Risk factors of unintentional injury among children in New Zealand: a systematic review.

OBJECTIVE: To identify contemporary studies investigating multifaceted and inter-linked contributory frameworks for unintentional injuries among children in New Zealand. METHODS: A literature review was performed in seven databases. Studies published in English up to February 2020 reporting risk factors for child injury in New Zealand were included. Eligible study designs included: cohort, case-control and case-crossover studies. The quality of studies was assessed using the GATE frame tool. The PRISMA (Preferred Reporting Items for Systematic Reviews and MetaAnalyses) reporting guidelines were followed. RESULTS: Thirteen studies fulfilled the inclusion criteria, dating from 1977 to 2008. The factors associated with child injury (0 to 14 years) included socioeconomic disadvantage, number of children, younger maternal age and sole parents. Vehicle speed and traffic volume were associated with an increased risk of driveway-related pedestrian injury. CONCLUSION: The review findings have reinforced the need for cross-agency action to address the social determinants of child injury. Implications for public health: Contemporary longitudinal studies are needed to assist in understanding how the interactions between children, family and their wider societal context affect their risk of experiencing injury over time.

Quantitative sonographic assessment of quadriceps muscle thickness for fall injury prediction in patients undergoing maintenance hemodialysis: an observational cohort study.

BACKGROUND: Accidental fall risk is high in patients undergoing maintenance hemodialysis. Falls are associated with fatal injury, comorbidities, and mortality. Risk assessment should be a primary component of fall prevention. This study investigated whether quadriceps muscle thickness measured using ultrasonography can predict fall injury among dialysis patients. METHODS: Using an observational cohort study design, 180 ambulatory hemodialysis patients were recruited from 2015 to 2016 from four dialysis clinics. The sum of the maximum quadriceps muscle thickness on both sides and the average of the maximum thigh circumference and handgrip strength after hemodialysis were calculated. Patients were stratified according to tertiles of quadriceps muscle thickness. Fall injury was surveyed according to the patient's self-report during the one-year period. RESULTS: Among the 180 hemodialysis patients, 44 (24.4%) had fall injuries during the 12-month follow-up period. When the quadriceps muscle thickness levels were stratified into sex-specific tertiles, patients in the lowest tertile were more likely to have a higher incidence of fall injury than those in the higher two tertiles (0.52 vs. 0.19 and 0.17 fall injuries/person-year). After adjusting for covariates, lower quadriceps muscle thickness was found to be an independent predictor of fall injury (hazard ratio [95% confidence interval], 2.33 [1.22-4.52], P < 0.05). Receiver operating characteristic curves were constructed to determine the optimal cutoffs of quadriceps muscle thickness, thigh circumference, and handgrip strength that best predicted fall injury (quadriceps muscle thickness, 3.37 cm and 3.54 cm in men and women; thigh circumference, 44.6 cm and 37.2 cm in men and women; and handgrip strength, 23.3 kg and 16.5 kg in men and women). Using these cutoff values, the areas under the curve were 0.662 (95% CI, 0.576-0.738), 0.625 (95% CI, 0.545-0.699), and 0.701 (95% CI, 0.617-0.774), for quadriceps muscle thickness, thigh circumference, and handgrip strength, respectively. Quadriceps muscle thickness was a more precise predictor of fall injury than thigh circumference and had similar diagnostic performance as handgrip strength tests in dialysis patients. CONCLUSIONS: Quadriceps muscle thickness can be measured easily at the bedside using ultrasonography and is a precise predictor of fall injury in patients undergoing maintenance hemodialysis.

Occupational Accidents in Iran: Risk Factors and Long Term Trend (2007-2016).

BACKGROUND: Although much is known about the distribution of occupational accidents in the world, less is known about occupational injuries in developing countries. Therefore, the aim of this study was to investigate the trend of occupational accidents during 10 years (2007-2016) and to find factors affecting the accident outcome. STUDY DESIGN: A cross-sectional study. METHODS: This study was done based on the data gathered by the Iranian Social Security Organization (ISSO), including demographic data (age, sex, marital status) and occupational accident characteristics (accident sector, cause, type, body part, location, time, month, and incident outcome). RESULTS: A decreasing pattern of occupational accidents was found from 2.95 per 1000 workers in 2007 to 1.46 per 1000 workers in 2016. The mean age of injured workers was 32.97 years. The most common cause and type of accidents were incaution and lack of attention and collision, and trapping, respectively. Limbs were the most affected body parts, and less than 1% of occupational accidents resulted in death. The highest incident was seen in the industrial sector during all years. More severe accident outcomes were seen at older ages and in the male gender, married subjects, winter season, agriculture sector, and outside of work place. CONCLUSION: These results provide a basis for further investigations regarding data collection and accident causes. Modification of some associated factors and implementation of safety prevention programs would be useful in reducing occupational accidents in Iran.