of the study was to estimate the prevalence and psychosocial correlates of nonfatal injury among middle school students in Cambodia and Vietnam. Cross-sectional data from 7137 school children (mean age 15.5 years, SD = 1.4) who were randomly sampled for participation in nationally representative Global School-based Health Surveys (GSHS) in Cambodia and Vietnam were analyzed. The proportion of school children reporting one or more serious injuries in the past year was 22.6% among boys and 17.5% among girls in Cambodia and 34.3% among boys and 25.1% among girls in Vietnam. The most prevalent cause of the most serious injury in Cambodia was traffic injuries (4.7% among boys and 4.3% among girls) and in Vietnam it was falls (10.0% among boys and 7.0% among girls). In multinomial logistic regression analyses, experiencing hunger (as an indicator for low socioeconomic status) and drug use were associated with having sustained one injury and two or more injuries in the past 12 months in Cambodia. In addition, poor mental health was associated with two or more injuries. In Vietnam, being male, experiencing hunger, current alcohol use, poor mental health and ever having had sex were associated with having sustained one injury and two or more injuries in the past 12 months. Several psychosocial variables were identified which could help in designing injury prevention strategies among middle school children in Cambodia and Vietnam. Full article

(This article belongs to the Special Issue Child Injury Prevention 2017)

445 KiB

Open AccessArticle

Characteristics of Traditional Chinese Medicine Use in Pediatric Dislocations, Sprains and Strains

by Chung-Yen Lu, Hen-Hong Chang, Fung-Chang Sung and Pei-Chun Chen

Int. J. Environ. Res. Public Health 2017, 14(2), 153; https://doi.org/10.3390/ijerph14020153 - 4 Feb 2017

Cited by 6 | Viewed by 5370

Abstract

Background and Objectives: Dislocations, sprains and strains are common childhood musculoskeletal injuries, requiring medical attention. We investigated the characteristics associated with using traditional Chinese medicine (TCM) for children suffering from these injuries. Methods: From a nationwide representative insurance database of Taiwan, this cross-sectional [...] Read more.

Background and Objectives: Dislocations, sprains and strains are common childhood musculoskeletal injuries, requiring medical attention. We investigated the characteristics associated with using traditional Chinese medicine (TCM) for children suffering from these injuries. Methods: From a nationwide representative insurance database of Taiwan, this cross-sectional study identified 50,769 children with dislocations, sprains and strains under 18 years of age, newly diagnosed between 1999 and 2009, without previous TCM experience. Children who initiated treatment with TCM (n = 24,063, 47.4%) were defined as TCM users, others were in the non-TCM group. Multivariable logistic regression models estimated odds ratios (ORs) of TCM use. Results: Girls and children living in central Taiwan (vs. northern) were associated with higher TCM use. The adjusted ORs (95% confidence interval (CI)) of TCM uses were 1.60 (1.42–1.79) for patients of 3–5 years, 2.20 (1.99–2.42) of 6–12 years and 1.82 (1.64–2.01) of 13–17 years, compared with those of the <2 years group. TCM users were less likely to have outpatient visits for Western medicine care and hospitalizations in the previous year. The TCM group was nearly twice more likely than the non-user group to receive treatments at local clinics (99.1% vs. 53.3%, p < 0.001). Conclusions: This study reveals important demographic and medical factors associated with TCM uses for children with dislocations, sprains and strains. Interestingly, local clinics are the main healthcare facilities providing TCM services. Further studies are needed to evaluate the outcomes of TCM treatment for these musculoskeletal injuries. Full article

(This article belongs to the Special Issue Child Injury Prevention 2017)

► Show Figures

Figure 1

Review

Jump to: Editorial, Research, Other

549 KiB

Open AccessReview

Disparities in Non-Fatal Health Outcomes in Pediatric General Trauma Studies

by Shanthi Ameratunga, Jacqueline Ramke, Nicki Jackson, Sandar Tin Tin and Belinda Gabbe

Int. J. Environ. Res. Public Health 2018, 15(1), 43; https://doi.org/10.3390/ijerph15010043 - 27 Dec 2017

Cited by 7 | Viewed by 4396

Abstract

When prevention efforts fail, injured children require high-quality health services to support their recovery. Disparities in non-fatal injury outcomes, an indicator of health-care quality, have received minimal attention. We evaluated the extent to which general trauma follow-up studies published in the peer-reviewed scientific [...] Read more.

