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Perkins LA, Lee JG, Santorelli JE, Strait E, Smith A, Costantini TW, Doucet JJ, Haines LN. The Scalding Truth: Geospatial Analysis Identifies Communities at Risk for Pediatric Scald Burns. J Surg Res 2024; 300:336-344. [PMID: 38843720 DOI: 10.1016/j.jss.2024.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 02/21/2024] [Accepted: 05/08/2024] [Indexed: 07/16/2024]
Abstract
INTRODUCTION Pediatric scald burns account for 12% of all U.S. burn center admissions and are the most common type of burn in children. We hypothesized that geospatial analysis of burn registry data could identify specific geographic areas and risk factors to focus injury prevention efforts. METHODS The burn registry of a U.S. regional burn center was used to retrospectively identify pediatric scald burn patients ages 0-17, from January 2018 to June 2023. Geocoding of patient home addresses with census tract data was performed. Area Deprivation Index (ADI) was assigned to patients at the census block group level. Burn incident hot spot analysis to identify statistically significant burn incident clusters was done using the Getis Ord Gi∗ statistic. RESULTS There were 950 pediatric scald burn patients meeting study criteria. The cohort was 52% male and 36% White, with median age of 3 y and median total body surface area of 1.5%; 23.8% required hospital admission. On multivariable logistic regression, increased child poverty levels (P = 0.004) and children living in single-parent households (P = 0.009) were associated with increased scald burn incidence. Geospatial analysis identified burn hot spots, which were associated with higher ADI (P < 0.001). Black patients were more likely to undergo admission compared to White patients. CONCLUSIONS Geospatial analysis of burn registry data identified geographic areas at high risk of pediatric scald burn. ADI, poverty, and children in single-parent households were the greatest predictors of injury. Addressing these inequalities requires targeted injury prevention education, enhanced outpatient support systems and more robust community resources.
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Affiliation(s)
- Louis A Perkins
- Division of Trauma, Surgical Critical Care, Burns and Acute Care Surgery, Department of Surgery, UC San Diego School of Medicine, San Diego, California.
| | - Jeanne G Lee
- Division of Trauma, Surgical Critical Care, Burns and Acute Care Surgery, Department of Surgery, UC San Diego School of Medicine, San Diego, California
| | - Jarrett E Santorelli
- Division of Trauma, Surgical Critical Care, Burns and Acute Care Surgery, Department of Surgery, UC San Diego School of Medicine, San Diego, California
| | - Eli Strait
- Division of Trauma, Surgical Critical Care, Burns and Acute Care Surgery, Department of Surgery, UC San Diego School of Medicine, San Diego, California
| | - Alan Smith
- Division of Trauma, Surgical Critical Care, Burns and Acute Care Surgery, Department of Surgery, UC San Diego School of Medicine, San Diego, California
| | - Todd W Costantini
- Division of Trauma, Surgical Critical Care, Burns and Acute Care Surgery, Department of Surgery, UC San Diego School of Medicine, San Diego, California
| | - Jay J Doucet
- Division of Trauma, Surgical Critical Care, Burns and Acute Care Surgery, Department of Surgery, UC San Diego School of Medicine, San Diego, California
| | - Laura N Haines
- Division of Trauma, Surgical Critical Care, Burns and Acute Care Surgery, Department of Surgery, UC San Diego School of Medicine, San Diego, California
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Lin Z, Iyappan P, Huang Z, Sooranna SR, Wu Y, Lan L, Huang C, Liang F, Zhao D, Huang D. Logistic regression analysis of risk factors for pediatric burns: a case-control study in underdeveloped minority areas in China. Front Pediatr 2024; 12:1365492. [PMID: 38655278 PMCID: PMC11035791 DOI: 10.3389/fped.2024.1365492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 03/19/2024] [Indexed: 04/26/2024] Open
Abstract
Background Pediatric burns are common, especially in underdeveloped countries, and these can physically affect the children involved and have an impact on their mental health. The aim of the present study was to assess the effect of pediatric burns in underdeveloped minority areas of China. Methods Case information from 192 children was collected from outpatient and inpatient clinics using a survey questionnaire. These included 90 pediatric burn cases and 102 controls who were children without burns. A stepwise logistic regression analysis was used to determine the risk factors for pediatric burns in order to establish a model. The goodness-of-fit for the model was assessed using the Hosmer and Lemeshow test as well as receiver operating characteristic and internal calibration curves. A nomogram was then used to analyze the contribution of each influencing factor to the pediatric burns model. Results Seven variables, including gender, age, ethnic minority, the household register, mother's employment status, mother's education and number of children, were analyzed for both groups of children. Of these, age, ethnic minority, mother's employment status and number of children in a household were found to be related to the occurrence of pediatric burns using univariate logistic regression analysis (p < 0.05). After a collinearity diagnosis, a multivariate logistic regression analysis of variables with tolerances of >0.2 and variance inflation factor <5 showed that age was a protective factor for pediatric burns [odds ratio (OR) = 0.725; 95% confidence interval (CI): 0.665-0.801]. Compared with single-child parents, those with two children were at greater risk of pediatric burns (OR = 0.389; 95% CI: 0.158-0.959). The ethnic minority of the child and the mother's employment status were also risk factors (OR = 6.793; 95% CI: 2.203-20.946 and OR = 2.266; 95% CI: 1.025-5.012, respectively). Evaluation of the model used was found to be stable. A nomogram showed that the contribution in the children burns model was age > mother's employment status > number of children > ethnic minority. Conclusions This study showed that there are several risk factors strongly correlated to pediatric burns, including age, ethnic minority, the number of children in a household and mother's employment status. Government officials should direct their preventive approach to tackling the problem of pediatric burns by promoting awareness of these findings.
