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1.
Lancet Public Health ; 6(9): e631-e640, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34371005

RESUMO

BACKGROUND: As with many Indigenous populations internationally, Maori in New Zealand suffer health inequity. We aimed to assess the rate of fall injuries at home with and without home modifications in houses with Maori occupants. METHODS: We did a single-blind randomised controlled trial in the Wellington and Taranaki regions of New Zealand and enrolled owner-occupied households with at least one Maori occupant. Only households who stated they intended to live at that address for the subsequent 3 years were eligible for participation. We randomly assigned (1:1) households to either the intervention group, who received home modifications (handrails for outside steps and internal stairs, grab rails for bathrooms, outside lighting, repairs to window catches, high-visibility and slip-resistant edging for outside steps, fixing of lifted edges of carpets and mats, non-slip bath mats, and slip-resistant surfacing for outside areas such as decks) immediately, or the control group, who received the modifications 3 years later. Data on home injuries were obtained from the Accident Compensation Corporation and coded by study team members, who were masked to study group allocation. The primary outcome was the rate of medically treated fall injuries at home per household per year, analysed according to intention to treat. This Maori Home Injury Prevention Intervention (MHIPI) trial is now completed, and is registered with the Australian New Zealand Clinical Trials Registry, ACTRN12613000148774. FINDINGS: Between Sept 3, 2013, and Oct 1, 2014, 824 households were assessed for eligibility and 254 were enrolled, of which 126 (50%) were assigned to the intervention group and 128 (50%) were assigned to the control group. After adjustment for previous falls and geographical region, there was an estimated 31% reduction in the rate of fall injuries at home per year exposed to the intervention compared with households in the control group (adjusted relative rate 0·69 [95% CI 0·47-1·00]). INTERPRETATION: Low-cost home modifications and repairs can be an effective means to reduce injury disparities. The high prevalence of modifiable safety issues in Maori homes merits considerable policy and community effort. FUNDING: Health Research Council of New Zealand.


Assuntos
Acidentes por Quedas/prevenção & controle , Acidentes Domésticos/prevenção & controle , Habitação/normas , Havaiano Nativo ou Outro Ilhéu do Pacífico/estatística & dados numéricos , Acidentes por Quedas/estatística & dados numéricos , Acidentes Domésticos/estatística & dados numéricos , Idoso , Disparidades nos Níveis de Saúde , Habitação/estatística & dados numéricos , Humanos , Nova Zelândia
2.
Afr Health Sci ; 20(2): 991-999, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33163068

RESUMO

BACKGROUND: Unintentional injuries from burns comprise a significant proportion of public health morbidity in Nigeria. In order to understand the type and impact of burns on youth in Low-and-Middle-Income countries, the epidemiology of burns must be adequately assessed. METHODS: This review describes the epidemiological patterns of burn occurrences in the pediatric populations and proposes interventions using the Haddon Matrix to address injuries in specific populations in Nigeria. A literature search was conducted using the Proquest, CINAHL, and PubMed databases at the Johns Hopkins University library (January 1, 1990 to August 14, 2018), on burns or thermal injury among pediatric populations in Nigeria. The review focused on the forms of injury, risk factors and potential interventions. RESULTS: Ten studies were identified and the main risk factors for burns were socioeconomic status, overcrowding, and involving young girls in traditional cooking roles. The main types of injuries include scald injuries (50%) and fire burns (45%) affecting mainly children aged 14 and below with significant regional epidemiological variations. We created a novel intervention to develop countermeasures and reduce the number of pediatric burns based on biological, physical and sociocultural environment.. CONCLUSION: Interventions such as improved supervision of children, improved emergency infrastructure and culturally sensitive first aid education and treatment can help ensure a reduction in morbidity and mortality resulting from burns. Epidemiological studies can provide an accurate depiction of the burden of burn injuries in different regions of Nigeria.


Assuntos
Acidentes Domésticos/prevenção & controle , Queimaduras/etiologia , Queimaduras/prevenção & controle , Classe Social , Acidentes Domésticos/estatística & dados numéricos , Queimaduras/epidemiologia , Humanos , Lactente , Escala de Gravidade do Ferimento , Nigéria/epidemiologia , Fatores de Risco , Fatores Socioeconômicos , Índices de Gravidade do Trauma
3.
S Afr Med J ; 111(1): 17-19, 2020 12 14.
Artigo em Inglês | MEDLINE | ID: mdl-33403999

RESUMO

Illuminating paraffin (kerosene) is the primary cooking fuel for approximately two million South Africans. The highly flammable and toxic fuel is burnt in poorly made stoves that are prone to malfunction and are associated with accidental fires, burns and household air pollution. However, the fuel continues to be used as it is easily decanted, widely available in neighbourhood outlets, perceived as affordable, and often the only available option for low-income urban settlements. It is anticipated that increased and enforced home congestion during COVID-19 lockdowns will exacerbate exposure of homebound families to unsafe energy, especially during the cold winter months. Based on an accumulation of evidence on the health and socioeconomic impacts of paraffin, this article advocates for its expedited phase-out and substitution with safer energy.


