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Abbe M, Rix K, Aguilar D, Alderete J, Fernandez A, Messiah S. Characteristics of fatal and non-fatal drownings at a Texas level-1 paediatric trauma centre. Inj Prev 2024:ip-2024-045296. [PMID: 39053922 DOI: 10.1136/ip-2024-045296] [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: 02/27/2024] [Accepted: 07/11/2024] [Indexed: 07/27/2024]
Abstract
BACKGROUND Drowning is a leading cause of death for young children and knowing what puts a child at risk helps efforts across the spectrum of prevention. The purpose of this study was to identify risk and protective factors associated with hospital admission and mortality following paediatric drowning from a large level-1 paediatric trauma centre. METHODS Children (ages 0-17) who presented at an emergency department or were admitted for a drowning event between 2017 and 2023 were included in this retrospective cohort study (n=698). This study examined differences between patients who were admitted compared with not admitted, and those who survived compared with those who did not survive. RESULTS Participants who had adult supervision at the time of their drowning were significantly less likely to be admitted (OR=0.31, 95% CI 0.22 to 0.43, p<0.001) and significantly more likely to survive (OR=6.9, 95% CI 3.2 to 15.4, p<0.001). The environment also played a significant role in drowning outcomes. Children who drowned in a pool compared with other bodies of water were significantly more likely to survive (OR=3.0, 95% CI 1.6 to 5.5, p<0.001). Children from communities with higher child opportunity compared with those from very low opportunity were both simultaneously more likely to be admitted (IRR=1.7-2.4, 95% CI 1.3 to 3.3, p<0.001) and more often survived (IRR=1.7-3.0, 95% CI 1.3 to 3.5, p<0.001). CONCLUSION Our analysis revealed significant differences in drowning risk related to adult supervision, location of drowning and where a child lives. These findings can help drowning prevention strategies mitigate the severity of drowning by enhancing educational messages, resources and policy.
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Affiliation(s)
- Marisa Abbe
- Injury Prevention, Children's Medical Center, Dallas, Dallas, Texas, USA
- Department of Surgery, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Kevin Rix
- School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - David Aguilar
- Injury Prevention, Children's Medical Center, Dallas, Dallas, Texas, USA
| | - Jesus Alderete
- Injury Prevention, Children's Medical Center, Dallas, Dallas, Texas, USA
| | - Alejandra Fernandez
- School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Sarah Messiah
- School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, USA
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2
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Ortiz Olivar A, Moreno-Murcia JA. Knowing how to swim and drowning prevention in children aged 10 to 14 years. Systematic review. JOURNAL OF SAFETY RESEARCH 2024; 89:181-189. [PMID: 38858041 DOI: 10.1016/j.jsr.2024.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 12/19/2023] [Accepted: 02/22/2024] [Indexed: 06/12/2024]
Abstract
PURPOSE Drowning is 1 of the 10 leading causes of death due to unintentional injuries in children and adolescents worldwide. Knowing how to swim has been traditionally associated with water safety. However, its conceptualization may vary across studies, leading to different measurements and effects on the risk of drowning. This review sought to understand the current state of scientific evidence associating both issues. OBJECTIVES To identify conceptualizations of knowing how to swim and to analyze the evidence indicating whether "knowing how to swim" may be a protective or a risk factor for unintentional drowning in children aged 10 to 14 years. METHOD A systematic review of observational etiology studies was conducted, considering original peer-reviewed research published up to the year 2020. Databases including PubMed, Cochrane Central, Tripdatabase, Science Direct, Epistemonikos, Bvs and Bireme were searched for studies associating swimming skills as a risk or a protective factor for drowning (10-14 years). Study quality was assessed, and quantitative data were synthesized (without performing a meta-analysis). RESULTS A total of 6,508 results were identified, with only 6 studies meeting the criteria for inclusion in the final cohort. It was evidenced that the exclusive possession of swimming skills, without a concurrent understanding of water safety, is associated with increased exposure to aquatic environments. Consequently, this may increase the risk of drowning. CONCLUSIONS Among children aged 10 to 14 years, there is insufficient evidence regarding whether knowing how to swim serves as a protective factor against drowning compared to not knowing how to swim. PRACTICAL APPLICATIONS The insufficiency of evidence and a lack of consensus in the conceptualization of swimming as a form of knowledge underscores the need for further research. Such research is crucial for informing investments in drowning prevention interventions, particularly during early adolescence.
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Affiliation(s)
- Ana Ortiz Olivar
- Miguel Hernández University, Avinguda de la Universitat d'Elx, s/n, 03202 Elche, Alicante, Spain; University of the Republic, Parque batlle s/n, Montevideo, Uruguay.
| | - Juan Antonio Moreno-Murcia
- Sports Research Center, Miguel Hernández University, Avinguda de la Universitat d'Elx, s/n, 03202 Elche, Alicante, Spain.
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3
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Agam A, Godler Y, Calif E. Child drowning mortality in Israel: Trends and measures for prevention. JOURNAL OF SAFETY RESEARCH 2024; 89:224-233. [PMID: 38858046 DOI: 10.1016/j.jsr.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 11/01/2023] [Accepted: 02/02/2024] [Indexed: 06/12/2024]
Abstract
INTRODUCTION In this study, we use the media-based database of Beterem-Safe Kids Israel, to provide a 15-year review of unintentional fatal childhood drowning in Israel, between 2008 and 2022. METHOD It total, we identified 257 cases of child mortality due to drowning during this period. RESULTS Our results demonstrate a gradual rise in childhood mortality due to drowning, from 72 cases in 2008-2012, to 85 cases in 2013-2017, and to 100 cases in 2018-2022. Especially worth noting is the increase in childhood drowning in domestic swimming pools. We point to a link between low socioeconomic status and cases of drowning, showing that the risk of drowning extends beyond a mere matter of caregiver inattention. We recommend a series of regulatory and legislative steps to reduce fatal childhood drowning, including fencing built around domestic swimming pools, extending lifeguard activity hours, adding declared beaches, forming programs of safe behavior in water environments for adolescents, and establishing swimming lessons during the 2nd grade, for all populations. We further recommend that a special focus will be put in municipalities situated at the bottom of the socioeconomic index.
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Affiliation(s)
- Aviad Agam
- Beterem - Safe Kids Israel, HaSivim 30, Petah Tikva, Israel.
| | - Yigal Godler
- Beterem - Safe Kids Israel, HaSivim 30, Petah Tikva, Israel
| | - Elad Calif
- Beterem - Safe Kids Israel, HaSivim 30, Petah Tikva, Israel
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4
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Peixoto-Pino L, Barcala-Furelos R, Paz-García B, Varela-Casal C, Lorenzo-Martínez M, Gómez-Silva A, Rico-Díaz J, Rodríguez-Núñez A. The "DrownSafe" Project: Assessing the Feasibility of a Puppet Show in Teaching Drowning Prevention to Children and Parents. CHILDREN (BASEL, SWITZERLAND) 2023; 11:19. [PMID: 38255332 PMCID: PMC10814459 DOI: 10.3390/children11010019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 12/14/2023] [Accepted: 12/20/2023] [Indexed: 01/24/2024]
Abstract
Drowning remains a prominent global pediatric health concern, necessitating preventive measures such as educational initiatives for children and caregivers. In this study, we aimed to assess the feasibility and educational effectiveness of an interactive puppet show centered on teaching water safety to children and parents. A 30 min original theater performance, featuring two actors and three puppets (a girl, a crab, and a lifeguard), was conducted. Subsequently, 185 children (aged 4 to 8) and their 160 parents (134 mothers and 26 fathers) participated in this quasi-experimental study. Pre- and post-show tests were administered to evaluate knowledge and behaviors regarding aquatic environments. Prior to the puppet show, 78% of the children exhibited basic aquatic competency. Only 33% considered swimming alone risky. Following the intervention, 81.6% of the children changed their perception of the risks of solo beach activities, showing improved knowledge regarding contacting an emergency number (from 63.2% to 98.9%, p < 0.001). The intervention increased parents' intention to visit lifeguard-patrolled beaches and improved their CPR knowledge with regard to drowning victims by 58.8%. In conclusion, a drowning prevention puppet show positively impacted children and parents, potentially enhancing safety behaviors during water-related leisure activities, warranting its consideration part of comprehensive drowning prevention strategies.
