The objective of this study was to examine the incidence of head injury and symptoms of concussion among children at school and to determine the relationship of age, gender, and cause to incidence rates. Incident reports involving head injury for schools in the Province of Ontario, Canada during the year 2000 were evaluated. The population base for the schools represented was 1,372,979 children aged 6 to 16. 95% of schools in the province of Ontario, Canada participated in the injury reporting system. A head injury was defined as any injury to the head that came to the attention of a school official. Head injuries accompanied by symptoms of concussion became a secondary outcome measure. Results showed that there were 11,068 unduplicated head injury reports for the year 2000 of which 1861 qualified as producing signs or symptoms of concussion. Young children were more likely to have a head injury than older children, but slightly less likely to experience concussive symptoms. The primary cause of injury to young children was falls. Older children were more likely to receive head injuries and symptoms of concussion from sports activities. In conclusion, overall rate of injury (3.98 per 100 children) was consistent with previous studies using prospective injury reporting systems. Probability of a head injury with symptoms of concussion among schoolchildren was only 1.9% for boys and <1% for girls during the course of their school years. There is ample justification for prevention efforts in schools.

Study to quantify the incidence of childhood accidents in Spain over a 3 month period. Accidents were 19.4 per cent higher in urban areas than rural, and lower as the age of the age group increased. Higher number of accidents were male, accidents occuring 0-4 years occured mainly at home, while 5-9 and 10-14 took place either outdoors or at school. Study also showed the need for knowledge of first aid measures, both for parents and educators. Showed need to inform parents, relatives and educators about the risks of childhood accidents since a number especially young children occurred in their presence.

The authors investigated socioeconomic disparities in injury hospitalisation rates and severity-adjusted mortality for pediatric trauma. They used 10 years of pediatric trauma data from Sacramento County, California, to compare trauma hospitalisation rates, trauma mechanism and severity, and standardized hospital mortality across socioeconomic strata (median household income, proportion of households in poverty, insurance). Results showed that children from lower socioeconomic status (SES) communities had higher injury hospitalisation and mortality rates, and presented more frequently with more lethal mechanisms of injury (pedestrian, firearm), but did not have higher severity-adjusted mortality. In conclusion, higher injury mortality rates among children of lower SES in Sacramento County are explained by a higher incidence of trauma and more fatal mechanisms of injury, not by greater injury severity or poorer inpatient care.

Many injuries are sustained during recreational activities. All-terrain vehicles (ATVs) are 3- or 4-wheeled motorized vehicles with large low-pressure tires that are designed to be ridden in off-road environments. They represent a serious hazard for children. In 1988, the major manufacturers of ATVs and the US Consumer Product Safety Commission signed a consent decree that was intended to reduce the hazard. This decree included recommendations that young children not ride the vehicles and that older children only be allowed to ride vehicles that match the strength and coordination that matches the child's developmental age. State legislatures are not required to implement the age restrictions. For example, in Utah 8 year-olds have reached the minimum age to operate ATVs of any engine size. Objective: To describe the types of injuries sustained by children who ride all-terrain vehicles (ATVs), to estimate the hospital charges associated with these injuries, and to determine adherence to existing rules and regulations governing ATV use. METHODS: Analysis of statewide hospital admissions (1992-1996) and emergency department (ED) visits (1996) in Utah. All patients who were younger than 16 years and had an external cause of injury code for ATV use were included. RESULTS: In 1996, 268 ED visits by children involved an ATV. Boys were twice as commonly injured as girls, and skin and orthopedic injuries were most frequent. From 1992 to 1996, 130 children were hospitalized as a result of injuries sustained during ATV use. Orthopedic injuries were most frequent, but 25% of children sustained head or spinal cord injury. Most children (94%) were discharged from the hospital, but 8 children died as a result of their injuries. Utah regulations prohibit children who are younger than 8 years from driving an ATV and advise against carrying passengers on ATVs. However, 25% of all injured children who were younger than 8 were driving the ATV when injured, and 15% of injured children were passengers on ATVs. Four of the 8 fatally injured children were younger than 8, and all were driving the ATV at the time of the crash. Finally, the estimated injury rate per 100 registered ATVs is significantly higher for children than for adults. CONCLUSIONS: ATV use results in significant injuries to children. Efforts to educate parents regarding the risks of ATV use, proper supervision, and use of safety equipment are warranted. Manufacturers of ATVs should continue to improve the safety profile of these inherently unstable vehicles.

