An international comparison of childhood injuries in Hong Kong

Effect of a Mobile Game-Based Intervention to Enhance Child Safety: Randomized Controlled Trial

BACKGROUND

Evidence supports the effectiveness of serious games in health education, but little is known about their effects on the psychosocial well-being of children in the general population.

OBJECTIVE

This study aimed to investigate the potential of a mobile game-based safety education program in improving children's safety and psychosocial outcomes.

METHODS

Safe City is a mobile roleplaying game specifically designed to educate children in Hong Kong about safety. This randomized controlled trial included 340 children in grades 4 through 6. Intervention arm participants (n=170) were instructed to play the Safe City mobile game for 4 weeks, whereas control arm participants (n=170) received a safety booklet. All participants completed a survey on safety knowledge and behaviors and psychosocial problems at baseline (T1), 1 month postintervention (T2), and 3 months postintervention (T3). Cumulative game scores and mini-game performance were analyzed as a proxy for the extent of exposure to the game. Outcome data were analyzed using 2-sample 2-tailed t tests to compare mean change from T1 to T2 and to T3 for intervention versus control arm participants. The association of game use with outcome changes postintervention was analyzed using generalized additive models.

RESULTS

No significant differences were found in mean changes between the intervention and control arms. However, use analyses showed that higher game scores were associated with improvements in safe behavior (P=.03) and internalizing problems (P=.01) at T3. Matching and Spot the Danger mini-game performance significantly predicted improvements in safety knowledge at T2 and T3.

CONCLUSIONS

Analysis of use has shown that playing the Safe City mobile game can result in significant improvements in safety knowledge and reductions in unsafe behavior and internalizing problems. These findings provide evidence for the positive impact of serious games on psychological and social well-being, highlighting the potential of technology-driven interventions to assist children in learning about safety and preventing injuries.

TRIAL REGISTRATION

ClinicalTrials.org NCT04096196; https://clinicaltrials.gov/show/NCT04096196.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.2196/17756.

Pattern of childhood injury in a tertiary centre

INTRODUCTION

Childhood injury and death have been projected to be a disease of public health significance, however, the trend in many developing countries of which Nigeria is one is still unknown. We, therefore, examine the pattern of childhood traumatic injury in our institution.

MATERIALS AND METHODS

The information of patients aged 16 years and below who presented with trauma was extracted from the trauma registry of the emergency units of University College Hospital, Ibadan, from 2015 to 2020. Data were analysed using the SPSS version 20.

RESULTS

A total of 3146 children were managed for trauma in the accident and emergency departments of the hospital. Most of them were males (61.2%) and within the under-five age group (36.4%). The majority of the injuries were secondary to fall (41.8%). Male child was more likely to be involved in any mechanism of injury and children between 11 and 16 years were commonly involved in machine hand injury (80%). Following intervention in the accident and emergency department, 44.1% were discharged in the emergency units, 21.5% required admission into the specialist ward, 6.0% died, 5.0% discharged against medical advice and 2.6% were referred.

CONCLUSION

The burden of childhood injury is becoming significant thus demands more attention.

A Mobile Game (Safe City) Designed to Promote Children's Safety Knowledge and Behaviors: Protocol for a Randomized Controlled Trial

Background

Children have high levels of curiosity and eagerness to explore. This makes them more vulnerable to danger and hazards, and they thus have a higher risk of injury. Safety education such as teaching safety rules and tips is vital to prevent children from injuries. Although game-based approaches have the potential to capture children’s attention and sustain their interest in learning, whether these new instructional approaches are more effective than traditional approaches in delivering safety messages to children remains uncertain.

Objective

The aim of this study is to test the effectiveness of a game-based intervention in promoting safety knowledge and behaviors among Hong Kong school children in Grades 4-6. It will also examine the potential effect of the game-based intervention on these children’s functioning and psychosocial difficulties.