Assuntos
Poluição do Ar/estatística & dados numéricos , Queimaduras/epidemiologia , Incêndios/estatística & dados numéricos , Querosene/efeitos adversos , Política Pública , Acidentes Domésticos/economia , Acidentes Domésticos/estatística & dados numéricos , Poluição do Ar/economia , Queimaduras/economia , Queimaduras/etiologia , COVID-19/prevenção & controle , Controle de Doenças Transmissíveis , Culinária , Fatores Econômicos , Fontes de Energia Elétrica , Incêndios/economia , Óleos Combustíveis , Utensílios Domésticos , Humanos , Querosene/intoxicação , Parafina , Intoxicação , Pobreza , SARS-CoV-2 , África do Sul/epidemiologia , População Urbana
4.
BMC Pediatr ; 19(1): 235, 2019 07 12.
Artigo em Inglês | MEDLINE | ID: mdl-31319811

RESUMO

BACKGROUND: Unintentional child poisoning represents a significant public health problem across the globe, placing a substantial burden on health services emergency departments. Around the world, every year, thousands of children die as a result of physical injuries, most of which involve children under 5 years old. Medicines are the main products involved in poisoning, and children under 5 years old are the most vulnerable age group. The objective of this study was to measure the prevalence of unsafe storage of medicines in households with a 4-year-old child. METHODS: We used data from the follow-up of 4-year-old in the 2004 Pelotas Birth Cohort Study in Brazil (N = 3799). "Unsafe storage" was considered present when medicines were stored unlocked and within reach of children (at a height below the eye level of the average adult). Independent variables included maternal and family socioeconomic and demographic characteristics and the child's health care. All information was collected during household interviews with the mothers using a standardized questionnaire. The overall prevalence rate with a 95% confidence interval (95% CI) and the prevalence associated with various independent variables were determined. RESULTS: The storage of medicines in unlocked areas was reported by 80.9% of the mothers, and, within reach of children for 26.5%. The overall prevalence rate of unsafe storage of medicines was 21.4% (20.1-22.7%). The main storage locations used were the kitchen (57.0%) and bedroom (53.3%). CONCLUSIONS: The results indicate that medicines were unsafely stored in a 21.4% number of homes, which can contribute to the vulnerability of children to poisoning from medicines. To minimize this risk, education about the safe storage of medicines should be reinforced by health professionals.


Assuntos
Armazenamento de Medicamentos , Acidentes Domésticos/prevenção & controle , Acidentes Domésticos/estatística & dados numéricos , Brasil/epidemiologia , Aleitamento Materno , Pré-Escolar , Estudos Transversais , Características da Família , Feminino , Seguimentos , Humanos , Masculino , Intoxicação/epidemiologia , Intoxicação/prevenção & controle , Segurança , Fatores Socioeconômicos , População Urbana
5.
Women Health ; 59(9): 985-996, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-30880631

RESUMO

Domestic accidents pose serious threats to the independence of the elderly. We explored associations between domestic accidents and gender, socioeconomic, medical, and environmental factors using data from the European Health Survey 2014 for elderly Spanish female and male nationals. Records of 5960 participants (mean age ± SD: 75.9 ± 7.6 years), 59.8% of whom were women, were examined. Domestic accidents occurred in 460 (7.1%) seniors, predominately in women (78.5%). Age (adjusted odds ratio [aOR]: 1.02 [95% confidence interval [CI]: 1.00-1.03, p = .003], female gender (aOR 2.04 [95% CI 1.60-2.60, p < .001]), difficulty managing 12 stairs (reference: none) (some: aOR 2.03 [95% CI 1.53-2.68, p < .001]; much: aOR 2.88 [95% CI 2.15-3.87, p < .001]; inability: aOR 3.09 [95% CI 2.14-4.45, p < .001]), and depressive symptoms severity (reference: absent) (mild: aOR 1.44 [95% CI 1.10-1.89, p = .008]; moderate: aOR 1.91 [95% CI 1.35-2.71, p < .001];. Very severe: aOR 2.53 [95% CI 1.72-3.71, p < .001]; extremely severe: aOR 2.38 [95% CI 1.45-3.93, p = .001]) were independently associated with domestic accidents. Severity of depressive symptoms was the most prominent feature for women, while inability to manage 12 stairs was the most prominent for men. Our results suggest important gender differences in factors associated with domestic accidents that are relevant to intervention and preventive programs.