This paper aims to identify what needs to be done and by which organisations, to encourage greater use of walking as a transport mode (as related to the Auckland Regional Land Transport Strategy) within the urban part of the Auckland region.

The American Academy of Pediatric Dentisitry makes recommendation critical for reducing the prevalence of oral and facial injuries as well as other bodily injuries from youth sports.

An example of a community prevention programme resource: This 16-page booklet is aimed at educating the general public.

CONTEXT: There is growing concern regarding the quality of health care available in the United States for young children, and specific limitations have been noted in developmental and behavioral services provided for children in the first 3 years of life. OBJECTIVE: To determine the impact of the Healthy Steps for Young Children Program on quality of early childhood health care and parenting practices. DESIGN, SETTING, AND PARTICIPANTS: Prospective controlled clinical trial enrolling participants between September 1996 and November 1998 at 6 randomization and 9 quasi-experimental sites across the United States. Participants were 5565 children enrolled at birth and followed up through age 3 years. INTERVENTION: Incorporation of developmental specialists and enhanced developmental services into pediatric care in participants' first 3 years of life. MAIN OUTCOME MEASURES: Quality of care was operationalized across 4 domains: effectiveness (eg, families received > or =4 Healthy Steps-related services or discussed >6 anticipatory guidance topics), patient-centeredness (eg, families were satisfied with care provided), timeliness (eg, children received timely well-child visits and vaccinations), and efficiency (eg, families remained at the practice for > or =20 months). Parenting outcomes included response to child misbehavior (eg, use of severe discipline) and practices to promote child development and safety (eg, mothers at risk for depression discussed their sadness with someone at the practice). RESULTS: Of the 5565 enrolled families, 3737 (67.2%) responded to an interview at 30 to 33 months (usual care, 1716 families; Healthy Steps, 2021 families). Families who participated in the Healthy Steps Program had greater odds of receiving 4 or more Healthy Steps-related services (for randomization and quasi-experimental sites, respectively: odds ratio [OR], 16.90 [95% confidence interval [CI], 12.78 to 22.34] and OR, 23.05 [95% CI, 17.38 to 30.58]), of discussing more than 6 anticipatory guidance topics (OR, 8.56 [95% CI, 6.47 to 11.32] and OR, 12.31 [95% CI, 9.35 to 16.19]), of being highly satisfied with care provided (eg, someone in the practice went out of the way for them) (OR, 2.06 [95% CI, 1.64 to 2.58] and OR, 2.11 [95% CI, 1.72 to 2.59]), of receiving timely well-child visits and vaccinations (eg, age-appropriate 1-month visit) (OR, 1.98 [95% CI, 1.08 to 3.62] and OR, 2.11 [95% CI, 1.16 to 3.85]), and of remaining at the practice for 20 months or longer (OR, 2.02 [95% CI, 1.61 to 2.55] and OR, 1.75 [95% CI, 1.43 to 2.15]). They also had reduced odds of using severe discipline (eg, slapping in face or spanking with object) (OR, 0.82 [95% CI, 0.54 to 1.26] and OR, 0.67 [95% CI, 0.46 to 0.97]). Among mothers considered at risk for depression, those who participated in the Healthy Steps Program had greater odds of discussing their sadness with someone at the practice (OR, 0.95 [95% CI, 0.56 to 1.63] and OR, 2.82 [95% CI, 1.57 to 5.08]). CONCLUSION: Universal, practice-based interventions can enhance quality of care for families of young children and can improve selected parenting practices.

This paper discusses the ACC's role in injury prevention both past and present. The speaker details two different ACC injury prevention programmes that were quite successful- (1) 'Put your bad back behind you' and (2) 'Hot water burns like fire'. Recommendations are provided for the promotion of injury prevention as a major focus of ACC.

This project sought to understand the extent and impact of injury on a rural community. Local agencies were encouraged to use this information to develop and implement programmes that target specific injuries and high-risk groups. Results showed that, amongst other things, Aboriginal people were more than three times more likely to present with injuries than non-Aboriginal people.

The program presented is a consolidation of the professional thinking which was then available on the subject of school crossing protection. Briefly, the program follows six steps as follows: 1. organise a School Traffic Safety Committee. 2. Develop a School Route Plan. 3. Study the school crossings where apparent hazards exist. 4. Analyze the need for school crossing protection. 5A Select appropriate mesures for locations where control is needed. 5B. Select appropriate "Assistance" Measures. and 6. Select the standard devices needed to carry out the protection measures.

