Effect of Training of Adolescents on Household Environmental Safety from Childhood Injuries in a Rural Area of Delhi.

Introduction: The environment poses an important risk in the causation of injuries in children. Simple measures in improving the safety of the domestic and peri-domestic environment can go a long way in preventing injuries. This study was conducted to assess the effect of training of the adolescents in the families, on the household environmental safety regarding childhood injuries. Materials and Methods: A pre- and post-intervention study was conducted over 16 months, on 116 families of two villages of Delhi. Data were collected regarding domestic and peri-domestic environments along with danger points with respect to injuries, of the enrolled houses, during the pre- and post-intervention phases of 4 months each. The intervention comprised training of the eldest adolescent of the family, on causes of common injuries and role of environment in injury causation. Scores were assigned to all relevant aspects, and the total environmental safety scores were calculated. The comparison was made between pre- and post-intervention scores of the two areas. Results: Environmental safety scores were more than 70% in both areas at the baseline with no difference between the two areas. In the intervention area, there was statistically significant improvement of scores after the intervention, in the domestic environment and danger signs within the houses. Conclusion: Training adolescents about the prevention of injuries and motivating them to remain vigilant over domestic environment are effective in bringing about significant change in the household environment with regard to safety from injuries in children. Repeated visits by health workers also increase awareness and change the household environment making it safer for children.

Risk factors for severe and fatal childhood unintentional injury: a systematic review protocol.

BACKGROUND: Unintentional injuries are a leading cause of death among children aged 1-19 years worldwide. Systematic reviews assessing various risk factors for different childhood injuries have been published previously. However, most of the related literature does not distinguish minor from severe or fatal injuries. This study aims to describe and summarize the current knowledge on the determinants of severe and fatal childhood unintentional injuries and to discuss the differences between risk factors for all injuries (including minor injuries) and severe and fatal injuries. The study also aims to quantify the reduction in childhood injuries associated with a reduction in exposure to some of the identified risk factors in the Canadian population. METHODS: A systematic review and meta-analysis will be conducted by searching MEDLINE, Embase, CINAHL, and Web of Science. Observational and experimental cohort studies assessing children and adolescents aged ≤ 19 years old and determinants of severe and fatal unintentional injury, such as personal behaviors, family and environmental characteristics, and socioeconomic and geographic context, will be eligible. The main outcome will be a composite of any severe or fatal unintentional injuries (including burns, drowning, transport-related injuries, and falls). Any severity measurement scale will be accepted as long as severe cases require at least one hospital admission. Two authors will independently screen for inclusion, extract data, and assess the quality of the data using the Cochrane ROBINS-E tool. Meta-analysis will be performed using random effects models. Subgroup analyses will examine age subgroups and high- vs low-income countries. Sensitivity analysis will be conducted after restricting analyses to studies with a low risk of bias. Attributable fractions will be computed to assess the burden of identified risk factors in the Canadian population. DISCUSSION: Given the numerous determinants of childhood injuries and the challenges that may be involved in identifying which individuals should be prioritized for injury prevention efforts, this evidence may help to inform the identification of high-risk children and prevention interventions, considering the disproportionate consequences of severe and fatal injuries. This evidence may also help pediatric healthcare providers prioritize counseling messaging. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42023493322.

Education on Preventing Early Childhood Injuries Using a Video Game: The VirtualSafeHome Platform.

Poisonings and household injuries are frequent events among toddlers. We developed VirtualSafeHome (VSH)-a novel self-contained, Internet-based home-safety learning tool-to improve awareness of household hazards. Study aims were to investigate VSH usage characteristics. A prototype, screen-based VSH kitchen was built in Unity and delivered through the web using 3DVista and Wix. Players spot and click 21 embedded hazards. A unique feature is the ability to capture the "child's perspective" in identifying hazards. We recruited a convenience sample of adults in 2021-2022. Outcomes included number of hazards discovered, session duration, and pretest/posttest knowledge scores. Twenty-four adults identified a median 15.5 hazards; median playing time was 1022 seconds. Players reported satisfaction with ease of navigation and game features. Mean pretest/posttest knowledge scores rose from 2.0 to 2.79 (P < .035). A web-enabled video game can provide easily accessed, enjoyable training on home safety.

