Injuries in Child Day Care: An Overview

Injuries in child day care are a microcosm of the overall problem of childhood injury. In 1985 the National Academy of Sciences characterized injury as the most important public health problem in America.1 Although infectious diseases account for substantial morbidity among children—including the needs for medical care and hospitalization—injury is the most common cause of serious disability and death to children. Over the last 25 years there have been remarkable reductions in morbidity and mortality from other causes of childhood death, particularly those from infections and more recently from childhood cancer.2 Unfortunately, the reduction in childhood death from injuries has been minimal.2 Thus, addressing injuries to children in child-care and other settings is a public health priority. INCIDENCE OF INJURIES Approximately 25% of children annually incur injuries requiring medical care, either in the emergency department or the physician's office.3 The most common injury event is a fall. Falls are a particular problem because they can result in head trauma and permanent disability. Falls are the main cause of traumatic brain injury in children and account for 55% of traumatic brain injury requiring admission to the hospital.4 Contrary to popular belief, outcomes from head injuries in children are worse than outcomes in adults.5 Comparison of injuries to children in out-of-home child care (OOHCC) and in home care (HC) requires the calculation of comparable incidence rates. All children in OOHCC also spend time in HC, so comparisons based on population denominators are not accurate. In addition, unlike most infectious diseases—for which illnesses occur following an incubation period—injuries occur immediately after the exposure.

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Infectious Disease in Child Day Care: An Overview

PEDIATRICS ◽

10.1542/peds.94.6.987a ◽

1994 ◽

Vol 94 (6) ◽

pp. 987-990

Author(s):

Michael T. Osterholm

Keyword(s):

Public Health ◽

Child Care ◽

Infectious Diseases ◽

Day Care ◽

Health And Safety ◽

Health Science ◽

American Public Health Association ◽

Child Day Care ◽

Health Association ◽

Care Health

In the early 1980s, the Minnesota Department of Health began to address the growing concern of the risk of infectious diseases in child day care by initiating a planning process that resulted in the first national symposium on infectious diseases in child day care. That symposium, which was held in June 1984 in Minneapolis, highlighted the fact that different vocabularies and points of reference would need to be bridged if day-care providers and regulators, clinicians, and public health practitioners are to work side-by-side in defining the risk of infectious diseases in day care and in developing appropriate prevention strategies.1 As a result of this meeting, the Minnesota Public Health Association submitted a resolution to the American Public Health Association (APHA) in the fall of 1984, stating that child-care standards, especially in the area of prevention of infectious diseases, were needed. This resolution, together with a simultaneous recommendation from the APHA's Maternal and Child Health Section for the development of health and safety standards for out-of-home child-care facilities, began a process which eventually led to the monumental effort now known as the American Public Health Association/American Academy of Pediatrics, National Health and Safety Performance Standards: Guidelines for Out-of-Home Child Care Programs.2 In June, 1992, the Centers for Disease Control and Prevention sponsored the "International Conference on Child Day Care Health: Science, Prevention and Practice," a historic meeting bringing together concerned individuals from many disciplines to further define and set the future agenda for the science, prevention and practice of child day-care health.

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Public health considerations of infectious diseases in child day care centers

The Journal of Pediatrics ◽

10.1016/s0022-3476(84)80285-1 ◽

1984 ◽

Vol 105 (5) ◽

pp. 683-701 ◽

Cited By ~ 50

Keyword(s):

Public Health ◽

Infectious Diseases ◽

Day Care ◽

Day Care Centers ◽

Child Day Care ◽

Child Day Care Centers

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Reply to Comment on Tsai, Y.-C., et al. Association of Stress-Induced Hyperglycemia and Diabetic Hyperglycemia with Mortality in Patients with Traumatic Brain Injury: Analysis of a Propensity Score-Matched Population. Int. J. Environ. Res. Public Health 2020, 17, 4266

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18052531 ◽

2021 ◽

Vol 18 (5) ◽

pp. 2531

Author(s):

Yu-Chin Tsai ◽

Shao-Chun Wu ◽

Ting-Min Hsieh ◽

Hang-Tsung Liu ◽

Chun-Ying Huang ◽

...

Keyword(s):

Public Health ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Propensity Score ◽

Brain Injuries ◽

Traumatic Brain Injuries ◽

Injury Analysis

Thank you for Eduardo Mekitarian Filho’s appreciation of our work on the study of stress-induced hyperglycemia (SIH) and diabetic hyperglycemia (DH) in patients with traumatic brain injuries [...]