Assuntos
Acidentes Domésticos/estatística & dados numéricos , Depressão/epidemiologia , Fatores Socioeconômicos , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Depressão/etiologia , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Fatores Sexuais , Espanha/epidemiologia , Inquéritos e Questionários
6.
PLoS One ; 13(8): e0199219, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30074996

RESUMO

OBJECTIVE: To determine the effectiveness of an individually-tailored multifactorial intervention in reducing falls among at risk older adult fallers in a multi-ethnic, middle-income nation in South-East Asia. DESIGN: Pragmatic, randomized-controlled trial. SETTING: Emergency room, medical outpatient and primary care clinic in a teaching hospital in Kuala Lumpur, Malaysia. PARTICIPANTS: Individuals aged 65 years and above with two or more falls or one injurious fall in the past 12 months. INTERVENTION: Individually-tailored interventions, included a modified Otago exercise programme, HOMEFAST home hazards modification, visual intervention, cardiovascular intervention, medication review and falls education, was compared against a control group involving conventional treatment. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was any fall recurrence at 12-month follow-up. Secondary outcomes were rate of fall and time to first fall. RESULTS: Two hundred and sixty-eight participants (mean age 75.3 ±7.2 SD years, 67% women) were randomized to multifactorial intervention (n = 134) or convention treatment (n = 134). All participants in the intervention group received medication review and falls education, 92 (68%) were prescribed Otago exercises, 86 (64%) visual intervention, 64 (47%) home hazards modification and 51 (38%) cardiovascular intervention. Fall recurrence did not differ between intervention and control groups at 12-months [Risk Ratio, RR = 1.037 (95% CI 0.613-1.753)]. Rate of fall [RR = 1.155 (95% CI 0.846-1.576], time to first fall [Hazard Ratio, HR = 0.948 (95% CI 0.782-1.522)] and mortality rate [RR = 0.896 (95% CI 0.335-2.400)] did not differ between groups. CONCLUSION: Individually-tailored multifactorial intervention was ineffective as a strategy to reduce falls. Future research efforts are now required to develop culturally-appropriate and affordable methods of addressing this increasingly prominent public health issue in middle-income nations. TRIAL REGISTRATION: ISRCTN Registry no. ISRCTN11674947.


Assuntos
Acidentes por Quedas/prevenção & controle , Medicina de Precisão/métodos , Prevenção Primária/métodos , Acidentes por Quedas/estatística & dados numéricos , Acidentes Domésticos/prevenção & controle , Acidentes Domésticos/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/terapia , Serviço Hospitalar de Emergência , Planejamento Ambiental/normas , Terapia por Exercício , Feminino , Humanos , Malásia , Masculino , Admissão do Paciente/estatística & dados numéricos , Transtornos da Visão/diagnóstico , Transtornos da Visão/epidemiologia , Transtornos da Visão/terapia
7.
Public Health Rep ; 133(5): 570-577, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30067452

RESUMO

OBJECTIVES: Characterization of the epidemiology and cost of lawn-mower injuries is potentially useful to inform injury prevention and health policy efforts. We examined the incidence, distribution, types and severity, and emergency department (ED) and hospitalization charges of lawn-mower injuries among all age groups across the United States. METHODS: This retrospective, cross-sectional study used nationally representative, population-based (all-payer) data from the US Nationwide Emergency Department Sample for lawn-mower-related ED visits and hospitalizations from January 1, 2006, through December 31, 2013. Lawn-mower injuries were identified by using International Classification of Diseases, Ninth Revision, Clinical Modification code E920 (accidents caused by a powered lawn mower). We analyzed data on demographic characteristics, age, geographic distribution, type of injury, injury severity, and hospital charges. RESULTS: We calculated a weighted estimate of 51 151 lawn-mower injuries during the 8-year study period. The most common types of injuries were lacerations (n = 23 907, 46.7%), fractures (n = 11 433, 22.4%), and amputations (n = 11 013, 21.5%). The most common injury locations were wrist or hand (n = 33 477, 65.4%) and foot or toe (n = 10 122, 19.8%). Mean ED charges were $2482 per patient, and mean inpatient charges were $36 987 per patient. The most common procedures performed were wound irrigation or debridement (n = 1436, 29.9%) and amputation (n = 1230, 25.6%). CONCLUSIONS: Lawn-mower injuries occurred at a constant rate during the study period. Changes to nationwide industry safety standards are needed to reduce the frequency and severity of these preventable injuries.


