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Background: Approximately 15% of pediatric firearm injuries are unintentional. While demographic characteristics of unintentional firearm injuries have been described, the relationship between injury characteristics and mortality is not well understood. In this study, we identified injury characteristics associated with fatality among unintentional firearm injuries in adolescents. Methods: We conducted a retrospective (May 2022-May 2023) cross-sectional study of unintentional firearm injuries among adolescents 12–17 years old using the Gun Violence Archive. Variables included victim age and sex, shooter age and sex, injury location, injury circumstance, number of firearms, type of firearm, firearm owner, census region, and shooter relationship to the victim. Logistic regression was used to identify variables associated with fatality. Results: Of 319 unintentional incidents, 212 (66.5%) were non-fatal and 107 (34.5%) were fatal. Of all shootings, 176 (55.2%) occurred in a residence. A shooter was identified in 256 (80.3%) cases; 43.0% of these were a peer of the victim. The adjusted odds of fatality were higher when a peer was the shooter (aOR 5.38, 95% CI 2.57, 11.80) compared to self-inflicted injury and when the shooting took place in the victim's residence (aOR 2.87, 95% CI 1.07, 7.88) or another residence (aOR 3.03, 95% CI 1.45, 6.67) versus a public location (Fig. 1). Conclusions: Unintentional firearm injuries were more likely fatal when a peer was the shooter and when the shooting occurred at a residence. This amplifies the importance of safe home firearm storage and exploring other evidence-based approaches to decreasing youth access to firearms. [ABSTRACT FROM AUTHOR]

Abstract Background Approximately 15% of pediatric firearm injuries are unintentional. While demographic characteristics of unintentional firearm injuries have been described, the relationship between injury characteristics and mortality is not well understood. In this study, we identified injury characteristics associated with fatality among unintentional firearm injuries in adolescents. Methods We conducted a retrospective (May 2022-May 2023) cross-sectional study of unintentional firearm injuries among adolescents 12–17 years old using the Gun Violence Archive. Variables included victim age and sex, shooter age and sex, injury location, injury circumstance, number of firearms, type of firearm, firearm owner, census region, and shooter relationship to the victim. Logistic regression was used to identify variables associated with fatality. Results Of 319 unintentional incidents, 212 (66.5%) were non-fatal and 107 (34.5%) were fatal. Of all shootings, 176 (55.2%) occurred in a residence. A shooter was identified in 256 (80.3%) cases; 43.0% of these were a peer of the victim. The adjusted odds of fatality were higher when a peer was the shooter (aOR 5.38, 95% CI 2.57, 11.80) compared to self-inflicted injury and when the shooting took place in the victim’s residence (aOR 2.87, 95% CI 1.07, 7.88) or another residence (aOR 3.03, 95% CI 1.45, 6.67) versus a public location (Fig. 1). Conclusions Unintentional firearm injuries were more likely fatal when a peer was the shooter and when the shooting occurred at a residence. This amplifies the importance of safe home firearm storage and exploring other evidence-based approaches to decreasing youth access to firearms.

Background: A community-based study on childhood injuries would provide valuable information on the epidemiology of injuries to undertake appropriate preventive measures. Therefore, the current study was conducted in urban poor resettlements of Rishikesh to estimate the prevalence of unintentional injuries and to document the sociodemographic risk factors associated with unintentional injuries among under-five children. Aims and Objectives: Estimation of the prevalence of unintentional injuries and their risk factors among under-five children of urban poor resettlements in Rishikesh. Materials and Methods: A community-based cross-sectional study was conducted in urban poor resettlement areas of Rishikesh for a period of 1 year. It included 300 children selected using a simple random sampling technique to collect data on injury status. Results: The prevalence of unintentional injury among study participants was 16%. Falls were (64.6%) the major cause of injury, followed by dog bites (12.5%). The major sites of the injury were the head (25%), face (22.9%), upper limb (27.1%), and lower limb (18.8%).75% of the injuries happened at home. 66% of injuries happened when the child was playing alone or playing with peers. About 20.8% of injuries were bruises or superficial injuries. 39.6% of children had cut/bite/open wound injuries. Fractures happened in 14.6% of injured children. More than half (54.2%) of children did not develop any physical disability due to injury. Among children who developed a disability, more than 90% are able to recover completely. The majority of study participants were taken to nearby hospitals (66.6%) or health centers (10.4%). Only one of them went to a traditional bone setter, rest all visited either a general practitioner or pharmacy. The median expenditure for the treatment of the injured child was INR 425 (175-2750). The age of the child and unintentional injury showed a statistically significant association. Conclusion: The prevalence of the injury was 16% (12–20.7%) similar to a number of similar studies. Although the majority of the injuries were mild in severity, injuries have also contributed to temporary disability among children and have led to loss of school days.

Objectives: To characterise unintentional injury‐related hospitalisation and mortality amongst older adults (aged 50+ years) in the Lakes and Bay of Plenty District Health Boards of Aotearoa New Zealand and to examine whether hospitalisation patterns differed by ethnicity. Methods: This observational study analysed unintentional injury‐related hospitalisations and deaths among older adults between 2014 and 2018. Routinely collected national data sets were used to calculate annualised, age‐standardised injury rates. The independent variable of interest was ethnicity (Māori or non‐Māori). Results: There were 11,834 unintentional injury‐related hospitalisations in the study period (n = 1444 for Māori). Overall, there was no significant difference in the age‐standardised hospitalisation rate between Māori and non‐Māori (Standardised Rate Ratio [SRR] = 0.96 [95% CI 0.90, 1.02]). Falls were the most common mechanism of injury among Māori and non‐Māori overall (50% and 71%) and relative risks of falls increased with age. Non‐Māori were 57% less likely to be hospitalised for unintentional poisoning than Māori (SRR = 0.43, [0.34, 0.59]). Conclusions: The mechanisms of injury, and variation in unintentional injury‐related hospitalisation rates between Māori and non‐Māori, change throughout older age, and incidence increase0073 with age. Falls cause significant injury‐related hospitalisations for older Māori and responsive injury prevention and rehabilitation efforts are warranted to achieve equitable health outcomes. [ABSTRACT FROM AUTHOR]

ObjectiveTo analyze the research findings and development trends of parental safety literacy in relation to child injury prevention, and to establish a theoretical framework for the development of assessment tool on the parental safety literacy. MethodsThe literature, dissertations, expert consensus, and guidelines related to the assessment of unintentional injuries in children and health literacy tools published from January 1, 2002 to January 1, 2022 were retrieved from various databases including CNKI, Wanfang Dara, CQVIP, PubMed, and Web of Science. After conducting a comprehensive screening and analysis of the current state and identified shortcomings in 41 domestic and international articles concerning the assessment tools for children′s unintentional injuries and health literacy, a preliminary framework for evaluating tool dimensions was established. Based on the principles of involving multiple stakeholders and achieving information saturation, a panel consisting of 18 experts was selected for group discussions or one-on-one consultations. This process resulted in the development of a preliminary framework for the assessment tool based on expert opinions. ResultsA total of 13 universal health literacy assessment tools and 28 specific health literacy assessment tools were obtained through a systematic literature search. The universal assessment tool comprehensively measures health literacy based on its definition, while the specific assessment tool focuses on measuring certain dimensions of health literacy. Consultation with 18 experts revealed that a systematic and comprehensive understanding of the concept of literacy forms the basis for evaluating parents′ safety literacy, and the objective of the assessment tool for parents′ safety literacy should be to identify high-risk parents. The final evaluation framework encompasses five dimensions: access, understanding, belief, communication, and utilization. ConclusionCurrently, there is a shortage of assessment tools in China that comprehensively measure parental health literacy across all dimensions. To create a complete health literacy scale suitable for application, further summarization of the assessment dimensions of the scales is necessary.

