Safety Practices in Al-Baha: A Cross-Sectional Study on Parental Awareness of Child Choking Events

BACKGROUND

Instances of choking continue to pose a concern for the health and safety of children. This study aims to assess parents' understanding, awareness, and perspectives on child choking.

METHODS

A cross-sectional study was conducted in the Al-Baha region of Saudi Arabia from September 13, 2023, to October 3, 2023. Data collection was done via an electronically validated questionnaire among parents aged 18 years and above, covering knowledge, attitudes, and practices. Statistical analysis was performed using the Mann-Whitney U test, the Kruskal-Wallis test, the Shapiro-Wilk test, and the Kolmogorov-Smirnov test. Any result below 0.05 (p < 0.05) was considered significant.

RESULTS

Out of 819 participants, 705 individuals were included in the analysis. The results indicated that there was a good level of knowledge (55%) regarding handling child choking situations. Interestingly, females demonstrated higher levels of awareness compared to males (79.4% versus 20.6%). Attitudes toward managing child choking incidents were rated as overall moderate, with 66.5% showing poor practices, such as being hesitant to seek medical assistance if symptoms improved. A majority of choking cases occurred at home (85%), underscoring the importance of enhancing intervention strategies through increased knowledge dissemination. Notably, the internet and social media platforms (71.8%) emerged as primary sources of information on dealing with child choking incidents. There was significant interest in cardiopulmonary resuscitation (CPR) classes (69.2%), although many people found it hard to make time for them (45%).

CONCLUSIONS

Parents in the Al-Baha area seem to have a good understanding but some concerning attitudes when it comes to child choking situations. It is important to spread awareness, correct misconceptions, and encourage CPR training.

From celebration to contamination: Analysing microplastics released by burst balloons

Air balloons are a ubiquitous presence in our daily lives, and their rupture may release a substantial quantity of debris, as investigated herein. We employ Raman imaging to capture the fragments resulting from balloon explosions, enabling the identification and direct visualisation of minute microplastic particles / fragments with an improved signal-to-noise ratio for precise quantification. To circumvent the generation of misleading confocal Raman images, we recommend employing terrain mapping to scan the three-dimensional surface of the sample. It is important to acknowledge that the analysis of microplastics at the micro-scale inherently poses limitations in terms of throughput, as it necessitates a trade-off between low and high magnifications. We conduct explosive experiments on ten-to-hundred balloons, collecting debris from various angles and positions. Our investigation involves the random testing of multiple samples / sample positions at the micro-scale, with subsequent extrapolation to estimate the total amount of microplastics. The amalgamation of these results through statistical analysis indicates that each balloon explosion can potentially release tens-to-thousands of microplastics, highlighting a concern that has hitherto received insufficient attention. The characterisation approach, particularly the random Raman scanning method in combination with SEM and the statistical analysis on accumulated samples employed in this report, has the potential to serve as a useful tool in future research on microplastics and even nanoplastics.

Bolus Texture Testing as a Clinical Method for Evaluating Food Oral Processing and Choking Risk: A Pilot Study

PURPOSE

Choking on food is a leading cause of accidental death in several populations, including children, people with intellectual/developmental disability, and older adults in residential care facilities. One contributor to choking risk is incomplete oral processing and failure to convert food to a cohesive, nonsticky bolus with a maximum particle size that will not block the airway. Clinical tests of mastication do not evaluate properties of chewed food boluses. We characterized expectorated boluses, after oral processing, using methods developed by the International Dysphagia Diet Standardisation Initiative (IDDSI).

METHOD

Seventeen adults without dysphagia (seven women and 10 men), aged 23-55 years, chewed samples of a cracker, a raw baby carrot, and a circular, dome-shaped gummy candy. Chewing metrics were obtained up to the point when the person indicated that they were ready to swallow. The bolus was then either expectorated or swallowed; IDDSI tests were used to characterize the expectorated boluses.

RESULTS

Measures of chewing did not differ between spit and swallow conditions. Expectorated cracker and carrot boluses had maximum particle size consistent with IDDSI Level SB6 Soft & Bite-Sized foods or lower. The gummy candy samples remained at IDDSI Level RG7 Regular food consistency.

CONCLUSIONS

This study suggests that expectorated ready-to-swallow boluses are representative of boluses that are swallowed and that oral processing in adults without dysphagia typically results in boluses at IDDSI's Level SB6 or lower. IDDSI's testing methods provide a practical method for evaluating oral processing by characterizing expectorated ready-to-swallow boluses and may guide food texture recommendations for persons who have increased risk of choking.

Toys and Toy Accessories Strike Back: Pediatric Injuries From Plush Toys, Toy Figurines, and Doll and Toy Accessories

OBJECTIVE

The aim of the study was to examine age-associated injury trends and severe injury proportions for plush toys, toy figurines, and doll and toy accessories. We hypothesized that the proportion of severe injuries would be highest in the younger than 3-year and 3- to 5-year age groups.

METHODS

We analyzed injury patterns from plush toys, toy figurines, and doll and toy accessories for ages of 0 to 18 years from 2010 to 2018 using the Consumer Product Safety Commission National Electronic Injury Surveillance System. Exclusion criteria included unspecified toy categories, adult or pet involvement, or unspecified disposition. National estimates were calculated with National Electronic Injury Surveillance System sample weights. Outcome of interest was severe injury proportions per age and toy category. Severe injury was defined as life- or limb-threatening injuries or injuries requiring admission. χ2 test was used to analyze the distribution of categorical variables.

RESULTS

We analyzed 1360 injuries. The majority occurred in female (n = 771, 56.7%) and ages of 3 to 5 years (n = 580, 42.7%). Annual injury frequency remained stable. One fifth of injuries were severe (n = 321, 23.6%), with a national estimate of 9304.7. The majority of both total (n = 778, 57.2%) and severe injuries (n = 182, 56.7%) resulted from toy figurines. Life-threatening injury secondary to foreign body aspiration or ingestion with a risk for asphyxiation was the most common severe injury. Severe injuries were significantly more common in the younger than 3-year group (odds ratio, 3.59; 95% confidence interval, 2.40-5.36) and 3- to 5-year age group (odds ratio, 2.97; 95% confidence interval, 2.01-4.39) than the older than 5-year age group.

CONCLUSIONS

Injury frequency remained stable. The greatest proportion of injuries were in ages up to 5 years, with most injuries occurring in the 3- to 5-year age category, and a significant proportion of injuries were severe.