Assuntos
Acidentes Domésticos/estatística & dados numéricos , Utensílios Domésticos/estatística & dados numéricos , Veículos Automotores/estatística & dados numéricos , Ferimentos e Lesões/epidemiologia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Estudos Transversais , Serviço Hospitalar de Emergência/estatística & dados numéricos , Segurança de Equipamentos , Feminino , Preços Hospitalares/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Humanos , Incidência , Lactente , Escala de Gravidade do Ferimento , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Estados Unidos/epidemiologia
8.
Rev Saude Publica ; 52: 22, 2018.
Artigo em Português, Inglês | MEDLINE | ID: mdl-29489998

RESUMO

OBJECTIVE Evaluate the prevalence and the factors associated with the occurrence of falls among older adults. METHODS A cross-sectional study with a representative sample of 1,451 elderly residents in the urban area of Pelotas, RS, in 2014. A descriptive analysis of the data was performed and the prevalence of falls in the last year was presented. The analysis of demographic, socioeconomic, behavioral and health factors associated with the outcome was performed using Poisson regression with adjustment for robust variance according to the hierarchical model. The variables were adjusted to each other within each level and for the higher level. Those with p ≤ 0.20 were maintained in the model for confounding control and those with p < 0.05 were considered to be associated with the outcome. RESULTS The prevalence of falls among older adults in the last year was 28.1% (95%CI 25.9-30.5), and most occurred in the person's own residence. Among the older adults who fell, 51.5% (95%CI 46.6-56.4) had a single fall and 12.1% (95%CI 8.9-15.3) had a fracture as a consequence, usually in the lower limbs. The prevalence of falls was higher in women, adults of advanced age, with lower income and schooling level, with functional incapacity for instrumental activities, and patients with diseases such as diabetes, heart disease, and arthritis. CONCLUSIONS The occurrence of falls reached almost a third of the older adults, and the prevalence was higher in specific segments of the population in question. About 12% of the older adults who fell fractured some bone. The factors associated with the occurrence of falls identified in this study may guide measures aimed at prevention in the older adult population.


Assuntos
Acidentes por Quedas/estatística & dados numéricos , Acidentes Domésticos/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Estudos Transversais , Feminino , Fraturas Ósseas/classificação , Fraturas Ósseas/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Fatores Sexuais , Fatores Socioeconômicos
9.
Int J Inj Contr Saf Promot ; 25(1): 23-30, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28387170

RESUMO

To determine the incidence and cost of non-fatal burns in Iran; this cross-sectional household survey of a nationally representative sample of 15-64 years old was conducted. Through face-to-face interviews and telephone calls, the data on the demographics, history and cost of burns were collected. The annual incidence rate of burns was estimated 129.85 per 1000 population. Burns occurred higher in younger age, female gender and urban residency. The most common burn description was as follows: unpaid work (activity during burn), home (place of burn), heat and hot substances (mechanism of burn) and upper limb (site of burn). The average total cost of burn includes victims seeking medical care was US$124 per case. The main findings of this study suggest that burns are a major public health concern in Iran. To stop this important health issue, a national program for burn prevention and education must be developed.


Assuntos
Queimaduras/economia , Queimaduras/epidemiologia , Acidentes Domésticos/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Queimaduras/etiologia , Queimaduras/terapia , Estudos Transversais , Honorários e Preços , Feminino , Custos de Cuidados de Saúde , Humanos , Incidência , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , População Rural/estatística & dados numéricos , Fatores Sexuais , Inquéritos e Questionários , População Urbana/estatística & dados numéricos , Adulto Jovem
10.
Artigo em Inglês | LILACS | ID: biblio-903490

RESUMO

ABSTRACT OBJECTIVE Evaluate the prevalence and the factors associated with the occurrence of falls among older adults. METHODS A cross-sectional study with a representative sample of 1,451 elderly residents in the urban area of Pelotas, RS, in 2014. A descriptive analysis of the data was performed and the prevalence of falls in the last year was presented. The analysis of demographic, socioeconomic, behavioral and health factors associated with the outcome was performed using Poisson regression with adjustment for robust variance according to the hierarchical model. The variables were adjusted to each other within each level and for the higher level. Those with p ≤ 0.20 were maintained in the model for confounding control and those with p < 0.05 were considered to be associated with the outcome. RESULTS The prevalence of falls among older adults in the last year was 28.1% (95%CI 25.9-30.5), and most occurred in the person's own residence. Among the older adults who fell, 51.5% (95%CI 46.6-56.4) had a single fall and 12.1% (95%CI 8.9-15.3) had a fracture as a consequence, usually in the lower limbs. The prevalence of falls was higher in women, adults of advanced age, with lower income and schooling level, with functional incapacity for instrumental activities, and patients with diseases such as diabetes, heart disease, and arthritis. CONCLUSIONS The occurrence of falls reached almost a third of the older adults, and the prevalence was higher in specific segments of the population in question. About 12% of the older adults who fell fractured some bone. The factors associated with the occurrence of falls identified in this study may guide measures aimed at prevention in the older adult population.