Issue Addressed: Drowning is one of the leading causes of unintentional deaths among children and adolescents globally. Adult supervision is one method to decrease the risk of drowning among youth. Methods: We sought to assess the acceptability of a Water Watcher toolkit among children's caregivers. The toolkit consists of a badge—to designate the adult(s) responsible for supervision during water activities—and a smartphone application. When activated, the application blocks incoming calls, text messages and other applications, for example, mobile games and social media, as well as providing a button to quickly dial 911 and information for guided cardiopulmonary resuscitation. We conducted online and in‐person semi‐structured interviews of 16 adults residing in Washington State, United States and providing supervision to a child under 18 years of age for at least 20 h per week. Interview guides were developed based on the Health Belief Model and we performed content analysis on interview transcripts using an inductive approach. Results: When asked about Water Watcher tools, respondents generally reacted favourably towards the intervention, citing benefits of formally delegating a responsible party during group activities and elimination of distractions. Primary challenges to using the toolkit were social acceptability, competence with technology, and the independence of older children (i.e., those 13‐ to 17‐years‐old). Conclusions: Caregivers recognized the importance of minimizing distractions, and many liked the strategy to formally designate responsibility for child supervision during aquatic recreation. So What?: Interventions such as the Water Watcher toolkit are generally considered acceptable and expanding access to these resources could reduce the burden of unintentional drownings. [ABSTRACT FROM AUTHOR]

Objective How youth think about injury risk can affect their decisions about whether to engage in behaviors that can lead to injury. Appraisals also influence the development of post-traumatic stress symptoms (PTSS), which occur in approximately 20% of children after a medically treated injury. The current study examined how the injury appraisals of youth are associated with the development of PTSS post-skateboarding injury, and if PTSS or perceived benefits of the sport are also associated with youths' intentions to return to the sport. Method One hundred three youth who had a medically treated skateboarding injury within the last year provided survey data on injury appraisals, PTSS, the benefits of skateboarding, and intentions to return to the sport. Results A two-stage moderated statistical mediation path model was specified. In the first stage, there was a positive relationship between pain at injury and PTSS, which was attenuated by the moderator, perceived bad luck. PTSS fully mediated the association between perceived pain at the time of injury and intentions to return to skateboarding. In the second stage of the mediation model, the moderator perceived benefits of skateboarding, reversed the negative relationship between PTSS and intentions to return to skateboarding. Conclusions Skateboarders are a group at risk for injury that can lead to PTSS, and they also are likely to return to the sport despite PTSS. This research identifies factors that impact the decision to return to skateboarding after injury. Limitations of the study and implications for mental health support and injury prevention are provided. [ABSTRACT FROM AUTHOR]

Background: Injuries are the leading cause of death and disability in preschool children who are subject to specific risk factors. We sought to clarify the determinants of unintentional injuries in children aged 5 years and under in high‐income countries and report on the methodological quality of the selected studies. Methods: A systematic review was conducted of observational studies investigating determinants of unintentional injury in children aged 0–5. Searches were conducted in Web of Science, Medline, Embase, PsycInfo and CINAHL. All methods of data analysis and reporting followed the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA 2021) guidelines. Determinants are reported at the child, parental, household and area level. Results: An initial search revealed 6179 records. Nineteen studies met the inclusion criteria: 17 cohort studies and 2 case control studies. While studies included longitudinal surveys and administrative healthcare data analysis, the highest quality studies examined were case–control designs. Child factors associated with unintentional injury include male gender, age of the child at the time of injury, advanced gross motor score, sleeping problems, birth order, attention deficit hyperactivity disorder (ADHD) diagnosis and below average score on the standard strengths and difficulties scale. Parental factors associated with unintentional injuries included younger parenthood, poor maternal mental health, hazardous or harmful drinking by an adult within the home, substance misuse, low maternal education, low paternal involvement in childcare and routine and manual socioeconomic classification. Household factors associated with injury were social rented accommodation, single‐parent household, White ethnicity in the United Kingdom, number of children in the home and parental perception of a disorganised home environment. Area‐level factors associated with injury were area‐level deprivation and geographic remoteness. Conclusion: Child factors were the strongest risk factors for injury, whereas parental factors were the most consistent. Further research is needed to examine the role of supervision in the relationships between these risk factors and injury. Injury intent should be considered in studies using administrative healthcare data. Prospective research may consider utilising linked survey and administrative data to counter the inherent weaknesses of these research approaches. [ABSTRACT FROM AUTHOR]

In the USA, intentional and accidental injuries are the most frequent causes of death in children. Many of these deaths could be avoided through preventive measures, and aetiological studies are needed to reduce fatalities. The leading causes of accidental death vary by age. We analysed all paediatric accidental deaths recorded by a busy urban Medical Examiner"s Office in Chicago, Illinois (USA). We searched the electronic database for accidental deaths in children aged under 10 between 1 August 2014 and 31 July 2019. 131 deaths were identified with a preponderance of males and African Americans. This is consistent with ratios of other deaths recorded for this age group (during the same period and area). The leading causes of death were asphyxia due to an unsafe sleeping environment (in subjects <1-year-old), and road traffic accidents/drowning (in subjects >1-year-old). Behaviours, risk factors and environments most likely to contribute to fatal injuries are discussed. Our study highlights the role of forensic pathologists and medico-legal death investigators who identify the causes and circumstances surrounding these deaths. The research results may help from an epidemiological perspective to implement age-specific preventive strategies. [ABSTRACT FROM AUTHOR]

Pediatric unintentional injury significantly burdens children, families, and society. Behavioral researchers have examined the problem for decades, identifying many risk factors and greatly enhancing knowledge of the injury antecedent process. Approaches using theories and models to guide inquiry into etiology and prevention are still needed. We offer an approach borrowed from the field of human factors to enhance understanding and prevention. We focus our exploration on an error modeling and accident investigation tool called the Swiss Cheese Model. We first introduce the basic elements of the model. Next, we apply error modeling concepts to example scenarios drawn from real unintentional incidents and discuss the implications for understanding etiology and prevention. Finally, potential future directions are discussed to illustrate paths for the advancement of injury etiology and prevention. [ABSTRACT FROM AUTHOR]

Objective Over 7,000 American children die from pedestrian injuries annually, and pedestrian injury ranks among the top 5 causes of unintentional child death. Prevention efforts are multifaceted. One strategy, use of virtual reality (VR) to teach children to cross streets, is of growing interest to public health practitioners. The present study is a systematic review and meta-analysis that examined the efficacy of using VR to teach children pedestrian safety. Methods Following PRISMA guidelines, searches among 7 databases were completed, followed by abstract/full-text screening and data extraction. Hedge's g was computed for the effect sizes of 3 outcomes: pedestrian knowledge, pedestrian-relevant cognition (attention to traffic, time to contact, start delay), and pedestrian behaviors (safe crossings, unsafe crossings). Risk of bias was assessed using Cochrane guidelines. Meta-regression analyses and subgroup analyses were conducted including 3 moderators: age, sex, and immersion level. Results A total of 20 studies, reported in 24 articles, were included in the qualitative analysis. Meta-analysis of the 12 studies with sufficient quantitative data available showed a statistically significant medium effect of VR safety interventions on child pedestrian knowledge and behavior. Mixed results emerged for the effect of VR safety interventions on children's pedestrian-relevant cognition. Age and sex moderated the effect of VR training on pedestrian knowledge. Conclusions This synthesis of the literature on pediatric VR pedestrian safety interventions suggests an overall beneficial impact of VR interventions to teach children how to cross streets safely. Efforts should continue to develop and disseminate effective VR interventions. Registration ID CRD42022309352 [ABSTRACT FROM AUTHOR]

