The DOG BITES program: documentation of growls and bites in the emergency setting

Online videos indicate human and dog behaviour preceding dog bites and the context in which bites occur

YouTube videos of dog bites present an unexplored opportunity to observe dog bites directly. We recorded the context of bites, bite severity, victim and dog characteristics for 143 videos and for 56 videos we coded human and dog behaviour before the bite. Perceived bite severity was derived from visual aspects of the bite. Associations between bite severity and victim, dog and context characteristics were analysed using a Bayesian hierarchical regression model. Human and dog behaviour before the bite were summarised with descriptive statistics. No significant differences in bite severity were observed between contexts. Only age of the victim was predictive of bite severity: adults were bitten more severely than infants and infants more severely than children. Non-neutral codes describing dog body posture and some displacement and appeasement behaviours increased approximately 20 seconds before the bite and humans made more tactile contacts with dogs 21 seconds before the bite. This analysis can help to improve understanding of context in which bites occur and improve bite prevention by highlighting observable human and dog behaviours occurring before the bite.

Maxillofacial injuries due to animal bites

INTRODUCTION

Animal bites are a significant public health problem, with the majority of bites coming from dogs, cats and humans. These may present as punctures, abrasions, tears, or avulsions. The force and relative bluntness of the teeth also increases the possibility of a crush injury with devitalized tissue .The clinical presentation and appropriate treatment of infected bite wounds vary according to the animal and causative organisms. These wounds have always been considered complex injuries contaminated with a unique polymicrobial inoculum.

MATERIALS

This article reviews animal bite wound incidence, bacteriology, risk factors for complications, evaluation components, recommended treatment and prevention based on advanced PUBMED search of the English language literature from the years 1970 to present.

CONCLUSION

As the bite wounds are frequently located on the face, an oral and maxillofacial surgeon needs to be familiar with the treatment of animal bites, pitfalls in management and to educate patients on ways to avoid future bite injuries. The management of animal bites is an evidence poor area and most recommendations are based on small case series, microbiological data and expert opinion. The main controversies include whether wounds should or should not undergo primary closure and the use of prophylactic antimicrobials.

Examining parents' behaviors and supervision of their children in the presence of an unfamiliar dog: does The Blue Dog intervention improve parent practices?

OBJECTIVES

Young children are at particular risk for dog bite injuries. This study examined parents' supervision of and reactions to their children in the vicinity of an unfamiliar dog.

METHODS

A pre/post intervention/control group randomized design assessed whether exposure to The Blue Dog, a dog bite prevention and education program, positively impacted parent behaviors.

RESULTS

No group differences in pre or post-intervention measures emerged, indicating that The Blue Dog did not evoke improvements in parents' behaviors. Generally, parents showed risky reactions and encouraged children to interact with the dog, even though they knew very little about the dog's safety or disposition. Supervision measures (proximity, watching) remained unchanged (watching) or more lax (proximity) across sessions.

CONCLUSIONS

The results highlight the importance of targeting parent behavior, not just child behavior, in programs that aim to reduce risk of childhood dog bites. The Blue Dog did not effectively change parent behavior.

Brief report: Don't kiss a sleeping dog: the first assessment of "the blue dog" bite prevention program

OBJECTIVE

The authors attempted to remedy the current lack of empirically evaluated dog-bite prevention programs for children under 7 by assessing children's learning success with the "Blue Dog" CD.

METHODS

Ninety-six 3-, 4-, 5-, and 6-year-old children used the interactive CD in an initial exposure phase, a training and a testing phase. Half received verbal feedback, and the other half additional practice with parents. All children were re-tested after 2 weeks.

RESULTS

There were significant increases in safe choices after the training phase at all ages, with older children performing better than younger children. Children still retained their ability to make safe choices after 2 weeks. Interestingly, children practicing with parents performed better than others when under 6 years. Verbal feedback did not play a role, the CD is equally effective without.

CONCLUSIONS

Children learned successfully about safe behavior with dogs; thus, the CD can help educate children about dog-bite prevention.