Exploring parental risk perception regarding childhood unintentional home injuries: A cross-sectional study.

INTRODUCTION: While previous studies on childhood injury focused mainly on the relationship between parents' preventive behavior and its determinants, knowledge about parental risk perception that can help to develop, implement, and evaluate successful interventions to prevent childhood unintentional home injuries is still limited. The aim of this study was to gain a deeper understanding of parental risk perception regarding unintentional home injuries of children under six years of age. METHOD: A convenience sample of 469 parents, residing in Germany, completed a web-based questionnaire assessing factors potentially associated with parental risk perception on the child, parental, and environmental level. Descriptive statistics, p for trend, and Spearman's Rho correlation coefficients were calculated. RESULTS: Key factors influencing parental risk perception included children's sex, age, migrant status, emotionality, and injury risk as well as parents' parenting style and external locus of control. While parental risk perception was positively associated with children's injury risk, the analyses showed no associations between parental risk perception and parents' preventive behavior. CONCLUSIONS: Our findings add to a better understanding of parental risk perception, provide practical implications for injury prevention, and indicate that the relationship between parental risk perception and parents' preventive behavior is based on a complex mechanism which is possibly moderated by parents' locus of control. PRACTICAL APPLICATIONS: The identified key factors help to assess parental risk perception more accurately. Therefore, they should be considered in the development of tailored interventions to prevent unintentional home injuries of children, for instance, by targeting specific groups of parental risk perception.

Community features' varying insight into emergency department use for different childhood injuries.

BACKGROUND: Community-level factors, including poverty level, minority population, and rurality are predictive of child injury rates. Community-based interventions targeting high-risk communities have been suggested for prevention and are reliant on understanding details of the community and prevalent types of injuries. The present study assessed injury rates based on characteristics of the community and for different types of injuries. METHOD: A retrospective review of emergency department visits identified zip-code and injury type data for children 0-19. Injuries related to bicycles, falls, motor-vehicle traffic (MTV), and violence were examined. Poverty level, minority population, rural classification, and insured population were obtained at the zip-code level. Regression models examined the association between community features and injury rates for the four categories of injuries. RESULTS: The results showed that the relationship between community features and injury rates was dependent on injury type. Rurality was associated with a lower rate for bicycle and falls, but a higher rate of MVT; higher insured population was associated with higher MVT and violence rates; higher minority population was associated with lower rates for falls and MTV; and higher population in poverty was associated with lower rate for MTV. CONCLUSIONS: The findings indicate that injury rates not only cluster among community-level characteristics, but also the type of injury. Variation in community features and injury types offer insight into a holistic approach to child health. PRACTICAL APPLICATIONS: In addition to other factors related to risk for injuries, health providers' knowledge of features of the local community and prevalent injuries in the environment may be helpful additions to programming geared toward lessening the burden of injuries on children and healthcare systems.

Road safety hazards for children while commuting to school: Findings from a pilot study in Karachi, Pakistan.

INTRODUCTION: Road traffic injuries are a leading cause of mortality and morbidity among children. Travelling to and from school is a major risk exposure for children around the globe. OBJECTIVE: The purpose of this study was to assess road traffic injury hazards for school children during dropp-off or picked-up times. METHODS: This observational cross-sectional study included 94 public and private schools in Karachi, Pakistan. A structured observational tool was used to collect data on school demographics, the road traffic environment, infrastructure, injury hazards in vehicles used by school children, and child pedestrian injury risk and road use behaviors. RESULTS: A total of 860 observations of school children, drivers of vehicles transporting children, schools, and vehicles were recorded. Most schools (n = 83, 88%) did not have designated parking spaces around the school; only one public school had a parking area. Only one private school had a zebra crossing around the school premises. Very few schools (n = 13, 14%), mostly private (n = 12) had pedestrian sidewalks. Only 35 (18%) adult motorcyclists, out of 199, were wearing a helmet, and eight (6%), out of 145, car passengers were wearing seatbelts. Compressed natural gas (CNG) cylinders were installed in 83 (35%), out of 235, observed vehicles. The remaining 152 (65%) did not have CNG cylinders or they were not visible to our data collectors. In 55 (23%) observations, bus passengers stepped off the bus in the middle of the road. Most pedestrians (n = 266, 99.5%) did not use a Zebra crossing. More than a quarter (n = 74, 28%) of pedestrians looked left and right before crossing the road. CONCLUSION: While traveling to school, either by walking or taking vehicular trips, children face many road traffic injury hazards in Karachi. Pedestrians and passengers exhibited risky behaviors while using roads. Further initiatives are advised from a public health viewpoint aiming at minimizing transport-related hazards.