RESUMO OBJETIVO Avaliar a prevalência e os fatores associados à ocorrência de quedas em idosos. MÉTODOS Estudo transversal com amostra representativa de 1.451 idosos residentes na zona urbana de Pelotas, RS, em 2014. Foi realizada análise descritiva dos dados e apresentada a prevalência de quedas no último ano. A análise de fatores demográficos, socioeconômicos, comportamentais e de saúde associados ao desfecho foi realizada por meio de regressão de Poisson com ajuste para variância robusta conforme modelo hierárquico. As variáveis foram ajustadas entre si dentro de cada nível e para as de nível superior. Aquelas com p ≤ 0,20 foram mantidas no modelo para controle de confusão e aquelas com p < 0,05 foram consideradas associadas ao desfecho. RESULTADOS A prevalência de quedas em idosos no último ano foi de 28,1% (IC95% 25,9-30,5), e a maioria ocorreu na própria residência do idoso. Entre os idosos que sofreram queda, 51,5% (IC95% 46,6-56,4) tiveram uma única queda e 12,1% (IC95% 8,9-15,3) tiveram fratura como consequência, sendo a de membros inferiores a mais relatada. A prevalência de quedas foi maior em mulheres, idosos com idade avançada, de menor renda e escolaridade, com incapacidade funcional para atividades instrumentais e portadores de enfermidades como diabetes, doença cardíaca e artrite. CONCLUSÕES A ocorrência de quedas atingiu quase um terço dos idosos, e a prevalência foi mais elevada em segmentos específicos da população em questão. Cerca de 12% dos idosos que caíram, fraturaram algum osso. Os fatores associados à ocorrência de quedas identificados neste estudo poderão nortear medidas que visem sua prevenção na população de idosos.


Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Acidentes por Quedas/estatística & dados numéricos , Fatores Socioeconômicos , Brasil/epidemiologia , Acidentes Domésticos/estatística & dados numéricos , Fatores Sexuais , Prevalência , Estudos Transversais , Fatores de Risco , Fraturas Ósseas/classificação , Fraturas Ósseas/epidemiologia , Pessoa de Meia-Idade
11.
Burns ; 42(7): 1581-1587, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27522637

RESUMO

PURPOSE: Legislative changes in 2008 in Australia mandated that all new treadmills display a warning sticker about the risk of friction burns in children. This was accompanied by a health promotion campaign advising of the risks of treadmills to children. METHODS: Analyses of pediatric burns data identified all cases of treadmill burns occurring between 2005 and 2014. The incidence of treadmill burns, associations with age and gender, characteristics of the burns and the adequacy of first aid provided immediately after the burn was examined. RESULTS: There were 298 cases of treadmill burns over the 10-year period (3.5% of all pediatric burns). The incidence rose until the introduction of legislation and health promotion in 2008, and then declined over the remaining study period. The majority of treadmill burns in children were inflicted on the upper limbs (91%), and 93% involved the hands. Most burns were full thickness (62%, n=182) and 49% (n=148) required skin grafts. Approximately one-third of treadmill burns (35%, n=105) occurred while someone else was using the treadmill. In the vast majority of treadmill burn injuries (74%, n=223), there was either no first aid or inadequate first aid provided immediately after the injury. CONCLUSION: A significant number of treadmill burns occur in children, and these often result in serious injuries that are not treated with appropriate first aid. A reduction in the incidence of these burns was associated with the introduction of legislation and health promotion targeted at child safety around treadmills.


