Updating the evidence. A systematic review of what works in preventing childhood unintentional injuries: Part 2

Towner, Elizabeth

doi:10.1136/ip.7.3.249

Cited by 50 publications

(24 citation statements)

References 30 publications

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“…Beside these improvements, media campaign to elevate the public awareness of this hazard, individual parent education to highlight the possible risks, door-to-door hazard identifications, and contact points are possibilities to protect vulnerable families. Many studies reinforce the need of childhood injury protection and suggest improved prevention tools such as window guards, home safety programs, and national laws [10,[16][17][18][19][20].…”

Section: Discussionmentioning

confidence: 99%

The silent epidemic of falls from buildings: analysis of risk factors

et al. 2006

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This study wanted to search for potential risk factors associated with falls from windows and balconies in order to eventually improve prevention. All children under the age of 16 years suffering from head injuries/multiple trauma due to falls from windows or balconies treated over the last 7 years at the intensive care unit (ICU) of the University Children's Hospital Zürich were analysed retrospectively (group A). Fifty patients out of all children suffering from head injuries/multiple trauma due to other types of accidents in the same period were selected at random as controls (group B). Out of a total of 241 children with head injury and/or multiple trauma, 31 (13%) fell out of a building. Twenty-seven of these victims (87%) fell from the third floor or lower. Twenty-one of the falls (68%) occurred at home. Fifteen children (49%) climbed on a piece of furniture before falling. In almost 20% of the accidents dangerous balcony or house constructions led to the fall. Parents did not witness the fall, except for three cases (10%) with direct parental involvement (one mother jumped out with her child, two mothers threw their child out of the window). Two children (6%) attempted suicide. Children aged 0-5 years were predominantly represented (84%), and all six children who died were in this age group. There were significantly more patients with foreign nationalities and lower socio-professional categories in group A than in group B. In both groups, the accidents concerned the youngest child of the family in approximately 50% and happened mostly during summer evenings. There were no significant differences in injured systems and in injury severity between the two groups. This study identified young age, an immigrant family setting, low socio-professional category of the parents, dangerous house constructions, inappropriate furniture placement, and summertime evenings as risk factors for serious building falls in children. This information may foster focused prevention.

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Section: Discussionmentioning

confidence: 99%

The silent epidemic of falls from buildings: analysis of risk factors

et al. 2006

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“…Uma cuidadosa revisão sistemática, recentemente publicada 13,14 , chegou às seguintes conclusões: esquemas de acalmação de tráfego urbano reduzem o número de injúrias a pedestres e ciclistas; o treinamento intensivo de escolares melhora seu comportamento como pedestres; campanhas multisetoriais promovem o aumento do uso de capacetes por ciclistas; legislação obrigando o uso de assentos de segurança infantis leva à redução da incidência de traumatismos em crianças ocupantes de veículos automotores; campanhas de promoção do uso de alarmes de fumaça podem aumentar efetivamente o seu uso; legislação sobre tampas de segurança em medicamentos diminui a incidência de intoxicações; intervenções baseadas na comunidade podem melhorar o nível geral de segurança, embora a qualidade da evidência seja limitada; campanhas públicas informativas aumentam o conhecimento sobre segurança e riscos, mas continua não havendo evidências de que reduzam a incidên-cia de injúrias.…”

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Prevenção e controle de injúrias físicas: saímos ou não do século 20?

Blank¹

2002

J. Pediatr. (Rio J.)

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Este número do Jornal de Pediatria apresenta um dos raros artigos originais sobre aspectos preventivos do trauma que se têm visto nestas páginas. Diferente das costumeiras descrições retrospectivas, baseadas em atendimentos hospitalares, o estudo sobre fatores de risco para injúrias em pré-escolares, de autoria de Sílvia Fonseca e colaboradores 1 , suscita várias reflexões que deveriam interessar a todo pediatra clínico que se preze.Em primeiro lugar, cabe ressaltar a gritante desproporção entre a importância do tema -sob o prisma da morbimortalidade de crianças e jovens -e a exígua quantidade de estudos a ele relacionados. Seria oportuno que todos nós ponderássemos um pouco mais, por exemplo, sobre dois documentos relevantes e minuciosos, divulgados recentemente, em que a OMS e o UNICEF reiteram o que muita gente parece não querer enxergar: as injúrias físicas constituem um enorme problema de saúde pública entre crianças e jovens 2,3 . A Tabela 1, adaptada dos dados da OMS, fala por si: as causas externas respondem por 53% da sobrecarga total das dez principais doenças, entre 5 e 14 anos, nos países menos ricos das Américas. Mesmo incluindo os primeiros anos de vida, com todas as suas peculiaridades, o peso das injúrias físicas é notório. O relatório do UNICEF, que se detém na mortalidade, enfatiza que 98% das mortes de crianças e jovens causadas por injúrias físicas ocorrem nos países em desenvolvimento, apontando como os principais fatores de risco a pobreza, mãe solteira e jovem, baixo nível de educação materna, habitações pobres, famílias numerosas e uso de álcool e drogas pelos pais 2 . E mais, segundo o relatório "The Global Burden of Disease" (um marco na caracterização da injúria física como problema prioritário de saúde pública), no âmbito mundial, as causas externas representam 15% da sobrecarga de mortes e incapacitação, penalizando os países do Terceiro Mundo em escala quase duplicada; para os próxi-mos vinte anos, o relatório projeta um aumento desse índice para cerca de 20% 4 . Ou seja, trata-se de uma questão muito nossa, que, apesar dos maus prognósticos, seguimos menosprezando.A moderna ciência do controle de injúrias físicas -a tentativa de diminuir as conseqüências do trauma por meio da prevenção primária, primeiros-socorros mais efetivos e técnicas melhores de reabilitação -consolidou-se, na segunda metade do século passado, como uma das bases da pediatria clínica 5,6 . A epidemiologia, a biomecânica e a ciência do comportamento constituem seus três pilares fundamentais. Neste contexto, o trabalho de Fonseca e colaboradores pode ser considerado um marco, pois é o primeiro estudo prospectivo de base populacional, com o objetivo de avaliar os fatores de risco associados a injúrias não intencionais, de que se tem notícia na literatura pediátrica brasileira. Traz um enfoque que sinaliza de modo positivo o alinhamento da investigação clínica nacional com as tendências acadêmicas globais. Caso sua inspiração motive pesquisas semelhantes em outros lugares, conforme expressam os autores, estaremos p...