Injury hazard assessment in schools: Findings from a pilot study in Karachi, Pakistan.

INTRODUCTION: Injuries are a major public health concern and one of the leading causes of death and disability worldwide. Childhood injuries contribute to a major proportion of this burden. OBJECTIVE: To identify injury hazards within school premises and playgrounds in Karachi, Pakistan. METHODS: This observational cross-sectional study took place in 107 public and private schools of Karachi, Pakistan using a self-structured standard injury risk assessment tool. This tool was developed after an extensive literature review, expert consultation, and field visits to a few local schools. Data related to school demographics, administrative data and injury hazards within the school boundaries were collected in schools offering education from nursery to secondary grades (through 10th grade, matriculation). Descriptive analysis were calculated. RESULTS: Out of 107 schools, only 12 were recording school-related injuries. A quarter (25%) of schools had some type of disaster drill exercises and built-in fire exits. Fire alarms were placed in 10 schools (9%), all of which were private. In 16 schools (15%), students had access to rooftop doors. There were multiple injury hazards in the school playgrounds. More than half of the schools had hazardous playground surfaces, such as slippery, concrete and uneven ground. Over 80% of schools were not supervising the children during playtime and did not have a separate play area for children under 6 years old. In 38 schools (22%), there were multiple injury hazards in the play rides, such as broken equipment, rusted parts, and sharp edges. Moreover, nine schools (7%) had loose nuts, bolts, edges, belts, steps, or rails in their play rides. Inside, almost a quarter (24%, n = 76) of schools did not have proper insulation of electric wires. Protruded metal nails, which could be high risk for prick and cut injuries, were observed in 20% of the observed furniture. CONCLUSION: In conclusion, there are multiple injury hazards in the private and public schools of Karachi, Pakistan.

Caregiver accounts of unintentional childhood injury events in rural Uganda.

OBJECTIVE: Complex environmental, social, and individual factors contribute to unintentional childhood injury events. Understanding context-specific antecedents and caregiver attributions of childhood injury events can inform the development of locally-targeted interventions to reduce injury risk in rural Uganda. METHODS: Fifty-six Ugandan caregivers were recruited through primary schools and completed qualitative interviews regarding 86 unintentional childhood injury events. Descriptive statistics summarized injury characteristics, child location and activity, and supervision at time of injury. Qualitative analyses informed by grounded theory identified caregiver attributions of injury causes and caregiver actions to reduce injury risk. RESULTS: Cuts, falls, and burns were the most common injuries reported. At the time of injury, the most common child activities were farming and playing and the most common child locations were the farm and kitchen. Most children were unsupervised. In cases where supervision was provided, the supervisor was typically distracted. Caregivers most often attributed injuries to child risk-taking but also identified social, environmental, and chance factors. Caregivers most often made efforts to reduce injury risk by teaching children safety rules, but also reported efforts to improve supervision, remove hazards, and implement environmental safeguards. CONCLUSION: Unintentional childhood injuries have a significant impact on injured children and their families, and caregivers are motivated to reduce child injury risk. Caregivers frequently perceive child decision-making a primary factor in injury events and respond by teaching children safety rules. Rural communities in Uganda and elsewhere may face unique hazards associated with agricultural labor, contributing to a high risk of cuts. Interventions to support caregiver efforts to reduce child injury risk are warranted.

Epidemiology and Pattern of Orthopedic Trauma in Children and Adolescents: Implications for Injury Prevention.