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Affiliation(s)
- Ziren Lin
- Department of Burn Surgery, The People’s Hospital of Baise, Baise, Guangxi, China
- Faculty of Pharmacy and Biomedical Sciences, MAHSA University, Kuala Lumpur, Malaysia
| | - Petchi Iyappan
- Faculty of Pharmacy and Biomedical Sciences, MAHSA University, Kuala Lumpur, Malaysia
| | - Zhiqun Huang
- Department of Burn Surgery, Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, Guangxi, China
| | - Suren Rao Sooranna
- Department of Metabolism, Digestion and Reproduction, Imperial College London, Chelsea and Westminster Hospital, London, United Kingdom
- Life Science and Clinical Research Center, Youjiang Medical University for Nationalities, Baise, Guangxi, China
| | - Yongfang Wu
- Department of Burn Surgery, The People’s Hospital of Baise, Baise, Guangxi, China
| | - Liuting Lan
- Department of Pediatrics, The People’s Hospital of Baise, Baise, Guangxi, China
| | - Cheng Huang
- Department of Burn Surgery, The People’s Hospital of Baise, Baise, Guangxi, China
| | - Feiteng Liang
- Department of Burn Surgery, Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, Guangxi, China
| | - Daji Zhao
- Department of Burn Surgery, The People’s Hospital of Baise, Baise, Guangxi, China
| | - Dingjin Huang
- Department of Burn Surgery, The People’s Hospital of Baise, Baise, Guangxi, China
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Tusiime M, Musoke D, Muneza F, Mutto M, Kobusingye O. Prevalence, risk factors and perceptions of caregivers on burns among children under 5 years in Kisenyi slum, Kampala, Uganda. Inj Epidemiol 2022; 9:18. [PMID: 35689273 PMCID: PMC9188101 DOI: 10.1186/s40621-022-00382-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 05/31/2022] [Indexed: 11/20/2022] Open
Abstract
Background Globally, burn related deaths are disproportionately higher among children below 5 years of age compared to other age groups. Although rarely fatal, most burns in this group occur within homes specifically in kitchens. This study assessed the prevalence, risk factors and perceptions of caregivers regarding burns among children under 5 years in an urban slum in Kampala, Uganda.
Methods The study used an analytic cross-sectional design with quantitative and qualitative techniques. Quantitative data were collected using a structured questionnaire and observational checklist, while qualitative data involved use of a key informant interview guide. A total of 426 children were involved in the study, while 6 key informants namely an adult mother, teenage mother, community health worker, health practitioner, father and local leader were interviewed. A modified Poisson regression model was used to determine the correlates of burn injuries, prevalence rate ratios and 95% confidence intervals, while thematic analysis was used for qualitative data. Results The prevalence of burns among under-fives was 32%, highest among those aged 24 to 35 months (39%), and least in those below 12 months (10%). Children with single parents (adj PR = 1.56 95% CI 1.07–2.29) and those from households in the middle and least poor wealth quintile (adj.PR = 1.72; 95% CI 1.02–2.89 and adj.PR = 1.77; 95% CI 1.02–3.05, respectively) were more likely to get burns compared to their counterparts in other quintiles. In households where flammables were safely stored, children were less likely to suffer from burn injuries (adj.PR = 0.61; 95% CI 0.44–0.83). Congestion, negligence of caregivers, and use of charcoal stoves/open cooking were the commonest determinants of burns. Although many caregivers offered first aid to burn patients, inadequate knowledge of proper care was noted. Crawling children were perceived as being at highest risk of burns. Conclusion The prevalence of burns among children under 5 years was high, with several household hazards identified. Health education, household modification and applicable public health law enforcement are recommended to reduce hazards and minimise burn risks among children.
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Affiliation(s)
- Marcia Tusiime
- Department of Disease Control and Environmental Health, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda.
| | - David Musoke
- Department of Disease Control and Environmental Health, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Fiston Muneza
- Department of Disease Control and Environmental Health, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Milton Mutto
- Chronic Trauma, Injury and Disability Program (TRIAD), School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda.,Pincer Training and Research Institute, Kampala, Uganda
| | - Olive Kobusingye
- Chronic Trauma, Injury and Disability Program (TRIAD), School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
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Aetiology of severe burn incidents in children under 5 years of age in the Netherlands: A prospective cohort study. Burns 2022; 48:713-722. [PMID: 34602299 DOI: 10.1016/j.burns.2021.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 06/01/2021] [Accepted: 08/24/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Risk factors and mechanisms of injury may change over time. Since knowledge on aetiology of severe burn incidents in children under 5 years of age in the Netherlands is outdated, this study aimed to identify current risk factors and mechanisms of severe burn injury in children under 5 years of age in the Netherlands to direct future prevention campaigns. METHODS Information on personal-, environmental- and behavioural circumstances as well as the mechanism of burn injury was prospectively collected in all burn centres during one year from patient records and structured interviews with parents. RESULTS Boys around 18 months of age, who, while in upright position, pulled down a cup of hot tea over themselves, were overrepresented. Children in families with more children, having a migration background, living in urbanised neighborhoods or with a low socioeconomic status (SES) are at increased risk for severe burn injury. Most incidents happened in their own home with the parents in close proximity to the child. CONCLUSION Outcomes of this prospective cohort study provide up-to-date and extensive knowledge on the aetiology of severe burn incidents in children under 5 years of age in the Netherlands, and provide directions for prevention policy and campaigns.
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5
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Atreya A, Gyawali L, Menezes RG, Ateriya N, Shreshtha J, Ghimire S. Case Report: Medicolegal evaluation in a pediatric case of fatal scald injury from rural Nepal. F1000Res 2022; 11:35. [PMID: 35317312 PMCID: PMC8917323 DOI: 10.12688/f1000research.74607.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/15/2022] [Indexed: 11/20/2022] Open
Abstract
Thermal injuries in young children involving the buttocks, perineum, and lower limbs raise suspicion of child abuse. Determining the manner of death and ruling out homicide in a fatal case of scalding remains a challenge for forensic practitioners. In the present article, the medicolegal evaluation in a case of fatal scald injury involving a two-year-old child from rural Nepal is discussed. Young children sustaining serious injuries from scalds is a grave social concern. Such young lives need to be protected from scald injuries whether accidental or purposeful. Differences in injury patterns on the basis of their distribution and their characteristics are important to determine the manner of death in such cases.
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Affiliation(s)
- Alok Atreya
- Department of Forensic Medicine, Lumbini Medical College, Palpa, 32500, Nepal
| | | | - Ritesh G Menezes
- Forensic Medicine Division, Department of Pathology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Navneet Ateriya
- Department of Forensic Medicine & Toxicology, All India Institute of Medical Sciences, Gorakhpur, Uttar Pradesh, 273008, India
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van Zoonen EE, van Baar ME, van Schie CHM, Koppes LLJ, Verheij RA. Burn injuries in primary care in the Netherlands: Risk factors and trends. Burns 2022; 48:440-447. [PMID: 34167851 DOI: 10.1016/j.burns.2021.04.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 04/25/2021] [Accepted: 04/29/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Research to date has mainly focused on burn injuries treated in secondary care. This study aims to provide knowledge on the epidemiology of burn injuries in primary care, to give directions for burn prevention. METHODS Data were derived from routine electronic health records of general practices and their out-of-hours service organisations in the Netherlands that participated in the Nivel Primary Care Database 2010-2015. We studied risk factors and trends. RESULTS The average burn injury prevalence rate was 4.40 (95% CI 4.27-4.53) per 1000 person-years in daytime general practice care and 1.47 (95% CI 1.46-1.49) per 1000 inhabitants in out-of-hours care. Children of 0-4 years old, especially boys, and young adult women had a higher risk. Burn injury risk was higher during the summer months and around New Year's Eve. Living in low socioeconomic and strongly urbanised neighbourhoods was associated with a higher risk of burn injury than living in other neighbourhoods. CONCLUSION Dutch general practitioners have a large share in burn care and therefore can play a significant role in burn prevention. Prevention may be most effective in the summer and around New Year's Eve, and specific attention seems to be warranted for low socioeconomic groups and strongly urbanised neighbourhoods.
