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Berger S, Siekmeyer M, Petzold-Quinque S, Kiess W, Merkenschlager A. Drowning and Nonfatal Drowning in Children and Adolescents: A Subsequent Retrospective Data Analysis. CHILDREN (BASEL, SWITZERLAND) 2024; 11:439. [PMID: 38671656 PMCID: PMC11049416 DOI: 10.3390/children11040439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 03/28/2024] [Accepted: 04/04/2024] [Indexed: 04/28/2024]
Abstract
Fatal and nonfatal drowning are among the leading causes of death and lifelong severe neurological impairment among children and adolescents. This study aimed to complement research from Leipzig 1994-2008 to seek trends within risk factors, treatments, and outcomes throughout the last decade. We retrospectively investigated data of 47 inpatients aged 0-18 admitted to Leipzig University Department of Pediatrics who matched ICD-10 code T75.1 from 2008 to 2020 and compared them to a preceding study at the same institution. We also examined the prognostic value of parameters regarding the patients' outcomes. There were three median incidents per annum. The median age was 2.75 years; 76% of incidents happened in males. An accumulation was seen during the summer months and weekends. Most drowning incidents occurred in private ponds or pools (48.9%). Thirty-nine children were discharged without resulting morbidity, four showed neurological impairment, and three died. Risk factors concerning age, sex, and incident characteristics were confirmed. Special supervision needs still apply to 1-3-year-old male children or children with pre-existing health conditions around private pools and ponds. Hospitalization duration shortened, and morbidity and lethality decreased since the previous study. There was structural improvement in primary care and medical documentation. Parameters suggesting good outcomes include a submersion time < 5 min, GCS > 3 points, spontaneous movement upon admission, remaining pupillary light response, the absence of cardiovascular arrest, body temperature ≥ 32 °C, pH > 7, blood glucose < 15 mmol/L, lactate < 14 mmol/L, base excess ≥ -15 mmol/L, and the absence of ARDS. Clear legislation can contribute to improved private home water safety. Further studies should include a broad in- and outpatient spectrum and standardized incident documentation presupposing Utstein-style reporting. Regular reinvestigation of consistent geographical regions facilitates process evaluations of drowning epidemiology and therapy evolution.
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Affiliation(s)
- Sebastian Berger
- Department of Women and Child Health, Hospital for Children and Adolescents, Division of Neuropediatrics, University of Leipzig, Liebigstraße 20a, 04103 Leipzig, Germany;
| | - Manuela Siekmeyer
- Department of Women and Child Health, Hospital for Children and Adolescents, Pediatric Intensive Care Unit, University of Leipzig, Liebigstraße 20a, 04103 Leipzig, Germany
| | - Stefanie Petzold-Quinque
- Department of Women and Child Health, Hospital for Children and Adolescents, Pediatric Intensive Care Unit, University of Leipzig, Liebigstraße 20a, 04103 Leipzig, Germany
| | - Wieland Kiess
- Department of Women and Child Health, Hospital for Children and Adolescents and Center for Pediatric Research, University Hospital Leipzig, Liebigstraße 20a, 04103 Leipzig, Germany
| | - Andreas Merkenschlager
- Department of Women and Child Health, Hospital for Children and Adolescents, Division of Neuropediatrics, University of Leipzig, Liebigstraße 20a, 04103 Leipzig, Germany;
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Morgan ER, Sakamoto I, Ardelean A, Diaz-Rohena A, Falk A, Starnes C, Rivara FP, Vavilala M. Caregiver perspectives on a water safety toolkit for child supervision. Health Promot J Austr 2024; 35:345-354. [PMID: 37277112 DOI: 10.1002/hpja.757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 05/11/2023] [Accepted: 05/30/2023] [Indexed: 06/07/2023] Open
Abstract
ISSUE ADDRESSED Drowning is one of the leading causes of unintentional deaths among children and adolescents globally. Adult supervision is one method to decrease the risk of drowning among youth. METHODS We sought to assess the acceptability of a Water Watcher toolkit among children's caregivers. The toolkit consists of a badge-to designate the adult(s) responsible for supervision during water activities-and a smartphone application. When activated, the application blocks incoming calls, text messages and other applications, for example, mobile games and social media, as well as providing a button to quickly dial 911 and information for guided cardiopulmonary resuscitation. We conducted online and in-person semi-structured interviews of 16 adults residing in Washington State, United States and providing supervision to a child under 18 years of age for at least 20 h per week. Interview guides were developed based on the Health Belief Model and we performed content analysis on interview transcripts using an inductive approach. RESULTS When asked about Water Watcher tools, respondents generally reacted favourably towards the intervention, citing benefits of formally delegating a responsible party during group activities and elimination of distractions. Primary challenges to using the toolkit were social acceptability, competence with technology, and the independence of older children (i.e., those 13- to 17-years-old). CONCLUSIONS Caregivers recognized the importance of minimizing distractions, and many liked the strategy to formally designate responsibility for child supervision during aquatic recreation. SO WHAT?: Interventions such as the Water Watcher toolkit are generally considered acceptable and expanding access to these resources could reduce the burden of unintentional drownings.