Methods

This study comprises the development of a city-based role-playing game Safe City, where players are immersed as safety inspectors to prevent dangerous situations and promote safety behavior in a virtual city environment. The usability and acceptability tests will be conducted with children in Grades 4-6 who will trial the gameplay on a mobile phone. Adjustments will be made based on their feedback. A 4-week randomized controlled trial with children studying in Grades 4-6 in Hong Kong elementary schools will be conducted to assess the effectiveness of the Safe City game–based intervention. In this trial, 504 children will play Safe City, and 504 children will receive traditional instructional materials (electronic and printed safety information). The evaluation will be conducted using both child self-report and parent proxy-report data. Specifically, child safety knowledge and behaviors will be assessed by a questionnaire involving items on knowledge and behaviors, respectively, for home safety, road safety, and sport-related safety; child functioning will be assessed by PedsQL Generic Core Scales; and psychosocial difficulties will be assessed by the Strength and Difficulties Questionnaire. These questionnaires will be administered at 3 time points: before, 1 month, and 3 months after the intervention. Game usage statistics will also be reviewed.

Results

This project was funded in September 2019. The design and development of the Safe City game are currently under way. Recruitment and data collection will begin from September 2020 and will continue up to March 1, 2021. Full analysis will be conducted after the end of the data collection period.

Conclusions

If the Safe City game is found to be an effective tool to deliver safety education, it could be used to promote safety in children in the community and upgraded to incorporate more health-related topics to support education and empowerment for the larger public.

Trial Registration

ClinicalTrials.gov NCT04096196; https://clinicaltrials.gov/ct2/show/NCT04096196

International Registered Report Identifier (IRRID)

PRR1-10.2196/17756

Mortality And Morbidity of Severe Traumatic Brain Injuries; A Pediatric Intensive Care Unit Experience Over 15 Years

Objective

To determine the mortality, morbidity, types of intracranial hemorrhages, and factors associated with length of stay (LOS) associated with accidental traumatic brain injury (TBI) at a pediatric intensive care unit (PICU) of a regional trauma center in an Asian city.

Methods

This study is a retrospective review of types of head injury, mortality and morbidity demographics of patients admitted to a PICU with TBI. All patients with accidental TBI were included, namely road traffic injury (RTI) and fall, and their demographics compared. Non-accidental injuries (NAI) were excluded.

Results

95 children (78% males) were admitted to a PICU with RTI or falls from 2002 to 2017. They accounted for 3.7% of PICU admissions. Comparing with falls, victims of RTI were older (p<0.001) and more likely to suffer from skull fracture (p=0.017). There were 4 deaths with falls (6.8%) but none with RTI. Subarachnoid hemorrhages, extradural hemorrhages, the use of mechanical ventilation, inotropes and neurological supports were associated with longer LOS in PICU in these injuries (p<0.001).

Conclusion

A longer PICU LOS is associated with extradural and subarachnoid hemorrhages, usage of inotropes, mechanical ventilation and neurological supports in falls and RTI. Three-quarters of victims are males. Preventive health education should be especially directed to boys to reduce severe TBI in this Asian city.

Fall-related attendance and associated hospitalisation of children and adolescents in Hong Kong: a 12-year retrospective study

OBJECTIVES

The present study aimed to examine the trends and characteristics of fall-related attendance in accident and emergency department (AED) by injury type and the trend in associated average length of stay (LOS) among children and adolescents in Hong Kong.

DESIGN

A retrospective approach was adopted.

SETTING

AED, involving all local public emergency departments from 2001 to 2012.

PARTICIPANTS

63 557 subjects aged 0-19 years with fall injury record were included in the analysis.

PRIMARY OUTCOME MEASURES

Fall-related injury number and rates were calculated and reported. Poisson and negative binomial regression models were used to study the trends of injury incidence rate at different body regions.

RESULTS

AED fall-related attendance rate increased significantly with an annual percentage change of 4.45 (95% CI 3.43 to 5.47%, p<0.0001). The attendance number of male subjects was persistently higher than female subjects. The standardised rate of fracture injury increased by 1.31% (95% CI 0.56 to 2.05%, p<0.0001) and that of non-fracture injury increased by 9.23% (95% CI 7.07 to 11.43%, p<0.0001) annually. Upper limb was the most frequently fractured location. It included forearm/elbow, shoulder/upper arm and wrist/hand with descending order of frequency. On the contrary, head was the most frequent non-fracture location, followed by forearm/elbow.