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Affiliation(s)
- Lucía Peixoto-Pino
- Facultade de Ciencias da Educación, Universidade de Santiago de Compostela, 15706 A Coruña, Spain; (L.P.-P.); (J.R.-D.)
- CLINURSID Research Group, Psychiatry, Radiology, Public Health, Nursing and Medicine Department, Universidade de Santiago de Compostela, 15706 A Coruña, Spain;
| | - Roberto Barcala-Furelos
- REMOSS Research Group, Facultade de Ciencias da Educación e do Deporte, Universidade de Vigo, 36005 Pontevedra, Spain; (B.P.-G.); (C.V.-C.); (M.L.-M.); (A.G.-S.)
| | - Begoña Paz-García
- REMOSS Research Group, Facultade de Ciencias da Educación e do Deporte, Universidade de Vigo, 36005 Pontevedra, Spain; (B.P.-G.); (C.V.-C.); (M.L.-M.); (A.G.-S.)
| | - Cristina Varela-Casal
- REMOSS Research Group, Facultade de Ciencias da Educación e do Deporte, Universidade de Vigo, 36005 Pontevedra, Spain; (B.P.-G.); (C.V.-C.); (M.L.-M.); (A.G.-S.)
| | - Miguel Lorenzo-Martínez
- REMOSS Research Group, Facultade de Ciencias da Educación e do Deporte, Universidade de Vigo, 36005 Pontevedra, Spain; (B.P.-G.); (C.V.-C.); (M.L.-M.); (A.G.-S.)
| | - Adrián Gómez-Silva
- REMOSS Research Group, Facultade de Ciencias da Educación e do Deporte, Universidade de Vigo, 36005 Pontevedra, Spain; (B.P.-G.); (C.V.-C.); (M.L.-M.); (A.G.-S.)
| | - Javier Rico-Díaz
- Facultade de Ciencias da Educación, Universidade de Santiago de Compostela, 15706 A Coruña, Spain; (L.P.-P.); (J.R.-D.)
- ESCULCA Knowledge and Educational Action Research Group, Universidade de Santiago de Compostela, 15706 A Coruña, Spain
| | - Antonio Rodríguez-Núñez
- CLINURSID Research Group, Psychiatry, Radiology, Public Health, Nursing and Medicine Department, Universidade de Santiago de Compostela, 15706 A Coruña, Spain;
- Faculty of Nursing, Universidade de Santiago de Compostela, 15782 A Coruña, Spain
- Paediatric Critical, Intermediate and Palliative Care Section, Hospital Clínico Universitario de Santiago de Compostela, 15706 A Coruña, Spain
- Collaborative Research Network Orientated to Health Results (RICORS): Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Developmental Origin, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Simulation and Intensive Care Unit of Santiago (SICRUS) Research Group, Health Research Institute of Santiago, University Hospital of Santiago de Compostela (CHUS), 15706 A Coruña, Spain
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5
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Brayne AB, Jones W, Lee A, Chatfield-Ball C, Kaye D, Ball M, Sacher G, Morgan P. Critical care drowning admissions in Southwest England 2009-2020, a retrospective study. J Intensive Care Soc 2023; 24:47-52. [PMID: 36874289 PMCID: PMC9975799 DOI: 10.1177/17511437221105774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Aim In the United Kingdom (UK), 600 deaths per annum are attributable to drowning. Despite this there is scarce critical care data on drowning patients globally. We describe drowning cases admitted to critical care units with a focus on functional outcomes. Materials and Methods Medical records for critical care admissions following a drowning event were retrospectively reviewed across six hospitals in Southwest England for cases presenting in the period between 2009 and 2020. Data was collected according to the Utstein international consensus guidelines on drowning. Results Forty-nine patients were included, 36 males and 13 females, including seven children. Median submersion duration was 2.5 min 20 cases were in cardiac arrest when rescued. At discharge 22 patients had preserved functional status, 10 patients had a reduced functional status. 17 patients died in hospital. Conclusion Admission to critical care following drowning is uncommon and associated with high rates of mortality and poor functional outcomes. We find that 31% of those who survived a drowning event subsequently required an increased level of assistance with their activities of daily living.
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Affiliation(s)
| | | | - Adrienne Lee
- University Hospitals Plymouth NHS Trust, Plymouth, UK
| | | | | | | | - Gorki Sacher
- Northern Devon Healthcare NHS Trust, Barnstaple, UK
| | | | - Patrick Morgan
- North Bristol NHS Trust, Bristol, UK.,HM Coastguard, Southampton, UK.,Surf Lifesaving Great Britain, Exeter, UK.,Medical Commission International Life Saving Federation, Leuven, Belgium.,Extreme Environments Laboratory, Department of Sport and Exercise Science, University of Portsmouth, Portsmouth, UK
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6
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Dunne CL, Sweet J, Clemens T. The link between medical conditions and fatal drownings in Canada: a 10-year cross-sectional analysis. CMAJ 2022; 194:E637-E644. [PMID: 35534027 PMCID: PMC9259405 DOI: 10.1503/cmaj.211739] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2022] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Drowning accounts for hundreds of preventable deaths in Canada every year, but the impact of preexisting medical conditions on the likelihood of death from drowning is not known. We aimed to describe the prevalence of pre-existing medical conditions among people who fatally drowned in Canada and evaluate the risk of fatal drowning among people with common pre-existing medical conditions. METHODS We reviewed all Canadian unintentional fatal drownings (2007-2016) in the Drowning Prevention Research Centre Canada's database. For each fatal drowning we established whether the person had pre-existing medical conditions and whether those conditions contributed to the drowning. We calculated relative risk (RR) of fatal drowning stratified by age and sex for each pre-existing medical condition using data from the Canadian Chronic Disease Surveillance System. RESULTS During 2007-2016, 4288 people fatally drowned unintentially in Canada, of whom one-third had a pre-existing medical condition. A pre-existing medical condition contributed to drowning in 43.6% (n = 616) of cases. Fatal drowning occurred more frequently in people with ischemic heart disease (RR 2.7, 95% confidence interval [CI] 2.5-3.0) and seizure disorders (RR 6.3, 95% CI 5.4-7.3) but less frequently in people with respiratory disease (RR 0.12, 95% CI 0.10-0.15). Females aged 20-34 years with a seizure disorder had a 23 times greater risk than their age- and sex-matched cohort (RR 23, 95% CI 14-39). In general, fatal drowning occurred more often while people were bathing (RR 5.9, 95% CI 4.8-7.0) or alone (RR 1.99, 95% CI 1.32-2.97) and less often in males (RR 0.92, 95% CI 0.88-0.95) or in those who had used alcohol (RR 0.72, 95% CI 0.65-0.80), among those with pre-existing medical conditions. INTERPRETATION The risk of fatal drowning is increased in the presence of some preexisting medical conditions. Tailored interventions aimed at preventing drowning based on pre-existing medical conditions and age are needed. Initial prevention strategies should focus on seizure disorders and bathtub drownings.