ObjectivesTo examine the epidemiological and clinical characteristics of hospitalized unintentional injuries among children in Central China and theoretically propose preventive and control measures.MethodsWe conducted a retrospective study of children aged 0–18 years with unintentional injuries who were admitted to a tertiary hospital in Central China from January 2017 to December 2023. We examined various aspects of the unintentional injuries, including age, gender, urban-rural distribution, external causes, trends, location of injury, cost, and length of stay.ResultsA total of 20,166 children with hospitalized unintentional injuries were enrolled. The median age with IQR was 2.8 (1.6, 5.1) years, with majority of the patients (57.0%) were aged 1–3 years, while the fewest were aged 11–18 years. The male-to-female ratio was 1.8:1, and the urban-to-rural ratio was 1.1:1. The most common external causes were foreign bodies (41.7%), exposure to inanimate mechanical forces (25.1%), and falls (22.1%). The most frequently injured body parts were head (72.5%). The total number of unintentional injuries exhibited an increasing trend from 2017–2022, and a decreasing trend from 2022–2023. The urban-rural distribution reversed after 2020. The overall hospitalization cost was 20,810,870.4 USD, with an median cost of 758.7 (556.4, 1,186.2) USD per person.ConclusionUnintentional injuries imposed a heavy burden on society and families. However, the number of cases and the urban-rural distribution showed significant trend changes from 2017–2023. The external causes varied by age group, gender, and region, while prevention and control measures should be developed accordingly.

ObjectiveTo analyze the epidemiological characteristics and wound healing conditions of common unintentional skin lacerations in children.MethodsA retrospective analysis was conducted on data from 1,107 children, aged 0–12 years, with skin lacerations who received emergency treatment at Qilu Hospital of Shandong University from January 1, 2019, to December 30, 2022. Data on age, injury site, time from injury to suturing, and wound healing conditions were statistically analyzed.ResultsAmong the 1,107 cases, 714 (64.5%) were male and 393 (35.5%) were female, with a male-to-female ratio of 1.8:1; median age was 5 years (IQR, 3–7). Infants and toddlers (0–3 years old) constituted the highest proportion, accounting for 36.3% (402 cases). The number of children aged over 3 years gradually decreased with increasing age. In younger children, the most common injuries were to the forehead, scalp, and lower jaw; in school-aged children, the proportion of limb and trunk injuries significantly increased. Age (OR, 1.34; 95% CI, 1.23–1.46), outdoor injuries (OR, 2.21; 95% CI, 1.18–4.16), lower limb injuries (OR, 5.35; 95% CI, 2.86–10.00), and wound length greater than 3 cm (OR, 10.65; 95% CI, 5.02–22.60) were significant risk factors for poor wound healing. The risk of poor wound healing increased by 34% for each additional year of age.ConclusionIn children, the common sites of unintentional skin lacerations show distinct age and gender distribution characteristics. Older age, outdoor injuries, longer wound lengths, and lower limb injuries are independent risk factors for poor wound healing.

Abstract Objectives This study aimed to identify the predictors of neurologic outcomes and mortality in physically abused and unintentionally injured children admitted to intensive care units (ICUs). Methods All maltreated children were admitted to pediatric, neurosurgical, and trauma ICUs between 2001 and 2019. Clinical factors, including age, sex, season of admission, identifying settings, injury severity score, etiologies, length of stay in the ICU, neurologic outcomes, and mortality, were analyzed and compared between the physically abused and unintentionally injured groups. Neurologic assessments were conducted using the Pediatric Cerebral Performance Category scale. The study was approved by the Institutional Review Board of Chang Gung Memorial Hospital and the Ethics Committee waived the requirement for informed consent because of the anonymized nature of the data. Results A total of 2481 children were investigated; of them, there were 480 (19.3%) victims admitted to the ICUs, including 156 physically abused and 324 unintentionally injured. Age, history of prematurity, clinical outcomes, head injury, neurosurgical interventions, clinical manifestations, brain computed tomography findings, and laboratory findings significantly differed between them (all p

Background Unintentional injuries are major threats to children's health, but most of them are preventable. Since the incidence and characteristics of distribution of unintentional injuries vary across regions, it is necessary to formulate preventive measures according to local characteristics. Objective To investigate the clinical characteristics of unintentional injuries in children in Ningbo, providing a theoretical basis for the development of relevant preventive and treatment measures. Methods This study retrospectively recruited 0-17-year-old children with unintentional injuries (including babies, toddlers, preschoolers, gradeschoolers and teens grouped by age) from Department of Emergency, Ningbo Women and Children's Hospital from August 2020 to July 2021. Clinical data were collected, including age, gender, registered residence, the way of getting to the hospital and pre-hospital emergency care, visit time, injury-to-admission time, places of occurrence of injury, cause of injury, site of injury, outcome of treatment, hospitalization time and hospitalization expenses. ICD-10 was used to classify the unintentional injuries, the children were divided into infancy (n=1 225), early childhood (n=5 116), preschool (n=4 447), school age (n=3 219) and adolescence (n=1 766) according to their age, and compared the types of unintentional injuries across the children by clinical data. Results Altogether, 15 773 cases〔including 9 608 males (60.91%) 〕were included, with a mean age of (5.3±3.6) years and a male to female ratio of 1.56∶1. Children with fall/fall injuries, burns and scald, cavity foreign body, poisoning, blunt instrument injury and electric shock injuries are mainly early childhood, road traffic injuries are mainly preschool age, and sharp instrument injuries are mainly school age. Most of the children were from rural areas〔59.15% (9 329/15 773) 〕. Children with rural household registration were mainly affected by falls/fall injuries, road traffic accidents, burns, foreign body aspiration, sharp instrument injuries, electric shocks and drowning. Children who suffered from falls, road traffic accidents and drowning mainly arrived at the hospital by self-driving. Children with fall/fall injuries, road traffic injuries, burns, poisoning, sharp device injuries, electric shock injuries and drowning are mainly treated without pre-hospital emergency rescue. Unintentional injuries occurred more frequently in summer〔27.27% (4 301/15 773) 〕. Road traffic injuries and burns are mainly in summer, blunt instrument injuries and electric injuries are mainly in autumn, and bites are mainly in spring and autumn. Unintentional injuries peaked in July and bottomed in February. Visits due to unintentional injuries peaked at 12:00 at noon and 20:00 in the evening. The injury-to-admission time in children with traffic injuries was shorter than that of those with the other injuries (P

Abstract Background Unintentional injuries among children and adolescents are a major public health problem worldwide. These injuries not only have negative effects on children’s physiology and psychology, but also bring huge economic losses and social burdens to families and society. Unintentional injuries are the leading cause of disability and death among Chinese adolescents, and left-behind children (LBC) are more prone to experience unintentional injury. The purpose of this study was to evaluate the type and incidence of unintentional injury among Chinese children and adolescents and explore the influences of personal and environmental factors by comparing the differences between LBC and not left-behind children (NLBC). Methods This cross-sectional study was conducted in January and February 2019. Additionally, 2786 children and adolescents from 10 to 19 years old in Liaoning Province in China were collected in the form of self-filled questionnaires, including Unintentional Injury Investigation, Unintentional Injury Perception Questionnaire, Multidimensional Subhealth Questionnaire of Adolescent (MSQA), Negative life events, “My Class” questionnaire and Bullying/victim Questionnaire. Multiple logistic regression analysis was used to explore the factors associated with unintentional injury among children and adolescents. Binary logistic regression analysis was used to explore the factors affecting unintentional injuries between LBC and NLBC. Results The top three unintentional injuries were falling injuries (29.7%), sprains (27.2%) and burns and scalds (20.3%) in our study population. The incidence of unintentional injuries in LBC was higher than that in NLBC. Burn and scalds, cutting injury and animal bites in LBC were higher than those in NLBC. The results show that junior high school students (odds ratio (OR) = 1.296, CI = 1.066–1.574) were more likely to report multiple unintentional injuries than primary school students. Girls (OR = 1.252, CI = 1.042–1.504) had higher odds of reporting multiple unintentional injuries. The odds of multiple injuries in children and adolescents with low levels of unintentional injury perception were higher than those in children and adolescents with high levels of unintentional injury perception (OR = 1.321, C = 1.013–1.568). Children and adolescents with a higher levels of mental health symptoms (OR = 1.442, CI = 1.193–1.744) had higher odds of reporting multiple unintentional injuries. Compared with teenagers who had never experienced negative life events, teenagers who had experienced negative life events many times (OR = 2.724, CI = 2.121–3.499) were more likely to suffer unintentional injuries many times. Low-level discipline and order (OR = 1.277, CI = 1.036–1.574) had higher odds of reporting multiple unintentional injuries. In-school adolescents who were bullied were more likely to report being injured multiple times than their counterparts who were not bullied (OR = 2.340, CI = 1.925–2.845). Low levels of unintentional injury perception, experienced negative life events and bullying had greater impacts on LBC than on NLBC. Conclusion The survey found that the incidence of at least one unintentional injury was 64.8%. School level, sex, unintentional injury perception, subhealth, negative life events, discipline and order and bullying were associated with incidents of unintentional injury. Compared with NLBC, LBC had a higher incidence of unintentional injury, and special attention should be given to this group.