The program proposed, for Health Units, is broad in scope. Its aim is to reduce injury incidence, injury severity and fatal accidents by 50 percent in a ten-year period and includes both active and passive measures.

The HFA commissioned the IPRC and the IPRU to develop a national injury prevention strategy. While it is recognised within the health sector that preventing injury is a multi-sector pursuit requiring community and organisational involvement, the health sector believes that it also has an important role to play in the prevention of injuries. The aim of this national injury prevention strategy is to inform the health sector of purchasing options for public health injury prevention initiatives. It will also provide information on how the health sector could work with other sectors to reduce the human and societal costs of injuries. In doing so, the project team highlights the need for all sectors involved in injury prevention to avoid purchasing and delivering injury prevention activities in isolation.

OBJECTIVE: The implementation of the compulsory wearing of seat belts (SBs) for children and improvements in child restraint systems have reduced the number of deaths and severe injuries among children involved in motor vehicle (MV) collisions (MVCs). Establishing the characteristics predictive of such injuries may provide the basis for targeted safety campaigns and lead to a further reduction in mortality and morbidity among children involved in MVCs. This study performed a multidisciplinary investigation among child occupants involved in MVCs to elucidate injury mechanisms, evaluate the safety measures used and determine the characteristics that are predictive of injury. METHODS: A prospective study was conducted of all child occupants aged <16 years involved in severe MVCs in south-eastern Norway during 2009-2013. The exterior and interior of the MVs were investigated and the injured children were medically examined. Supplementary information was obtained from witnesses, the crash victims, police reports, medical records and reconstructions. Each case was reviewed by a multidisciplinary team to assess the mechanism of injury. RESULTS: In total, 158 child occupants involved in 100 MVCs were investigated, of which 27 (17%) exhibited Abbreviated Injury Scale (AIS) scores of 2+ injuries and 15 (9%) exhibited AIS 3+ injuries. None of the children died. Of those with AIS 2+ injuries (n=27), 89% (n=24) were involved in frontal impact collisions and 11% (3/27) were involved in side impacts. Multivariate analysis revealed that restraint misuse, age, the prevailing lighting conditions and V were all independently correlated with AIS 2+ injuries. Safety errors were found in 74% (20/27) of those with AIS 2+ injuries and 93% (14/15) of those with AIS 3+ injuries. The most common safety error was misuse of restraints, and in particular loose and/or improperly positioned SBs. CONCLUSION: The risk of injury among child occupants is significantly higher when the child occupants are exposed to safety errors within the interior of the vehicle. Future campaigns should focus on the prevention of restraint misuse and unsecured objects in the passenger compartment or boot.

Introduction: The domestic use of trampolines is on the rise and the cause of an increasing need of medical care for injuries that occur during their use. Our aim was to pinpoint the epidemiologic and traumatological profiles of the patients, victim to accidents, who were cared for at the emergency department. METHOD We conducted a prospective bi-centric transversal study during a period of three months, on injuries reported as being the result of private trampoline use. We have taken into consideration the epidemiologic data concerning the victims, the types of injury and their treatment, as well as the respect of the safety recommendations that apply when using of this type of equipment. RESULTS During the collection period we identified 101 victims of trampoline accidents, mostly children between 6 and 14 (67%), with a media age of 8 [6-11], with 5 patients being over 18 years of age. The majority of the injuries were to the lower body (66%) followed by the upper body injuries (22%), and finally an equal amount for spine and craniofacial. A third of the lesions were fractures to the lower and upper body. A total of 80% of the traumas examined resulted in therapeutic intervention, the extend of which decreased significantly with the presence of a safety net on the trampoline in question. The safety equipment (nets, spring protection) were absent or defective in 7% of the cases. Trampolines were considered as dangerous by 40% of the patients or their parents but only 13% would consider removing them. CONCLUSION Playing on trampolines is a hazardous activity, causing sometimes serious injury often through ignorance or non-respect of safety recommendations. A public campaign must be launched to raise awareness of trampoline users concerning the dangers of this activity and the necessity of respecting these recommendations.