BACKGROUND: Orthopedic injuries are prevalent in children and can result in hospitalization and damage. The number of accidental injuries among children increases every year, leading to a huge burden on communities and health institutions. AIM: This study aimed to assess the epidemiological pattern of orthopedic trauma among children and adolescents in Abha, Saudi Arabia. METHODS: A retrospective record-based study was carried out to investigate the epidemiological pattern of orthopedic trauma among children and adolescents treated at Abha Maternity and Children Hospital in Saudi Arabia, a traumatic center for pediatric patients. The study covered all children and adolescents treated at the hospital for orthopedic trauma. The parents of the children and adolescents were called to get their consent to participate in the study. The following data were extracted from the medical files: personal information, medical history, trauma-related details, management, hospitalization, and complications. RESULTS: A total of 295 children and adolescents were included. The mean ± standard deviation age was 6.8 ± 3.1 years old (range 1 month to 13 years). Of the patients, 186 (63.1%) were male. The most reported causes of traumas were fall from height (48.1%) and injury while playing (19.7%). The most affected body parts included the forearm (22.4%), head (21.7%), thigh (20%), and leg (10.8%). The vast majority of the children and adolescents (87.1%) had no complications. CONCLUSION: The current study revealed that pediatric orthopedic injuries are not rare, and there is a higher likelihood of injuries among young male children. Fall from height and play-associated injuries are the most frequent causes.

Profile of Pediatric Traumatic Brain Injury in South-West Nigeria.

BACKGROUND: Traumatic brain injury (TBI) is a major cause of morbidity and mortality in children. In Nigeria, there is paucity of information about TBI in children. We describe the profile of pediatric TBI in a university hospital in South-West Nigeria. METHODS: A retrospective study of children who had TBI from 2012 to 2022 was performed. Data were extracted from the neurosurgery database. Patient demographics, etiology/patterns of injuries, clinical/radiologic findings, management, and outcomes were assessed. We performed simple descriptive analyses. RESULTS: Pediatric TBIs represented 20% (128) of the head injury admissions (631). There was male preponderance (male/female = 1.8:1); most patients were adolescents (29%). In total, 61%, 18%, and 21% had mild, moderate, and severe TBI, respectively. Road traffic crashes were responsible for 74% of cases, with motorcycle accidents (46%) much greater than motor vehicular accidents (28%), mostly pedestrian (51%). Fall from heights accounted for 21%, mostly in toddlers. A total of 70% had associated injuries, mainly skull fractures (54%) and soft-tissue injuries (47%). In total, 31% had post-traumatic seizures. Only 40 (31%) had a cranial computed tomography scan. Common findings were contusions in 70%, extradural hematomas in 28%, and intracranial aerocoeles in 18%. There were no neurosurgical lesions in 20%. Six had operative intervention. Mortality rate was 12%. In total, 84% had good recovery. The average follow-up period was 7 months. CONCLUSIONS: Children account for a large number of TBIs in our environment, which are mostly from road traffic crashes and falls. Only a few received computed tomography scan of the brain. Most cases had nonoperative care, and outcomes are worse with increasing severity of head injury. Specific preventive measures need to be formulated and/or enforced by governments at all levels.

A Study on Epidemiology of Unintentional Childhood Injury at One of the Districts of Gujarat State: An Indian Council of Medical Research Task Force Study.

Context: Childhood injuries are a less explored area of public health. In the presence of public health problems such as communicable and noncommunicable diseases, childhood injury has gained less attention from the health system. Aims: The aim of the study was to assess the prevalence of various types of unintentional injuries (UI) amongst children and to assess the factors associated with same. Settings and Design: The study was conducted at Ahmedabad District of Gujarat State, and this is a cross-sectional sStudy. Subjects and Methods: The current study was a part of a multicentric national level research supported by Indian Council of Medical Research. Total 11 sites were selected across India, which all followed a uniform methodology. One of the selected sites was Dholka taluka of Ahmedabad district, Gujarat. This cross-sectional study was conducted in 2341 households. The study participants were children aged from 6 months up to 18 years. A total of 3018 children and their caretakers were interviewed using software-based questionnaire. Statistical Analysis Used: Statistical analysis was performed by frequencies and Percentage, Chi-square Test, Z-Test. Results: The overall prevalence of injuries was 7.62%. Gender and area of residence were significantly associated with UI. Fall-related injuries had the highest prevalence (3.38%), followed by road traffic injuries (RTI) (1.62%). The prevalence of burn-related injuries and poisoning was higher among females compared to males. No mortality was observed due to UI. Conclusions: Majority of the injuries were of minor or trivial type. Fall-related injury and RTI were the most common types of UIs among children.

Evaluation of forensic cases presented to the pediatric emergency department.

