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3.
Artículo en Inglés | MEDLINE | ID: mdl-34158405

RESUMEN

BACKGROUND: Unintentional home injuries are a leading cause of preventable death in young children. Safety education and equipment provision improve home safety practices, but their impact on injuries is less clear. Between 2009 and 2011, a national home safety equipment scheme was implemented in England (Safe At Home), targeting high-injury-rate areas and socioeconomically disadvantaged families with children under 5. This provided a 'natural experiment' for evaluating the scheme's impact on hospital admissions for unintentional injuries. METHODS: Controlled interrupted time series analysis of unintentional injury hospital admission rates in small areas (Lower Layer Super Output Areas (LSOAs)) in England where the scheme was implemented (intervention areas, n=9466) and matched with LSOAs in England and Wales where it was not implemented (control areas, n=9466), with subgroup analyses by density of equipment provision. RESULTS: 57 656 homes receiving safety equipment were included in the analysis. In the 2 years after the scheme ended, monthly admission rates declined in intervention areas (-0.33% (-0.47% to -0.18%)) but did not decline in control areas (0.04% (-0.11%-0.19%), p value for difference in trend=0.001). Greater reductions in admission rates were seen as equipment provision density increased. Effects were not maintained beyond 2 years after the scheme ended. CONCLUSIONS: A national home safety equipment scheme was associated with a reduction in injury-related hospital admissions in children under 5 in the 2 years after the scheme ended. Providing a higher number of items of safety equipment appears to be more effective in reducing injury rates than providing fewer items.

7.
BMJ ; 371: m4389, 2020 11 16.
Artículo en Inglés | MEDLINE | ID: mdl-33199291
8.
Inj Prev ; 26(6): 573-580, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33067223

RESUMEN

BACKGROUND: Unintentional injuries in children under the age of 5 years commonly occur in the home and disproportionately affect those living in disadvantaged circumstances. Targeted home safety promotion should be offered to families most at risk but there is a paucity of standardised evidence-based resources available for use across family-support practitioners. OBJECTIVE: To assess the effectiveness, implementation and cost-effectiveness of a 2-year home safety programme (Stay One Step Ahead) developed by parents, practitioners and researchers, and delivered by a range of family support providers in inner-city localities, compared with usual care in matched control localities. METHODS: Parents of children aged 0 to 7 months will be recruited to a controlled before and after observational study. The primary outcome is home safety assessed by the proportion of families with a fitted and working smoke alarm, safety gate on stairs (where applicable) and poisons stored out of reach, assessed using parent-administered questionnaires at baseline, 12 and 24 months.Secondary outcomes include: the impact on other parent-reported safety behaviours, medically-attended injuries, self-efficacy for home safety and knowledge of child development and injury risk using questionnaires and emergency department attendance data; implementation (reach, acceptability, barriers, facilitators) of home safety promotion assessed through interviews and observations; and cost-effectiveness using medically-attended injury costs ascertained from healthcare records. CONCLUSION: If shown to be effective and cost-effective this study will provide a practical resource to underpin national guidance. The study could inform public health prevention strategies to reduce home injury in children most at risk, while delivering cost savings to health and care services. TRIAL REGISTRATION NUMBER: ISRCTN31210493; Pre result.

10.
BMJ ; 369: m1412, 2020 04 14.
Artículo en Inglés | MEDLINE | ID: mdl-32291268
11.
Burns ; 46(5): 1179-1192, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-32192866

RESUMEN

BACKGROUND: Burn injuries disproportionally affect the world's poorest populations. However, there has been a lack of research that has investigated the social, cultural or contextual factors associated with this injury mechanism in these areas. As a result, there is a scarcity of information from which to develop culturally appropriate and targeted burn prevention initiatives. METHODS: A community survey was used to identify households to take part in this qualitative study. Semi-structured interviews were conducted with 32 parents from four different villages in Malawi to discuss their experiences of burn injuries sustained by children in the household as well as any existing preventative strategies used. In addition, 29 of the study households took part in an observation exercise to identify and discuss burn hazards present around the home environment. Transcripts and observations were recorded and transcribed verbatim. A thematic approach was used to analyse the data. RESULTS: The final themes could be categorised into three key areas: parental perception of hazards around the home; socio-cultural and developmental factors associated with burn injuries; and parental perception of burns prevention. Factors associated with unintentional burn injuries, as perceived by parents, included: increased exposure to hazards, children's play and development activities, increased fire use during the morning hours and the children's household roles and responsibilities. Although some parents identified possible burns prevention strategies numerous barriers to prevention were highlighted including: poverty, poor housing infrastructure and restrictions, knowledge deficit, inability to provide adequate supervision and the child's behaviour. CONCLUSIONS: Parents recognise that there are a number of burn hazards and risks present around the home however factors that prevented them acting included: a lack of knowledge about injury prevention, a lack of household safety equipment, a lack of control to make alternations to their housing and an inability to adequately supervise their children. In the future it is crucial that the local context and community are consulted in the development of any future burn injury prevention strategies to ensure that they are appropriate, accepted and effective.