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Affiliation(s)
| | - Margriet E van Baar
- Association of Dutch Burn Centres, Burn Centre, Maasstad Hospital, Rotterdam, The Netherlands; Department of Public Health, Erasmus MC, Rotterdam, The Netherlands
| | | | - Lando L J Koppes
- Nivel, Netherlands Institute for Health Services Research, Utrecht, The Netherlands; Faculty of Health, Nutrition & Sports, The Hague University of Applied Sciences, The Hague, The Netherlands
| | - Robert A Verheij
- Nivel, Netherlands Institute for Health Services Research, Utrecht, The Netherlands; Tranzo, Tilburg School of Social and Behavioural Sciences, Tilburg University, Tilburg, The Netherlands
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Javaid AA, Johnson E, Hollén L, Kemp AM. Influence of agents and mechanisms of injury on anatomical burn locations in children <5 years old with a scald. Arch Dis Child 2021; 106:1111-1117. [PMID: 33727239 DOI: 10.1136/archdischild-2020-320710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 02/18/2021] [Accepted: 02/22/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To demonstrate how the mechanism and agent of injury can influence the anatomical location of a scald. DESIGN Prospective multicentre cross-sectional study. SETTING 20 hospital sites across England and Wales including emergency departments, minor injury units and regional burns units. PATIENTS Children aged 5 years and younger who attended hospital with a scald. MAIN OUTCOME MEASURES Primary outcome: a descriptive analysis of the mechanism, agent and anatomical location of accidental scalds. Secondary outcome: a comparison of these factors between children with and without child protection (CP) referral. RESULTS Of 1041 cases of accidental scalds, the most common narrative leading to this injury was a cup or mug of hot beverage being pulled down and scalding the head or trunk (132/1041; 32.9% of cases). Accidental scalds in baths/showers were rare (1.4% of cases). Accidental immersion injuries were mainly distributed on hands and feet (76.7%). There were differences in the presentation between children with accidental scalds and the 103 who were referred for CP assessment; children with scalds caused by hot water in baths/showers were more likely to get referred for CP assessment (p<0.0001), as were those with symmetrically distributed (p<0.0001) and unwitnessed (p=0.007) scalds. CONCLUSIONS An understanding of the distributions of scalds and its relationship to different mechanisms of injury and causative agents will help clinicians assess scalds in young children, particularly those new to the emergency department who may be unfamiliar with expected scald patterns or with the importance of using appropriate terminology when describing scalds.
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Affiliation(s)
- Assim Ali Javaid
- Department of Population Health, Cardiff University, Cardiff, UK
| | - Emma Johnson
- Paediatric Department, New Cross Hospital, Wolverhampton, UK
| | - Linda Hollén
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Alison Mary Kemp
- Division of Population Medicine, Department of Child Health, Cardiff, UK
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Aghaei A, Soori H, Ramezankhani A, Mehrabi Y. Factors Related to Pediatric Unintentional Burns: The Comparison of Logistic Regression and Data Mining Algorithms. J Burn Care Res 2020; 40:606-612. [PMID: 31116850 DOI: 10.1093/jbcr/irz066] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Burn injuries are one of the traumas seen in all parts of the world and children are usually one of the vulnerable groups. The aim of this study was to determine the factors related to unintentional burns in children, using data mining algorithms. In this hospital-based case-control study conducted in Kermanshah province, Iran, data were collected over a period of 15 months. Children under the age of 15 years old who were referred to the burn ward of Imam Khomeini Hospital, the only burn referral in Kermanshah province, were included as cases. For the control group, children who were admitted to Dr. Mohammad Kermanshahi Hospital, the only specialist and subspecialist pediatric center in this province, were included. Frequency matching was performed for age and sex. Support vector machine, artificial neural network (ANN), random forest, and logistic regression were employed to determine the factors related to burns in children. The mean age of children with burn injuries was 4.29 ± 3.51 years and 58% of them were boys. The ANN algorithm had better performance than other algorithms. Body mass index (BMI), socioeconomic status, hours without a watchful, mother's age, mother's education, household size, father's job, father's age, having more than one watchful, and petroleum storage were the most important factors related to pediatric burns. The majority of the burn-related variables were related to individuals' social welfare status and their environments. Lessening the effects of these factors could reduce the incidence of pediatric burns.
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Affiliation(s)
- Abbas Aghaei
- Department of Epidemiology and Biostatistics, Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Hamid Soori
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azra Ramezankhani
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Yadollah Mehrabi
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Orton E, Watson MC, Hayes M, Patel T, Jones M, Coupland C, Timblin C, Carpenter H, Kendrick D. Evaluation of the effectiveness, implementation and cost-effectiveness of the Stay One Step Ahead home safety promotion intervention for pre-school children: a study protocol. Inj Prev 2020; 26:573-580. [PMID: 33067223 DOI: 10.1136/injuryprev-2020-043877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 08/26/2020] [Accepted: 08/29/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND Unintentional injuries in children under the age of 5 years commonly occur in the home and disproportionately affect those living in disadvantaged circumstances. Targeted home safety promotion should be offered to families most at risk but there is a paucity of standardised evidence-based resources available for use across family-support practitioners. OBJECTIVE To assess the effectiveness, implementation and cost-effectiveness of a 2-year home safety programme (Stay One Step Ahead) developed by parents, practitioners and researchers, and delivered by a range of family support providers in inner-city localities, compared with usual care in matched control localities. METHODS Parents of children aged 0 to 7 months will be recruited to a controlled before and after observational study. The primary outcome is home safety assessed by the proportion of families with a fitted and working smoke alarm, safety gate on stairs (where applicable) and poisons stored out of reach, assessed using parent-administered questionnaires at baseline, 12 and 24 months.Secondary outcomes include: the impact on other parent-reported safety behaviours, medically-attended injuries, self-efficacy for home safety and knowledge of child development and injury risk using questionnaires and emergency department attendance data; implementation (reach, acceptability, barriers, facilitators) of home safety promotion assessed through interviews and observations; and cost-effectiveness using medically-attended injury costs ascertained from healthcare records. CONCLUSION If shown to be effective and cost-effective this study will provide a practical resource to underpin national guidance. The study could inform public health prevention strategies to reduce home injury in children most at risk, while delivering cost savings to health and care services. TRIAL REGISTRATION NUMBER ISRCTN31210493; Pre result.