BACKGROUND: Pediatric all-terrain vehicle (ATV) injuries have been increasing annually for more than a decade. The purpose of this study was to prospectively evaluate crash circumstances and clinical outcomes resulting from pediatric ATV crashes. METHODS: Three pediatric trauma centers prospectively collected data from patients during their hospitalization for injuries sustained in ATV crashes from July 2007 through June 2012. Patients completed a 35-item questionnaire describing the crash circumstances (ATV engine size, safety equipment use, and training/experience). Clinical data (injuries, surgical procedures, etc.) were collected for each patient. RESULTS: Eighty-four patients were enrolled, with a mean (SD) age of 13.0 (3.1) years, and were predominantly male (n = 55, 65%). Injuries were musculoskeletal (42%), central nervous system (39%), abdominal (20%), thoracic (16%), and genitourinary (4%). Multisystem injuries were prevalent (27%), and two patients died. Thirty-three patients (43%) required operative intervention. Most children were riding for recreation (96%) and ignored ATV manufacturers' recommendation that children younger than 16 years ride ATVs with smaller (=90 cc) engines (71%). Dangerous riding practices were widespread: no helmet (70%), no adult supervision (56%), double riding (50%), riding on paved roads (23%), and nighttime riding (16%). Lack of helmet use was significantly associated with head injury (53% vs. 25%, p = 0.03). Rollover crashes were most common (44%), followed by collision with a stationary object (25%) or another vehicle (12%). Half (51%) of children said that they would ride an ATV again. CONCLUSION: These data demonstrate a relationship between dangerous ATV riding behaviors and severe injuries in children who crash. Children younger than 16 years should not operate ATVs, and legislation that effectively restricts ATV use in children is urgently needed. LEVEL OF EVIDENCE: Epidemiologic study, level III. [Abstract from SafetyLit]

This is a series of PowerPoint slides used to support the paper presented by John Langley at the seminar.

The objective of this study was to calculate the preventable fraction of unintentional childhood injury deaths in the United States. This was an ecological study of cause specific unintentional childhood injury mortality rates across the 50 states (and the District of Columbia) of the United States (US) over the 10 year period 1989–98. The Internet accessible database from the National Center for Injury Prevention and Control was used in order to estimate unintentional childhood (0–14 years) injury mortality rates by external cause and time trends over the study period for each of the US states and for the four major geographical regions of the country. In the principal analysis, a calculation was made of the fraction and absolute number of unintentional childhood injury deaths that could have been prevented annually if the mortality rate in the region with the lowest rate also existed in the remaining three. In another scenario, the lowest external cause specific unintentional childhood injury mortality rates from the 50 US states and the District of Columbia were summed to provide the ‘‘ideal’’ lowest conceivable unintentional childhood injury mortality rate from all causes. Ecological correlations between unintentional childhood injury mortality rates from specified external causes, median income, and percent of the population with a college degree were made. The main outcome measures were unintentional childhood injury mortality rates by cause. Results showed that the unintentional childhood injury mortality rate declined by 3.5% per year in the country as a whole. If every region of the US had experienced the same injury rate as the Northeast, then one third of all unintentional childhood injuries would not have occurred. More optimistic scenarios indicate that up to two thirds of all unintentional childhood injury deaths could be prevented. Across states, unintentional childhood injury mortality is strongly inversely related to median income. In conclusion, about one third of all unintentional childhood injury deaths in the US are preventable with the means and resources available in the Northeastern states. Among the relevant characteristics in the Northeast region, in comparison with other US regions, are the higher education level of parents, the lower gun ownership, the higher population density that implies shorter distances traveled by cars, a better developed emergency medical system, and the existence of several injury prevention programs.

BACKGROUND: Toddler-aged children are vulnerable to unintentional injuries, especially those in low-income families. OBJECTIVE: To examine the effectiveness of an intervention grounded in social cognitive theory (SCT) on the reduction of home safety problems among low-income families with toddlers. METHODS: 277 low-income mother-toddler dyads were randomised into a safety promotion intervention (n=91) or an attention-control group (n=186). Mothers in the safety promotion intervention group received an eight-session, group-delivered safety intervention targeting fire prevention, fall prevention, poison control and car seat use, through health education, goal-setting and social support. Data collectors observed participants' homes and completed a nine-item checklist of home safety problems at study enrolment (baseline), 6 and 12 months after baseline. A total score was summed, with high scores indicating more problems. Linear mixed models compared the changes over time in home safety problems between intervention and control groups. RESULTS: The intent-to-treat analysis indicated that the safety promotion intervention group significantly reduced safety problems to a greater degree than the attention-control group at the 12-month follow-up (between-group difference in change over time ß=-0.54, 95% CI -0.05 to -1.03, p=0.035), with no significant differences at the 6-month follow-up. CONCLUSIONS: A safety promotion intervention built on principles of SCT has the potential to promote toddlers' home safety environment. Future studies should examine additional strategies to determine whether better penetration/compliance can produce more clinically important improvement in home safety practices. TRIAL REGISTRATION NUMBER: NCT02615158; post-results.