12.
BMJ ; 368: m544, 2020 02 11.
Artículo en Inglés | MEDLINE | ID: mdl-32046956
13.
BMJ ; 367: l6396, 2019 11 12.
Artículo en Inglés | MEDLINE | ID: mdl-31719158
14.
Prim Health Care Res Dev ; 20: e146, 2019 10 30.
Artículo en Inglés | MEDLINE | ID: mdl-31663491

RESUMEN

BACKGROUND: Health professionals are key stakeholders who potentially have important roles in preventing unintentional child home injuries. This study aimed to identify facilitators and barriers to the prevention of unintentional child home injuries perceived by health professionals. DESIGN: A generic qualitative study involving semi-structured interviews. SETTING: The capital city of Iran. METHOD: Data for this study were collected through 28 in-depth interviews with health professionals. Purposive sampling was conducted from three areas of Tehran based on their socio-economic development. FINDINGS: Thematic data analysis yielded nine overarching themes: prioritising child home injury, knowledge, the nature of injury and injury prevention, child-related factors, parent-related factors, living environment, cultural issues, resources and management. CONCLUSIONS: Health professionals can potentially be supportive to meet families' needs. However, further support and resources will be required if they are to fully develop their potential in preventing injuries in the home. The lack of a national action plan was a significant constraint for health professionals.


Asunto(s)
Prevención de Accidentes , Personal de Salud/psicología , Vivienda , Heridas y Lesiones/prevención & control , Niño , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Entrevistas como Asunto , Irán , Masculino , Investigación Cualitativa , Heridas y Lesiones/etiología
15.
BMJ ; 365: l4300, 2019 Jun 25.
Artículo en Inglés | MEDLINE | ID: mdl-31239261
16.
BMJ ; 365: l4158, 2019 Jun 14.
Artículo en Inglés | MEDLINE | ID: mdl-31201198
17.
Arts Health ; 11(3): 246-263, 2019 10.
Artículo en Inglés | MEDLINE | ID: mdl-31038436

RESUMEN

Background: There are few research studies reporting findings from creative writing groups amongst refugees and people seeking asylum. This study evaluates the educational, wellbeing, social and satisfaction outcomes of writing groups across three cities in the UK. Methods: This study employs a mixed-method design comprising: a thematic analysis of writers' (facilitators) diaries, demographic and satisfaction survey and 14 qualitative interviews. Results: The project delivered a creative writing programme for refugees and people seeking asylum in three UK cities. This evaluation has determined that it provided both educational and wellbeing outcomes for 144 attendees. Participants asserted that they had improved their English language and wellbeing. Satisfaction was extremely high across the cities. Participants reported increased confidence and an increased sense of hope. Conclusions: Professionally led creative writing groups may be effective in enabling people to help come to terms with past experiences and find ways of coping for the future.


Asunto(s)
Refugiados , Apoyo Social , Escritura , Adulto , Anciano , Femenino , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Adulto Joven
18.
Int J Health Plann Manage ; 34(4): 1133-1143, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-30924975

RESUMEN

BACKGROUND: Unintentional injuries are an important global public health problem. Potentially, some senior managers have a major role to play in the prevention of home injuries. AIMS: To explore senior managers' perceptions and practices regarding the prevention of home injuries among children and the potential factors that might influence such practice in Ramallah District of Palestine. METHOD: Qualitative interviews were undertaken using a purposive sampling strategy of 18 senior-level managers. Thematic analysis was undertaken. RESULTS: The study revealed that half of the interviewed managers' thought that injury prevention was a priority, and the majority of their institutions had worked on increasing parental awareness regarding injury prevention. Nevertheless, their practice in providing financial and psychological support to the parents was reported less. The participants stated that many factors had interchangeably influenced the practice in injury prevention, including factors related to staff, parents, and environment. CONCLUSION: This study highlights the importance of managers' role in injury prevention and draws attention to the numerous obstacles that they face. Attempts to prevent injuries should use a combination of interventions at many levels including: parents, health staff, as well as the wilder governmental, physical.


Asunto(s)
Accidentes Domésticos/prevención & control , Árabes , Heridas y Lesiones/prevención & control , Adulto , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , Padres , Investigación Cualitativa , Adulto Joven
20.
Compr Child Adolesc Nurs ; 42(3): 172-189, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-29578812

RESUMEN

Unintentional injuries are a growing global public health problem that causes mortality, morbidity, and disability among children. These injuries are common among under-fives and form a significant burden on healthcare systems, particularly in low- and middle-income countries. Nurses and doctors have a major role to play in the prevention of home injuries, as expressed in many international reports. In Palestine, there is a paucity of research in this area. Therefore, this study aims to explore nurses' and doctors' perceptions and practices regarding the prevention of home injuries among children aged under-five years. A qualitative approach was followed, whereby semi-structured interviews were undertaken with 24 nurses and doctors who worked with children in a primary health care setting. The derived data were analyzed using thematic analysis. This study found that most of the nurses and doctors who were interviewed reported positive attitudes toward working on this topic; the majority of them attempted to work on injury prevention. Nevertheless, they needed further support to fulfil this potential role, as they faced many barriers in their daily practice in this area. Policy makers could potentially take advantage of this attitude and support them by providing training, resources, and time for them to implement this role.


Asunto(s)
Accidentes Domésticos/prevención & control , Árabes/psicología , Personal de Salud/psicología , Percepción , Heridas y Lesiones/prevención & control , Accidentes Domésticos/estadística & datos numéricos , Árabes/estadística & datos numéricos , Personal de Salud/estadística & datos numéricos , Humanos , Investigación Cualitativa
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