Assuntos
Acidentes Domésticos/prevenção & controle , Queimaduras/prevenção & controle , Fricção , Traumatismos da Mão/prevenção & controle , Promoção da Saúde/métodos , Rotulagem de Produtos/legislação & jurisprudência , Acidentes Domésticos/estatística & dados numéricos , Adolescente , Distribuição por Idade , Austrália/epidemiologia , Queimaduras/epidemiologia , Queimaduras/etiologia , Queimaduras/terapia , Criança , Pré-Escolar , Feminino , Primeiros Socorros , Traumatismos da Mão/epidemiologia , Traumatismos da Mão/etiologia , Traumatismos da Mão/terapia , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Estudos Retrospectivos , Distribuição por Sexo , Transplante de Pele
12.
Burns ; 42(8): 1861-1866, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27364090

RESUMO

Electrical injuries and especially those of high voltage still remain a source of high morbidity. Over the past few years, a change in the epidemiologic profile of these lesions was noticed at the Vall d'Hebron University Hospital Burn Unit, corresponding to an increase in cases out of the legal framework. It is our aim to describe this particular subset, to determine the extent of their injuries and to understand the reason for their increased incidence. We think this was favoured by the rise in the unemployment rate, along with higher copper prices.


Assuntos
Acidentes Domésticos/estatística & dados numéricos , Queimaduras por Corrente Elétrica/epidemiologia , Recessão Econômica , Traumatismos Ocupacionais/epidemiologia , Roubo/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Amputação Cirúrgica , Queimaduras por Corrente Elétrica/complicações , Queimaduras por Corrente Elétrica/cirurgia , Criança , Pré-Escolar , Síndromes Compartimentais/etiologia , Síndromes Compartimentais/cirurgia , Cobre , Desbridamento , Fasciotomia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Distribuição por Sexo , Transplante de Pele , Espanha/epidemiologia , Desemprego/estatística & dados numéricos , Adulto Jovem
13.
Soc Sci Med ; 153: 250-7, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26928586

RESUMO

This study examined the relationship between home risk and hospital treated injury in Australian children up to five years old. Women with children between two and four years of age enrolled in the Environments for Healthy Living (EFHL): Griffith Birth Cohort Study were invited to complete a Home Injury Prevention Survey from March 2013 to June 2014. A total home risk score (HRS) was calculated and linked to the child's injury related state-wide hospital emergency and admissions data and EFHL baseline demographic surveys. Data from 562 households relating to 566 child participants were included. We found an inverse relationship between home risk and child injury, with children living in homes with the least injury risk (based on the absence of hazardous structural features of the home and safe practices reported) having 1.90 times the injury rate of children living in high risk homes (95% CI 1.15-3.14). Whilst this appears counter-intuitive, families in the lowest risk homes were more likely to be socio-economically disadvantaged than families in the highest risk homes (more sole parents, lower maternal education levels, younger maternal age and lower income). After adjusting for demographic and socio-economic factors, the relationship between home risk and injury was no longer significant (p > 0.05). Our findings suggest that children in socio-economically deprived families have higher rates of injury, despite living in a physical environment that contains substantially fewer injury risks than their less deprived counterparts. Although measures to reduce child injury risk through the modification of the physical environment remain an important part of the injury prevention approach, our study findings support continued efforts to implement societal-wide, long term policy and practice changes to address the socioeconomic differentials in child health outcomes.


Assuntos
Acidentes Domésticos/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Ferimentos e Lesões/epidemiologia , Austrália , Pré-Escolar , Estudos de Coortes , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Humanos , Masculino , Fatores de Risco , Fatores Socioeconômicos , Ferimentos e Lesões/terapia
14.
Inj Prev ; 22(6): 412-419, 2016 12.
Artigo em Inglês | MEDLINE | ID: mdl-27016460

RESUMO

BACKGROUND: Fall-related injuries are a global public health problem, especially in elderly populations. The effect of an intervention aimed at reducing the risk of falls in the homes of community-dwelling elderly persons was evaluated. The intervention mainly involves the performance of complicated tasks and hazards assessment by a trained assessor, and has been adopted gradually over the last decade by 191 of 290 Swedish municipalities. METHODS: A quasi-experimental design was used where intention-to-treat effect estimates were derived using panel regression analysis and a regression discontinuity (RD) design. The outcome measure was the incidence of fall-related hospitalisations in the treatment population, the age of which varied by municipality (≥65 years, ≥67 years, ≥70 years or ≥75 years). RESULTS: We found no statistically significant reductions in injury incidence in the panel regression (IRR 1.01 (95% CI 0.98 to 1.05)) or RD (IRR 1.00 (95% CI 0.97 to 1.03)) analyses. The results are robust to several different model specifications, including segmented panel regression analysis with linear trend change and community fixed effects parameters. CONCLUSIONS: It is unclear whether the absence of an effect is due to a low efficacy of the services provided, or a result of low adherence. Additional studies of the effects on other quality-of-life measures are recommended before conclusions are drawn regarding the cost-effectiveness of the provision of home help service programmes.


