Objective-The research was undertaken to describe the injury severity score (ISS) and the new injury severity score (NISS) and to illustrate their statistical properties. Design-Descriptive analysis and assessment of the distribution of these scales. Methods-Three data sources-the National Pediatric Trauma Registry; the Massachusetts Uniform Hospital Discharge Data Set; and a trauma registry from an urban level I trauma center in Massachusetts-were used to describe the distribution of the ISS and NISS among injured patients. Results-The ISS/NISS was found to have a positively skewed distribution and transformation did not improve their skewness.Conclusion-The findings suggest that for statistical or analytical purposes the ISS/ NISS should not be considered a continuous variable, particularly if ISS/NISS is treated as a continuous variable for correlation with an outcome measure. (Injury Prevention 2001;7:10-13)

Injured children with ADHD are more likely to sustain severe injuries than are children without ADHD. More research is needed to identify prevention efforts specifically targeted at this population.

No abstract

The protective eVect of child restraint and the relative safety of front and rear seating in a population where children often travel unrestrained was assessed in a population based case-control study. The cases were all 129 children aged 0-11 years injured as car passengers in a motor vehicle accident who contacted, during 1996, one of the two major children's hospitals in Athens; emergency cases are accepted by the two hospitals on alternate days throughout the year, thus generating a random sample of children injured as car passengers. The prevalence of the studied exposures in the study base was estimated from an inspection survey comprising a random sample of 191 children of the same age who travelled in passenger cars. The survey was conducted by medical staV from our centre in collaboration with the road traffic police. Odds ratios (ORs) were calculated after adjustment for confounding factors through the Mantel-Haenszel procedure. The OR for injury was 3.3 among unrestrained children compared with restrained children (comparison essentially limited to children aged 0-4 years) and 5.0 for children seated in the front compared with those seated in the rear (comparison essentially limited among unrestrained children). Protective eVect estimates derived from this analytical study suggest that in Greece about two thirds of all childhood injuries from car crashes could have been avoided through the regular use of a proper child restraint. The data also indicate that, in the absence of a child restraint system, a rear seating position conveys substantial protection and could explain the low mortality of children as car passengers in Greece, a country which is characterised by a high overall road traYc mortality as well as a high childhood accident mortality. (Arch Dis Child 1998;78:335-339) Keywords: child car restraints; seating positions; protective eVects; road traYc injuries Child safety during transportation by car depends in principle on the same factors that aVect adult safety, namely, the skills and the behaviour of the driver and vehicle characteristics as well as the seating position and proper use of restraint systems. Child restraints operate in the same way as adult seat belts, but rear facing restraints have been reported to provide better protection because of the larger head mass and poor head control of infants.

We estimated age-specific and sex-specific incidence rates of intentional injuries (assaults or suicide attempts) occurring between 1979 and 1982 in a population of 87,022 Massachusetts children and adolescents under 20 years of age in 14 communities with populations of 100,000 or less. The average annual incidence of intentional injuries treated at a hospital was estimated to be 76.2 per 10,000 person-years. Overall, 1 in 130 children was treated each year for an intentional injury. More than 85 percent of the injuries resulted from assaults, such as fights, rape, and child battering; 11.4 percent were self-inflicted. Intentional injuries were most common among adolescents. Each year, 1 in 42 teenage boys was treated for an assault-related injury, and 1 in 303 teenage girls was seen for a suicide attempt. Repeated episodes of intentional injury were identified in 4.3 percent of the children. In this population, intentional injuries accounted for 3.4 percent of all injuries but 9.8 percent of hospital admissions and 15.7 percent of deaths from injury. The rate of intentional injury was directly correlated with both the degree of urbanization and the poverty level of the community of residence. We conclude that intentional injuries are relatively common in this population and that attempts to prevent them must be directed to the children who are at greatest risk.