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Interrupted time series design to evaluate ICD-9-CM to ICD-10-CM coding changes on trends in Colorado emergency department visits related to traumatic brain injury

Injury Epidemiology ◽

10.1186/s40621-021-00308-y ◽

2021 ◽

Vol 8 (1) ◽

Author(s):

Lauren Alexis De Crescenzo ◽

Barbara Alison Gabella ◽

Jewell Johnson

Keyword(s):

Public Health ◽

Traumatic Brain Injury ◽

Emergency Department ◽

Brain Injury ◽

Interrupted Time Series ◽

Emergency Department Visits ◽

Control And Prevention ◽

Icd 10 ◽

Ed Visits ◽

The Impact

Abstract Background The transition in 2015 to the Tenth Revision of the International Classification of Disease, Clinical Modification (ICD-10-CM) in the US led the Centers for Disease Control and Prevention (CDC) to propose a surveillance definition of traumatic brain injury (TBI) utilizing ICD-10-CM codes. The CDC’s proposed surveillance definition excludes “unspecified injury of the head,” previously included in the ICD-9-CM TBI surveillance definition. The study purpose was to evaluate the impact of the TBI surveillance definition change on monthly rates of TBI-related emergency department (ED) visits in Colorado from 2012 to 2017. Results The monthly rate of TBI-related ED visits was 55.6 visits per 100,000 persons in January 2012. This rate in the transition month to ICD-10-CM (October 2015) decreased by 41 visits per 100,000 persons (p-value < 0.0001), compared to September 2015, and remained low through December 2017, due to the exclusion of “unspecified injury of head” (ICD-10-CM code S09.90) in the proposed TBI definition. The average increase in the rate was 0.33 visits per month (p < 0.01) prior to October 2015, and 0.04 visits after. When S09.90 was included in the model, the monthly TBI rate in Colorado remained smooth from ICD-9-CM to ICD-10-CM and the transition was no longer significant (p = 0.97). Conclusion The reduction in the monthly TBI-related ED visit rate resulted from the CDC TBI surveillance definition excluding unspecified head injury, not necessarily the coding transition itself. Public health practitioners should be aware that the definition change could lead to a drastic reduction in the magnitude and trend of TBI-related ED visits, which could affect decisions regarding the allocation of TBI resources. This study highlights a challenge in creating a standardized set of TBI ICD-10-CM codes for public health surveillance that provides comparable yet clinically relevant estimates that span the ICD transition.

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Interrupted time Series Design to Evaluate ICD-9-CM to ICD-10-CM Coding Changes on Trends in Colorado Emergency Department visits Related to Traumatic Brain Injury

10.21203/rs.3.rs-134764/v1 ◽

2020 ◽

Author(s):

Lauren Alexis De Crescenzo ◽

Barbara Alison Gabella ◽

Jewell Johnson

Keyword(s):

Public Health ◽

Traumatic Brain Injury ◽

Emergency Department ◽

Brain Injury ◽

Interrupted Time Series ◽

Emergency Department Visits ◽

P Value ◽

Icd 10 ◽

The Usa ◽

Definition Of

Abstract Background. The transition in 2015 to the Tenth Revision of the International Classification of Disease, Clinical Modification (ICD-10-CM) in the USA led public health professionals to propose a surveillance definition of traumatic brain injury (TBI) that uses ICD-10-CM codes. The proposed definition excludes “unspecified injury of the head,” previously included in the ICD-9-CM TBI definition. The purpose of this study was to evaluate this change in surveillance methods on monthly rates of TBI-related emergency department visits in Colorado from 2012 to 2017.Results. The monthly rate of TBI-related emergency department visits in the transition month to ICD-10-CM (October 2015) decreased 41 visits per 100,000 population (p-value <0.0001), compared to September 2015, and remained low through December 2017, due to the exclusion of “unspecified injury of head” (ICD-10-CM code S09.90) in the proposed TBI definition. Conclusion. This study highlights a challenge in creating a standardized set of TBI ICD-10-CM codes for public health surveillance that provides comparable yet clinically relevant estimates over time. The findings inform estimation of TBI magnitude based on ICD coded data and decisions about allocating TBI resources based on an estimated TBI magnitude.

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Traumatic Brain Injuries: Unreported and Untreated in an Army Population

Military Medicine ◽

10.1093/milmed/usz259 ◽

2020 ◽

Vol 185 (Supplement_1) ◽

pp. 154-160 ◽

Cited By ~ 2

Author(s):

Sandra M Escolas ◽

Margie Luton ◽

Hamid Ferdosi ◽

Bianca D Chavez ◽

Scot D Engel

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Medical Care ◽

Brain Injuries ◽

Negative Impact ◽

Traumatic Brain Injuries ◽

Future Research ◽

Treatment History ◽

Anonymous Questionnaire ◽

The Military

ABSTRACT Introduction In 2008, it was reported that 19.5% of service members previously deployed experienced a mild traumatic brain injury (mTBI). Fifty-seven percent of those did not seek medical care. It was suggested that concerns with seeking care involved confidentiality and career issues. Objective: This study addressed mTBI history, medical treatment history, and stigmas associated with mTBI/concussion. Materials and Methods An anonymous questionnaire was developed. Data collection occurred throughout March 2018 in conjunction with Brain Injury Awareness Month activities. Results All 5,174 volunteers were Army; 86% male; 87% were between 18 and 34 years old; 89% had <14 years in the military; 35% had a combat deployment; and 10% reported having one or more mTBIs in their military careers. Of the Soldiers who reported a concussion, 52% sought medical care. Of those not seeking care, 64% reported they did not think the injury required care, followed by 18% fearing negative impact on their career. Twenty-eight percent who experienced an mTBI versus 11% who have not reported that there is a stigma associated with an mTBI. Conclusions Soldiers sometimes failed to report their suspected concussions and did not seek medical care. Educational efforts may increase reporting of and medical screening for potentially concussive events. Future research to determine the ramifications of unreported and untreated mTBIs/concussions is recommended.

