Home safety education and provision of safety equipment for injury prevention (Review)

[Repeated poisoning episodes: Alarm sign of risk situations]

INTRODUCTION

Prevention is an essential aspect in paediatric poisonings, especially when recurrent episodes are detected. The aims of this article are to detect the recurrence rate for suspected poisoning in emergency consultations, as well as to identify the cases in which specific preventive measures are indicated, and to determine whether the creation of a specific item for recurrent episodes in the computerised medical records system facilitates its detection.

MATERIAL AND METHODS

A retrospective study was conducted on patients less than 18 years of age treated in the emergency room due to suspected poisoning during 2013 and 2014. Patients were divided according to the presence or absence of previous episodes. From January 2014, a specific item is present in the computerised medical records of the poisoned patient, where the history of previous episodes is registered. The preventive measures used between both groups were compared.

RESULTS

A total of 731 consultations were recorded for suspected poisoning. A history of previous episodes was detected in 9% of cases. Medical injury reports and follow-up in outpatient clinics were more often performed in patients with recurrent episodes than in patients without them (28.8% vs 18.0%, P=.034, and 65.2% vs. 18.8%, P<.001, respectively). In 2013, the recurrence rate was 5.9% vs 12% in 2014 (P=.004).

CONCLUSIONS

The recurrence rate observed is significant. Although preventive measures are more frequently indicated in these patients, their application is low. The creation of a specific item for recurrent episodes in a computerised medical records system facilitates their detection.

Effectiveness of a Technology-Based Injury Prevention Program for Enhancing Mothers' Knowledge of Child Safety: Protocol for a Randomized Controlled Trial

BACKGROUND

Provision of anticipatory guidance for parents is recommended as an effective strategy to prevent injuries among young children. Technology-based anticipatory guidance has been suggested to reinforce the effectiveness of injury prevention and improve parents' knowledge of child safety.

OBJECTIVE

This study aims to examine the effectiveness of a technology-based injury prevention program with parental anticipatory guidance for enhancing mothers' knowledge of child safety.

METHODS

In this randomized controlled trial, 308 mothers will be recruited from the antenatal clinics and postnatal wards of two major public hospitals in Hong Kong. Participating mothers will be randomly assigned into intervention and control groups. Mothers in the intervention group will be given free access to a technology-based injury prevention program with anticipatory guidance, whereas mothers in the control group will be given a relevant booklet on parenting. The injury prevention program, available as a website or on a mobile app, includes behavioral components based on the Theory of Planned Behavior. The primary outcome measure will be the change in the mother's knowledge of child safety. The secondary outcome measures will be age-appropriate domestic safety knowledge, attitudes, intentions, perceived behavioral control, and self-reported behavior related to home safety practice. We will also determine dose-response relationships between the outcome measures and the website and mobile app usage.

RESULTS

Enrolment of participants will begin in October 2016. Results are expected by June 2018.

CONCLUSIONS

Parents will be able to easily access the domestic injury prevention website to find information regarding child injury prevention. It is anticipated that the technology-based intervention will help parents improve their knowledge of child safety and raise their awareness about the consequences of domestic injuries and the importance of prevention.

TRIAL REGISTRATION

Clinicaltrials.gov Clinicaltrials.gov NCT02835768; http://clinicaltrials.gov/ct2/show/NCT02835768 (Archived by WebCite at http://www.webcitation/6lbXYM6b9).

Interventions to Prevent Unintentional Injuries Among Adolescents: A Systematic Review and Meta-Analysis

Globally, every day, ∼2,300 children and adolescents succumb to unintentional injuries sustained from motor vehicle collisions, drowning, poisoning, falls, burns, and violence. The rate of deaths due to motor vehicle injuries in adolescents is 10.2 per 100,000 adolescents. We systematically reviewed published evidence to identify interventions to prevent unintentional injuries among adolescents aged 11-19 years. We defined unintentional injuries as a subset of injuries for which there was no evidence of predetermined intent, and the definition included motor vehicle injuries, suffocation, drowning, poisoning, burns, falls, and sports and recreation. Thirty-five studies met study eligibility criteria. The included studies focused on interventions to prevent motor vehicle injuries and sports-related injuries. Results suggest that possession of a graduated driver license (GDL) significantly reduced road accidents by 19% (relative risk [RR]: .81; 95% confidence interval [CI]: .75-.88; n = 5). There was no impact of GDL programs on incidence of injuries (RR: .78; 95% CI: .57-1.06; n = 2), helmet use (RR: 1.0; 95% CI: .98-1.02; n = 3), and seat belt use (RR: .99; 95% CI: .97-1.0; n = 3). Sports-related injury prevention interventions led to reductions in the incidence of injuries (RR: .66; 95% CI: .53-.82; n = 15), incidence of injury per hour of exposure (RR: .63; 95% CI: .47-.86; n = 5), and injuries per number of exposures (RR: .79; 95% CI: .70-.88; n = 4). Subgroup analysis according to the type of interventions suggests that training ± education and the use of safety equipment had significant impacts on reducing the incidence of injuries. We did not find any study focusing on interventions to prevent suffocation, drowning, poisoning, burns, and falls in the adolescent age group. The existing evidence is mostly from high-income countries, limiting the generalizability of these findings for low- and middle-income countries. Studies evaluating these interventions need to be replicated in a low- and middle-income country-context to evaluate effectiveness with standardized outcome measures.