Assuntos
Acidentes por Quedas/prevenção & controle , Acidentes Domésticos/prevenção & controle , Serviços de Saúde para Idosos/organização & administração , Serviços de Assistência Domiciliar/organização & administração , Hospitalização/estatística & dados numéricos , Ferimentos e Lesões/prevenção & controle , Acidentes por Quedas/estatística & dados numéricos , Acidentes Domésticos/estatística & dados numéricos , Atividades Cotidianas , Idoso , Idoso de 80 Anos ou mais , Cidades , Planejamento Ambiental , Ergonomia , Feminino , Pesquisas sobre Atenção à Saúde , Humanos , Incidência , Masculino , Avaliação de Programas e Projetos de Saúde , Análise de Regressão , Projetos de Pesquisa , Suécia/epidemiologia , Ferimentos e Lesões/economia , Ferimentos e Lesões/epidemiologia
15.
Br J Gen Pract ; 66(644): e193-9, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26917659

RESUMO

BACKGROUND: Steam inhalation has long been considered a beneficial home remedy to treat children with viral respiratory tract infections, but there is no evidence to suggest a benefit and children are at risk of serious burn injuries. AIM: To determine the demographics, mechanism, management, and costs of steam inhalation therapy scalds to a regional burns centre in the UK, and to ascertain whether this practice is recommended by primary care providers. DESIGN AND SETTING: A retrospective study of all patients admitted to a regional burns centre in Swansea, Wales, with steam inhalation therapy scalds. METHOD: Patients who attended the burns centre for steam inhalation therapy scalds between January 2010 and February 2015 were identified using the burns database and data on patient demographics, treatment, and costs incurred were recorded. In addition, an electronic survey was e-mailed to 150 local GPs to determine whether they recommended steam inhalation therapy to patients. RESULTS: Sixteen children attended the burns centre with steam inhalation scalds. The average age attending was 7.4 years (range 1-15 years) and, on average, three children per year were admitted. The most common indication was for the common cold (n = 9). The average size of the burns was 3.1% (range: 0.25-17.0%) of total body area. One child was managed surgically; the remainder were treated with dressings, although one patient required a stay in a high-dependency unit. The total cost of treatment for all patients was £37,133. All in all, 17 out of 21 GPs surveyed recommended steam inhalation to their patients; eight out of 19 GPs recommended it for children aged <5 years. CONCLUSION: Steam inhalation incurs a significant cost to patients and the healthcare system. Its practice continues to be recommended by GPs but children, due to their limited motor skills, curiosity, and poor awareness of danger, are at significant risk of burn injuries and this dangerous practice should no longer be recommended.


Assuntos
Acidentes Domésticos/estatística & dados numéricos , Queimaduras , Resfriado Comum/terapia , Medicina Tradicional , Pais/educação , Terapia Respiratória/efeitos adversos , Autocuidado/efeitos adversos , Vapor/efeitos adversos , Acidentes Domésticos/prevenção & controle , Adolescente , Distribuição por Idade , Queimaduras/etiologia , Queimaduras/prevenção & controle , Criança , Pré-Escolar , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Hospitalização/estatística & dados numéricos , Humanos , Tempo de Internação , Masculino , Estudos Retrospectivos , País de Gales/epidemiologia
16.
Child Care Health Dev ; 42(4): 473-7, 2016 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-26892878

RESUMO

BACKGROUND: Childhood injuries, especially the unintentional category of injuries, occur most commonly in the environment inside a child's home. The primary objective of the present study was to assess the presence of home hazards for childhood injuries in households in an urban resettlement colony in New Delhi. METHODS: A community-based cross-sectional study was carried out in an urban resettlement colony in Delhi. A hazards assessment tool was used to check the presence of hazards in the houses. RESULTS: A total of 225 households were included. It was seen that121 (53.7%) had a cooking stove within the reach of the child, and 190 (84.3%) had the gas pipe within reach. Fire hazard was seen in 84% of houses. About 78% of households did not have locked storage for chemicals. CONCLUSION: The study revealed a significant burden of hazards for childhood injuries within their own homes, thus emphasizing the need for injury prevention interventions to reduce the number of hazards.