CONCLUSIONS

The rates of fall-related attendance have been increasing and still remain high. There were significant increases in non-fracture injuries. Fractures were most frequently found in the upper extremity of a child while the most common non-fracture location was head. It appears that more efforts should be made and preventive measures should be implemented for children and adolescents in Hong Kong.

Profile and Risk Factor Analysis of Unintentional Injuries in Children

OBJECTIVE

To study the profile and various risk factors associated with unintentional injuries in children.

METHODS

The study is a cross sectional analysis of data collected from 351 children presenting with unintentional injury to a tertiary care hospital in Navi Mumbai, India. Data were collected about variables based on Haddon Phase Factor Matrix - host, environment and agent factors. Proportions for categorical variables across various groups were compared using Chi square test or Fisher's exact test. Logistic regression model was used to evaluate the factors.

RESULTS

Falls (36 %) were the most common injuries followed by bites (23 %). Majority of children were school going children (38 %) followed by preschool children (29 %). Forty-seven percent were from lower socioeconomic class. Commonest place of injury was home (48 %) and the commonest time was evening (49 %). Though there was male predominance in injuries, the difference across gender did not vary significantly (p = 0.15). Poisonings were significantly more common in infants and toddlers and in rural population (p < 0.001); kerosene being the commonest agent. Rural population is at more risk of bites compared to urban (p < 0.001); dog bites being the commonest followed by scorpion bites. Foreign bodies were significantly more common in upper and middle socioeconomic class and bites, in lower socioeconomic class (p < 0.005). Injuries from rural area and lower socioeconomic class were more serious, requiring hospitalization; they were also more likely to present late to the hospital (p < 0.05).

CONCLUSIONS

Profile of injuries varies widely as per the variations in agent, host and environmental factors. Socio-environmental, economic conditions and infancy-toddler age groups are predisposing risk factors for bites and poisoning. Although rural areas and lower socioeconomic class population are more vulnerable to serious types of injuries, they still lack essential basic medical care.

Childhood Injuries in Singapore: Can Local Physicians and the Healthcare System Do More to Confront This Public Health Concern?

Childhood injury is one of the leading causes of death globally. Singapore is no exception to this tragic fact, with childhood injuries accounting up to 37% of Emergency Department visits. Hence, it is important to understand the epidemiology and risk factors of childhood injuries locally. A search for relevant articles published from 1996–2016 was performed on PubMed, Cochrane Library and Google Scholar using keywords relating to childhood injury in Singapore. The epidemiology, mechanisms of injury, risk factors and recommended prevention strategies of unintentional childhood injuries were reviewed and described. Epidemiological studies have shown that childhood injury is a common, preventable and significant public health concern in Singapore. Home injuries and falls are responsible for majority of the injuries. Injuries related to childcare products, playground and road traffic accidents are also important causes. Healthcare professionals and legislators play an important role in raising awareness and reducing the incidence of childhood injuries in Singapore. For example, despite legislative requirements for many years, the low usage of child restraint seats in Singapore is worrisome. Thus, greater efforts in public health education in understanding childhood injuries, coupled with more research studies to evaluate the effectiveness and deficiencies of current prevention strategies will be necessary.

Pediatric Canadian Triage and Acuity Scale (PaedsCTAS) as a Measure of Injury Severity

This research explored whether the pediatric version of the Canadian Triage Acuity Scale (PaedsCTAS) represented a valid alternative indicator for surveillance of injury severity. Every patient presenting in a Canadian emergency department is assigned a CTAS or PaedsCTAS score in order to prioritize access to care and to predict the nature and scope of care that is likely to be required. The five-level PaedsCTAS score ranges from I (resuscitation) to V (non-urgent). A total of 256 children, 0 to 17-years-old, who attended a pediatric hospital for an injury were followed longitudinally. Of these children, 32.4% (n = 83) were hospitalized and 67.6% (n = 173) were treated in the emergency department and released. They completed the PedsQL(TM), a validated measure of health related quality of life, at baseline (pre-injury status), one-month, four- to six-months, and 12-months post-injury. In this secondary data analysis, PaedsCTAS was found to be significantly associated with hospitalization and length of stay, sensitive to the differences between PaedsCTAS II and III, and related to physical but not psychosocial HRQoL. The findings suggest that PaedsCTAS may be a useful proxy measure of injury severity to supplement or replace hospitalization status and/or length of stay, currently proxy measures.