Introduction: Worldwide injury & violence is most important cause of death in children, every year it causes death in approximately 950000 children under the age group of 18. This study was conducted to find out the magnitude & epidemiological factors associated with unintentional childhood injuries. Methods: The study was conducted in urban field practice area of a Medical College, in Southern India. Community based cross sectional study was conducted by enrolling 500 children (0-18 years) during October 2018 to September 2020. Multistage simple random sampling method was followed to select the participants. Source of data was Mother/Father. Predesigned pretested validated structured questionnaire was used to collect the data. Results: Period prevalence of unintentional childhood injury was 18.6%. Fall was reported as most common cause of injury among children. Fall, sharp injuries, burn was associated with certain environmental risk factors. Children were at risk of road traffic injuries, burns, sharp injuries, and fall. Protective factors against injury were children belonging to lower and middle socio-economic status, child with 1 sibling. Conclusions: Period prevalence of unintentional childhood injury was 18.6%. Majority of them had fall as a cause of injury, with the risk factors for fall in the child’s environment.

Objectives: This study aimed to identify the predictors of neurologic outcomes and mortality in physically abused and unintentionally injured children admitted to intensive care units (ICUs). Methods: All maltreated children were admitted to pediatric, neurosurgical, and trauma ICUs between 2001 and 2019. Clinical factors, including age, sex, season of admission, identifying settings, injury severity score, etiologies, length of stay in the ICU, neurologic outcomes, and mortality, were analyzed and compared between the physically abused and unintentionally injured groups. Neurologic assessments were conducted using the Pediatric Cerebral Performance Category scale. The study was approved by the Institutional Review Board of Chang Gung Memorial Hospital and the Ethics Committee waived the requirement for informed consent because of the anonymized nature of the data. Results: A total of 2481 children were investigated; of them, there were 480 (19.3%) victims admitted to the ICUs, including 156 physically abused and 324 unintentionally injured. Age, history of prematurity, clinical outcomes, head injury, neurosurgical interventions, clinical manifestations, brain computed tomography findings, and laboratory findings significantly differed between them (all p < 0.05). Traumatic brain injury was the major etiology for admission to the ICU. The incidence of abusive head trauma was 87.1% among the physically abused group. Only 46 (29.4%) and 268 (82.7%) cases achieved favorable neurologic outcomes in the physically abused and unintentionally injured groups, respectively. Shock within 24 h, spontaneous hypothermia (body temperature, < 35 °C), and post-traumatic seizure were strongly associated with poor neurologic outcomes and mortality in both groups. Conclusions: Initial presentation with shock, spontaneous hypothermia at ICU admission, and post-traumatic seizure were associated with poor neurologic outcomes and mortality in physically abused and unintentionally injured children. [ABSTRACT FROM AUTHOR]

Abstract Background Interactive and experiential learning programs have proven effective to teach children safety and prevent child unintentional injury. However, previously-published programs were designed primarily to address safety concerns of children living in urban, well-resourced areas, and therefore might be less effective or economically infeasible to distribute to children in resource-limited areas, such as those living in rural areas or underdeveloped regions. This proposed study will evaluate the effectiveness of teaching children safety lessons to rural preschoolers in China through the preschool-based Safety Experience Room intervention that was developed based on relevant theories, the lessons of previous intervention research, the characteristics of child injuries in underdeveloped rural areas, and the needs and circumstances of rural families and preschools in China. The study will also evaluate the cost-effectiveness of delivering the program. Methods and analysis A single-blinded, 12-month follow-up, parallel-group cluster randomized controlled trial with a 1:1 allocation ratio will be implemented in two selected counties. In total, at least 2378 rural preschoolers aged 3–6 years old will be recruited from 12 preschools, 6 in Yang County and 6 in Shicheng County. Clusters will be randomized at the preschool level and allocated to the control group (routine school-based education) or the intervention group (routine school-based education plus the Safety Experience Room education). External support strategies will be implemented by local partners to minimize attrition. Data collection will be conducted at baseline and then every 3 months during a 12-month follow-up time period. Intention-to-treat (ITT) data analysis will be used. Generalized estimation equations (GEE) will evaluate the effectiveness of the program and generalized cost-effectiveness analysis (GCEA) will evaluate the cost-effectiveness of it. A per-protocol (PP) sensitivity analysis will assess the robustness of ITT results. Subgroup analyses will be performed to evaluate the impact of socio-demographic factors on the intervention effect, following the same strategies as the primary analyses. Discussion The newly-designed Safety Experience Room program is expected to be feasible, effective, and financially beneficial. If these hypotheses prove true, we will take steps to disseminate the program to rural preschools across China. Trial registration Chinese Clinical Trial Registry ( http://www.chictr.org.cn ), CHiCTR2000038025, registered on 8 September 2020.

Background: Unintentional injuries among children and adolescents are a major public health problem worldwide. These injuries not only have negative effects on children's physiology and psychology, but also bring huge economic losses and social burdens to families and society. Unintentional injuries are the leading cause of disability and death among Chinese adolescents, and left-behind children (LBC) are more prone to experience unintentional injury. The purpose of this study was to evaluate the type and incidence of unintentional injury among Chinese children and adolescents and explore the influences of personal and environmental factors by comparing the differences between LBC and not left-behind children (NLBC). Methods: This cross-sectional study was conducted in January and February 2019. Additionally, 2786 children and adolescents from 10 to 19 years old in Liaoning Province in China were collected in the form of self-filled questionnaires, including Unintentional Injury Investigation, Unintentional Injury Perception Questionnaire, Multidimensional Subhealth Questionnaire of Adolescent (MSQA), Negative life events, "My Class" questionnaire and Bullying/victim Questionnaire. Multiple logistic regression analysis was used to explore the factors associated with unintentional injury among children and adolescents. Binary logistic regression analysis was used to explore the factors affecting unintentional injuries between LBC and NLBC. Results: The top three unintentional injuries were falling injuries (29.7%), sprains (27.2%) and burns and scalds (20.3%) in our study population. The incidence of unintentional injuries in LBC was higher than that in NLBC. Burn and scalds, cutting injury and animal bites in LBC were higher than those in NLBC. The results show that junior high school students (odds ratio (OR) = 1.296, CI = 1.066–1.574) were more likely to report multiple unintentional injuries than primary school students. Girls (OR = 1.252, CI = 1.042–1.504) had higher odds of reporting multiple unintentional injuries. The odds of multiple injuries in children and adolescents with low levels of unintentional injury perception were higher than those in children and adolescents with high levels of unintentional injury perception (OR = 1.321, C = 1.013–1.568). Children and adolescents with a higher levels of mental health symptoms (OR = 1.442, CI = 1.193–1.744) had higher odds of reporting multiple unintentional injuries. Compared with teenagers who had never experienced negative life events, teenagers who had experienced negative life events many times (OR = 2.724, CI = 2.121–3.499) were more likely to suffer unintentional injuries many times. Low-level discipline and order (OR = 1.277, CI = 1.036–1.574) had higher odds of reporting multiple unintentional injuries. In-school adolescents who were bullied were more likely to report being injured multiple times than their counterparts who were not bullied (OR = 2.340, CI = 1.925–2.845). Low levels of unintentional injury perception, experienced negative life events and bullying had greater impacts on LBC than on NLBC. Conclusion: The survey found that the incidence of at least one unintentional injury was 64.8%. School level, sex, unintentional injury perception, subhealth, negative life events, discipline and order and bullying were associated with incidents of unintentional injury. Compared with NLBC, LBC had a higher incidence of unintentional injury, and special attention should be given to this group. [ABSTRACT FROM AUTHOR]