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Affiliation(s)
- Elizabeth Orton
- Division of Primary Care, University of Nottingham Faculty of Medicine and Health Sciences, Nottingham, Nottingham, UK
| | | | - Mike Hayes
- Child Accident Prevention Trust, London, UK
| | - Tina Patel
- Division of Primary Care, University of Nottingham Faculty of Medicine and Health Sciences, Nottingham, Nottingham, UK
| | - Matthew Jones
- Division of Primary Care, University of Nottingham Faculty of Medicine and Health Sciences, Nottingham, Nottingham, UK
| | - Carol Coupland
- Division of Primary Care, University of Nottingham Faculty of Medicine and Health Sciences, Nottingham, Nottingham, UK
| | - Clare Timblin
- Division of Primary Care, University of Nottingham Faculty of Medicine and Health Sciences, Nottingham, Nottingham, UK
| | - Hannah Carpenter
- Division of Primary Care, University of Nottingham Faculty of Medicine and Health Sciences, Nottingham, Nottingham, UK
| | - Denise Kendrick
- Division of Primary Care, University of Nottingham Faculty of Medicine and Health Sciences, Nottingham, Nottingham, UK
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10
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Padalko A, Cristall N, Gawaziuk JP, Logsetty S. Social Complexity and Risk for Pediatric Burn Injury: A Systematic Review. J Burn Care Res 2020; 40:478-499. [PMID: 30918946 DOI: 10.1093/jbcr/irz059] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Social complexity in health outcomes has been attributed to greater risk of injury, adverse health consequences, and early death in a variety of populations. To determine what social complexity factors associated with burn injury in children, a systematic review of the literature was performed. Two different databases (PubMed and SCOPUS) were searched for articles related to environmental and social determinants of burn injury. Selected literature examined social complexity factors to establish the strength of evidence in relation to incidence of burn injury in children. The extent of factors and the most common social complexities were reviewed. The 641 manuscripts found in PubMed and 327 from SCOPUS were initially reviewed for duplication and English language. Subsequently, manuscripts were selected for relevance based on titles followed by abstracts. Forty-seven manuscripts were reviewed in their entirety. The literature supports a relationship between an increased incidence of pediatric burns in lower income families, children with behavioral disorders, fewer years of parental education and children residing in a rural setting. The majority of reports came from Europe followed by Australia, and scattered information from other countries. Social complexity factors in the environment of the child are associated with an increased risk of burn injury in children. The literature supports the influence of lower income, lower parental education, behavioral disorders and living rurally with an increased incidence of injury. By identifying children at increased risk, it is possible to develop targeted burn prevention and education programs to mitigate burn injury.
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Affiliation(s)
- Adam Padalko
- BSc Med Research Program, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Nora Cristall
- Manitoba Firefighters' Burn Unit, Health Sciences Centre, Winnipeg, Canada
| | | | - Sarvesh Logsetty
- Manitoba Firefighters' Burn Unit, Health Sciences Centre, Winnipeg, Canada.,Department of Surgery, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.,Department of Psychiatry, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
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11
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Padalko A, Gawaziuk J, Chateau D, Sareen J, Logsetty S. Social Determinants Associated with Pediatric Burn Injury: A Population-Based, Case-Control Study. J Burn Care Res 2020; 41:743-750. [PMID: 32352522 DOI: 10.1093/jbcr/iraa045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Social determinants of health (SDoH) influence risk of injury. We conducted a population-based, case-control study to identify which social determinants influence burn injury in children. Children (≤16 years of age) admitted to a Canadian regional burn center between January 1, 1999 and March 30, 2017 were matched based on age, sex, and geographic location 1:5 with an uninjured control cohort from the general population. Population-level administrative data describing the SDoH at the Manitoba Center for Health Policy (MCHP) were compared between the cohorts. Specific SDoH were chosen based on a published systematic review conducted by the research team. In the final multivariable model, children from a low-income household odds ratio (OR) (95% confidence interval) 1.97 (1.46, 2.65), in care 1.57 (1.11, 2.21), from a family that received income assistance 1.71 (1.33, 2.19) and born to a teen mother 1.43 (1.13, 1.81) were significantly associated with an increased risk of pediatric burn injury. This study identified SDoH that are associated with an increased risk of burn injury. This case-control study supports the finding that children from a low-income household, children in care, from a family that received income assistance, and children born to a teen mother are at an elevated risk of burn injury. Identifying children at increased potential risk allows targeting of burn risk reduction and home safety programs.
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Affiliation(s)
- Adam Padalko
- BSc Med Research Program, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Justin Gawaziuk
- Manitoba Firefighters' Burn Unit, Health Sciences Centre, Winnipeg, Canada; From the
| | - Dan Chateau
- Manitoba Centre for Health Policy, Winnipeg, Canada.,Department of Community Health Sciences, Winnipeg, Canada
| | - Jitender Sareen
- Department of Community Health Sciences, Winnipeg, Canada.,Department of Psychiatry, Winnipeg, Canada
| | - Sarvesh Logsetty
- Department of Psychiatry, Winnipeg, Canada.,Department of Surgery, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
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12
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Jones F, Whitehouse A, Dopson A, Palaghias N, Aldiss S, Gibson F, Shawe J. Reducing unintentional injuries in under fives: Development and testing of a mobile phone app. Child Care Health Dev 2020; 46:203-212. [PMID: 31782175 DOI: 10.1111/cch.12729] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 11/21/2019] [Accepted: 11/23/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Unintentional injuries are a leading cause of preventable death and a major cause of ill health and disability in children under 5 years of age. A health promotion mobile phone application, "Grow up Safely" (GUS), was developed to support parents and carers in reducing unintentional injuries in this population of children. METHODS A prototype of the mobile application was developed to deliver health education on unintentional injury prevention linked to stages of child development. In order to explore the usability of the app and refine its content, three focus groups were conducted with 15 mothers. Data were analysed using thematic analysis. RESULTS The majority of participants reported previous use of health apps, mainly related to pregnancy and recommended by health professionals. The app was considered user-friendly and easy to navigate. Participants in two focus groups found the app informative and offered new information, and they would consider using it. Participants in the "young mum's" group considered the advice to be "common sense" but found the language too complex. All participants commented that further development of push-out notifications and endorsement by a reputable source would increase their engagement with the app. CONCLUSION The GUS mobile phone app, aimed at reducing unintentional injuries in children under five, was supported by mothers as a health promotion app. They would consider downloading it, particularly if recommended by a health professional or endorsed by a reputable organization. Further development is planned with push-out notifications and wider feasibility testing to engage targeted groups, such as young mothers, fathers, and other carers.