OBJECTIVE: Child forensic cases constitute an essential part of emergency presentations. The most crucial point is that the correct planning of protective and preventive activities depends on the correct analysis of the problem; therefore, there is a need for studies on childhood forensic cases. This study aimed to obtain data on the etiological characteristics of forensic cases presented to the pediatric emergency department. We believe that the collected data will guide the social measures in preventing forensic cases. METHODS: This retrospective study consists of forensic cases aged from 1 month to 18 years and presented to the pediatric emergency service of Adana City Training and Research Hospital between January 1, 2018, and December 31, 2019. The general forensic examination report of the cases was surveyed. RESULTS: For this study, 6577 general forensic examination reports were surveyed. 40% of the patients were females, and 60% were males. Traffic accidents were the most common (35.1%) cause of the emergency presentation, which was followed by assault (16.5%), fall from height (9.2%), accidental drug-caustic corrosive substance intake (7.8%), early pregnancy (7.4%), blunt or sharp force injuries (6.3%), electrical burn injuries (5.7%), suicide (5.1%), carbon monoxide-food poisoning (2.7%), and others that consisted of work accident, firearm injury, substance ingestion, suffocation, animal attack, sudden death, and missing child (4.2%). CONCLUSIONS: This most extensive study with 6577 cases has several important implications. First of all, traffic accidents continue to be an important public health problem today. Second, cases presented to the emergency department due to assault and blunt or sharp force injuries constitute an important part of forensic cases, and children who are driven to violence and crime in childhood are a situation that requires immediate action. Our third yet most important result is that early pregnancy is a much ignored social problem despite its importance.

Risk factors and parental risk perception of unintentional home injuries of children under 6 years in Germany: A secondary data analysis.

INTRODUCTION: Unintentional home injuries are a major health risk for children. To develop and implement appropriate interventions, both theoretical guidance and empirical evidence are required. While theoretical models informing injury prevention are available, detailed information on unintentional home injuries of children and parental risk perception is still missing. The objective of this study was to identify relevant determinants of unintentional home injuries of children under 6 years of age and parental risk perception from an empirical perspective. METHOD: The secondary data analysis is based on data from two nationally representative surveys from Germany conducted in 2014-2017 (n = 4,009) and 2019 (n = 411). Both bivariate analyses and multivariate binary logistic regression models were conducted to determine the associations between various factors with unintentional home injuries and parental risk perception. RESULTS: Key determinants of unintentional home injuries included the age and personality of the child, migrant status, and housing tenure. Parental risk perception was significantly associated with children's sex. The number of children living in the household and household net income were identified as determinants for both unintentional home injuries and parent's risk perception. Furthermore, a discrepancy between parent's risk perception and actual risk factors of unintentional home injuries was found. CONCLUSIONS: Findings from this study strengthen the evidence base by demonstrating relevant determinants of unintentional home injuries of children and parent's risk perception. Since this study provides first evidence of a distorted parental risk perception, future research should focus on parental risk perception to assess it more accurately in interventions to prevent unintentional home injuries of children. PRACTICAL APPLICATIONS: The present findings may inform health practitioners about which points they should address when interacting with parents. For instance, they should focus on raising parent's awareness of actual risk factors and discuss concrete behavioral or environmental safety precautions.

Study on the Causes, Types, and Mechanisms of Childhood Injuries-Age and Disease Specificity.

INTRODUCTION: To clarify the causes, types, and mechanisms of injuries in children, we collected injury cases and analyzed their causes. METHODS: During the 3-year period from 2013, we collected injury cases from three sources: nursery schools and kindergartens (A), emergency clinics of hospitals (B), and schools and a clinic for the developmentally disabled (C), using a format designed by Safe Kids Japan. RESULTS: In all, 383 cases were collected during the 3-year period. The causes of the injuries in group A were crashes, falls, and so on. The types of injuries were cuts, bruises, fractures, injuries of teeth, etc. Dislocations and abrasions were prominent in nursery school children (aged less than 3 years) and bone fractures were prominent in kindergarten children aged more than 3 years.Group B consisted of 144 cases. The most common causes of injuries were falls, traffic accidents, and so on, and the types of injuries were fractures, abrasions, sprains, etc. The incidence of fractures was particularly high and 50% of the accidents were bicycle accidents.Group C consisted of 41 cases. Although the age distribution was similar to that of group B, the types of accidents and injuries were similar to those of group A.The Bodygraphic Injury Surveillance System (BISS) analysis showed that groups A and C were similar, that is, injuries occurred mainly to the head, whereas in group B, the extremities were mainly affected. CONCLUSIONS: We analyzed the causes, types, and mechanisms of childhood injuries. The BISS may help to clarify the mechanisms of injuries in childhood.