Abstract Background Firearms are a substantial cause of injury-related morbidity and mortality in Canada and globally, though evidence from contexts other than the USA is relatively limited. We examined deaths, hospitalizations and emergency department (ED) visits due to firearm-related injuries in Canada to identify population groups at increased risk of fatal and non-fatal outcomes. Methods We conducted a population-based study using three national administrative databases on deaths, hospitalizations, and ED visits. ICD-10 codes were used to identify firearm-related injuries from January 1, 2016, through December 31, 2020. Fatal and non-fatal firearm injuries were classified as suicide/self-harm, homicide/assault, unintentional, undetermined or legal intervention injuries. We analyzed the data with counts, rates and proportions, stratified by sex, age group, province/territory, and year. Results Over the 5-year period, we identified 4005 deaths, 3169 hospitalizations, and 2847 ED visits related to firearm injuries in various jurisdictions in Canada. Males comprised the majority of fatal and non-fatal injury cases. The highest rates of fatal and non-fatal firearm injuries were among 20- to 34-year-olds. The leading cause of fatal firearm injuries was self-harm (72.3%). For non-fatal firearm hospitalizations and ED visits, assault (48.8%) and unintentional injuries (62.8%) were the leading causes of injury. Rates varied by province and territory. Conclusions Our results showed that males comprised the majority of fatal and non-fatal firearm injuries in Canada. The rates of both fatal and non-fatal firearm injuries were highest among the 20- to 34-year-old age group. This comprehensive overview of the epidemiology of firearm injuries in Canada provides baseline data for ongoing surveillance and policy evaluation related to public health interventions.

Introduction/Objective. Unintentional injuries is a global health issue among children and adolescents. The aim of this study was to examine the characteristics of unintentional injuries divided according to different age groups and sex among the children and adolescents who have been hospitalized in public hospitals of the Republic of Srpska, Bosnia and Herzegovina. Methods. A retrospective analysis of the e-base of the Agency for Certification, Accreditation and Health Care Quality Improvement of the Republic of Srpska data were collected from 10 public hospitals for patients aged ≤ 19 years, who have been hospitalized for unintentional injuries in the period of January 2018 and December 2020. Results. The study identified 1336 patients who were hospitalized for unintentional injuries, most of whom were boys (67.4%). Falls were the most frequent cause of hospitalization in children of all age categories (aged 1 (70.6%), 1–4 (59.1%), 5–9 (68.5%)) and adolescents aged 10–14 (64.1%), while road traffic injuries were the leading cause of hospitalization in adolescents aged 15–19 (62.6%). The cause of injury for the hospitalized patients were significantly related to age (p < 0.001) and sex (p < 0.05) groups. According to the nature of the injury in relation to the area of the body, the most frequent injuries were to the head (41.1%), caused by traffic accidents and falls. Conclusion. Since falls and road traffic injuries were the leading causes of hospitalization, preventive measures should be taken to reduce the frequency of these injuries.

ObjectiveTo analyze the characteristics of hospitalized unintentional injuries and to provide evidence for formulating injury prevention and control strategies.MethodsDescriptive analysis was conducted on injury information of unintentional injury cases reported from 22 monitoring hospitals during 2017 to 2020 by injury surveillance system. The composition ratio index was used to analyze and explore the distribution（population， time and place）of injuries related to different causes. The disease burden was described by the length of hospital stay and hospitalization cost.ResultsA total of 32 716 hospitalized unintentional injury cases were reported from 22 monitoring hospitals. The male to female ratio was 1.18∶1. The majority of males were aged 15‒64 years and the majority of females were aged over 45 years. The top three causes of injuries were falls， traffic-related and blunt injury. Injuries occurred more frequently in July and August. 42.81% of the cases occurred at home. Fracture cases accounted for 75.79%. The median length of hospital stay was 10 days and the median cost was 15 431.50 yuan. The share of both falls and non-motor vehicle accidents increased year by year.ConclusionFalls among elderly people and road traffic injuries are the main causes of hospitalized unintentional injuries， and sharp or blunt instrument injuries are more severe in the male workforce. Considering high direct and indirect economic losses from injuries， steps should to be taken to improve injury surveillance system and to implement injury prevention and control strategies targeted on key groups and key injuries.

Abstract Background Nursing experts regularly visited the community to deliver safety education on the prevention of unintentional injuries in children to the parents of children aged 0–6 years and to pregnant women in a maternity school. This was undertaken to explore the effects of the measure on preventing unintentional injuries in children in Chizhou, China. Methods Using the convenience sampling method, the guardians(it means mother in this study)of children were investigated. The nursing experts visited communities in which the number of nursing experts is declining. Data on unintentional injuries in children in the previous year were collected retrospectively. Results After the nursing experts delivered safety education to the community, the scores of the questionnaire on unintentional injury prevention knowledge completed by children’s guardians increased significantly (p 0.05). However, there were significant differences in terms of gender ratio and location (p

Abstract Background Emotional expression has been suggested to affect the well-being of individuals with unintentional injuries. However, few studies have investigated it as a heterogeneous phenomenon. The purpose of this study was to characterize the patterns of emotional expression among patients with unintentional injuries using latent profile analysis, and to examine the relationship among these latent profiles and cognitive processing, posttraumatic growth, and posttraumatic stress disorder. Methods A cross-sectional study was carried out at two general hospitals in Wenzhou, China. In total, 352 patients with unintentional injuries completed the socio-demographic questionnaire, Berkeley Expressivity Questionnaire, Ambivalence Over Emotional Expression Questionnaire, Event-Related Rumination Inventory, the Posttraumatic Growth Inventory, and PTSD Checklist-Civilian Version. Results Three unique profiles were identified: high emotional expressivity (n = 238, 67.6%), moderate emotional expressivity (n = 45, 12.8%), and low emotional expressivity (n = 69, 19.6%). The ANOVA and chi-square tests demonstrated significant differences among the three groups concerning deliberate rumination and posttraumatic growth. Multinomial logistic regression analysis indicated that monthly income and time since injury significantly predicted profile membership. Conclusions Most patients showed high emotional expressivity after an unintentional injury. Emotional expression profiles were associated with deliberate rumination and posttraumatic growth. Emotional expression interventions tailored for different profiles are warranted after an unintentional injury.