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Affiliation(s)
- Cody L Dunne
- Department of Emergency Medicine (Dunne), University of Calgary, Calgary, Alta.; International Drowning Researchers' Alliance (Dunne, Clemens), Kuna, Idaho; Faculty of Medicine (Sweet), University of Ottawa, Ottawa, Ont.; Drowning Prevention Research Centre Canada (Clemens), Toronto, Ont.
| | - Julia Sweet
- Department of Emergency Medicine (Dunne), University of Calgary, Calgary, Alta.; International Drowning Researchers' Alliance (Dunne, Clemens), Kuna, Idaho; Faculty of Medicine (Sweet), University of Ottawa, Ottawa, Ont.; Drowning Prevention Research Centre Canada (Clemens), Toronto, Ont
| | - Tessa Clemens
- Department of Emergency Medicine (Dunne), University of Calgary, Calgary, Alta.; International Drowning Researchers' Alliance (Dunne, Clemens), Kuna, Idaho; Faculty of Medicine (Sweet), University of Ottawa, Ottawa, Ont.; Drowning Prevention Research Centre Canada (Clemens), Toronto, Ont
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7
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Dimitrić G, Maksimović N, Tabakova E, Jakšić M, Orlić D, Sadiković S, Karaba-Jakovljević D, Zenić N, Drid P. Personality Dimensions of Serbian Lifeguards. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182412927. [PMID: 34948537 PMCID: PMC8702172 DOI: 10.3390/ijerph182412927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 12/02/2021] [Accepted: 12/06/2021] [Indexed: 11/16/2022]
Abstract
According to the World Health Organization’s (WHO) global drowning report (2017), drowning is the third leading cause of unintentional injury death worldwide. Drowning can occur anywhere there is water: oceans, seas, lakes, pools, bathtubs, rivers or water collection on the side of the road, etc. In many countries, there are drowning prevention programs for children and adults. The two most commonly used strategiesagainst drowning are the presence of lifeguards in public places and the use of protected areas that could prevent most of the drownings. The main aim of the present study is to examine the individual differences in a Big Five plus Two (BF+2) personality traits in lifeguards and non-lifeguards (including students). The subsample of lifeguards represented 122 male respondents who were, at the time of the survey, licensed as lifeguards (60.9%) or were in training for lifeguards—candidates (39.1%). The subsample of students represented 138 male respondents who were studying at the University of Novi Sad. The results indicate that lifeguards in comparison to students are more extraverted, open to experience, and conscientious, less neurotic, and aggressive. Both positive and negative valence are higher in student subsample. All of the above traits are desirable traits for people working as lifeguards.
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Affiliation(s)
- Goran Dimitrić
- Faculty of Sport and Physical Education, University of Novi Sad, 21000 Novi Sad, Serbia; (G.D.); (N.M.); (M.J.); (D.O.)
| | - Nebojša Maksimović
- Faculty of Sport and Physical Education, University of Novi Sad, 21000 Novi Sad, Serbia; (G.D.); (N.M.); (M.J.); (D.O.)
| | - Elena Tabakova
- Institute of Sport and Physical Education, Russian State University of Physical Education, Sports, Youth and Tourism, 105122 Moscow, Russia;
| | - Milorad Jakšić
- Faculty of Sport and Physical Education, University of Novi Sad, 21000 Novi Sad, Serbia; (G.D.); (N.M.); (M.J.); (D.O.)
| | - Dejan Orlić
- Faculty of Sport and Physical Education, University of Novi Sad, 21000 Novi Sad, Serbia; (G.D.); (N.M.); (M.J.); (D.O.)
| | - Selka Sadiković
- Faculty of Philosophy, University of Novi Sad, 21000 Novi Sad, Serbia;
| | | | - Nataša Zenić
- Faculty of Kinesiology, University of Split, 21000 Split, Croatia;
| | - Patrik Drid
- Faculty of Sport and Physical Education, University of Novi Sad, 21000 Novi Sad, Serbia; (G.D.); (N.M.); (M.J.); (D.O.)
- Correspondence:
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8
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Denny SA, Quan L, Gilchrist J, McCallin T, Shenoi R, Yusuf S, Weiss J, Hoffman B. Prevention of Drowning. Pediatrics 2021; 148:peds.2021-052227. [PMID: 34253571 DOI: 10.1542/peds.2021-052227] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Drowning is a leading cause of injury-related death in children. In 2018, almost 900 US children younger than 20 years died of drowning. A number of strategies are available to prevent these tragedies. As educators and advocates, pediatricians can play an important role in prevention of drowning.
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Affiliation(s)
- Sarah A Denny
- Nationwide Children's Hospital and College of Medicine, The Ohio State University, Columbus, Ohio;
| | - Linda Quan
- Pediatric Emergency Medicine, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Washington
| | | | - Tracy McCallin
- Children's Hospital of San Antonio, San Antonio, Texas.,Baylor College of Medicine, Houston, Texas
| | - Rohit Shenoi
- Section of Emergency Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Shabana Yusuf
- Section of Emergency Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Jeffrey Weiss
- Phoenix Children's Hospital Medicine, Phoenix Children's Hospital, Phoenix, Arizona.,University of Arizona College of Medicine-Phoenix, Phoenix, Arizona; and
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9
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Alonge O, Bishai D, Wadhwaniya S, Agrawal P, Rahman A, Dewan Hoque EM, Baset KU, Salam SS, Bhuiyan AA, Islam MI, Talab A, Rahman QSU, Rahman F, El-Arifeen S, Hyder AA. Large-scale evaluation of interventions designed to reduce childhood Drownings in rural Bangladesh: a before and after cohort study. Inj Epidemiol 2020; 7:17. [PMID: 32389128 PMCID: PMC7212604 DOI: 10.1186/s40621-020-00245-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 04/14/2020] [Indexed: 11/29/2022] Open
Abstract
Background This paper estimates the impact on childhood drowning rates of community-based introduction of crèches or playpens or both in rural Bangladesh for children aged 0–47 months. Methods A baseline census of the whole population of 270,387 households in 51 unions, 451 villages from 7 rural sub-districts in Bangladesh was conducted in 2013. The baseline census determined retrospective, age-specific, and cumulative drowning incidence rates (IR) experienced in the target households in the 12 months prior to the intervention. Beginning in late 2013, creches for drowning prevention were established across the study area. Acceptance into creches was provided and written assent to attend a creche was obtained for all children aged 9–47 months in all participating unions. Playpens were provided to 45,460 of these children, of which 5981 children received only the playpens. All children were followed-up until their 48-month birthday or administrative censoring (fixed timepoint to stop observing the drowning deaths), after a two-year implementation period (2014–2016). Drowning IR were estimated for children and compared to corresponding baseline rates from 2012. Age-specific drowning IR under different “as treated” categories (playpen-only, creche-only, and playpen-plus-creche) were compared to the baseline rates experienced by the categorized households prior to intervention. Results A total of 3205 creches (average of 7 creches per village) were established, and 116,054 children aged 9–47 months were exposed to the intervention packages. Aggregated drowning IRs between age 0 and 47 were estimated per 100,000 population per year at 86.73 (95% CI: 69.67–107.97) and 43.03 (95% CI: 35.55–52.10) in the baseline and post implementation period, respectively. Risk ratios were 0.40 (95% CI: 0.28–0.57) overall, and 0.34 (95% CI: 0.13–0.90), 0.09 (95% CI: 0.02–0.36), and 0.04 (95% CI: 0.002–0.60) in children under the creche-only, aged, 1, 2, and 3 years old respectively. Inexplicably, drowning rates were statistically significantly higher post-intervention in children 0-11 months. There was no mortality reduction with playpen use (alone or in combination), and this group may actually have had a higher risk of drowning. Conclusions Creches are effective for preventing childhood drowning in rural Bangladesh for children above age 1-year, and should be considered for further scale-up.