When prevention efforts fail, injured children require high-quality health services to support their recovery. Disparities in non-fatal injury outcomes, an indicator of health-care quality, have received minimal attention. We evaluated the extent to which general trauma follow-up studies published in the peer-reviewed scientific literature provide evidence of socially patterned inequities in health, functional or disability outcomes ≥4 weeks after childhood injuries. Using a systematic search, we identified 27 eligible cohort studies from 13 high-income countries. We examined the extent to which the reported health outcomes varied across the PROGRESS criteria: place of residence, race/ethnicity, occupation, gender/sex, religion, socio-economic status, and social capital. The available evidence on differential outcomes is limited as many studies were compromised by selection or retention biases that reduced the participation of children from demographic groups at increased risk of adverse outcomes, or the analyses mainly focused on variations in outcomes by sex. Given the limited research evidence, we recommend greater attention to systematic collection and reporting of non-fatal injury outcomes disaggregated by socio-demographic indicators in order to identify disparities where these exist and inform equity-focused interventions promoting the recovery of injured children. Full article

(This article belongs to the Special Issue Child Injury Prevention 2017)

► Show Figures

Figure 1

332 KiB

Open AccessReview

Executive Function Capacities, Negative Driving Behavior and Crashes in Young Drivers

by Elizabeth A. Walshe, Chelsea Ward McIntosh, Daniel Romer and Flaura K. Winston

Int. J. Environ. Res. Public Health 2017, 14(11), 1314; https://doi.org/10.3390/ijerph14111314 - 28 Oct 2017

Cited by 77 | Viewed by 10089

Abstract

Motor vehicle crashes remain a leading cause of injury and death in adolescents, with teen drivers three times more likely to be in a fatal crash when compared to adults. One potential contributing risk factor is the ongoing development of executive functioning with [...] Read more.

Motor vehicle crashes remain a leading cause of injury and death in adolescents, with teen drivers three times more likely to be in a fatal crash when compared to adults. One potential contributing risk factor is the ongoing development of executive functioning with maturation of the frontal lobe through adolescence and into early adulthood. Atypical development resulting in poor or impaired executive functioning (as in Attention-Deficit/Hyperactivity Disorder) has been associated with risky driving and crash outcomes. However, executive function broadly encompasses a number of capacities and domains (e.g., working memory, inhibition, set-shifting). In this review, we examine the role of various executive function sub-processes in adolescent driver behavior and crash rates. We summarize the state of methods for measuring executive control and driving outcomes and highlight the great heterogeneity in tools with seemingly contradictory findings. Lastly, we offer some suggestions for improved methods and practical ways to compensate for the effects of poor executive function (such as in-vehicle assisted driving devices). Given the key role that executive function plays in safe driving, this review points to an urgent need for systematic research to inform development of more effective training and interventions for safe driving among adolescents. Full article

(This article belongs to the Special Issue Child Injury Prevention 2017)

661 KiB

Open AccessReview

Interventions Aimed at the Prevention of Childhood Injuries in the Indigenous Populations in Canada, Australia and New Zealand in the Last 20 Years: A Systematic Review

by Alyssa Margeson and Selena Gray

Int. J. Environ. Res. Public Health 2017, 14(6), 589; https://doi.org/10.3390/ijerph14060589 - 2 Jun 2017

Cited by 7 | Viewed by 4810

Abstract

Globally, Indigenous children are found to be at a significantly higher risk of injury compared to non-Indigenous children. It has been suggested that mainstream injury prevention strategies are ineffective within Indigenous communities. The aim of this review is to identify existing interventions aimed [...] Read more.

