Child victims of dog bites treated in emergency departments: a prospective survey

The study was conducted to determine the characteristics of child victims of dog bite accidents. Pediatricians and nurses prospectively collected standardized information on all child victims of dog bites brought in for treatment to six hospital emergency departments (three urban university teaching hospitals and three rural hospitals). One hundred completed questionnaires were collected and analyzed. The frequency of dog bites brought for care to the emergency departments was equivalent to about one-quarter of all road traffic casualties and one-third of burns at home. Of the 100 victims, 65 were bitten at home, and 35 in a public place. The bite accidents that occurred at home concerned children with a median age of 5 years, who were without adult supervision at the time of the accident. The children who were bitten by dogs in public places had a median age of 9 years. For 77 bites, the dog was not familiar to the child. Based on the history, it appeared that 56 out of 65 accidents at home and 11 out of 35 in public places resulted mainly from the children's or adult's behavior.

CONCLUSION

To reduce the frequency of dog bites both at home and in public places, education could be the preventive measure with the highest priority. Out of 100 accidents, 67 children might not have been bitten had they and their parents been adequately educated on safe conduct towards dogs.

Maternal education and risk factors for sudden death in infants. Working Group of the Groupe Belge de Pédiatres Francophones

To monitor infant care practices associated with risks for sudden infant death, 400 Belgian families with infants less than 6 months old were questioned by 21 paediatricians during routine visits to local paediatric practices and well baby services (11 in urban centres, 10 in rural areas). Because of incomplete information, 35 families were excluded. Of the 365 mothers included in the study, 36.1% had under 7 years of schooling, 38.4% less than 13 years, and 25.5% had a professional school or a university degree. Risk factors for sudden infant death were found in 208 (56.9%) families: a usual non-supine sleep position (31.5% of the infants); sleeping under a duvet (24.1%); mothers smoking during and after gestation (16.4%); a high room temperature (6.6%); use of sedatives (3.8%); necklaces or plastic film in the cot (2.5%); and soft beddings (2.2%). Maternal education, but not the fathers' profession was significantly related to the number of risk factors (mean odds ratio of 4.4; 95% CI: 1.5 to 5.3; P = 0.001). A stepwise logistic regression analysis identified the mother's length of schooling as the single most significant independent factor for the presence of risk (P < 0.005).

CONCLUSION

Less educated mothers reported having been informed of risk-reducing recommendations as frequently as better educated mothers. It can be concluded that future reduction in risks for sudden infant death syndrome should include new strategies designed to modify infant care practices.

[Evaluation of the quality of life of infants and very young children: validation of a questionnaire. Multicenter European study]

In the last few years, evaluating quality of life in children has become possible using specific instruments; nevertheless, there is still an unsolved issue concerning the earliest ages, when the child is not able to give his/her own opinion. QUALIN, a new instrument designed to assess an infant's quality of life (between the ages of three months and three years) was developed from the study of spontaneous criteria used by parents or caregivers (paediatricians or nurses) when they think about the quality of life of a baby (preliminary survey including 800 open-ended questionnaires).

PATIENTS AND METHODS

One thousand four hundred and twelve children under the age of three were included in this validation study. QUALIN questionnaire is a 34-item scale and can be completed by parents or caregivers. Two forms are available: one form is designed for children under the age of one and the other is designed for children between the ages of one and three. The QUALIN questionnaire was translated into English, Italian and Spanish, and a European multicentric validation study was conducted in Belgium, France, Italy, Luxembourg, Spain and Switzerland. Data were collected with QUALIN questionnaires from children's parents and paediatricians.

RESULTS

The psychometric properties of the scale are satisfactory (acceptability 90%, Cronbach's coefficient alpha over 0.75, correlations between two raters over 0.50, construct validity with principal component analysis showed emerging factors in agreement with the hypotheses linked to the questionnaire construction). The results are interesting, showing significant differences according to the health status of the children and their country of origin.

CONCLUSION

The QUALIN questionnaire can be used for studies concerning the quality of life of children less than three years of age.