Unintentional Injuries in Children: A Hospital-Based Study in Trivandrum

Unintentional injuries are a major cause of morbidity and mortality in children around the world. A hospital based retrospective descriptive study was done in the Department of Pediatric Surgery of a tertiary care hospital in Trivandrum, to find out the pattern of unintentional injuries in children. The study population constituted, all children admitted with unintentional injuries for a period of 5years from 2016 to 2020. Mechanical Trauma (44.2%) was the most common reason for admission followed by Burns (37.9%) and foreign body (17.1%). Major reason for trauma was fall from height, and head injury was the most common type of injury. Preschool children were affected most. Large proportion of these children belonged to low socioeconomic group (85.6%). Injuries occurred commonly at homes and surroundings (91%), compared to other places. Majority of the injuries were moderate (88.46%) and remaining (10.05%) was severe requiring ICU care. The study highlights the different types of unintentional injuries requiring hospitalization; this will help to devise strategies aimed at prevention of unintentional injuries in children especially preschool children and those living below poverty line. Keywords: Unintentional Injuries, Children, Trauma.

Knowledge and attitude regarding home safety measures on unintentional injuries among mothers of under-five children in Paediatrics units at Pondicherry Institute of Medical Sciences, Puducherry

Introduction: Children are like butterflies. They really love to explore the living surroundings they live. The environment they live has many potential hazards. Unintentional injuries are mainly responsible for many injury and death in children especially under five children. But most of the potential risks can be avoided if the parents of under five children are aware of the risk factors in their surroundings and children should be properly taken care by their parents. There are many causes of injury and death among children but most of the leading causes are Drowning, Falling, Burns, Choking and Poisoning. Educating and giving awareness to parents about the preventive measures which should be adopted to prevent these injuries can save the children especially under five thereby reducing the mortality rate upto 90 percentage. Statement of Problem: A Study to Assess the level of Knowledge and Attitude regarding Home safety measures on unintentional injuries among mothers of under- five children at Paediatric units, Pondicherry Institute of Medical Sciences, Puducherry. Objectives: 1. To assess the level of knowledge and attitude regarding home safety measures on unintentional injuries among mothers of under five children. 2. To find out the association between level of knowledge and attitude regarding home safety measures on unintentional injuries among mothers of under five children with selected demographic variables. Methodology: Data was collected over a period of one week in march 2020.Exploratory research approach is used in this study and descriptive research design is used to assess the knowledge and attitude regarding home safety measures on unintentional injuries among mothers of under five children. Mothers of under five children who fulfil inclusion criteria were selected using Purposive Sampling Technique and the sample size is 67. Data was collected using structured questionnaire. The data collected will be analysed by using descriptive and inferential statistics. Fisherman exact test was used to test the association between level of knowledge regarding home safety measures on unintentional injuries among mothers of under five children with selected demographic variables. Results: In the present study, level of knowledge of mothers of under five children regarding home safety measures on unintentional injuries revealed that 21(31.34%) were having inadequate knowledge, 37(55.22%) mothers were having moderately adequate knowledge, 9 (13.43%) mothers were having adequate knowledge regarding home safety measures on unintentional injuries. The level of attitude of mothers of under five children regarding home safety measures revealed that 67(100%) of the mothers were having favourable attitude regarding home safety measures on unintentional injuries. Conclusion: The researchers gave health education leaflets to all the mothers of under-five children in order to improve the knowledge of the mother so that risks of unintentional injury can be reduced thereby reducing mortality rate of under five children.

Is Age Just a Number? Influence of Caregiver Age on Injuries of Children Raised by Grandparents

Unintentional injuries are the most common cause of death for children in the United States. One factor linked to their occurrence is parenting style (i.e., a collection of factors such as physical health, mental health, and possible cohort differences in parenting role expectations). Differences in parenting behaviors may be evident in grandparents caring for their grandchildren, due to cohort differences and age-related declines in cognitive and physiological processes. This may impact their abilities to monitor, supervise, and respond to children. Further, Hayslip & Kaminski report custodial grandparents are less likely than parents to understand and respond to the psychological and emotional needs of children but are more likely to enforce discipline. This study sought to explore the ways in which parenting styles are associated with unintentional injury behaviors in children (via caregiver age) for grandchildren raised by grandparents. Participants were grandparents raising their grandchildren, recruited via Qualtrics Panel Service (N = 323). Conditional process analyses were conducted using Model 1 of SPSS PROCESSv3.5. Age moderated the relation between consistency of discipline and child unintentional injury (F (1, 231) = 12.67, p <.001) as well as level of supervision and child unintentional injury (F (1,146) = 6.23, p = .01). Age did not moderate the relation between positive parenting and unintentional injuries. These results imply that children being raised by older grandparents were especially at risk for increased injuries when their grandparents used less consistent discipline or lower rates of supervision. Pathways are suggested for age-specific psychoeducation interventions for custodial grandparents.