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Affiliation(s)
- Felicity Jones
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Ali Whitehouse
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Amy Dopson
- School of Health Sciences, University of Surrey, Guildford, UK
| | | | - Susie Aldiss
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Faith Gibson
- School of Health Sciences, University of Surrey, Guildford, UK.,Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Jill Shawe
- Institute of Health and Community, University of Plymouth, Plymouth, UK
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13
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Mahboob A, Richmond SA, Harkins JP, Macpherson AK. Childhood unintentional injury: The impact of family income, education level, occupation status, and other measures of socioeconomic status. A systematic review. Paediatr Child Health 2019; 26:e39-e45. [PMID: 33542777 DOI: 10.1093/pch/pxz145] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 08/05/2019] [Indexed: 11/13/2022] Open
Abstract
Introduction Unintentional injuries represent a substantial public health burden among children and adolescents, and previous evidence suggests that there are disparities in injury by socioeconomic status (SES). This paper reports on a systematic review of literature on injury rates among children and adolescents by measures of SES. Methods A systematic literature search was conducted using six electronic databases: MEDLINE, PsycINFO, CINAHL, HealthSTAR, EMBASE, and SportsDiscus. This review considered children ages 19 years and under and publications between 1997 and 2017-representing an update since the last systematic review examined this specific question. Fifty-four articles were summarized based on study and participant descriptions, outcome and exposure, statistical tests used, effect estimates, and overall significance. Results Most articles addressed risk factors across all injury mechanisms; however, some focused particularly on burns/scalds, road traffic injuries, falls/drowning cases, and playground/sports injuries. Other studies reported on specific injury types including traumatic dental injuries, traumatic brain injuries, and fractures. The studies were of moderate quality, with a median of 15.5 (95% confidence interval [CI]: 15.34 to 15.66) out of 19. Thirty-two studies found an inverse association between SES and childhood unintentional injury, three found a positive association while twenty were not significant or failed to report effect measures. Conclusion Given the variability in definition of the exposure (SES) and outcome (injury), the results of this review were mixed; however, the majority of studies supported a relationship between low SES and increased injury risk. Public health practice must consider SES, and other measures of health equity, in childhood injury prevention programming, and policy.
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Affiliation(s)
- Afifa Mahboob
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, Ontario
| | - Sarah A Richmond
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Ontario.,Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario
| | - Joshua P Harkins
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, Ontario
| | - Alison K Macpherson
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, Ontario
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14
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Ribeiro MGC, Paula ABR, Bezerra MAR, Rocha SSD, Avelino FVSD, Gouveia MTDO. Social determinants of health associated with childhood accidents at home: An integrative review. Rev Bras Enferm 2019; 72:265-276. [PMID: 30916294 DOI: 10.1590/0034-7167-2017-0641] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2017] [Accepted: 12/07/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to analyze the factors associated with childhood accidents at home according to the levels of the social determinants of health. METHOD integrative review of the literature, with research in databases CINAHL, LILACS and PubMed, with the following main descriptors: child; social determinants of health; accidentes, home. We included 31 studies that related the social determinants of health and childhood accidents, in English, Portuguese and Spanish. RESULTS the proximal determinants identified were: age and sex of children, and ethnicity. Among the intermediate determinants of health, parental behavior, related to the supervision of an adult, prevailed. Parental employment and socioeconomic status were identified as distal determinants. CONCLUSION the age and sex of the child, besides direct supervision, were the determinants most associated with accidents. The distal determinants should be better studied because their relation with the occurrence of domestic accidents has not been sufficiently clarified.
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15
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Zonfrillo MR, Linakis JG, Yang ES, Mello MJ. A Systematic Review of Longitudinal Cohort Studies Examining Unintentional Injury in Young Children. Glob Pediatr Health 2018; 5:2333794X18774219. [PMID: 29761142 PMCID: PMC5946359 DOI: 10.1177/2333794x18774219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 03/30/2018] [Indexed: 11/23/2022] Open
Abstract
Objective. Injury is the leading cause of death and long-term disability in children. Longitudinal cohorts are designed to follow subjects longitudinally in order to determine if early-life exposures are related to certain health outcomes. Methods. We conducted a systematic review to identify studies of children from birth through 5 years who were followed longitudinally with unintentional injury as an outcome of interest. Results. Of the 1892 unique references based on the search criteria, 12 (published between 2000 and 2013) were included. The studies varied on the population of focus, injury definition, and incidence rates. Existing studies that longitudinally follow children aged 0 to 5 years are limited in number, scope, and generalizability. Conclusions. Further study using population-based longitudinal cohorts is necessary to more comprehensively estimate incidence of injury in young children.