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How to estimate mild Traumatic Brain Injury Incidence? The interest of Emergency Departments data

European Journal of Public Health ◽

10.1093/eurpub/ckz186.635 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

V Bourdin ◽

L Manitchoko ◽

P Azouvi ◽

R Hellmann ◽

L Josseran

Keyword(s):

Public Health ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Incidence Rate ◽

Emergency Departments ◽

Mild Tbi ◽

Health Measures ◽

High Incidence ◽

High Incidence Rate ◽

Screening Procedures

Abstract Background Traumatic brain injury (TBI) is a major public health issue, with a significant socio-economic burden. In France, very little is known about TBI epidemiology, and the TBI population is mainly described via studies carried out on the most severe patients. A large number of studies showed that a significant proportion of patients suffer from long-term disability after mild TBI (mTBI). This Post-Concussive Syndrome (PCS) remains poorly known by health professionals. Identifying early prognostic factors for the development of PCS is therefore essential, since it can ensure widespread clinical and economic benefits. This work aims at providing an updated description of the incidence of mild TBI (mTBI) based on data from Emergency Departments (ED) in the Ile-de-France (IDF) region (Paris area). Methods We estimated the mTBI incidence, using mainly data from the OSCOUR (Organisation de la Surveillance Coordonnée des Urgences) database from 01/01/2011 to 31/12/2015. The OSCOUR Network data collection methodology is based on the registration of all patients visiting the emergency services (ED) of participating hospitals. An extrapolation of the proportion of TBI patients visiting an OSCOUR ED to all ED of the IDF allowed us to compute a mTBI Annual Incidence Rate (AIR) in IDF. Results Between 2011 and 2015, 95,910 mTBI patients visited the OSCOUR ED in IDF, and the AIR was estimated at 292.4/100,000 inhabitants (when reported to the French population scale: a total of 196,000 mTBI are supposed to happen each year). Conclusions The surprisingly high incidence rate of mTBI observed in this study requires an evaluation of public health measures to prevent these injuries and reduce their consequences. New screening procedures should be implemented to point out the patients at risk for complications and PCS. Alongside the care aspect, prevention should be developed to reduce the incidence of TBIs, and prevention policies should be assessed by reiterating our evaluation. Key messages Between 2011 and 2015, 95,910 mTBI patients visited the OSCOUR Emergency Departments in Ile de France, and the annual incident rate was estimated at 292.4/100,000 inhabitants. The mTBI high incidence rate requires an evaluation of public health measures to prevent these injuries and reduce their consequences, but also the implementation of new screening procedures.

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Effects of Transient Receptor Potential Cation 5 (TRPC5) Inhibitor, NU6027, on Hippocampal Neuronal Death after Traumatic Brain Injury

International Journal of Molecular Sciences ◽

10.3390/ijms21218256 ◽

2020 ◽

Vol 21 (21) ◽

pp. 8256 ◽

Cited By ~ 1

Author(s):

Min Kyu Park ◽

Bo Young Choi ◽

A Ra Kho ◽

Song Hee Lee ◽

Dae Ki Hong ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Neuronal Death ◽

Transient Receptor Potential ◽

Neuronal Cell Death ◽

Neuronal Cell ◽

Treated Group ◽

Therapeutic Window ◽

Permanent Disability ◽

Fluoro Jade B

Traumatic brain injury (TBI) can cause physical, cognitive, social, and behavioral changes that can lead to permanent disability or death. After primary brain injury, translocated free zinc can accumulate in neurons and lead to secondary events such as oxidative stress, inflammation, edema, swelling, and cognitive impairment. Under pathological conditions, such as ischemia and TBI, excessive zinc release, and accumulation occurs in neurons. Based on previous research, it hypothesized that calcium as well as zinc would be influx into the TRPC5 channel. Therefore, we hypothesized that the suppression of TRPC5 would prevent neuronal cell death by reducing the influx of zinc and calcium. To test our hypothesis, we used a TBI animal model. After the TBI, we immediately injected NU6027 (1 mg/kg, intraperitoneal), TRPC5 inhibitor, and then sacrificed animals 24 h later. We conducted Fluoro-Jade B (FJB) staining to confirm the presence of degenerating neurons in the hippocampal cornus ammonis 3 (CA3). After the TBI, the degenerating neuronal cell count was decreased in the NU6027-treated group compared with the vehicle-treated group. Our findings suggest that the suppression of TRPC5 can open a new therapeutic window for a reduction of the neuronal death that may occur after TBI.

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