Globally, Indigenous children are found to be at a significantly higher risk of injury compared to non-Indigenous children. It has been suggested that mainstream injury prevention strategies are ineffective within Indigenous communities. The aim of this review is to identify existing interventions aimed at preventing injury in Indigenous children in the hope that it guides future strategies. To the best of the authors’ knowledge, no prior systematic reviews exist looking at interventions specifically aimed at preventing injury in Indigenous child populations in the three chosen countries. Electronic databases were systematically searched for relevant childhood interventions aimed at the prevention of injuries in Indigenous populations based in Canada, Australia and New Zealand from 1996 to 2016. A manual search of the reference lists of relevant articles and a manual search of relevant websites were also completed. After 191 records were screened, six interventions were identified meeting the criteria for inclusion. Eligible papers underwent a quality appraisal using adapted assessment checklists and key information was extracted. Findings were then synthesized using a narrative approach. The interventions mainly promoted child safety through activities focusing on education and awareness. Only three of the six studies measured changes in injury hospitalization rates, all but one evaluation reporting a significant decrease. Studies which measured awareness all demonstrated positive changes. Results suggest that interventions delivered in a culturally appropriate manner acted as a main success factor. Barriers identified as hindering intervention success included lack of cohesion within the intervention due to staff turnover and lack of experienced staff with Indigenous knowledge. This review revealed a limited amount of evaluated interventions for the prevention of Indigenous childhood injuries. Conclusive evidence of the effectiveness of existing interventions is lacking due to the predominantly small-scale evaluations of pilot interventions. Future research is needed to provide more rigorous evidence of the mechanisms driving the successful implementation, delivery and uptake of such strategies tailored to Indigenous children. Full article

(This article belongs to the Special Issue Child Injury Prevention 2017)

► Show Figures

Figure 1

Other

Jump to: Editorial, Research, Review

276 KiB

Open AccessBrief Report

Analysis of Baseline Computerized Neurocognitive Testing Results among 5–11-Year-Old Male and Female Children Playing Sports in Recreational Leagues in Florida

by Karen D. Liller, Barbara Morris, Jessica Fillion, Yingwei Yang and Omonigho M. Bubu

Int. J. Environ. Res. Public Health 2017, 14(9), 1028; https://doi.org/10.3390/ijerph14091028 - 7 Sep 2017

Cited by 4 | Viewed by 5489

Abstract

There is a paucity of data related to sports injuries, concussions, and computerized neurocognitive testing (CNT) among very young athletes playing sports in recreational settings. The purpose of this study was to report baseline CNT results among male and female children, ages 5–11, [...] Read more.

There is a paucity of data related to sports injuries, concussions, and computerized neurocognitive testing (CNT) among very young athletes playing sports in recreational settings. The purpose of this study was to report baseline CNT results among male and female children, ages 5–11, playing sports in Hillsborough County, Florida using ImPACT Pediatric, which is specifically designed for this population. Data were collected from 2016 to 2017. The results show that 657 baseline tests were conducted and t-tests and linear regression were used to assess mean significant differences in composite scores with sex and age. Results showed that females scored better on visual memory and in general as age increased, baseline scores improved. The results can be used to build further studies on the use of CNT in recreational settings and their role in concussion treatment, management, and interventions. Full article

(This article belongs to the Special Issue Child Injury Prevention 2017)

Journal Menu

Journal Browser

Child Injury Prevention 2017

Share This Special Issue

Special Issue Editor

Special Issue Information

Keywords

Benefits of Publishing in a Special Issue

Published Papers (24 papers)

Editorial

Research

Review

Other

Further Information

Guidelines

MDPI Initiatives

Follow MDPI