Economic cost of childhood unintentional injuries

AIMS

This study aims to review the economic cost of childhood (0-18 years) unintentional injuries (UI) and focuses upon comparing the cost burden between developing and developed countries.

METHODS

Articles were selected from PUBMED using the search words "Economic Cost", "Unintentional injuries" and "Children". Nine articles were selected.

RESULTS

Studies in China focused upon cost to hospitals, in Bangladesh they focused on personal payment in rural areas, and in Vietnam they focused upon community-based cost analysis. There was one study from Norway on UI at home. There were 5 articles from the USA focusing on submersion injury, UI insurance, unintentional traumatic brain injury, UI due to firearms and UI medical costs. The cost of childhood UI is enormous, ranging from US $516,938 to US $9,550,704 per year. This represents a large economic burden on society. Additionally, there is a large gap between lower-middle income countries (LMIC) and high income countries (HIC) in the burden of injury, injury health care and insurance systems.

CONCLUSION

Different bases and contexts of studies make it difficult to draw a solid conclusion about the amount of costs of UI among children. Therefore, more studies of children's unintentional injuries should be carried out in low and middle income countries.

An analysis of 6215 hospitalized unintentional injuries among children aged 0-14 in northwest China

The aim of this study was to analyze the sorts and the external causes of hospitalized unintentional injuries among children aged 0-14 so as to learn the status of children's unintentional injuries in northwest China and then to give some references for the prevention. As many as 6215 abstracts of the discharged medical records of hospitalized children for unintentional injuries from 31 hospitals in northwest China from January 1, 2002 to December 31, 2003 were analyzed, especially for the different external causes and sorts of injuries according to ages, genders and locations. We identified 2081 (33.5%) fractures, 1279 (20.6%) scald/burns, 1125 (18.1%) internal organ injuries and 611 (9.8%) open injuries among the 6215 hospitalized children for unintentional injuries. Boy's cases were 2.2 times as many as those of girl's. The age characteristics of each injury was as follows: scald/burns occurred mostly in children under 3 (53.8%), especially in children under 1 year (58.5%); fractures occurred mostly in children above 4 (38.2%), especially in children aged 7-14 years (41.0%). The proportion of traffic accidents and falls were the highest among children aged 7-14, with 28.5% for traffic accidents and 34.4% for falls, respectively. The total cost of hospitalization was US $1033876.0, with a mean cost of US $166.3 per case. The total length of stay in hospital was 106915.2 days, with a mean of 17.2 days per case. A large proportion of fall, traffic accident, and fire/explosion induced fractures, scald/burns, internal organ and encephalic injuries characterize the childhood unintentional injuries in northwest China. From the analyses of external causes, prevention strategies for different external causes should be correspondingly specific.

Does living density matter for nonfatal unintentional home injury in Asian urban settings? Evidence from Hong Kong

Injury is a major global disease burden for the twenty-first century. There are, however, few studies of unintentional household injury in Asian urban settings where living environments are characterized by extremely compact, high-living-density, multistory apartments. This study investigated the association between nonfatal unintentional household injuries with the resident's sociodemographic attributes and household characteristics in Hong Kong, the city with the world's highest population density. A cross-sectional retrospective recall study was conducted in May 2007 using a random telephone survey with a modified Chinese version of the World Health Organization Injury and Violence instrument. The study sample included 1,001 noninstitutionalized Cantonese-speaking Hong Kong residents of all ages, including foreign live-in domestic helpers. Multivariate regression was conducted to identify risk factors for nonfatal unintentional injuries in Hong Kong. Among a predominantly adult sample, household size and time spent at home were not associated with nonfatal unintentional household injuries in the general population in Hong Kong. The multivariate analyses indicated that female gender, owners of private homes, lower square footage of living space per person, and those with slip prevention devices in the bathroom were significantly associated with household injuries. Injured and noninjured groups were found to have adopted different injury prevention strategies toward household injuries. The results identified potential target groups for household injury prevention programs.