Brief report: Adherence to fluid recommendations in children receiving treatment for retentive encopresis

OBJECTIVE

Limited data are available regarding whether children being treated for retentive encopresis are adherent to recommendations to increase their daily fluid intake. The purpose of this study was to examine fluid adherence in children who received treatment for retentive encopresis.

METHODS

A retrospective chart review was performed using diet diary data for 26 children (ages 3-12) who completed a group behavioral intervention for retentive encopresis.

RESULTS

Mean daily intake of clear fluid increased significantly during treatment and children relied primarily on water and juice to make this dietary change. However, adherence rates to clear fluid goals were <50%.

CONCLUSIONS

Children's increased clear fluid intake did not equate to high fluid adherence. Children's high juice consumption is concerning as it could place them at risk for other negative health consequences. Future research should examine whether enhanced fluid education and use of behavior change strategies yield higher fluid adherence.

An investigation into the prevalence of dog bites to primary school children in Trinidad

BACKGROUND

To estimate the prevalence of dog bites to primary school children between the ages of 8-12 years using a semi-structured interview process. With the increase in the pet population and popularity of dangerous breeds of dog and a high stray dog population combined with a dearth of information on the risk of dog attacks to children in Trinidad, a semi-structured interview process was used to determine risk factors associated with dog attacks.

METHODS

A questionnaire survey of 1109 primary school children between the ages of 8-12 years was conducted in Trinidad from November 2002 to September 2003. The survey was conducted to determine the risk factors such as age, gender, size of dog and relationship of dog and victim, in dog bite incidents. The chi-square statistic and odds ratios were used to estimate risk factors for a bite incident.

RESULTS

Twenty-eight percent of children were bitten at least once by a dog. Gender (male) and owning a dog were statistically significant risk factors (p = 0.003 and 0.008 respectively, chi2 df, 95% confidence). Most attacks occurred outside of the home (58.0%) followed by the victims' home (42.0%) and were by a dog known but not owned (54.6%) by the victim. Many victims (33.0%) were bitten without having any interaction with the dog and the majority (61.9%) of victims did not receive professional medical assistance. Overall, the lower leg or foot was most often injured (39.3%).

CONCLUSION

A public educational campaign is needed on responsible pet ownership. In addition, children must be taught effective ways of avoiding attacks or reducing injury in the event of a dog attack. The Dangerous dogs Act 2000 must be proclaimed in parliament by the Government of Trinidad and Tobago to exert more pressure on pet owners to safeguard the public from the menace of dog attacks.

An emergency department intervention to increase booster seat use for lower socioeconomic families

OBJECTIVES

To evaluate the effectiveness of booster seat education within an emergency department (ED) setting for families residing in lower socioeconomic neighborhoods.

METHODS

This was a prospective, randomized study of families with children aged 4 to 7 years and weighing 40 to 80 lb who presented to a pediatric ED without a booster seat and resided in lower socioeconomic communities. Subjects were randomly assigned to one of three groups: 1) received standard discharge instructions, 2) received five-minute booster seat training, and 3) received five-minute booster seat training and free booster seat with installation. Automobile restraint practices were obtained initially and by telephone at one month.

RESULTS

A total of 225 children were enrolled. Before randomization in the study, 79.6% of parents reported that their child was usually positioned in the car with a lap/shoulder belt and 13.3% with a lap belt alone. Some parents (16.4%) had never heard of a booster seat, and 44.9% believed a lap belt was sufficient restraint. A total of 147 parents (65.3%) were contacted for follow-up at one month. Only one parent (1.3%) in the control group and four parents (5.3%) in the education group purchased and used a booster seat after their ED visit, while 55 parents (98.2%) in the education and installation group reported using the booster seat; 42 (75.0%) of these parents reported using the seat 100% of the time.

CONCLUSIONS

Education in a pediatric ED did not convince parents to purchase and use booster seats; however, the combination of education with installation significantly increased booster seat use in this population.