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Affiliation(s)
- Mark R Zonfrillo
- Department of Emergency Medicine, Alpert Medical School of Brown University, Providence, RI, USA.,Injury Prevention Center at Rhode Island Hospital and Hasbro Children's Hospital, Providence, RI, USA
| | - James G Linakis
- Department of Emergency Medicine, Alpert Medical School of Brown University, Providence, RI, USA.,Injury Prevention Center at Rhode Island Hospital and Hasbro Children's Hospital, Providence, RI, USA
| | - Eunice S Yang
- Injury Prevention Center at Rhode Island Hospital and Hasbro Children's Hospital, Providence, RI, USA
| | - Michael J Mello
- Department of Emergency Medicine, Alpert Medical School of Brown University, Providence, RI, USA.,Injury Prevention Center at Rhode Island Hospital and Hasbro Children's Hospital, Providence, RI, USA
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16
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Steinvall I, Karlsson M, Elmasry M. C-reactive protein response patterns after antibiotic treatment among children with scalds. Burns 2018; 44:718-723. [DOI: 10.1016/j.burns.2017.10.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 10/27/2017] [Accepted: 10/30/2017] [Indexed: 11/28/2022]
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17
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Lehna C, Furmanek S, Fahey E, Hanchette C. Geographic modeling for children at risk for home fires and burns. Burns 2018; 44:201-209. [DOI: 10.1016/j.burns.2017.07.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 06/14/2017] [Accepted: 07/10/2017] [Indexed: 11/25/2022]
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18
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Sadeghi-Bazargani H, Mohammadi R, Ayubi E, Almasi-Hashiani A, Pakzad R, Sullman MJM, Safiri S. Caregiver-related predictors of thermal burn injuries among Iranian children: A case-control study. PLoS One 2017; 12:e0170982. [PMID: 28151942 PMCID: PMC5289537 DOI: 10.1371/journal.pone.0170982] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 01/14/2017] [Indexed: 11/18/2022] Open
Abstract
PURPOSE Burns are a common and preventable cause of injury in children. The aim of this study was to investigate child and caregiver characteristics which may predict childhood burn injuries among Iranian children and to examine whether confounding exists among these predictors. METHODS A hospital based case-control study was conducted using 281 burn victims and 273 hospital-based controls, which were matched by age, gender and place of residence (rural/urban). The characteristics of the children and their caregivers were analyzed using crude and adjusted models to test whether these were predictors of childhood burn injuries. RESULTS The age of the caregiver was significantly lower for burn victims than for the controls (P<0.05). Further, the amount of time the caregiver spent outdoors with the child and their economic status had a significant positive association with the odds of a burn injury (P<0.05). A multivariate logistic regression found that Type A behaviour among caregivers was independently associated with the child's odds of suffering a burn injury (OR = 1.12, 95% CI: 1.04-1.21). The research also found that children with ADHD (Inattentive subscale: Crude OR = 2.14, 95% CI: 1.16-3.95, Adjusted OR = 5.65, 95% CI: 2.53-12.61; Hyperactive subscale: Crude OR = 1.73, 95% CI: 1.23-2.41, Adjusted OR = 2.53, 95% CI: 1.65-3.87) also had increased odds of suffering a burn injury. However, several variables were identified as possible negative confounder variables, as the associations were stronger in the multivariate model than in the crude models. CONCLUSION The caregiver's characteristics which were predictors of burn injuries among Iranian children were: being younger, high socio-economic status, Type A behavioural pattern and spending more time outdoors. In addition, the relationship between a child's ADHD scores and the odds of a burn injury may be negatively confounded by the caregivers predictor variables.
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Affiliation(s)
- Homayoun Sadeghi-Bazargani
- Road Traffic Injury Research Center, Department of Statistics & Epidemiology, Tabriz University of Medical Sciences, Tabriz, Iran
- WHO Collaborating Center on Community Safety Promotion, Karolinska Institute, Stockholm, Sweden
| | - Reza Mohammadi
- WHO Collaborating Center on Community Safety Promotion, Karolinska Institute, Stockholm, Sweden
| | - Erfan Ayubi
- Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Almasi-Hashiani
- Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Reza Pakzad
- Student Research Committee, Ilam University of Medical Sciences, Ilam, Iran
| | - Mark J. M. Sullman
- Driving Research Group, Cranfield University, Bedfordshire, United Kingdom
| | - Saeid Safiri
- Managerial Epidemiology Research Center, Department of Public Health, School of Nursing and Midwifery, Maragheh University of Medical Sciences, Maragheh, Iran
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- * E-mail:
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19
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Barcelos RS, Santos IS, Matijasevich A, Barros AJD, Barros FC, França GVA, Silva VLSD. Acidentes por quedas, cortes e queimaduras em crianças de 0-4 anos: coorte de nascimentos de Pelotas, Rio Grande do Sul, Brasil, 2004. CAD SAUDE PUBLICA 2017; 33:e00139115. [DOI: 10.1590/0102-311x00139115] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 04/06/2016] [Indexed: 11/22/2022] Open
Abstract
Resumo: O conhecimento da incidência de acidentes na infância, de acordo com o estágio de desenvolvimento da criança, é importante para a formulação de programas de prevenção dirigidos para cada faixa etária. O objetivo deste estudo foi descrever a incidência de quedas, cortes e queimaduras, até os quatro anos de idade, conforme nível econômico da família e idade e escolaridade maternas, entre as crianças da coorte de nascimentos de Pelotas, Rio Grande do Sul, Brasil, 2004. Foram calculadas as taxas de incidências e razões de taxas de incidências entre 0-12, 12-24 e 24-48 meses. As quedas foram os acidentes mais relatados em todos os períodos, seguidas dos cortes e queimaduras. Os meninos sofreram mais quedas e cortes do que as meninas nos dois primeiros anos de vida. No segundo ano de vida, a incidência de quedas e queimaduras praticamente triplicou e a de cortes dobrou, em comparação ao primeiro ano, dentre ambos os sexos. As queimaduras ocorreram com igual frequência entre meninas e meninos nos três períodos de idade analisados. Em suma, a incidência de quedas e cortes foi maior entre os meninos. Em ambos os sexos, ter mãe adolescente foi associado a quedas e cortes nos três períodos analisados; ter mãe com baixa escolaridade esteve associado a queimaduras e cortes aos 48 meses; e ser de família de baixo nível socioeconômico, a quedas e cortes aos 48 meses.
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20
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Household and caregiver characteristics and behaviours as predictors of unsafe exposure of children to paraffin appliances. Burns 2016; 43:866-876. [PMID: 27865548 DOI: 10.1016/j.burns.2016.10.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 10/20/2016] [Accepted: 10/26/2016] [Indexed: 11/22/2022]
Abstract
This study examines adult safety knowledge and practices regarding the use of paraffin cooking appliances. The use of these is common in South Africa with injury risks that are poorly understood. This cross-sectional study was in an informal settlement in Johannesburg, South Africa, where children were reportedly at high risk for burns. This study sought to clarify relationships between key risks and developed individual and composite variables from theoretical constructs and operational definitions of risks for burns. Risks included Child Use of Paraffin Appliances, Child Proximity to Cooking, Risky Stove Use, Caregiver's Burn Treatment Knowledge, Children Locked in House, Children Alone in House. Number of children remains as in proof as this was not a composite scale. Child Proximity to Cooking was associated with more children in the home. Households where children were in greater proximity to cooking were 6 times more likely to be left alone at home, with caregivers with no education over 100 times more likely to lock their children at home. Children locked in were often from homes where caregivers used appliances unsafely. In settings with hazardous energy use, compressed household configurations, and families with multiple children, Risky Stove Use and the practice of locking children in the home may be catastrophic.