Assuntos
Prevenção de Acidentes/métodos , Acidentes Domésticos/prevenção & controle , Educação em Saúde/organização & administração , Avaliação das Necessidades/organização & administração , Ferimentos e Lesões/prevenção & controle , Acidentes Domésticos/estatística & dados numéricos , Criança , Estudos Transversais , Feminino , Incêndios/prevenção & controle , Habitação/normas , Humanos , Índia/epidemiologia , Decoração de Interiores e Mobiliário/normas , Masculino , Formulação de Políticas , Equipamentos de Proteção/estatística & dados numéricos , Medição de Risco , Fatores Socioeconômicos , População Urbana , Ferimentos e Lesões/epidemiologia
17.
Int J Inj Contr Saf Promot ; 23(2): 214-23, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-25262785

RESUMO

Considering the high burden of injuries, the Health Authority-Abu Dhabi developed a draft electronic and paper-based injury and poisoning notification system (IPNS) to generate better data on the nature and severity of injuries. The pilot testing and evaluation of IPNS was conducted with the specific objectives to (1) identify the characteristics of injury cases, (2) explore potential risk factors, (3) illustrate the nature and type of data, and (4) the working mechanism of data collection. Data were collected from selected hospitals on patient demographics, injury information and clinical assessment. Descriptive, bivariate and multivariate analyses were conducted. Of 4226 injury cases, nearly three-fourths were male, majority were non-UAE nationals, and the mean age was 21.9. Multivariate findings suggested that compared to UAE nationals, non-UAE nationals were 27% more likely to experience fatal, severe or moderate injuries (p = 0.01). Individuals with health insurance were 31% less likely to suffer a fatal, severe or moderate injury compared to those having no health insurance (p < 0.001). This is the first systematically standardised collection of injury data across three facilities in Abu Dhabi, and provides initial information on characteristics and injury risk factors that will help identify the need for evidence-based intervention for injury prevention and control.


Assuntos
Monitoramento Epidemiológico , Vigilância da População/métodos , Ferimentos e Lesões/epidemiologia , Ferimentos e Lesões/etiologia , Acidentes por Quedas/estatística & dados numéricos , Acidentes Domésticos/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Sudeste Asiático/etnologia , Bangladesh/etnologia , Criança , Pré-Escolar , Egito/etnologia , Feminino , Humanos , Índia/etnologia , Lactente , Seguro Saúde/estatística & dados numéricos , Jordânia/etnologia , Masculino , Pessoa de Meia-Idade , Traumatismos Ocupacionais/epidemiologia , Paquistão/etnologia , Projetos Piloto , Fatores de Risco , Fatores Sexuais , Índices de Gravidade do Trauma , Emirados Árabes Unidos/epidemiologia , Ferimentos e Lesões/etnologia , Adulto Jovem
20.
J Oral Maxillofac Surg ; 73(4): 676-82, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25795578

RESUMO

PURPOSE: Retrospective studies on the types and causes of facial burns are important because the patterns might vary in different societies. Our aim was to assess the burn-related factors of significance that might be useful in healthcare planning and implementing preventive strategies, adding to the body of current data on the subject. MATERIALS AND METHODS: A retrospective cross-sectional study was conducted to assess the data from a major burns referral center during a 5-year period (2009 to 2013). The data relevant to age, gender, cause, source, location, burn degree, extent (body surface area [BSA]) of the burns, and mortality were gathered from comprehensive patient medical records, recorded, and analyzed using SPSS, version 20, software (SPSS, Chicago, IL). RESULTS: Within the study period, we found 808 documented cases of second- and third-degree facial burns. These burns were more common in men (81.9%) and in the 16- to 35-year age group (42.3%). The mean hospitalization was 9.85 ± 8.94 days. In 443 patients (54.83%), 10 to 19% of their BSA was burned, and 3.06% had associated inhalation burns. The most common burn was scalding (19%), and the deadliest was burns from acid, with a mortality rate of 7.4%. Accidents accounted for 776 burns (96.03%). Other causes were attempted homicide (16 cases, 1.98%) and suicide attempts (16 cases, 1.98%). The overall mortality was 1.6%. CONCLUSIONS: The key findings were that second- and third-degree facial burns were more common in males aged 16 to 35 years with burns covering 10 to 19% of the BSA. Accidental scalding was commonly responsible for the second-degree burns, and electrical accidents were commonly responsible for third-degree facial burns. Burn accidents occurred more often at the patient's home.


Assuntos
Queimaduras/epidemiologia , Traumatismos Faciais/epidemiologia , Acidentes Domésticos/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Superfície Corporal , Queimaduras/classificação , Queimaduras/mortalidade , Queimaduras Químicas/epidemiologia , Queimaduras por Corrente Elétrica/epidemiologia , Queimaduras por Inalação/epidemiologia , Estudos Transversais , Traumatismos Faciais/classificação , Traumatismos Faciais/mortalidade , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Irã (Geográfico)/epidemiologia , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Fatores Sexuais , Tentativa de Suicídio/estatística & dados numéricos , Adulto Jovem
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