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Affiliation(s)
- Olakunle Alonge
- Johns Hopkins International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.
| | - David Bishai
- Johns Hopkins International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.,Department of Population and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Shirin Wadhwaniya
- Johns Hopkins International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Priyanka Agrawal
- Johns Hopkins International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Aminur Rahman
- Center for Injury Prevention Research, Dhaka, Bangladesh
| | - Emdad Md Dewan Hoque
- Maternal and Child Health Division, International Center for Diarrhoeal Diseases Research, Dhaka, Bangladesh
| | | | - Shumona Sharmin Salam
- Maternal and Child Health Division, International Center for Diarrhoeal Diseases Research, Dhaka, Bangladesh
| | | | - Md Irteja Islam
- Maternal and Child Health Division, International Center for Diarrhoeal Diseases Research, Dhaka, Bangladesh
| | - Abu Talab
- Center for Injury Prevention Research, Dhaka, Bangladesh
| | - Qazi Sadeq-Ur Rahman
- Maternal and Child Health Division, International Center for Diarrhoeal Diseases Research, Dhaka, Bangladesh
| | - Fazlur Rahman
- Center for Injury Prevention Research, Dhaka, Bangladesh
| | - Shams El-Arifeen
- Maternal and Child Health Division, International Center for Diarrhoeal Diseases Research, Dhaka, Bangladesh
| | - Adnan A Hyder
- Milken Institute School of Public Health, George Washington University, Washington DC, USA
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10
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Farizan NH, Sutan R, Hod R, KC Mani K. Development and validation of a health educational booklet. JOURNAL OF HEALTH RESEARCH 2020. [DOI: 10.1108/jhr-05-2019-0101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PurposeThis study aimed to develop and validate a health education booklet (Be SAFE booklet) as a guide to improving knowledge, attitude, and practice toward drowning prevention and water safety among parents of primary school children in a local community in Selangor.Design/methodology/approachThis methodological study was conducted in two phases: the development of the content, and validation of the educational material. Booklet development involved content survey and design development. These steps consisted of a content analysis method, information from current literature, document analysis from the stakeholder, and input from parents or guardians and children. The validation by nine panel experts and 15 parents/guardians involved both review, content validity, and face validity.FindingsThe booklet was developed by emphasizing on four main aspects related to drowning prevention and water safety; namely, supervision, alertness, first aid, and education. The assessment rated by the content validity index (CVI), resulted in an I-CVI ranging from 0.78 to 1 and S-CVI of 0.94; the face validity achieved a level of agreement with an average of 94 percent. The results indicated that the Be SAFE booklet was validated and could be considered useful in helping to promote drowning prevention and water safety among primary school pupils' parents.Originality/valueThis article contributed ideas for the concept and aspect of health messages to be incorporated into health education materials for drowning prevention and water safety.
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11
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Chang SSM, Ozanne-Smith J. Drowning mortality in children aged 0-14 years in Victoria, Australia: detailed epidemiological study 2001-2016. Inj Prev 2019; 26:593-598. [PMID: 31422366 DOI: 10.1136/injuryprev-2019-043307] [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: 05/15/2019] [Revised: 07/18/2019] [Accepted: 07/24/2019] [Indexed: 11/03/2022]
Abstract
BACKGROUND Major reductions in child drowning mortality rates have been observed historically in Victoria, Australia, for the period 1863-2000. Despite this trend, drowning remains the leading cause of unintentional child death in Victoria. This study investigates the residual fatal drowning problem in the Victorian child population (0-14 years) for the period 2001-2016. AIMS Describe the epidemiology of child drowning deaths in the Victorian population in 2001-2016; investigate risk factors and direct antecedents to these deaths. METHODS Population-based retrospective case data were extracted from the National Coronial Information System for 16 years (January 2001-December 2016), and case-by-case analysis was conducted. Associated factors were determined using univariate and Poisson analyses. RESULTS 88 of 97 cases had information available for analysis, pools were the most frequent location (30%); 70% of all cases occurred between 08:00 and 17:00; most victims were not deliberately in the body of the water (73%), for example, the pool. Supervision lapses included carers leaving the room when the child was in the bath (16/18), siblings left to supervise the child in private pools (7/23), inadequate pool fences (8/23) or faulty/open gates (4/23), or neighbours' pool spa (4/23). Delays in finding the child occurred when searches occurred elsewhere, before the body of water (21/88) and when carers were asleep (5/88). Fourteen of the 88 children had an intellectual disability or predisposing medical condition. The grouped Poisson analysis demonstrated that age 0-4 years, male gender and rural place of residence were significant. A downward trend in drowning rate continued in this period. DISCUSSION AND CONCLUSIONS A case-by-case analysis of a drowned population of children identified details of risk factors and antecedents not previously described. Missing data on antecedents were common, likely resulting in undercounting. Further enhancements to systematic data collection are needed. The results support a systems approach to drowning prevention.
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Affiliation(s)
- Susan Soon Mee Chang
- Department of Forensic Medicine, Monash University, Southbank, Victoria, Australia
| | - Joan Ozanne-Smith
- Injury Prevention Unit, Department of Forensic Medicine, Monash University, Southbank, Victoria, Australia
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12
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Denny SA, Quan L, Gilchrist J, McCallin T, Shenoi R, Yusuf S, Hoffman B, Weiss J, Agran PF, Hirsh M, Johnston B, Lee LK, Monroe K, Schaechter J, Tenenbein M, Zonfrillo MR, Quinlan K. Prevention of Drowning. Pediatrics 2019; 143:peds.2019-0850. [PMID: 30877146 DOI: 10.1542/peds.2019-0850] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Drowning is a leading cause of injury-related death in children. In 2017, drowning claimed the lives of almost 1000 US children younger than 20 years. A number of strategies are available to prevent these tragedies. As educators and advocates, pediatricians can play an important role in the prevention of drowning.
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Affiliation(s)
- Sarah A. Denny
- College of Medicine, The Ohio State University and Nationwide Children’s Hospital, Columbus, Ohio
| | - Linda Quan
- School of Medicine, University of Washington and Seattle Children’s Hospital, Seattle, Washington
| | | | - Tracy McCallin
- Children’s Hospital of San Antonio, San Antonio, Texas
- Baylor College of Medicine and
| | - Rohit Shenoi
- Baylor College of Medicine and
- Texas Children’s Hospital, Houston, Texas
| | - Shabana Yusuf
- Baylor College of Medicine and
- Texas Children’s Hospital, Houston, Texas
| | - Benjamin Hoffman
- Oregon Health and Science University and Doernbecher Children’s Hospital, Portland, Oregon; and
| | - Jeffrey Weiss
- College of Medicine, University of Arizona and Phoenix Children’s Hospital, Phoenix, Arizona
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13
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Ishikawa T, Mâsse LC, Brussoni M. Changes in parents' perceived injury risk after a medically-attended injury to their child. Prev Med Rep 2019; 13:146-152. [PMID: 30591856 PMCID: PMC6305837 DOI: 10.1016/j.pmedr.2018.12.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Revised: 10/31/2018] [Accepted: 12/16/2018] [Indexed: 11/29/2022] Open
Abstract
Unintentional injuries are a major cause of hospitalization and death for children worldwide. Since children who sustain a medically-attended injury are at higher risk of recurrence, it is crucial to generate knowledge that informs interventions to prevent re-incidence. This study examines when, in the year following a medically-attended injury, parents perceive the greatest risk of injury recurrence. Since perception of injury risk is associated with parental preventive behavior, this can inform decisions on the timing of parent-targeted interventions to prevent re-injury. Study participants were 186 English-fluent parents of children 0 to 16 years, presenting at the British Columbia Children's Hospital for an unintentional pediatric injury. Parents were excluded if their child had a disability or chronic health condition. Perceived risk of the same and of any injury recurring were elicited from parents, when they sought treatment at the hospital, as well as one, four, and twelve months later. The study ran between February 2011 and December 2013. Mixed-effects models were used to analyze changes in parents' responses. Analysis indicates that perceived risk of the same injury recurring did not change. However, perceived risk of any injury recurring increased from baseline to first follow-up, then decreased during the rest of the year. Overall, perceived risk of any injury was higher for parents whose child had a history of injuries. Visits to the Emergency Department for a pediatric injury may not be optimal timing to deploy injury prevention interventions for parents. Follow-up visits (when parents' perceived risk is highest) may be better.