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21
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Kirkwood G, Hughes TC, Pollock AM. Unintentional injury in England: an analysis of the emergency care data set pilot in Oxfordshire from 2012 to 2014. J Epidemiol Community Health 2016; 71:289-295. [PMID: 27742743 DOI: 10.1136/jech-2016-207581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 07/13/2016] [Accepted: 09/20/2016] [Indexed: 11/04/2022]
Abstract
BACKGROUND A pilot injury data collection exercise at the emergency departments (EDs) of Oxford University Hospitals National Health Service (NHS) Foundation Trust (OUH) ran from 2012 to 2014 to inform the current development of the new NHS England emergency care data set. METHODS Data collected at the EDs of OUH 1 January 2012 to 30 March 2014 analysed for Oxford City and Cherwell District Council areas. Data completeness and quality checked against Hospital Episode Statistic (HES) returns. RESULTS Of the 63 877 injury attendances recorded at the 2 sites, 26 536 were unintentional with a home postcode within Oxford City or Cherwell District Council areas. The most frequent location, mechanism, activity and diagnosis were home (39.1% of all unintentional injuries (UIs)), low-level falls (47.1%), leisure (31.1%) and 'injuries to unspecified part of trunk, limb or body region' (20.5%), respectively. The most deprived quintile of the population (Index of Multiple Deprivation (IMD) 1) had the highest European Age Standardised Rate (EASR) for all UIs and IMD 5 had the lowest, 54.4 (95% CI 52.3 to 56.5) and 32.2 (31.4 to 33.0) per 1000 person-years, respectively. There was a significant association between increasing levels of deprivation and an increasing incidence rate ratio (IRR) for all UIs, for those in the home, for low-level fall UIs and for non-sport leisure UIs with a particularly sharp increase in the IRR for IMD 1 compared with IMD 5. Sport-related injuries were inversely related to deprivation apart from football. CONCLUSIONS This pilot has demonstrated both the feasibility and importance of prioritising the collection of a national injury data set.
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Affiliation(s)
- Graham Kirkwood
- Blizard Institute, Queen Mary University of London, Centre for Primary Care and Public Health, London, UK
| | - Thomas C Hughes
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Allyson M Pollock
- Blizard Institute, Queen Mary University of London, Centre for Primary Care and Public Health, London, UK
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22
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Stewart J, Benford P, Wynn P, Watson MC, Coupland C, Deave T, Hindmarch P, Majsak-Newman G, Kendrick D. Modifiable risk factors for scald injury in children under 5 years of age: A Multi-centre Case-Control Study. Burns 2016; 42:1831-1843. [PMID: 27576925 DOI: 10.1016/j.burns.2016.06.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 06/18/2016] [Accepted: 06/24/2016] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To determine the relationship between a range of modifiable risk factors and medically attended scalds in children under the age of 5 years. METHODS Multicentre matched case-control study in acute hospitals, minor injury units and GP practices in four study centres in England. Cases comprised 338 children under 5 presenting with a scald, and 1438 control participants matched on age, gender, date of event and study centre. Parents/caregivers completed questionnaires on safety practices, safety equipment use, home hazards and potential confounders. Odds ratios were estimated using conditional logistic regression. RESULTS Parents of cases were significantly more likely than parents of controls to have left hot drinks within reach of their child (adjusted odds ratio (AOR) 2.33, 95%CI 1.63 to 3.31; population attributable fraction (PAF) 31%). They were more likely not to have taught children rules about climbing on kitchen objects (AOR 1.66, 95%CI 1.12 to 2.47; PAF 20%); what to do or not do when parents are cooking (AOR 1.95, 95%CI 1.33 to 2.85; PAF 26%); and about hot things in the kitchen (AOR 1.89, 95%CI 1.30 to 2.75; PAF 26%). CONCLUSIONS Some scald injuries may be prevented by parents keeping hot drinks out of reach of children and by teaching children rules about not climbing on objects in the kitchen, what to do or not do whilst parents are cooking using the top of the cooker and about hot objects in the kitchen. Further studies, providing a more sophisticated exploration of the immediate antecedents of scalds are required to quantify associations between other hazards and behaviours and scalds in young children.
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Affiliation(s)
- Jane Stewart
- Nottinghamshire Healthcare NHS Foundation Trust, Institute of Mental Health, University of Nottingham Innovation Park, Jubilee Campus, Triumph Road, Nottingham NG7 2TU, United Kingdom.
| | - Penny Benford
- Faculty of Medicine and Health Sciences, University of Nottingham, Division of Primary Care, 13(th) Floor, Tower Building, University Park, Nottingham NG72RD, United Kingdom
| | - Persephone Wynn
- Faculty of Medicine and Health Sciences, University of Nottingham, Division of Primary Care, 13(th) Floor, Tower Building, University Park, Nottingham NG72RD, United Kingdom
| | - Michael Craig Watson
- Faculty of Medicine and Health Sciences, University of Nottingham, School of Health Sciences, D1019, Queen's Medical Centre, Nottingham NG7 2HA, United Kingdom
| | - Carol Coupland
- Faculty of Medicine and Health Sciences, University of Nottingham, 13(th) Floor, Tower Building, University of Nottingham NG72RD, United Kingdom
| | - Toity Deave
- Centre for Child & Adolescent Health, Faculty of Health & Life Sciences, University of the West of England Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, United Kingdom
| | - Paul Hindmarch
- Institute of Health & Society, Newcastle University, The Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne NE2 4AX, United Kingdom
| | - Gosia Majsak-Newman
- Norfolk and Norwich University Hospitals NHS Foundation Trust, NHS Clinical Research & Trials Unit, Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, United Kingdom
| | - Denise Kendrick
- Faculty of Medicine and Health Sciences, University of Nottingham, 13(th) Floor, Tower Building, University of Nottingham NG72RD, United Kingdom
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23
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The impact of socio-economic deprivation on burn injury: A nine-year retrospective study of 6441 patients. Burns 2016; 42:446-52. [DOI: 10.1016/j.burns.2015.08.019] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 06/06/2015] [Accepted: 08/12/2015] [Indexed: 11/22/2022]
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25
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Laitakari E, Koljonen V, Rintala R, Pyörälä S, Gissler M. Incidence and risk factors of burn injuries among infants, Finland 1990-2010. J Pediatr Surg 2015; 50:608-12. [PMID: 25840072 DOI: 10.1016/j.jpedsurg.2014.05.034] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Revised: 04/29/2014] [Accepted: 05/25/2014] [Indexed: 12/19/2022]
Abstract
BACKGROUND Our aim was to study the incidence, mechanisms, treatment, and risk factors of burn injuries in infants younger than 1 year. METHODS Data on burn-injured infants during 1990-2011 in Finland came from the National Hospital Discharge Register (NHDR). Information on birth and maternal-related factors came from the Finnish Medical Birth Register, and data on fatal injuries from the Cause of Death Register of Finland. RESULTS This study included 1842 children, female to male 1:1.5. The annual overall incidence of inhospital and outpatient admissions increased during the study period (p<0.05). Major risk factors were male gender, parity, and the mother's socioeconomic status and young age. The most common causes were scalds and contact burns. Severity of the injury increased along with increasing age, and children aged 9-12 months had the highest prevalence of surgical treatment. CONCLUSIONS Burn injury incidence in children under 1 year has increased during recent decades in Finland. First-born 9- to 12-month-old boys of young mothers of low socioeconomic status are at higher risk of burn injuries. Preventative work needs strengthening to reduce infant burn injuries.