The Socioeconomic Characteristics of Childhood Injuries in Regional Victoria, Australia: What the Missing Data Tells Us.

BACKGROUND: Injury is the leading cause of death among those between 1-16 years of age in Australia. Studies have found that injury rates increase with socioeconomic disadvantage. Rural Urgent Care Centres (UCC) represent a key point of entry into the Victorian healthcare system for people living in smaller rural communities, often categorised as lower socio-economic groups. Emergency presentation data from UCCs is not routinely collated in government datasets. This study seeks to compare socioeconomic characteristics of children aged 0-14 attending a UCC to those who attend a 24-h Emergency Departments with an injury-related emergency presentation. This will inform gaps in our current understanding of the links between socioeconomic status and childhood injury in regional Victoria. METHODS: A network of rural hospitals in South West Victoria, Australia provide ongoing detailed de-identified emergency presentation data as part of the Rural Acute Hospital Data Register (RAHDaR). Data from nine of these facilities was extracted and analysed for children (aged 0-14 years) with any principal injury-related diagnosis presenting between 1 February 2017 and 31 January 2020. RESULTS: There were 10,137 injury-related emergency presentations of children aged between 0-14 years to a participating hospital. The relationship between socioeconomic status and injury was confirmed, with overall higher rates of child injury presentations from those residing in areas of Disadvantage. A large proportion (74.3%) of the children attending rural UCCs were also Disadvantaged. Contrary to previous research, the rate of injury amongst children from urban areas was significantly higher than their more rural counterparts. CONCLUSIONS: Findings support the notion that injury in Victoria differs according to socioeconomic status and suggest that targeted interventions for the reduction of injury should consider socioeconomic as well as geographical differences in the design of their programs.

Beware of the bicycle! An increase in paediatric bicycle related injuries during the COVID-19 period in Western Australia.

BACKGROUND: In Western Australia, the media has reported on an increase in the purchasing, repairs and use of bicycles during the COVID-19 period. The study aimed to investigate for a relationship in bicycle related injuries in the paediatric population during the time of COVID-19 restrictions. METHODS: A retrospective study of the incident of motorized and non-motorized bicycle related injuries and trauma presentations during the COVID-19 'shutdown' period from March to June 2020. Data were collected from the Emergency Department Information System, discharge summaries, operation and radiology reports. The data presented is from Perth Children's Hospital, the only tertiary paediatric hospital and the only referral centre for childhood trauma in the state of Western Australia. Participants were children aged 15 years and younger attending the emergency department (ED) at Perth Children's Hospital during the designated time period. The primary outcomes included total ED presentations, bicycle related presentations and bicycle related admissions during the COVID-19 period. RESULTS: Bicycle related presentations to the ED increased by 42.7% over the COVID-19 period from 1.4% to 3.0% of all children attending the ED. Children admitted to the hospital with bicycle related injuries or trauma increased by 48.7% from 76 to 113 children in comparison to the same period in 2019. CONCLUSION: During the period of COVID-19 restrictions, paediatric ED presentations decreased dramatically, but bicycle related injuries and trauma increased substantially. Safety equipment including helmets and protective gear should be worn for all children riding bicycles, and social distancing should be maintained.

Sociodemographic Characteristics and Risk Factors for Childhood Poisoning Reported by Parents at a Tertiary Care Teaching Hospital.