Children's Understanding of No Diving Warning Signs: Implications for Preventing Childhood Injury

The current study examined children’s understanding of No Diving warning signs. Normally-developing 7 to 10 year olds were asked questions to assess their understanding of text, images, and main messages on No Diving warning signs. These structured interviews were audio recorded and responses were later coded. Results revealed that children understood the behavior advised against (diving), why it is prohibited (can hit head on the bottom), and what can happen (serious injury including hospitalization). They understood that breaking your neck results in limitations in mobility and can occur from diving, but they did not anticipate that such an injury is likely to occur. There were no gender and few age differences, but diving experience was associated with children significantly downplaying their risk of injury. The findings suggest that having No Diving warning signs explicitly mention a broken neck, may serve to remind children of this potential consequence at the time of decision making. Active adult supervision is particularly important for children who have prior positive diving experiences.

Application and Developmental Strategies for Community-Based Injury Prevention Programs of the International Safe Communities Movement in Korea

PURPOSE

Safety of humans is an important factor that affects health overall, and injuries are one of the major public-health problems in the world. The purposes of this study were to describe the International safe Community movement which contributes to the injury prevention and safety promotion all over the world, and to identify out the application and developmental strategies for Korea.

METHODS

A review was done of previous research, reviews, and reports on the history, concepts, basic principles, and recommendations for actions of the Safe Community.

RESULTS

For this study, the application strategies of the International Safe Community movement in Korea were examined to deduce the strengths of the safe Community program. Community-based injury prevention work according to the International Safe Community model is a successful and cost-effective way of reducing injuries in the community.

CONCLUSION

Through the International Safe Community program, communities are able to realize a healthy community and achieve improved quality of lives for the people, which is the ultimate objective of the Safe Community model. In addition, it will contribute to the economic vitalization and gain through energy and enhancement of productivity of people.

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

OBJECTIVE

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.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.

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

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.

Country level economic disparities in child injury mortality

BACKGROUND

Injuries are a neglected cause of child mortality globally and the burden is unequally distributed in resource poor settings. The aim of this study is to explore the share and distribution of child injury mortality across country economic levels and the correlation between country economic level and injuries.

METHODS

All-cause and injury mortality rates per 100,000 were extracted for 187 countries for the 1-4 age group and under 5s from the Global Burden of Disease Study 2010. Countries were grouped into four economic levels. Gross domestic product (GDP) per capita was used to determine correlation with injury mortality.

RESULTS

For all regions and country economic levels, the share of injuries in all-cause mortality was greater when considering the 1-4 age group than under 5s, ranging from 36.6% in Organization for Economic Cooperation and Development countries to 10.6% in Sub-Saharan Africa. Except for Sub-Saharan Africa, there is a graded association between country economic level and 1-4 injury mortality across regions, with all low-income countries having the highest rates. Except for the two regions with the highest overall injury mortality rates, there is a significant negative correlation between GDP and injury mortality in Latin America and the Caribbean, Eastern Europe/Central Asia, Asia East/South-East and Pacific and North Africa/ Middle East.

CONCLUSIONS

Child injury mortality is unevenly distributed across regions and country economic level to the detriment of poorer countries. A significant negative correlation exists between GDP and injury in all regions, exception for the most resource poor where the burden of injuries is highest.

Child safety from the perspective of essential needs

OBJECTIVE:

to characterize the maternal care for children under one year of age with a view to child health promotion at home.

METHOD:

exploratory study with qualitative data analysis, thematic mode, based on the conceptual framework of the essential needs of children, based on interviews recorded with 16 mothers.

RESULTS:

the analysis of the maternal narratives showed elements that facilitate the promotion of child safety: presence and involvement of the parents, constant surveillance for physical and emotional protection, experiences to stimulate child development, support networks for childcare at home; and inhibiting elements of child safety: limited perception of characteristics of child development and of children's singularities, overprotection and difficulties to set limits.

CONCLUSION:

the study enhances the understanding of home care in child health promotion, directing professional actions to guarantee ongoing nurturing relationships, protection, respect for individual differences, experiences appropriate to child development, limit setting and construction of stable and supportive social networks. In addition, the relevance of considering the maternal perspective in child health care is considered, as a strategy to apprehend aspects related to the attendance of the growth and development needs, particularly for child health promotion at home.