Emergency department visits for nonfatal childhood injuries in Romania

BACKGROUND

Childhood injury rates are higher in low and middle-income countries than in high-income countries. Childhood injuries have not been widely studied in Romania, a middle-income country, because data sources are lacking.

OBJECTIVE

This study presents the first surveillance data of nonfatal childhood injuries from a large children's hospital in Cluj, a major city of Romania.

METHODS

This retrospective study included review of medical records of injured children of 0-18 years of age treated in a major city pediatric emergency department from 1999 to 2003.

RESULTS

In the 5-year study period, 1179 childhood injuries were treated in the emergency department, for an average of 236 patients per year. For the county of Cluj, this represents an annual average injury incidence of 197 per 100,000 children younger than 5 years, 140 per 100 000 children aged 5-14 years, and 135 per 100 000 for children aged 15-18 years. Unintentional injuries represented 77.8% of cases, 18% were self-harm and suicide attempts, and 4.3% were assaults.

CONCLUSION

These trends, among the first reported from Romania, can help identify priority prevention areas.

Adolescent injuries in Canada: findings from the Canadian community health survey, 2000-2001

This article presents a description of injuries among 24312 Canadian adolescents, aged 12-24 years, based on the Canadian Community Health Survey, 2000-2001. A total of 3214 (25.6%) males and 2227 (16.5%) females reported having at least one serious injury in the past year. The leading causes of injury in adolescents were: falls; overexertion or strenuous movement; accidentally bumped, pushed or bitten; and accidentally struck or crushed by objects. The parts of the body most often affected were the ankles/feet, wrists/ hands and knees/lower legs. The most frequent locations of injuries were: sports or athletic areas; home; school, college or university areas; and the street, highway or pavement. Injuries were more often reported to have occurred during the summer months. Low socio-economic status was inversely associated with the occurrence of injury in the past year whereas risk-taking behaviour in the form of cigarette smoking and drinking alcohol was positively associated with injury occurrence.

Completeness of cause of injury coding in healthcare administrative databases in the United States, 2001

OBJECTIVES

To determine the completeness of external cause of injury coding (E-coding) within healthcare administrative databases in the United States and to identify factors that contribute to variations in E-code reporting across states.

DESIGN

Cross sectional analysis of the 2001 Healthcare Cost and Utilization Project (HCUP), including 33 State Inpatient Databases (SID), a Nationwide Inpatient Sample (NIS), and nine State Emergency Department Databases (SEDD). To assess state reporting practices, structured telephone interviews were conducted with the data organizations that participate in HCUP.

RESULTS

The percent of injury records with an injury E-code was 86% in HCUP's nationally representative database, the NIS. For the 33 states represented in the SID, completeness averaged 87%, with more than half of the states reporting E-codes on at least 90% of injuries. In the nine states also represented in the SEDD, completeness averaged 93%. Twenty two states had mandates for E-code reporting, but only eight had provisions for enforcing the mandates. These eight states had the highest rates of E-code completeness.

CONCLUSIONS

E-code reporting in administrative databases is relatively complete, but there is significant variation in completeness across the states. States with mandates for the collection of E-codes and with a mechanism to enforce those mandates had the highest rates of E-code reporting. Nine statewide ED data systems demonstrate consistently high E-coding completeness.

Childhood injuries from motor vehicle-pedestrian collisions in Wuhan, The People's Republic of China

OBJECTIVES

To examine motor vehicle-pedestrian collision injuries resulting in hospitalisation among children admitted into Wuhan Children's Hospital, The People's Republic of China.