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Affiliation(s)
- Erin R Morgan
- Harborview Injury Prevention and Research Center, University of Washington, Seattle, Washington, USA
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
- College of Medicine, Institute for Research and Education to Advance Community Health, Washington State University, Seattle, Washington, USA
| | | | - Alan Ardelean
- Harborview Injury Prevention and Research Center, University of Washington, Seattle, Washington, USA
- Department of Public Health, University of Rochester, Rochester, New York, USA
| | - Alejandra Diaz-Rohena
- Harborview Injury Prevention and Research Center, University of Washington, Seattle, Washington, USA
- College of Natural Sciences, University of Puerto Rico, Rio Piedras, Puerto Rico
| | - Allison Falk
- Harborview Injury Prevention and Research Center, University of Washington, Seattle, Washington, USA
- Department of Biological Sciences, University of Idaho, Moscow, Idaho, USA
| | - Cara Starnes
- Harborview Injury Prevention and Research Center, University of Washington, Seattle, Washington, USA
- School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Frederick P Rivara
- Harborview Injury Prevention and Research Center, University of Washington, Seattle, Washington, USA
- Department of Pediatrics, University of Washington, Seattle, Washington, USA
| | - Monica Vavilala
- Harborview Injury Prevention and Research Center, University of Washington, Seattle, Washington, USA
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Banihani S, Waldrop I, K Singh M, Vukcevich O, Sheets NW, Plurad D. Unintentional Drownings in Pediatric Populations: Injury Prevention in the Post-COVID-19 Era. Cureus 2023; 15:e38264. [PMID: 37252466 PMCID: PMC10225248 DOI: 10.7759/cureus.38264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2023] [Indexed: 05/31/2023] Open
Abstract
Unintentional injuries are one of the leading causes of death in Americans. A large proportion of these deaths are attributable to accidental drownings and falls, both of which oftentimes take place in or around swimming pools and swimming pool-related apparatuses such as diving boards. The American Academy of Family Physicians (AAFP) has reported drowning incidents as the most common injury-related cause of death in children ages one to four years. Although the AAFP has outlined steps to take to prevent drownings, there has not been a current large-scale study illustrating the effectiveness of these strategies with regard to their effect on the prevalence of swimming pool drowning cases in the last 10 years. Thus, we aim to utilize the National Electronic Injury Surveillance System (NEISS) database to uncover these rates, which can ultimately help aid in the reevaluation of current recommended guidelines.