Abstract Background Unintentional injuries to children are a major public health problem. The online social media is a potential way to implement health education for caregivers in online communities. Using WeChat, a free and popular social media service in China, this study evaluated the effectiveness of social online community-based parental health education in preventing unintentional injuries in children aged 0–3. Methods We recruited 365 parents from two community health centers in Shanghai and allocated them into intervention and control groups randomly. Follow-up lasted for one year. The intervention group received and followed their WeChat group and a WeChat official account for dissemination of reliable medical information. The control group received only the WeChat group. Results Between the intervention and control groups, changes in unintentional injuries (OR = 1.71, 95% CI: 1.02–2.87, P = .04), preventability (β = 0.344, 95% CI: 0.152–0.537, P

Policy PointsTraditional approaches to addressing motor vehicle crashes are yielding diminishing returns. A comprehensive strategy known as the Safe Systems approach shows promise in both advancing safety and equity and reducing motor vehicle crashes.In addition, a range of emerging technologies, enabled by artificial intelligence, such as automated vehicles, impairment detection and telematics hold promise to advance road safety.Ultimately, the transportation system will need to evolve to provide the safe, efficient, and equitable movement of people and goods without reliance on private vehicle ownership, towards encouraging walking, bicycling and the use of public transportation. [ABSTRACT FROM AUTHOR]

Objectives: To provide a nationally representative estimate of the proportion of gun owners who report a child has independent access to one of their guns and to describe characteristics of these gun owners relative to other gun owning parents.Study Design: We conducted a cross-sectional analysis of online survey data collected in 2019 from a nationally representative sample of US adults in households with firearms (n=4030, response 65%). The sample comprised gun owning respondents living in homes with children (n=689) who were asked questions about their firearms, including how they were stored, and about whom other than themselves had access to their guns: "If you were not there, who in your household could get one of your guns (and load it if it is not loaded already) if they needed to?"Results: Twelve percent of US gun owners in homes with children report that a child has independent access to one of their guns (about one-fifth of those having children under age 12 only). Gun owners who reported child access were more likely than those who reported no child access to store guns unlocked and loaded, but still one fifth of those reporting access stored all guns locked and unloaded.Conclusions: We find that more than 10% of gun owners with children report that a child can independently access one of their guns, including parents who store all guns locked and unloaded, suggesting that guidance to parents should focus on access in addition to firearm storage. [ABSTRACT FROM AUTHOR]

Background: Interactive and experiential learning programs have proven effective to teach children safety and prevent child unintentional injury. However, previously-published programs were designed primarily to address safety concerns of children living in urban, well-resourced areas, and therefore might be less effective or economically infeasible to distribute to children in resource-limited areas, such as those living in rural areas or underdeveloped regions. This proposed study will evaluate the effectiveness of teaching children safety lessons to rural preschoolers in China through the preschool-based Safety Experience Room intervention that was developed based on relevant theories, the lessons of previous intervention research, the characteristics of child injuries in underdeveloped rural areas, and the needs and circumstances of rural families and preschools in China. The study will also evaluate the cost-effectiveness of delivering the program. Methods and analysis: A single-blinded, 12-month follow-up, parallel-group cluster randomized controlled trial with a 1:1 allocation ratio will be implemented in two selected counties. In total, at least 2378 rural preschoolers aged 3–6 years old will be recruited from 12 preschools, 6 in Yang County and 6 in Shicheng County. Clusters will be randomized at the preschool level and allocated to the control group (routine school-based education) or the intervention group (routine school-based education plus the Safety Experience Room education). External support strategies will be implemented by local partners to minimize attrition. Data collection will be conducted at baseline and then every 3 months during a 12-month follow-up time period. Intention-to-treat (ITT) data analysis will be used. Generalized estimation equations (GEE) will evaluate the effectiveness of the program and generalized cost-effectiveness analysis (GCEA) will evaluate the cost-effectiveness of it. A per-protocol (PP) sensitivity analysis will assess the robustness of ITT results. Subgroup analyses will be performed to evaluate the impact of socio-demographic factors on the intervention effect, following the same strategies as the primary analyses. Discussion: The newly-designed Safety Experience Room program is expected to be feasible, effective, and financially beneficial. If these hypotheses prove true, we will take steps to disseminate the program to rural preschools across China. Trial registration: Chinese Clinical Trial Registry (http://www.chictr.org.cn), CHiCTR2000038025, registered on 8 September 2020. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to determine the risk factors associated with unintentional injury in children aged 0–6 years. Design: This is a case‐control study. Sample: A total of 150 participants (n: 75 case group, n: 75 control group) were included in the study. The case group consisted of mothers of children who had unintentional injuries and the control group was composed of the mothers of children who did not have unintentional injuries. Measurements: Data were collected using the Participant Information Form and the Identification of Safety Precautions of Mothers with 0–6 year‐old Children for the Prevention of Unintentional Injuries Scale. Results: The mean attitude score of the mothers in the case group toward preventing unintentional injury (177.72 ± 15.53) was found to be higher than the mean score of the mothers in the control group (171.64 ± 17.93). An increase in mothers' scores on preventing unintentional injury reduces the risk of children having unintentional injuries 0.98 times. Conclusion: The findings of the study revealed that mothers' attitudes toward preventing injury, the birth order of the child, and the child having a disability increase risk for unintentional injury. [ABSTRACT FROM AUTHOR]

Introduction: Injuries continue to be a leading cause of death and contribute significantly to hospitalizations each year in Canada. Substance use has been associated with an increase in intentional and unintentional injuries, resulting in hospitalizations. This study examines trends in injury hospitalizations with a co-occurring substance diagnosis, to quantify the burden of injuries and identify at risk populations. Methods: We analyzed Discharge Abstract Database data between 2010/11 and 2020/21, for clinical and demographic information about hospital discharges across Canada. We used ICD-10 codes to identify injury hospitalizations with co-occurring substance diagnostic codes, by injury intent and substance type. Rates, proportions, age-specific rates and age-standardized rates were calculated, trends quantified using average annual percent change and results stratified by sex and age group. Results: From 2010/11 to 2020/21, unintentional injuries accounted for over half of all substance-related injury hospitalizations. Substance-related injuries accounted for 12% of total injury hospitalizations over this period. Overall, substance-related injury hospitalizations with co-occurring use of stimulants, opioids, cannabinoids and alcohol increased significantly among males and females. Unintentional substance-related, injury hospitalizations were more common later in life, and intentional substancerelated injuries were more common among adolescents and young adults. Conclusion: These results highlight key demographic groups with higher rates of substance-related injury hospitalizations that would benefit from targeted prevention efforts. [ABSTRACT FROM AUTHOR]

Unintentional injury prevention research focuses on parental supervision as critical to reducing toddler injury. We examine how the promotion of childproofing-as a mode of supervision-sells mothers "peace of mind" while also increasing "intensive mothering" and the "privatization of risk." Drawing on the childproofing literature and meaning centered interviews with mothers of toddlers and childproofing business owners, we argue that the connection made by these groups between childproofing and "good parenting" ultimately obscures how this form of harm reduction economically and socially individualizes responsibility for child care.

Introduction: Safe firearm storage is associated with a lower risk of firearm-related injury and death. Although providing firearm locking devices is a key component of firearm safety interventions, little is known about the types and characteristics of devices preferred by firearm users or others who make decisions about firearm storage. The aim of this study was to describe preferences for firearm locking devices and device features among firearm safety event participants.Methods: We conducted a cross-sectional survey in the State of Washington in 2016 that assessed participants’ preferences for five firearm locking devices (eg, trigger lock) and seven device features (eg, quick access). We categorized respondents (n=401) as adults in households with 1) all firearms locked, 2) at least one unlocked firearm, and 3) no firearms. We analyzed data in 2017.Results: Device ownership and feature preferences varied substantially but were similar across the three household categories. Of those residing with unlocked firearms, 84% reported they would consider using or definitely use a lock box, whereas 11% reported they would never use a trigger lock. Additionally, of those residing with unlocked firearms, 80% and 89% reported that the ability to lock a firearm while loaded and unlock it quickly were, respectively, “very important” or “absolutely essential.”Conclusion: Participants had differing preferences for firearm locking devices and device features, although preferences were largely similar across households with locked, unlocked, or no firearms. At least eight in ten participants reported “great importance” regarding the ability to lock a firearm while loaded and unlock it quickly, which is likely related to perceptions about the utility of safely stored firearms for household protection. Designing firearm safety interventions to match the needs and preferences of those who make firearm storage decisions may improve their effectiveness.