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Affiliation(s)
- Takuro Ishikawa
- Department of Pediatrics, University of British Columbia: Rm 2D19, 4480 Oak Street, Vancouver, BC V6H 3V4, Canada
- British Columbia Children's Hospital Research Institute, F503, 4480 Oak Street, Vancouver, BC V6H 3V4, Canada
- BC Injury Research and Prevention Unit, F508, 4480 Oak Street, Vancouver, BC V6H 3V4, Canada
| | - Louise C. Mâsse
- School of Population and Public Health, University of British Columbia, 2206 E Mall, Vancouver, BC V6T 1Z3, Canada
- British Columbia Children's Hospital Research Institute, F503, 4480 Oak Street, Vancouver, BC V6H 3V4, Canada
| | - Mariana Brussoni
- Department of Pediatrics, University of British Columbia: Rm 2D19, 4480 Oak Street, Vancouver, BC V6H 3V4, Canada
- School of Population and Public Health, University of British Columbia, 2206 E Mall, Vancouver, BC V6T 1Z3, Canada
- British Columbia Children's Hospital Research Institute, F503, 4480 Oak Street, Vancouver, BC V6H 3V4, Canada
- BC Injury Research and Prevention Unit, F508, 4480 Oak Street, Vancouver, BC V6H 3V4, Canada
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14
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Peden AE, Franklin RC, Pearn JH. Unintentional fatal child drowning in the bath: A 12-year Australian review (2002-2014). J Paediatr Child Health 2018; 54:153-159. [PMID: 29417672 DOI: 10.1111/jpc.13688] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Revised: 06/19/2017] [Accepted: 07/16/2017] [Indexed: 11/28/2022]
Abstract
AIM To establish the prevalence of unintentional fatal drowning in baths involving children <18 years in Australia and to identify causal factors to underpin prevention. METHODS We report a total population study of all childhood (0-17 years) unintentional drowning fatalities in baths (bathtubs, spa baths and showers) in Australia between 1 July 2002 and 30 June 2014. Demographic, forensic and aetiological data (including co-bathing, use of bath aids, supervision and enactment of cardiopulmonary resuscitation) were documented for each victim. RESULTS Seventy-eight children were identified; two thirds (66.7%) were under 2 years old, of which 43.6% were aged less than 1 year (1.0/100 000/annum) and 23.1% 1-2 years (0.27/100 000/annum). Nine older children (10-17 years) also drowned. Common causes included: infants and children unable to hold their head out of water while unsupervised and associated pre-existing medical conditions, including epilepsy. All children who drowned were left without adult supervision. No child drowned in a bath with water deeper than 40 cm (M = 19.4 cm). Custodian-reported 'time left unsupervised' ranged from 30 s to 60 min. Children with pre-existing medical conditions were, on average, older (9.9 years; confidence interval: 7.9-11.9) and left unsupervised for longer (M = 15.4 min; confidence interval: 3.8-27.1) than those without. CONCLUSIONS On average, 6.5 children drown every year in baths in Australia. Children aged younger than 1 year are most affected, with both genders equally represented. Infants and toddlers left unsupervised, false confidence in the preventive role of bath aids, unrealistic expectations in the supervisory capabilities of co-bathing children and epilepsy remain threats to children in the bath.
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Affiliation(s)
- Amy E Peden
- Royal Life Saving Society - Australia, Sydney, New South Wales, Australia.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Richard C Franklin
- Royal Life Saving Society - Australia, Sydney, New South Wales, Australia.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - John H Pearn
- Royal Life Saving Society - Australia, Sydney, New South Wales, Australia.,Department of Paediatrics and Child Health, Lady Cilento Children's Hospital, Brisbane, Queensland, Australia
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15
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Gipson JS, Wood EM, Cole-Sinclair MF, McQuilten Z, Waters N, Woodford NW. Major haemorrhage fatalities in the Australian national coronial database. Emerg Med Australas 2017; 30:382-388. [PMID: 29224237 DOI: 10.1111/1742-6723.12915] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 11/02/2017] [Indexed: 12/27/2022]
Abstract
OBJECTIVE The aim of the study is to describe the epidemiology of major bleeding fatalities. METHODS A case series analysis of Australia's National Coronial Information System was conducted. Keywords were used to search for closed cases of major haemorrhage in the state of Victoria for the period 1 January 2009 to 31 December 2011. Coroners' findings, autopsy reports and police reports of cases were reviewed. Demographic data were extracted, and cases were assigned to a clinical bleeding context. RESULTS A total of 427 cases of major bleeding causing death were identified. The cohort was predominately men (69%), with a median age of 63 years (interquartile range 45-77 years). Trauma accounted for 38%, gastrointestinal haemorrhage 28%, surgical/procedural bleeding 14%, ruptured/leaking aneurysms 12% and other 8%. Most events began in homes (46%), hospitals (22%) and at the roadside (17%). Of those whose haemorrhage began in the community, 69% did not survive to hospital. CONCLUSIONS Major bleeding fatalities occurred across a diverse range of contexts, with trauma and gastrointestinal bleeding accounting for most deaths. The majority of patients did not survive to reach hospital. Major haemorrhage occurring entirely outside hospital may be underrecognised from analyses of datasets based primarily on traumatic or in-hospital bleeding. These findings have implications for management of pre-hospital resuscitation and development of clinical practice guidelines for identification and management of major bleeding in the community.
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Affiliation(s)
- Jacob S Gipson
- Transfusion Research Unit, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Erica M Wood
- Transfusion Research Unit, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Merrole F Cole-Sinclair
- Transfusion Research Unit, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Department of Haematology, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - Zoe McQuilten
- Transfusion Research Unit, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Victoria, Australia
| | - Neil Waters
- Transfusion Research Unit, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Noel W Woodford
- Victorian Institute of Forensic Medicine, Melbourne, Victoria, Australia.,Department of Forensic Medicine, Monash University, Melbourne, Victoria, Australia
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16
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Holland AJ, Soundappan SS. Trauma hazards in children: An update for the busy clinician. J Paediatr Child Health 2017; 53:1096-1100. [PMID: 28665528 DOI: 10.1111/jpc.13603] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 04/17/2017] [Indexed: 12/29/2022]
Abstract
Trauma and injury continue to be common in children and remain an important cause of mortality and morbidity. Legislation mandating the use of helmets for all cyclists appears to have been effective in reducing the incidence and severity of head and facial injuries, with no clear evidence of a reduction in cycling usage or activity. Straddle injuries, whilst uncommon and generally minor, require careful clinical assessment as they may be associated with urethral trauma. Quad bikes remain highly dangerous with continuing reports of deaths in child riders due to their inherent lack of stability: a ban on their use by children would seem the most effective solution. The popularity of mobile devices and toys, coupled with the development of higher voltage, lithium button batteries have seen a surge in the number of cases and subsequent complications from ingestion. The problems seen in children following ingestion of high-powered, rare earth magnets in the late 1990s and 2000s has now receded due to legislation introduced in 2012. Inhaled, typically organic foreign bodies remain a diagnostic challenge with rigid bronchoscopy still the most effective diagnostic and therapeutic modality. Corrosive ingestion, now seen much less commonly, continues to be a potentially devastating injury when occurring as a result of caustic soda. Recent publicity concerning the problem of childhood drowning highlights the need for constant parental vigilance, the limitations of pool fencing and the importance of community cardiopulmonary resuscitation training, together with repeated education of the risk of rips when swimming in the sea.