Firearm injury epidemiology in children and youth in Ontario, Canada: a population-based study

Background and objectiveDespite firearms contributing to significant morbidity and mortality globally, firearm injury epidemiology is seldom described outside of the USA. We examined firearm injuries among youth in Canada, including weapon type, and intent.DesignPopulation-based, pooled cross-sectional study using linked health administrative and demographic databases.SettingOntario, Canada.ParticipantsAll children and youth from birth to 24 years, residing in Ontario from 1 April 2003 to 31 March 2018.ExposureFirearm injury intent and weapon type using the International Classification of Disease-10 CM codes with Canadian enhancements. Secondary exposures were sociodemographics including age, sex, rurality and income.Main outcomesAny hospital or death record of a firearm injury with counts and rates of firearm injuries described overall and stratified by weapon type and injury intent. Multivariable Poisson regression stratified by injury intent was used to calculate rate ratios of firearm injuries by weapon type.ResultsOf 5486 children and youth with a firearm injury (annual rate: 8.8/100 000 population), 90.7% survived. Most injuries occurred in males (90.1%, 15.5/100 000 population). 62.3% (3416) of injuries were unintentional (5.5/100 000 population) of which 1.9% were deaths, whereas 26.5% (1452) were assault related (2.3/100 00 population) of which 18.7% were deaths. Self-injury accounted for 3.7% (204) of cases of which 72.0% were deaths. Across all intents, adjusted regression models showed males were at an increased risk of injury. Non-powdered firearms accounted for half (48.6%, 3.9/100 000 population) of all injuries. Compared with handguns, non-powdered firearms had a higher risk of causing unintentional injuries (adjusted rate ratio (aRR) 14.75, 95% CI 12.01 to 18.12) but not assault (aRR 0.84, 95% CI 0.70 to 1.00).ConclusionsFirearm injuries are a preventable public health problem among youth in Ontario, Canada. Unintentional injuries and those caused by non-powdered firearms were most common and assault and self-injury contributed to substantial firearm-related deaths and should be a focus of prevention efforts.

Associations of childhood unintentional injuries with maternal emotional status during COVID-19

Background To explore the characteristics of unintentional childhood-injury during the COVID-19 pandemic and assess the association of unintentional-injury with maternal emotional status. Methods A cross-sectional survey was conducted with a convenience sample of 1300 children under 12-years-old from 21 schools (including nurseries/ kindergartens/ primary schools) in Wuhan and Shanghai during March to April 2020, and the mothers completed questionnaires online. Self-rating Depression/Anxiety Scales were used to evaluate maternal emotional status, questions on child unintentional-injury were based on the International-Statistical-Classification-of-Diseases-and-Related-Health-Problems-version-10 (ICD-10), and a total of 11 kinds of unintentional injuries were inquired. Information on socio-demographic and family-background factors was also collected. Results The children of 0–4, 5–9, and 10–12 years accounted for 29.2, 55.2 and 15.6%, respectively, the unintentional-injury rates were 10.29, 4.18 and 3.45%, respectively (P < 0.001), and boys had higher rates than girls. The three leading causes included “being struck by/against”, falls and animal bites (traffic-injury accounted for a small proportion). Lower maternal educational, living in suburban/rural (vs. urban) areas, grandparents (vs. mothers) being main caregivers, more child exposure to secondhand smoke, close relatives being suspected/ confirmed COVID-19 cases were associated with a higher risk of child unintentional-injury. After adjusting for related confounders, higher maternal depression levels were associated with a higher risk of unintentional injury. Conclusions The characteristics of unintentional childhood injury were different from those in non-pandemic periods. The main causes, risk factors and the association of unintentional injury with maternal depression deserve attention for development of effective measures for preventing children from unintentional injury during COVID-19 pandemic. Graphical abstract