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“…48,145 Scientific evidence exists that family guidance about injury risks inherent to each stage of development can increase knowledge, as well as the adoption of efficient safety measures; also, primary care physicians are the ones who best engage in preventive guidance, with their conviction that it is an important health problem. 55,76,103,146,147 However, it should be highlighted that a positive effect on the behavior of families in terms of safety only occurs if the access to products, such as bars for windows, safety seats, locker and door latches, by way of community-based programs, is allowed. 148 On the other hand, preventive guidance has been poorly practiced by pediatricians, who address safety issues in about 70% of appointments, but superficially.…”

Section: Society: Cultural Factorsmentioning

confidence: 99%

Controle de injúrias sob a ótica da pediatria contextual

Blank¹

2005

J. Pediatr. (Rio J.)

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Suggested citation: Blank D. Injury control from the perspective of contextual pediatrics. J Pediatr (Rio J). 2005;81(5 Suppl):S123-S136. AbstractObjective: To describe the relationship between injury control and contextual pediatrics. Sources of data:Quasi-systematic review of MEDLINE, SciELO and LILACS databases, using combinations of the words contextual, community, injury, accident and violence; and non-systematic review of book chapters and classic articles.Summary of the findings: Safety depends on the interaction of family habits, cultural patterns and surroundings. Contextual pediatrics sees the child, the family, and the community as a continuum; health diagnosis (sequential observation of problems and assets) is one of its cornerstones. Changing intrapersonal factors for injuries requires the use of both passive and active strategies. Family and cultural risk factors for injury: home overcrowding, moving, poverty, and young, illiterate and unemployed parents. The main neighborhood factors: material deprivation and traffic. Cultural factors: illiteracy, unsafe products, lack of mass transportation, handguns, workplaces without safety rules, faulty community organization, lack of communication between social sectors, inadequate legislation, low priority for safety among government actions, lack of economic resources, and low academic commitment with the field of safety. Conclusions:The pediatricians roles include strengthening of the longitudinal relationship with families, integrated interdisciplinary work, constructive intervention, partnership with community, counseling on injury risks pertaining to each developmental stage, by using lists with explicit processes and contents, and by handing out written materials. Active advocacy for safety promotion in different environments, besides the clinical setting.J Pediatr (Rio J). 2005;81(5 Suppl):S123-S136: Community medicine, wounds and injuries, counseling, health education. Injury control from the perspective of contextual pediatricsDanilo Blank* 0021-7557/05/81-05-Suppl/S123 Jornal de Pediatria Copyright © 2005 by Sociedade Brasileira de Pediatria REVIEW ARTICLEPediatrics is a contextual specialty concerned about children, their families, and the communities in which they live (...) Although the morbidity and mortality of children have changed over the past 150 years, the need for engaging in the community with families and community-based partners has not. Rather, the salience of community pediatrics has risen as the effects of societal forces have intensified and knowledge of the bioenvironmental interface has become more sophisticated (...)Pediatricians began collaborating with others in the community to prevent disease and promote health.Beyond the clinic doors, they found clear patterns and explanations. Child health outcomes were in a dynamic interplay with the environment, secular trends, commercial developments, the economy, family customs, and cultural norms.Judith S. Palfrey, Thomas F. Tonniges, Morris Green and Julius Richmond 1 S124 Jornal d...

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Updating the evidence. A systematic review of what works in preventing childhood unintentional injuries: Part 2

Cited by 50 publications

References 30 publications

The silent epidemic of falls from buildings: analysis of risk factors

The silent epidemic of falls from buildings: analysis of risk factors

Prevenção e controle de injúrias físicas: saímos ou não do século 20?

Controle de injúrias sob a ótica da pediatria contextual

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