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Affiliation(s)
- Andrew Ja Holland
- Douglas Cohen Department of Paediatric Surgery, Children's Hospital at Westmead, University of Sydney, Sydney, New South Wales, Australia.,Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Soundappan Sv Soundappan
- Douglas Cohen Department of Paediatric Surgery, Children's Hospital at Westmead, University of Sydney, Sydney, New South Wales, Australia.,Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
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17
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Bugeja L, Ibrahim JE, Ferrah N, Murphy B, Willoughby M, Ranson D. The utility of medico-legal databases for public health research: a systematic review of peer-reviewed publications using the National Coronial Information System. Health Res Policy Syst 2016; 14:28. [PMID: 27067413 PMCID: PMC4828834 DOI: 10.1186/s12961-016-0096-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 03/24/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Medico-legal death investigations are a recognised data source for public health endeavours and its accessibility has increased following the development of electronic data systems. Despite time and cost savings, the strengths and limitations of this method and impact on research findings remain untested. This study examines this issue using the National Coronial Information System (NCIS). METHODS PubMed, ProQuest and Informit were searched to identify publications where the NCIS was used as a data source for research published during the period 2000-2014. A descriptive analysis was performed to describe the frequency and characteristics of the publications identified. A content analysis was performed to identify the nature and impact of strengths and limitations of the NCIS as reported by researchers. RESULTS Of the 106 publications included, 30 reported strengths and limitations, 37 reported limitations only, seven reported strengths only and 32 reported neither. The impact of the reported strengths of the NCIS was described in 14 publications, whilst 46 publications discussed the impacts of limitations. The NCIS was reported to be a reliable source of quality, detailed information with comprehensive coverage of deaths of interest, making it a powerful injury surveillance tool. Despite these strengths, researchers reported that open cases and missing information created the potential for selection and reporting biases and may preclude the identification and control of confounders. CONCLUSIONS To ensure research results are valid and inform health policy, it is essential to consider and seek to overcome the limitations of data sources that may have an impact on results.
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Affiliation(s)
- Lyndal Bugeja
- />Health Law & Ageing Research Unit, Department of Forensic Medicine, School of Public Health and Preventive Medicine, Monash University, 65 Kavanagh Street, Southbank, 3006 Australia
- />Coroners Court of Victoria, 65 Kavanagh Street, Southbank, Victoria 3006 Australia
| | - Joseph E. Ibrahim
- />Health Law & Ageing Research Unit, Department of Forensic Medicine, School of Public Health and Preventive Medicine, Monash University, 65 Kavanagh Street, Southbank, 3006 Australia
| | - Noha Ferrah
- />Health Law & Ageing Research Unit, Department of Forensic Medicine, School of Public Health and Preventive Medicine, Monash University, 65 Kavanagh Street, Southbank, 3006 Australia
| | - Briony Murphy
- />Health Law & Ageing Research Unit, Department of Forensic Medicine, School of Public Health and Preventive Medicine, Monash University, 65 Kavanagh Street, Southbank, 3006 Australia
| | - Melissa Willoughby
- />Health Law & Ageing Research Unit, Department of Forensic Medicine, School of Public Health and Preventive Medicine, Monash University, 65 Kavanagh Street, Southbank, 3006 Australia
- />Coroners Court of Victoria, 65 Kavanagh Street, Southbank, Victoria 3006 Australia
| | - David Ranson
- />Victorian Institute of Forensic Medicine, 65 Kavanagh Street, Southbank, 3006 Australia
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18
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Abstract
OBJECTIVE This retrospective population-based study examined drowning location by the site of immersion for both fatal and non-fatal drowning events in Queensland. Drowning location is not routinely collected, and this study used data linkage to identify drowning sites. The resulting enhanced quality data quantify drowning incidence for specific locations by geographic region, age group and by severity for the first time. DESIGN Linked data were accessed from the continuum of care (prehospital, emergency, hospital admission and death data) on fatal and non-fatal drowning episodes in children aged 0-19 years in Queensland for the years 2002-2008 inclusive. RESULTS Drowning locations ranked in order of overall incidence were pools, inland water, coastal water, baths and other man-made water hazards. Swimming pools produced the highest incidence rates (7.31/100,000) for overall drowning events and were more often privately owned pools and in affluent neighbourhoods. Toddlers 0-4 years were most at risk around pools (23.94/100,000), and static water bodies such as dams and buckets-the fatality ratios were highest at these 2 locations for this age group. Children 5-14 years incurred the lowest incidence rates regardless of drowning location. Adolescents 15-19 years were more frequently involved in a drowning incident on the coast shoreline, followed by inland dynamic water bodies. CONCLUSIONS Linked data have resulted in the most comprehensive data collection on drowning location and severity to date for children in the state of Queensland. Most mortality and morbidity could have been prevented by improving water safety through engaged supervision around pools and bath time, and a heightened awareness of buckets and man-made water hazards around the farm home for young children. These data provide a different approach to inform prevention strategies.
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Affiliation(s)
- Belinda A Wallis
- Centre for Children's Burns & Trauma Research, Queensland University Child Health Research Centre, Lady Cilento Children's Hospital, Brisbane, Queensland, Australia
- Dept of Paediatric Surgery, Urology, Burns & Trauma, Lady Cilento Children’s Hospital, Brisbane, Queensland, Australia
| | - Kerrianne Watt
- Centre for Children's Burns & Trauma Research, Queensland University Child Health Research Centre, Lady Cilento Children's Hospital, Brisbane, Queensland, Australia
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
| | - Richard C Franklin
- Centre for Children's Burns & Trauma Research, Queensland University Child Health Research Centre, Lady Cilento Children's Hospital, Brisbane, Queensland, Australia
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
- Royal Life Saving Society Australia, Townsville, Queensland, Australia
| | - James W Nixon
- Centre for Children's Burns & Trauma Research, Queensland University Child Health Research Centre, Lady Cilento Children's Hospital, Brisbane, Queensland, Australia
| | - Roy M Kimble
- Centre for Children's Burns & Trauma Research, Queensland University Child Health Research Centre, Lady Cilento Children's Hospital, Brisbane, Queensland, Australia
- Dept of Paediatric Surgery, Urology, Burns & Trauma, Lady Cilento Children’s Hospital, Brisbane, Queensland, Australia
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19
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Petrass LA, Blitvich JD. Preventing adolescent drowning: understanding water safety knowledge, attitudes and swimming ability. The effect of a short water safety intervention. ACCIDENT; ANALYSIS AND PREVENTION 2014; 70:188-194. [PMID: 24798651 DOI: 10.1016/j.aap.2014.04.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Revised: 04/01/2014] [Accepted: 04/10/2014] [Indexed: 06/03/2023]
Abstract
Worldwide, epidemiological data indicate that children are a high-risk group for drowning and while progress has been made in understanding toddler drownings, there is a lack of empirical evidence regarding the drowning risk and protective factors inherent for adolescents and young adults. This study used a self-report questionnaire to establish swimming and water safety knowledge and attitudes of young adults and objectively measured their actual swimming ability using formal practical testing procedures. Participants then completed a short, 12-week intervention that encompassed swimming, survival and rescue skills, along with water safety knowledge applicable to a range of aquatic environments. Knowledge, attitudes and swimming ability were then re-measured following the intervention to evaluate its effectiveness. The Wilcoxon matched pairs signed ranks test was performed to detect whether there were significant differences between knowledge, attitude and swim ability scores pre-intervention and post-intervention. A total of 135 participants completed the baseline and follow up questionnaire and all practical testing. Results indicated that these young adults had a very low level of water safety knowledge pre-intervention, although the majority had sound swimming and water safety skills and attitudes. Overall, significant improvements were evident in knowledge (p<0.001) and swim ability (p<0.001) post-intervention, although no changes were observed in attitudes (p=0.079). Previous participation in formal swimming lessons and/or swimming within the school curriculum had no significant impact on water safety knowledge, skills or attitudes of these young adults, and there were few significant gender differences. While it is important to conduct further studies to confirm that these findings are consistent with a more representative sample of young adults, our findings are the first to provide empirical evidence of the value of a comprehensive aquatic education program as a drowning prevention strategy for young adults.