METHODS

From the 1993 to 2004 inpatient data of Wuhan Children's Hospital, we identified injury cases from motor vehicle traffic crashes among children aged 18 years or less using the discharge diagnosis defined by the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). We examined characteristics of injuries from motor vehicle traffic crashes (ICD-9-CM = E810-E819) and then calculated the proportion of injuries from motor vehicle-pedestrian collisions (ICD-9-CM = E814) among all hospitalisations for childhood injuries (ICD-9-CM = 800-959). The trend of injuries from motor vehicle-pedestrian collisions from 1993 to 2004 was described.

RESULTS

Of the 12,939 injuries resulting in hospitalisation among children admitted into Wuhan Children's Hospital during 1993-2004, a total of 528 injuries were caused by motor vehicle traffic crashes. The majority of the injured children in motor vehicle traffic crashes were males (59.3%). In comparison with other traffic injuries, a higher proportion of motor vehicle-pedestrian collisions occurred among children aged 12-15 years. Motor vehicle-pedestrian collision injuries resulted in significantly longer lengths of stay in the hospital than other motor vehicle traffic injuries (19.4 days versus 14.3 days, respectively; t-test = 2.59, p-value < 0.05). The percentage of motor vehicle-pedestrian collision injuries among all hospitalisations for childhood injuries increased significantly from 1.6% (95% confidence interval [CI] = 1.2-2.1) in 1993 to 3.1% (95% CI = 2.7-3.6) in 2004 (p < 0.05).

CONCLUSIONS

Hospitalisations for injuries from motor vehicle-pedestrian collisions at this large children's hospital increased significantly in the past decade. These data underscore the need for additional research and a major concerted effort to prevent motor vehicle-pedestrian collisions among children in China.

Unintentional injuries among primary and middle school students in Maanshan City, eastern China

AIM

To describe the rates and patterns of unintentional injuries among primary and middle school students in China.

METHODS

A cross-sectional survey was conducted in Maanshan City of the Anhui Province in eastern China. All students attending six primary and four middle schools, selected randomly, were asked to report unintentional injuries occurring in the 12-mo period before the survey. The occurrence of unintentional injuries that resulted in medical attendance was summarized by study grade, sex, month and external causes.

RESULTS

The annual event-based injury rate per 100 students was higher among boys (21.7) than girls (17.6). Only 1.9% of the episodes resulted in hospitalization, and 17.8% resulted in missing school. The most frequent injuries were falls (38.2%) and transportation-related injuries (19.6%). The risk of injury was lower in middle schools than primary schools. Distribution by month of occurrence showed two peaks in boys during spring and autumn, but no clear peak was observed in girls.

CONCLUSION

The descriptive epidemiology of unintentional injuries among students in China provides useful information on the distributions in person, place and time, which in turn provide hints for the further exploration of possible risk factors that are important in planning strategies for future prevention.

Non-fatal injuries among Pacific infants in Auckland: data from the Pacific Islands families first two years of life study

AIMS

Child injury is the leading cause of mortality and morbidity in developed countries. While Pacific infant death rates are relatively high in New Zealand, little is known about non-fatal injury rates. We seek to describe maternally reported injury in Pacific infants aged between 0-24 months.

METHODS

A cohort of Pacific infants born during 2000 in Auckland, New Zealand, was followed. Maternal home interviews were conducted at 6 weeks, 12 months and 24 months postpartum and injury events were recalled. Marginal models using generalized estimating equations (GEEs) were used to analysis the longitudinal data.

RESULTS

The inception cohort included 1398 infants at 6 weeks, 1241 infants at 12 months and 1161 infants at 24 months. The age-specific injury incidence per 1000 person-years exposure was estimated at 48 (95% CI: 23, 88) injuries for infants aged 0-6 weeks, 106 (95% CI: 88, 127) injuries for infants aged 7 weeks-12 months and 174 (95% CI: 151, 199) injuries for infants aged 13-24 months. In the multivariable GEE model, older infants (P < 0.001), infants who were male (P = 0.01), born to Pacific Island fathers and non-Pacific Island mothers (P < 0.001), and in higher or unknown income groups (P = 0.01) were significantly more likely to suffer injury events. No significant two-factor interaction with infant age was identified.