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Affiliation(s)
- Elina Laitakari
- Department of Pediatric Surgery, Children's Hospital, Helsinki University Central Hospital, Helsinki, Finland.
| | - Virve Koljonen
- Department of Plastic Surgery, Helsinki University Hospital, Helsinki, Finland, Institute of Clinical Medicine, Helsinki University, Helsinki, Finland
| | - Risto Rintala
- Department of Pediatric Surgery, Children's Hospital, Helsinki University Central Hospital, Helsinki, Finland
| | - Sari Pyörälä
- Department of Pediatric Surgery, Children's Hospital, Helsinki University Central Hospital, Helsinki, Finland
| | - Mika Gissler
- National Institute for Health and Welfare, Helsinki, Finland; Nordic School of Public Health, Gothenburg, Sweden
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Lehna C, Fahey E, Janes EG, Rengers S, Williams J, Scrivener D, Myers J. Home fire safety education for parents of newborns. Burns 2015; 41:1199-204. [PMID: 25816967 DOI: 10.1016/j.burns.2015.02.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Revised: 01/13/2015] [Accepted: 02/03/2015] [Indexed: 10/23/2022]
Abstract
In children under 1 year of age, the proportion of unintentional burns increases with infant age and mobility. Infants are not able to avoid burns and are dependent on parental or adult help. Treatment of burns in young children is expensive in terms of the life-long costs. The purpose of this study was to examine changes in home fire safety (HFS) knowledge and practices over time for parents of newborn children and expecting parents. HFS knowledge of 103 parents was assessed at baseline, immediately after watching a DVD on HFS (recall), and at 2-week follow-up (retention). In addition, the United States Fire Administration (USFA)/Federal Emergency Management Agency (FEMA) Home Safety Checklist which examines HFS practices in the homes was administered. Seventy percent of the participants were Caucasian, 65% were married, and 81% were first-time parents. HFS knowledge increased significantly from baseline to recall (45±12% vs. 87±17% correct responses, p<0.0001), but declined to 75±18% correct at retention. That is, an individual's baseline scores nearly doubled at recall (42±11% change in baseline score), but only increased by 67% at retention (30±15% change in baseline score). For a subsample of parents who completed the USFA Checklist (n=22), the mean percentage of advocated practices followed was 71±11% (range: 40-89%). Using DVDs was an effective educational modality for increasing HFS knowledge. This addressed an important problem of decreasing burns in infants through increasing parent knowledge and HFS practices using a short, inexpensive DVD.
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Affiliation(s)
- Carlee Lehna
- University of Louisville School of Nursing, 555 S. Floyd St., Louisville, KY 40202, United States; University of Louisville School of Medicine, Abell Administration Building, 323 E. Chestnut St., Louisville, KY 40202, United States.
| | - Erin Fahey
- University of Louisville School of Nursing, 555 S. Floyd St., Louisville, KY 40202, United States.
| | - Erika G Janes
- Safe Kids Louisville, led by Kosair Children's Hospital and Children's Hospital Foundation Office of Child Advocacy at Kosair Children's Hospital, 315 E. Broadway, 5th Floor, Louisville, KY, 40202, United States.
| | - Sharon Rengers
- Safe Kids Louisville, led by Kosair Children's Hospital and Children's Hospital Foundation Office of Child Advocacy at Kosair Children's Hospital, 315 E. Broadway, 5th Floor, Louisville, KY, 40202, United States.
| | - Joseph Williams
- Louisville Fire Department, 1135 W. Jefferson St., Louisville, KY 40203, United States.
| | - Drane Scrivener
- Louisville Fire Department, 1135 W. Jefferson St., Louisville, KY 40203, United States.
| | - John Myers
- University of Louisville School of Medicine, Abell Administration Building, 323 E. Chestnut St., Louisville, KY 40202, United States.
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27
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Wynn P, Stewart J, Kumar A, Clacy R, Coffey F, Cooper N, Coupland C, Deave T, Hayes M, McColl E, Reading R, Sutton A, Watson M, Kendrick D. Keeping children safe at home: protocol for a case-control study of modifiable risk factors for scalds. Inj Prev 2014; 20:e11. [PMID: 24842981 PMCID: PMC4174015 DOI: 10.1136/injuryprev-2014-041255] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Background Scalds are one of the most common forms of thermal injury in young children worldwide. Childhood scald injuries, which mostly occur in the home, result in substantial health service use and considerable morbidity and mortality. There is little research on effective interventions to prevent scald injuries in young children. Objectives To determine the relationship between a range of modifiable risk factors for medically attended scalds in children under the age of 5 years. Design A multicentre case-control study in UK hospitals and minor injury units with parallel home observation to validate parental reported exposures. Cases will be 0–4 years old with a medically attended scald injury which occurred in their home or garden, matched on gender and age with community controls. An additional control group will comprise unmatched hospital controls drawn from children aged 0–4 years attending the same hospitals and minor injury units for other types of injury. Conditional logistic regression will be used for the analysis of cases and matched controls, and unconditional logistic regression for the analysis of cases and unmatched controls to estimate ORs and 95% CI, adjusted and unadjusted for confounding variables. Main exposure measures Use of safety equipment and safety practices for scald prevention and scald hazards. Discussion This large case-control study will investigate modifiable risk factors for scalds injuries, adjust for potential confounders and validate measures of exposure. Its findings will enhance the evidence base for prevention of scalds injuries in young children.
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Affiliation(s)
- P Wynn
- Division of Primary Care, School of Medicine, Nottingham, UK
| | - J Stewart
- School of Health Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, UK
| | - A Kumar
- Division of Primary Care, School of Medicine, Nottingham, UK
| | - R Clacy
- Division of Primary Care, School of Medicine, Nottingham, UK
| | - F Coffey
- Nottingham University Hospitals NHS Trust, Queen's Medical Centre Campus, Nottingham, UK
| | - N Cooper
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - C Coupland
- Division of Primary Care, School of Medicine, Nottingham, UK
| | - T Deave
- Centre for Child & Adolescent Health, Health and Life Sciences, University of the West of England, Bristol, UK
| | - M Hayes
- Child Accident Prevention Trust, Canterbury Court (1.09), 1 - 3 Brixton Road, London, UK
| | - E McColl
- Great North Children's Hospital, Research Unit Level 2, New Victoria Wing, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - R Reading
- Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - A Sutton
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - M Watson
- School of Health Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, UK
| | - D Kendrick
- Division of Primary Care, School of Medicine, Nottingham, UK
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