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Affiliation(s)
- Lauren A Petrass
- Faculty of Health Federation University Australia Mt Helen, Ballarat, VIC, Australia.
| | - Jennifer D Blitvich
- Faculty of Health Federation University Australia Mt Helen, Ballarat, VIC, Australia
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20
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Immersion-related deaths in infants and children: autopsy experience from a specialist center. Forensic Sci Med Pathol 2014; 10:363-70. [DOI: 10.1007/s12024-014-9569-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2014] [Indexed: 10/25/2022]
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21
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VÄHÄTALO R, LUNETTA P, OLKKOLA KT, SUOMINEN PK. Drowning in children: Utstein style reporting and outcome. Acta Anaesthesiol Scand 2014; 58:604-10. [PMID: 24580104 DOI: 10.1111/aas.12298] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2014] [Indexed: 01/07/2023]
Abstract
BACKGROUND We report the incidence and mortality of paediatric drowning incidents according to 'Utstein Style for Drowning' guidelines. METHODS Retrospective study including all the drowned children under 16 years of age who were hospitalised or died with or without attempted cardiopulmonary resuscitation (CPR) between 1997 and 2007 in the province of Uusimaa, Finland. Survival rates provided at hospital discharge and after 1-year follow-up period are reported. RESULTS A total of 58 drowned children were either admitted to the paediatric intensive care unit or died during the study period. The median (interquartile range) age was 5.9 (3.1, 7.8) years. The annual incidence of drowning was 1.9/100,000 and was highest, 2.8/100,000, in children aged between 1 and 4 years. The annual mortality rate was 0.9/100,000. Of all the 58 patients, 14 (24%) died at the scene, 22 (38.1%) before the hospital discharge, and 26 (45%) within the 1 year. The number of non-fatal drownings was 1.2-fold that of fatal drownings. The survival rate of the 26 patients for whom CPR was initiated by emergency medical service (EMS) personnel was 42% at hospital discharge, with the 1-year survival rate being 27%. CONCLUSIONS The incidence of drowning in children and the survival rate of those children in whom CPR was initiated by EMS personnel was in line with the previously reported. However, the overall mortality rate in drowned children was higher than estimated in previous studies.
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Affiliation(s)
- R. VÄHÄTALO
- Department of Anaesthesia and Intensive Care; Children's Hospital; Helsinki University Central Hospital; Helsinki Finland
| | - P. LUNETTA
- Department of Forensic Medicine; University of Helsinki; Helsinki Finland
| | - K. T. OLKKOLA
- Department of Anaesthesiology; Intensive Care; Emergency Care and Pain Medicine; Helsinki University Central Hospital and Institute of Clinical Medicine; University of Helsinki; Helsinki Finland
- Department of Anaesthesiology; Intensive Care; Emergency Care and Pain Medicine; University of Turku and Turku University Hospital; Turku Finland
| | - P. K. SUOMINEN
- Department of Anaesthesia and Intensive Care; Children's Hospital; Helsinki University Central Hospital; Helsinki Finland
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22
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Risk factors associated with injury and mortality from paediatric low speed vehicle incidents: a systematic review. Int J Pediatr 2013; 2013:841360. [PMID: 23781251 PMCID: PMC3679758 DOI: 10.1155/2013/841360] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Accepted: 04/21/2013] [Indexed: 11/26/2022] Open
Abstract
Objective. This study reviews modifiable risk factors associated with fatal and nonfatal injury from low-speed vehicle runover (LSVRO) incidents involving children aged 0–15 years. Data Sources. Electronic searches for child pedestrian and driveway injuries from the peer-reviewed literature and transport-related websites from 1955 to 2012. Study Selection. 41 studies met the study inclusion criteria. Data Extraction. A systematic narrative summary was conducted that included study design, methodology, risk factors, and other study variables. Results. The most commonly reported risk factors for LSVRO incidents included age under 5 years, male gender, and reversing vehicles. The majority of reported incidents involved residential driveways, but several studies identified other traffic and nontraffic locations. Low socioeconomic status and rental accommodation were also associated with LSVRO injury. Vehicles were most commonly driven by a family member, predominantly a parent. Conclusion. There are a number of modifiable vehicular, environmental, and behavioural factors associated with LSVRO injuries in young children that have been identified in the literature to date. Strategies relating to vehicle design (devices for increased rearward visibility and crash avoidance systems), housing design (physical separation of driveway and play areas), and behaviour (driver behaviour, supervision of young children) are discussed.
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23
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Anthikkat AP, Page A, Barker R. Low-speed vehicle run over fatalities in Australian children aged 0-5 years. J Paediatr Child Health 2013; 49:388-93. [PMID: 23586496 DOI: 10.1111/jpc.12188] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/06/2012] [Indexed: 12/01/2022]
Abstract
AIM The study aims to investigate environmental, socio-demographic and other antecedent risk factors associated with low-speed vehicle run over (LSVRO) mortality in Australian children aged 0-5 years. METHODS This is a population-based retrospective case series study of Australian LSVRO mortality, July 2000-December 2010. MAIN OUTCOME MEASURES Mortality and corresponding population data were stratified by sex and period to examine trends in incidence rates over the study period. Proportional mortality was also investigated by sex, age, period, area, location of injury, mechanism and other antecedent factors identified from textual coronial information. RESULTS There were 82 fatal LSVRO cases over the 11-year study period. The annual incidence was low (less than 1 per 100,000) and declined over the study period. More than three-quarters of incidents occurred in non-traffic settings, in particular residential driveways. The most common vehicle involved was a four-wheel drive or utility with vehicles most likely to be reversing or leaving at the time of the incident. More than three-quarters of cases were aged 36 months or less. A higher proportion of LSVRO fatalities occurred in lower socio-economic status areas compared with higher socio-economic status areas. Where the vehicle was actively being driven (77 cases), the driver was known to the child in three-quarters of cases, most commonly the father (32%). CONCLUSION The study provides a detailed analysis of mortality due to LSVRO incidents in Australia and highlights a number of modifiable antecedent factors. Precedents for the identification and reporting of LSVRO incidents as well as prevention strategies are discussed.