CONCLUSIONS

Among Pacific infants, non-fatal injury is common and injury incidence rates are considerably higher than national levels. Male infants and those born into ethnically mixed families, where the father was of Pacific Island ethnicity and the mother was non-Pacific, were at increased relative risk of injury and might benefit from specific injury prevention targeting. However, given the high injury incidence levels found, we advocate that investigation and targeting of culturally appropriate prevention strategies for all Pacific families with young children is required to reduce injury rates for Pacific infants in New Zealand.

Unintentional injuries at school in China--patterns and risk factors

OBJECTIVE

To describe the rate and pattern of unintentional school injuries among primary and middle school students and to explore the major risk factors involved.

STUDY DESIGN

A cross-sectional survey of more than 10,000 students attending 6 primary and 4 middle schools selected randomly from all schools in Maanshan City of Anhui Province in eastern China was conducted to collect information on school injuries occurring in the 12-month period before the survey. Rate ratios for risk factors were estimated using the negative binomial regression analysis.

RESULTS

The annual person-based school injury rate was 5.22 (95% CI: 3.90-6.53) percent. The annual event-based injury rate was 5.40 (95% CI: 4.04-6.76) per 100 students. Most injuries in school were relatively mild and only 1.53% (9/590) of the episodes resulted in hospitalization. The most frequent injures were falls (73%), and the most commonly injured sites were the upper limbs (46%). Male sex, primary school grades, poor health status, poor ability to concentrate, bad risk-taking behavior and high study-related stress were important risk factors.

CONCLUSION

This study provided useful baseline information on school injuries in China and identified important risk factors that would be important in planning prevention strategies.

Epidemiologia e grau de satisfação do paciente vítima de trauma músculo-esquelético atendido em hospital de emergência da rede pública brasileira

O objetivo desse estudo é descrever o perfil sócio-demográfico de pacientes vítimas de trauma atendidos em um hospital de referência da rede pública de Fortaleza - Brasil. Também pretende relacionar o tempo de espera para o atendimento com a satisfação pessoal do paciente em relação ao serviço prestado. Outro ponto abordado nesse estudo é a análise das patologias músculo-esqueléticas mais freqüentes nessa população. Foi realizado um estudo transversal durante os anos de 2002 e 2003 em hospital de referência em trauma da rede pública da cidade de Fortaleza - Brasil. Foram incluídos no estudo 500 pacientes atendidos na emergência. Após a realização da análise desse estudo, podemos idealizar um perfil do paciente atendido na rede pública de saúde vítima de trauma músculo-esquelético em Fortaleza: Paciente do sexo masculino (60,7%), cor parda (55%), jovem entre quinze e trinta anos (55%), procedente de Fortaleza (74%), proveniente de família com renda inferior a dois salários mínimos (60%) e relativamente hígido, sendo as fraturas o principal tipo de lesão (48%). Pacientes atendidos em hospitais de referência em trauma constituem um problema social importante e, na maioria dos casos, apresentam lesões graves, o que demonstra a necessidade e importância de investimentos nesse setor.

Unintentional residential child injury surveillance in Hong Kong

OBJECTIVES

To provide an overall pattern of morbidity in unintentional residential childhood injuries (URCI) in Hong Kong.

METHODOLOGY

A cross-sectional telephone survey of caregivers of children aged under 16-years and adolescents suffering from URCI and admitted to three selected local Accident and Emergency Departments.

RESULTS

Falls, cuts and scalds were the most common external causes of URCI observed, while boys predominated in the sample population. Most of the observed URCI were of moderate to mild severity. Children of new immigrant mothers were more likely to receive first aid immediately after the incidents. Parents were aware of potentially injurious behaviour and intervened on occasion, but most resorted to verbal warnings only.

CONCLUSIONS

Prevalence of falls among observed URCI offers evidence in support of the hypothesis that the high population density in Hong Kong plays an integral role in understanding mechanisms of morbidity. Parents show concern about URCI but often lack substantial action that modifies injury risk. Considering the local injury differentials, an active prevention effort such as behavioural intervention and education for parents may be useful.