Introduction: Injuries are a major global public health problem. There are very few community-based studies on childhood injury from India in this study, we identified the distribution and risk factors for fall-related child injuries in the Chengalpattu district, Tamil Nādu community. Methodology: A descriptive analysis was done among 710 children of age up to 14 years residing in the Kattankulathur region in Tamil Nādu. The appropriate number of samples were recruited using the cluster sampling method by dividing the subjects into separate clusters and from each cluster 40 samples were obtained. The information on fall-related injury was collected according to mechanism of ‘injury’ Results: The annual incidence of fall-related injuries was 9.1 %. About 72.3% of children had injuries at home and 36% of the persons had fractures in the upper limb. 42% of children had disability in their hands. The age, gender, education and type of family was significant to injury. Conclusion: Our study reported a higher incidence of Fall injuries in Tamil Nādu when compared other studies done in India. Male children are the most common victims of injury and also identified homes, roads/streets as the most common places for the occurrences of fall injury in children.

Background: Firearms are a substantial cause of injury-related morbidity and mortality in Canada and globally, though evidence from contexts other than the USA is relatively limited. We examined deaths, hospitalizations and emergency department (ED) visits due to firearm-related injuries in Canada to identify population groups at increased risk of fatal and non-fatal outcomes. Methods: We conducted a population-based study using three national administrative databases on deaths, hospitalizations, and ED visits. ICD-10 codes were used to identify firearm-related injuries from January 1, 2016, through December 31, 2020. Fatal and non-fatal firearm injuries were classified as suicide/self-harm, homicide/assault, unintentional, undetermined or legal intervention injuries. We analyzed the data with counts, rates and proportions, stratified by sex, age group, province/territory, and year. Results: Over the 5-year period, we identified 4005 deaths, 3169 hospitalizations, and 2847 ED visits related to firearm injuries in various jurisdictions in Canada. Males comprised the majority of fatal and non-fatal injury cases. The highest rates of fatal and non-fatal firearm injuries were among 20- to 34-year-olds. The leading cause of fatal firearm injuries was self-harm (72.3%). For non-fatal firearm hospitalizations and ED visits, assault (48.8%) and unintentional injuries (62.8%) were the leading causes of injury. Rates varied by province and territory. Conclusions: Our results showed that males comprised the majority of fatal and non-fatal firearm injuries in Canada. The rates of both fatal and non-fatal firearm injuries were highest among the 20- to 34-year-old age group. This comprehensive overview of the epidemiology of firearm injuries in Canada provides baseline data for ongoing surveillance and policy evaluation related to public health interventions. [ABSTRACT FROM AUTHOR]

Objective: To investigate the prevalence and risk factors of cooking-related child burn injury. Methods: A cross-sectional community-based study was conducted among a total of 5830 children with their respective caretakers in randomly selected 100 clusters. Data were collected through face-to-face interviews using a structured questionnaire. Logistic regression was used to identify the risk factors and adjusted odds ratios were used as measures of effect. Results: The prevalence of cooking-related child burn injury was 6.2% (95% CI: 5.5–6.8). This burden was linked with risk factors such as lower literacy of caretaker, family size, using traditional cook stove, long cooking time, and presence of extra indoor burning events as well as lack of separate kitchen, child supervision, and injury prevention awareness. Conclusion: Children experience a high burden of burn injury. Thus, stakeholders should work to reduce this burden by controlling the aforementioned risk factors. [ABSTRACT FROM AUTHOR]

Background: Nursing experts regularly visited the community to deliver safety education on the prevention of unintentional injuries in children to the parents of children aged 0–6 years and to pregnant women in a maternity school. This was undertaken to explore the effects of the measure on preventing unintentional injuries in children in Chizhou, China. Methods: Using the convenience sampling method, the guardians(it means mother in this study)of children were investigated. The nursing experts visited communities in which the number of nursing experts is declining. Data on unintentional injuries in children in the previous year were collected retrospectively. Results: After the nursing experts delivered safety education to the community, the scores of the questionnaire on unintentional injury prevention knowledge completed by children's guardians increased significantly (p < 0.01). Among the children whose guardians completed the questionnaire, there were 157 cases of unintentional injury in 2020 and 103 cases in 2021 (p < 0.05). The types of unintentional injuries included scratches, falls, sharp object injuries, swallowing of foreign bodies, burns and traffic accidents; there was no statistical difference (p > 0.05). However, there were significant differences in terms of gender ratio and location (p < 0.05). Conclusion: In conjunction with the maternity school for pregnant women and the vaccination programme, nursing experts delivered safety education regarding unintentional injuries in children; this may have promoted safety and protection awareness in the children's guardians and reduced unintentional injuries. [ABSTRACT FROM AUTHOR]

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Background/Aim: Unintentional injuries among children and adolescents have become a common issue in public healthcare. The study objective was to analyse the characteristics and identify predictors associated with unintentional injuries in children and adolescents treated in emergency medical services (EMS) in the Republic of Srpska, Bosnia and Herzegovina. Methods: A cross-section study with retrospective analysis of WebMedic e-database from 14 EMS, in the period between January 2018 and December 2020 was conducted. Research included patients with unintentional injuries, aged ≤ 19 years, of both sexes. For comparison between groups, Chi-squared and multivariate logistic regression were used in risk factor analysis. Results: A total of 1,856 cases were identified, most injuries resulted from falls (46.7 %) and traffic injuries (26.9 %). Boys were significantly more affected by injuries than girls (p < 0.001). Falls were the major cause for reporting to EMS among age groups of children (0-9 years) and adolescents (10-14 years), whereas injuries in traffic were dominant in adolescents aged 15 to 19. The most common injuries were head injuries (35.7 %). Risk factors of unintentional injuries were age (p < 0.001), sex (p = 0.046), weekday (p = 0.016), winter (p = 0.014), body region (head, abdomen, lower and upper limbs (p < 0.001), thorax (p = 0.009)). Conclusions: There were significant differences in characteristics of unintentional injuries according to age and sex. Chances for occurrence of unintentional injuries among children increased with their age, especially for boys. These differences might indicate areas where preventive measures should be undertaken. [ABSTRACT FROM AUTHOR]

This study described the distribution of unintentional injuries among Inuit youth in Nunavik, Quebec, Canada, and examined the relationship between socio-demographic factors, substance use and unintentional injuries. A cross-sectional study design was used on data collected for the Nunavik Child Development Study (2013–2015) among eligible youth aged 16 to 21 years old. Unintentional injury occurrence and causes (last 12 months) were assessed through individual interviews. A multivariate logistic regression model tested the relationship between socio-demographic, substance use variables and unintentional injury occurrence. Among the 199 youth who participated (94% response rate), thirty youth reported being unintentionally injured in the past 12 months, of which 50% were female. All-terrain vehicle collisions were the most frequent injuries reported (23%). The odds of being injured decreased by 62% for youth who were currently employed compared to those who were unemployed, adjusting for other socio-demographic variables (p-value = 0.04). Heavy alcohol drinking in the past 12 months was not significantly associated with unintentional injury. This study highlights the burden of unintentional injuries among Nunavik youth and the need for future work to explore additional and diverse variables that may prevent or contribute to injuries in order to inform culturally and developmentally-appropriate injury prevention strategies. [ABSTRACT FROM AUTHOR]