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Affiliation(s)
- Anne Paul Anthikkat
- Discipline of Epidemiology and Biostatistics, School of Population Health, University of Queensland, Brisbane, Queensland, Australia
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van Beelen MEJ, van Beeck EF, den Hertog P, Beirens TMJ, Raat H. Correlates of unsupervised bathing of infants: a cross-sectional study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:856-66. [PMID: 23459215 PMCID: PMC3709290 DOI: 10.3390/ijerph10030856] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Revised: 02/25/2013] [Accepted: 02/25/2013] [Indexed: 11/20/2022]
Abstract
Drowning represents the third leading cause of fatal unintentional injury in infants (0-1 years). The aim of this study is to investigate correlates of unsupervised bathing. This cross-sectional study included 1,410 parents with an infant. Parents completed a questionnaire regarding supervision during bathing, socio-demographic factors, and Protection Motivation Theory-constructs. To determine correlates of parents who leave their infant unsupervised, logistic regression analyses were performed. Of the parents, 6.2% left their child unsupervised in the bathtub. Parents with older children (OR 1.24; 95%CI 1.00-1.54) were more likely to leave their child unsupervised in the bathtub. First-time parents (OR 0.59; 95%CI 0.36-0.97) and non-Western migrant fathers (OR 0.18; 95%CI 0.05-0.63) were less likely to leave their child unsupervised in the bathtub. Furthermore, parents who perceived higher self-efficacy (OR 0.57; 95%CI 0.47-0.69), higher response efficacy (OR 0.34; 95%CI 0.24-0.48), and higher severity (OR 0.74; 95%CI 0.58-0.93) were less likely to leave their child unsupervised. Since young children are at great risk of drowning if supervision is absent, effective strategies for drowning prevention should be developed and evaluated. In the meantime, health care professionals should inform parents with regard to the importance of supervision during bathing.
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Affiliation(s)
- Mirjam E. J. van Beelen
- Department of Public Health, Erasmus MC-University Medical Center, P.O. Box 2040, Rotterdam 3000 CA, The Netherlands; E-Mails: (M.E.J.B.); (E.F.B.); (T.M.J.B.)
| | - Eduard F. van Beeck
- Department of Public Health, Erasmus MC-University Medical Center, P.O. Box 2040, Rotterdam 3000 CA, The Netherlands; E-Mails: (M.E.J.B.); (E.F.B.); (T.M.J.B.)
| | - Paul den Hertog
- Consumer Safety Institute, P.O. Box 75169, Amsterdam 1070 AD, The Netherlands; E-Mail:
| | - Tinneke M. J. Beirens
- Department of Public Health, Erasmus MC-University Medical Center, P.O. Box 2040, Rotterdam 3000 CA, The Netherlands; E-Mails: (M.E.J.B.); (E.F.B.); (T.M.J.B.)
- Dutch Association for Youth Health Care Physicians, Churchillaan 11, Utrecht 3527 GV, The Netherlands
| | - Hein Raat
- Department of Public Health, Erasmus MC-University Medical Center, P.O. Box 2040, Rotterdam 3000 CA, The Netherlands; E-Mails: (M.E.J.B.); (E.F.B.); (T.M.J.B.)
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Bugeja L, Franklin RC. An analysis of stratagems to reduce drowning deaths of young children in private swimming pools and spas in Victoria, Australia. Int J Inj Contr Saf Promot 2012; 20:282-94. [PMID: 22950370 DOI: 10.1080/17457300.2012.717086] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This population-based retrospective case series study examined the frequency and distribution of protective stratagems (legislatively compliant safety barrier, adequate caregiver supervision, water familiarisation and early administration of cardiopulmonary resuscitation [CPR]) amongst drowning deaths of young children (0-4 years) in private swimming pools or spas in Victoria, Australia. In 65.0% (52/80) of deaths, none of the four protective stratagems were known to be present and there was only one case where all four were known to be present. This indicates that if the presence of all four stratagems is increased, this may reduce drowning in this age group and setting. While these results are positive, further examination of the presence and interaction of these stratagems for effectiveness is required. Further research is also warranted to explore the impact of enforcement of pool fencing legislation and potential associations between water familiarisation and drowning risk. In addition, a consensus on the definition of adequate supervision in needed.
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Affiliation(s)
- Lyndal Bugeja
- a Monash Injury Research Institute, Building 70, Monash University , Clayton , 3800 , Victoria , Australia
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26
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Panzino F, Quintillá JM, Luaces C, Pou J. [Unintentional drowning by immersion. Epidemiological profile of victims attended in 21 Spanish emergency departments]. An Pediatr (Barc) 2012; 78:178-84. [PMID: 22938758 DOI: 10.1016/j.anpedi.2012.06.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2012] [Revised: 06/25/2012] [Accepted: 06/26/2012] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVES To determine the frequency of accidental drowning seen in paediatric emergency departments, to define the epidemiological profile of the victims, and to analyse the circumstances related to prognosis and survival. PATIENTS AND METHODS A multicentre, prospective and descriptive study was conducted on victims of accidental drowning seen in 21 paediatric emergency departments between June and September 2009 and 2010. We collected personal, environmental, safety, security data, as well as the need for cardiopulmonary resuscitation (CPR), hospitalisation rate, sequelae and mortality. RESULTS Out of 234,566 emergency department cases, 53 were due to accidental drowning (frequency: 2.2/10,000 consultations during the summer period, 64.2% males). The median age was 3.5 years (p25-75: 2.6-8.4), with 34 had less than 6 years. Thirty-two children were hospitalised. Most drowning occurred in the afternoon (40), in freshwater (49), in private pools (33) and unprotected (33). The victims, mostly healthy children (40), did not know how to swim (38) and were not wearing flotation systems (37/38). There was lack of supervision in 42 cases. Acidosis (20) and hypoxaemia (18) were the most frequent findings. Five children died, 4 were healthy, none knew how to swim or had a float device, and none were supervised. Thirty six children required CPR, mostly applied by family (15). In the children who died, CPR was started after 3 min. Two survivors had hemiparesis. CONCLUSIONS Accidental drowning was a rare cause of consultation in paediatric emergency departments. In children less than 6 years, who did not know how to swim, did not use flotation devices in unprotected private pools, and were not properly supervised, there is an increased of suffering from accidental drowning and its associated morbidity. An immersion time> 10 min, starting CPR > 3 min, acidosis, hyponatraemia, and hypothermia on arrival at the emergency department increases mortality. Training family members in cardiopulmonary resuscitation can be useful.
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Affiliation(s)
- F Panzino
- Servicio de Urgencias, Hospital Sant Joan de Déu, Universitat de Barcelona, España.
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27
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Eszenyi D. Lack of caregiver supervision: a contributing factor in Australian unintentional child drowning deaths, 2000–2009. Med J Aust 2011; 195:156-7; author reply 157. [DOI: 10.5694/j.1326-5377.2011.tb03250.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2011] [Accepted: 06/28/2011] [Indexed: 11/17/2022]
Affiliation(s)
- Dymphna Eszenyi
- Child Death and Serious Injury Review Committee, South Australian Government Department for Families and Communities, Adelaide, SA
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28
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Petrass LA, Blitvich JD, Finch CF. Lack of caregiver supervision: a contributing factor in Australian unintentional child drowning deaths, 2000–2009. Med J Aust 2011. [DOI: 10.5694/j.1326-5377.2011.tb03251.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Lauren A Petrass
- School of Human Movement & Sport Sciences, University of Ballarat, Ballarat, VIC
| | - Jennifer D Blitvich
- School of Human Movement & Sport Sciences, University of Ballarat, Ballarat, VIC
| | - Caroline F Finch
- School of Human Movement & Sport Sciences, University of Ballarat, Ballarat, VIC
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