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Affiliation(s)
- Shamieh Banihani
- School of Medicine, University of California, Riverside, Riverside, USA
| | - Ian Waldrop
- Trauma and Acute Care Surgery, Riverside Community Hospital, Riverside, USA
| | - Manpreet K Singh
- School of Medicine, University of California, Riverside, Riverside, USA
| | - Olivia Vukcevich
- School of Medicine, University of California, Riverside, Riverside, USA
| | - Nicholas W Sheets
- Trauma and Acute Care Surgery, Riverside Community Hospital, Riverside, USA
| | - David Plurad
- Trauma and Acute Care Surgery, Riverside Community Hospital, Riverside, USA
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Xie X, Li Z, Xu H, Peng D, Yin L, Meng R, Wu W, Ma W, Chen Q. Non-Fatal Drowning Risk Prediction Based on Stacking Ensemble Algorithm. CHILDREN 2022; 9:children9091383. [PMID: 36138692 PMCID: PMC9498184 DOI: 10.3390/children9091383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 09/06/2022] [Accepted: 09/10/2022] [Indexed: 11/16/2022]
Abstract
Drowning is a major public health problem and a leading cause of death in children living in developing countries. We seek better machine learning (ML) algorithms to provide a novel risk-assessment insight on non-fatal drowning prediction. The data on non-fatal drowning were collected in Qingyuan city, Guangdong Province, China. We developed four ML models to predict the non-fatal drowning risk, including a logistic regression model (LR), random forest model (RF), support vector machine model (SVM), and stacking-based model, on three primary learners (LR, RF, SVM). The area under the curve (AUC), F1 value, accuracy, sensitivity, and specificity were calculated to evaluate the predictive ability of the different learning algorithms. This study included a total of 8390 children. Of those, 12.07% (1013) had experienced non-fatal drowning. We found the following risk factors are closely associated with the risk of non-fatal drowning: the frequency of swimming in open water, distance between the school and the surrounding open waters, swimming skills, personality (introvert) and relationality with family members. Compared to the other three base models, the stacking generalization model achieved a superior performance in the non-fatal drowning dataset (AUC = 0.741, sensitivity = 0.625, F1 value = 0.359, accuracy = 0.739 and specificity = 0.754). This study indicates that applying stacking ensemble algorithms in the non-fatal drowning dataset may outperform other ML models.
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Affiliation(s)
- Xinshan Xie
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou 510200, China
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Zhixing Li
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
- Department of Public Health, School of Medicine, Jinan University, Guangzhou 510630, China
| | - Haofeng Xu
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Dandan Peng
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Lihua Yin
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Ruilin Meng
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Wei Wu
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou 510200, China
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
- Correspondence:
| | - Wenjun Ma
- Department of Public Health, School of Medicine, Jinan University, Guangzhou 510630, China
| | - Qingsong Chen
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou 510200, China
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Study on the Attitudes and Knowledge of Teachers and Future Teachers about Immediate Health Care Measures at School. Eur J Investig Health Psychol Educ 2022; 12:854-869. [PMID: 35877462 PMCID: PMC9324608 DOI: 10.3390/ejihpe12070062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 07/15/2022] [Accepted: 07/19/2022] [Indexed: 11/17/2022] Open
Abstract
The level and need for immediate health care measures training for teachers are of growing concern for two main reasons: on the one hand, these contents are part of the school curriculum and, on the other hand, teachers are the first adults to intervene in case of school injury. However, in Spain, first aid (FA) does not appear as obligatory content in the university training of teachers. The aim of the present study was to design and validate a questionnaire on the attitude of pre-school and primary school teachers towards first aid knowledge adapted to the school context and to analyze its psychometric properties. First of all, the psychometric values of the questionnaire were tested: through its validation and reliability. Subsequently, a correlation study was carried out as well as a logistic regression in order to know the knowledge and attitudes of teachers and future teachers about the importance of the Immediate Attention Measures at school. The sample consisted of 392 participants: active teachers (71%) and future teachers (29%, the latter being final year students) of the infant and primary stages from the northern, central and southern areas of Spain. The results show adequate psychometric values, establishing three factors: attitude towards general knowledge in FA and learning methodology; attitude towards wounds and CPR algorithm (most frequent and/or serious events); self-perception of knowledge or skill in FA. Pearson’s correlation test identified significant values (p < 0.01) and positive association between Factors 1 and 2 (r = 0.422) and between 1 and 3 (0.244). The conclusions of the results of the validation process of the questionnaire on the attitude of teachers and future teachers to knowledge for immediate health care measures training are valid and reliable to an acceptable degree. Regression study demonstrates the importance of including first aid training in teachers’ degrees.
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Teaching First Aid to Prospective Teachers as a Way to Promote Child Healthcare. Healthcare (Basel) 2021; 9:healthcare9040367. [PMID: 33806034 PMCID: PMC8064469 DOI: 10.3390/healthcare9040367] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 03/20/2021] [Accepted: 03/22/2021] [Indexed: 11/23/2022] Open
Abstract
This article aimed to analyze, through a qualitative study (i.e., semi-structured interview), the opinions and knowledge of fourth-year future teachers at a Spanish public university (University of Granada) regarding training and the need for first aid (FA) at school. With a sample of 70 subjects in their last year of training, our conclusion is that although they are aware of the importance of first aid for their professional development, there is no such training in their careers, and thus they have great difficulty understanding how to react to emergency situations on the job.
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