AIM: To characterize a large cohort of patients presenting to the Department of Ophthalmology in Hunan Children's Hospital for ocular trauma, thus to offer supports for treatment and prevention of ocular trauma in children.METHODS:The retrospective study was conducted between January 2016 and December 2020, and the medical recorded of 2 298 children(2 332 eyes)diagnosed with ocular trauma in the Ophthalmology Department and Ophthalmic Emergency of Hunan Children's Hospital were reviewed. The record data included gender, age, wounded eye, time of day, injury month, cause of injury, zone of injury, types of ocular injury, complications, method of treatment and prognosis of visual acuity. RESULTS: The results showed that 44.26% of ocular trauma occurred in the age of 3-6 years old in children, and 1 718 cases(1 745 eyes)in male children versus 580 cases(587 eyes)in female children, with a male to female ratio of 2.96:1.00. The high incidence months were February and November for pediatric ocular injury. Collisions and falls were the main causes, accounting for 40.95%, following with blunt object injury and sharp object injury, accounting for 40.82%. Eyelid and other accessory organs were the main injury sites(65.40%). After injury, 58.62% of the children were treated with debridement, primary closure or topical administration of eye drops, 38.38% were treated with debridement and suturing, and 3.00% were treated with complex intraocular surgery. Most children patients were difficult to cooperate with the vision examination. Among the children who completed the vision examination, 60.60% showed visual impaired due to eye trauma. And after treatment, their vision improved to varying degrees. The severe impairment of visual acuity was mainly caused by corneal contusion, traumatic cataract, vitreous hemorrhage, bulbar foreign body and rupture of eyeball.CONCLUSION: Pediatric ocular injuries are usually accidental, with an increasing incidence in recent years. The majority of children with ocular trauma are male and preschool children, with generally mild injuries and relatively good visual prognosis. Prevention and education on children's ocular traumas should be emphasized, and timely treatments after injury can effectively reduce the visual damage.

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.

Background: Accidents mainly occur at home, children are the most vulnerable to in any household. Objectives: The goals of this study were to identify the commonest causes of home accidents that necessitate secondary and tertiary care admission. And to find out social variables related to home accidents. Patients and Methods: It is a descriptive hospital-based cross-sectional study which was carried out on a convenient sample of 200 preschool children who were cared for Emergency Department in Babylon Maternity and Pediatrics Hospital and Imam Sadik General Teaching Hospital whose mothers accepted to participate in this study. It was conducted over a period of four months from April 1 to August 1, 2021. Data were collected through interviewing the participants who were asked to give their verbal consent to a structural questionnaire containing information about sociodemographic factors, child, and family variables. The information was analyzed using SPSS version 24. Result: The rate of home accidents (falls and blows by forceful sticks) among children under the age of six years were 55.50% and 24.50%, respectively. From the different investigated factors, Paternal educational level showed significant relation to home accidents, and other variables (maternal educational level, number of family members, and home size) were found to be risk factors for home injuries. Conclusion: Falls were the commonest cause of unintentional injuries; in children, home accidents are still the major problem and jeopardize the lives of children. Home accidents among children under the age of six years are increasing and this issue requires more attention and effort.

IntroductionUnintentional injury among children represents a major public health problem. Online-social-network-based parental-health-education is a potential way to reduce child unintentional injuries. The study aimed to explore the mechanisms by which online-social-network-based health education may reduce the unintentional injuries among children aged 0–3 years.MethodsWe conducted a participant-blinded, randomized controlled, online-social-network-based health-education intervention study from March 2019 to February 2020 in Shanghai. We established four WeChat groups (two intervention groups and two control groups). For the intervention groups, a doctor's assistant regularly delivered information regarding unintentional injuries among children, and community childcare doctors answered parents' questions concerning their children's health, including unintentional injuries. Meanwhile, the control groups did not receive any information from the assistant. The study selected one intervention group and one control group and compared the ego network and whole network indicators to determine the differences between the intervention and control groups.ResultsIn the intervention and control groups, 64.5% and 31.9% of the members, respectively, engaged in communication, and 1,736 and 273 records, respectively, were obtained. Regarding ego network, the doctor showed the largest network in the intervention group, and the size of the intervention group's network was twice that of the control group; the number of ties in the intervention group was nine times that of the control group. Fourteen and four parents in the intervention and control group played an active role, respectively. Regarding centrality, all WeChat groups were loose and multiple centers existed. Regarding subgroup cohesion, the intervention group had 28 cliques with 27 members, and the control group had 4 cliques with 4 members. For structural hole, 23.7% and 7.5% members in the intervention and control group actively participated in interactions, respectively, having strong control and influence over other parents; 69.2% and 59.1% members in the intervention and control group, respectively, had values of < 1.000, showing that they had strong ability to cross-jump structural holes.DiscussionOnline-social-networks-based health education interventions could enhance communication among parents, and between parents and community childcare doctors, and also shorten the social distance between them. Thus, online-social-network-based parental-health-education-intervention can be a feasible and generalizable means of preventing unintentional injuries among children.

This study described the distribution of unintentional injuries among Inuit youth in Nunavik, Quebec, Canada, and examined the relationship between socio-demographic factors, substance use and unintentional injuries. A cross-sectional study design was used on data collected for the Nunavik Child Development Study (2013–2015) among eligible youth aged 16 to 21 years old. Unintentional injury occurrence and causes (last 12 months) were assessed through individual interviews. A multivariate logistic regression model tested the relationship between socio-demographic, substance use variables and unintentional injury occurrence. Among the 199 youth who participated (94% response rate), thirty youth reported being unintentionally injured in the past 12 months , of which 50% were female. All-terrain vehicle collisions were the most frequent injuries reported (23%). The odds of being injured decreased by 62% for youth who were currently employed compared to those who were unemployed, adjusting for other socio-demographic variables (p-value = 0.04). Heavy alcohol drinking in the past 12 months was not significantly associated with unintentional injury. This study highlights the burden of unintentional injuries among Nunavik youth and the need for future work to explore additional and diverse variables that may prevent or contribute to injuries in order to inform culturally and developmentally-appropriate injury prevention strategies.

Unintentional injury is a significant worldwide health concern. Researchers have called on several occasions for conceptual frameworks to guide work on unintentional injury. Using conceptual approaches to organize our inquiry is one way to advance our knowledge of injury etiology. To this end, we suggest a risk appraisal framework for examining enactment or avoidance of injury risk behaviors. Our framework comprises broad antecedents, focusing on the evaluative stage preceding behaviors. Four categories influencing efficacy related to injury risk behavior are included: environmental context, experience, social context, and strategy. In this article, we explain the categories and concepts in our framework, discuss each in terms of etiology, briefly discuss interrelations between the categories, and suggest future paths using the framework. [ABSTRACT FROM AUTHOR]

Aim: To explore gender differences in older adults' perceptions about preventing falls. Background: Falls are a major problem for older adults and health care systems and a challenge to the aging population. Consideration of older adults' perceptions of fall prevention is needed to increase their engagement in evidence-based prevention strategies. Method: A qualitative analysis of secondary data was performed. Results: Three major themes emerged: We've Seen It, Women Are Caregivers, and Men Are Analyzing Risks and Modifying Behaviors. The men and women in this study shared information about falls and fall prevention in alignment with traditional role expectations. The women learned about falling through their roles as caregivers and prevented falls by controlling extrinsic risk factors indoors such as holding onto handrails on stairs or making home modifications. The men demonstrated an analytical approach to reducing risk such as employing improved safety measures during outdoors activities as a responsibility to maintain independence. Implications: The different perceptions of men and women influence what they do to engage in fall prevention. Health care professionals need to consider gender differences and take an individualized approach that includes allowing older adults to share their experiences, acknowledging their successful fall prevention behaviors, and validating and addressing their concerns. [ABSTRACT FROM AUTHOR]