Background Childhood poisoning is a major health problem. Mostly, it is accidental and associated with low morbidity and mortality. The association between sociodemographic factors and childhood injury rates could be used for improvement to prevent and reduce such injuries. Childhood poisoning is preventable through appropriate education and judicious storage of drugs and household chemicals that might help in reducing and eliminating the accidental ingestion of toxic materials at home. Objectives To recognize the potential risk factors that might be associated with childhood home poisoning in Riyadh City, Kingdom of Saudi Arabia. Design A survey-based questionnaire study. Setting A tertiary care teaching hospital in Riyadh City. Patients and methods A structured questionnaire was created, which included questions on the poisoning incidence, home medication history, and possible risk factors for poisoning and the sociodemographic characteristics, and was disseminated to individuals who visited the King Khalid University Hospital. Main outcome measures Demographic characteristics of participants and risk factors related to childhood poisoning. Results The study included 152 randomly selected participants, 62 men (40.79%) and 90 women (59.21%). Self-ingestion was reported to be the most common mode of poisoning 28/44 (63.6%). The appearance of clinical manifestations suggesting poisoning was reported to be the most frequent method of discovery of children poisoning 20/44 (45.5%). Thirty-six out of the 44 respondents (81.8%) with a positive history of childhood poisoning in their family transferred their children to a hospital immediately. Drugs were the most common causative agent reported for poisoning among the respondents 21/44 (47.7%). Conclusion Accidental and non-intentional self-ingestion still presents as a major mode of childhood home poisoning. Despite the significant advancement in the lifestyle among the majority of Saudi Arabian regions, especially the capital city Riyadh, childhood poisoning remains a significant cause of morbidity and possible mortality. Creating health education and prevention programs might help to prevent such serious preventable problems. Limitations The limited number of participants may not reflect the whole population living in Riyadh City, hence, interpretation of the study results might be taken cautiously. Conflict of interest There was no conflict of interest.

Childhood unintentional injury: The impact of family income, education level, occupation status, and other measures of socioeconomic status. A systematic review.

INTRODUCTION: Unintentional injuries represent a substantial public health burden among children and adolescents, and previous evidence suggests that there are disparities in injury by socioeconomic status (SES). This paper reports on a systematic review of literature on injury rates among children and adolescents by measures of SES. METHODS: A systematic literature search was conducted using six electronic databases: MEDLINE, PsycINFO, CINAHL, HealthSTAR, EMBASE, and SportsDiscus. This review considered children ages 19 years and under and publications between 1997 and 2017-representing an update since the last systematic review examined this specific question. Fifty-four articles were summarized based on study and participant descriptions, outcome and exposure, statistical tests used, effect estimates, and overall significance. RESULTS: Most articles addressed risk factors across all injury mechanisms; however, some focused particularly on burns/scalds, road traffic injuries, falls/drowning cases, and playground/sports injuries. Other studies reported on specific injury types including traumatic dental injuries, traumatic brain injuries, and fractures. The studies were of moderate quality, with a median of 15.5 (95% confidence interval [CI]: 15.34 to 15.66) out of 19. Thirty-two studies found an inverse association between SES and childhood unintentional injury, three found a positive association while twenty were not significant or failed to report effect measures. CONCLUSION: Given the variability in definition of the exposure (SES) and outcome (injury), the results of this review were mixed; however, the majority of studies supported a relationship between low SES and increased injury risk. Public health practice must consider SES, and other measures of health equity, in childhood injury prevention programming, and policy.

Appalachian Caregiver Perspectives on Childhood Gun Safety in the Home.

Background: Childhood gun injuries pose a critical public health challenge. For children, unintentional gun injury deaths primarily occur in the home where parents or other adult guardians, referred to as caregivers hereafter, are responsible for safety. While the American Academic of Pediatrics recommends not having guns in areas where children live and play, firearms are often viewed as normative and fill an important role in many homes. This is particularly true in more rural areas, such as Appalachia, where there is a high density of gun ownership. Additional research is needed to understand rural caregivers' current gun safety practices in the home. Purpose: The purpose of this study was to gain an understanding of Appalachian caregivers' gun safety practices, perspectives, and attitudes to assist public health professionals develop more effective interventions and targeted messaging. Methods: Ten Appalachian caregivers were interviewed for a qualitative, phenomenologic study designed to elicit an in-depth understanding of firearm safety strategies in the home. An inductive analytic approach to coding and analysis was used to identify main themes and ideas. Results: Current attitudes, practices, and perspectives focused on the primary childhood injury prevention strategies of education, environmental change, and supervision. Findings matched and expanded upon previous literature in the field. Implications: Cross-cutting themes were identified that have practical implications for the development of public health interventions and messaging for this at-risk population.