Background Toddler-aged children are vulnerable to unintentional injuries, especially those in low-income families. Objective To examine the effectiveness of an intervention grounded in social cognitive theory (SCT) on the reduction of home safety problems among low-income families with toddlers. Methods 277 low-income mother–toddler dyads were randomised into a safety promotion intervention (n=91) or an attention-control group (n=186). Mothers in the safety promotion intervention group received an eight-session, group-delivered safety intervention targeting fire prevention, fall prevention, poison control and car seat use, through health education, goal-setting and social support. Data collectors observed participants' homes and completed a nine-item checklist of home safety problems at study enrolment (baseline), 6 and 12 months after baseline. A total score was summed, with high scores indicating more problems. Linear mixed models compared the changes over time in home safety problems between intervention and control groups. Results The intent-to-treat analysis indicated that the safety promotion intervention group significantly reduced safety problems to a greater degree than the attention-control group at the 12-month follow-up (between-group difference in change over time ß=-0.54, 95% CI -0.05 to -1.03, p=0.035), with no significant differences at the 6-month follow-up. Conclusions A safety promotion intervention built on principles of SCT has the potential to promote toddlers' home safety environment. Future studies should examine additional strategies to determine whether better penetration/compliance can produce more clinically important improvement in home safety practices.

OBJECTIVE: To test the efficacy of installing safety devices in the homes of young children on total injury rates and on injuries deemed a priori modifiable by the installation of these devices. DESIGN: A nested, prospective, randomized controlled trial. SETTING: Indoor environment of housing units. PARTICIPANTS: Mothers and their children from birth to 3 years old participating in the Home Observation and Measures of the Environment study. Among 8878 prenatal patients, 1263 (14.2%) were eligible, 413 (32.7%) agreed to participate, and 355 were randomly assigned to the intervention (n = 181) or control (n = 174) groups. INTERVENTION: Installation of multiple passive measures (eg, stair gates, cabinet locks, and smoke detectors) to reduce exposure to injury hazards. Injury hazards were assessed at home visits by teams of trained research assistants using a validated survey. MAIN OUTCOME MEASURE: Modifiable and medically attended injury (ie, telephone calls, office visits, and emergency visits for injury). RESULTS: The mean age of children at intervention was 6.3 months. Injury hazards were reduced in the intervention homes but not in the control homes at 1 and 2 years (P < .004). There was no difference in the rate for all medically attended injuries in intervention children compared with controls: 14.3 injuries (95% confidence interval [CI], 9.7-21.1 injuries) vs 20.8 injuries (95% CI, 14.4-29.9 injuries) per 100 child-years (P = .17); but there was a significant reduction in the rate of modifiable medically attended injuries in intervention children compared with controls: 2.3 injuries (95% CI, 1.0-5.5 injuries) vs 7.7 injuries (95% CI, 4.2-14.2 injuries) per 100 child-years (P = .03). CONCLUSION: An intervention to reduce exposure to hazards in homes led to a 70% reduction in the rate of modifiable medically attended injury.

BACKGROUND: Young children are at risk for injuries in the home. This study was to compare a safe house model to The Injury Prevention Program (TIPP) sheet for providing injury prevention information. METHODS: Parents of children who were younger than 6 years were randomized to injury prevention education using a safe home model or an age appropriate TIPP sheet. There was a pretest before the intervention. The recall of injury prevention information was assessed by a telephone posttest 4 weeks to 6 weeks after the intervention. To obtain a sample broadly representative of community demographics, we recruited families in the dermatology clinic of a teaching hospital. RESULTS: We collected complete information for 371 families of which 181 were in the safe home model group and 190 were in the TIPP group. There were no differences between groups in percent minority race, education, or insurance; the parents in the safe home group were slightly older (34.4 ± 6.5 vs. 32.9 ± 5.8). More than 80% in each group had education beyond high school. There was no difference between groups in pretest scores, 8.0 ± 1.3 for the safe home model group and 8.1 ± 1.1 for the TIPP group. There was no difference between groups in posttest scores, 9.0 ± 0.8 for the safe home model group and 9.1 ± 0.9 for the TIPP group. CONCLUSIONS: The safe home model and the TIPP sheets were both effective in improving safety knowledge. The use of a safe home model complements current strategies to improve injury prevention knowledge.

The aim of this study was to test an intervention aimed at addressing the risk of injury in infants 2 - 12 months of age. A non-blinded, randomized controlled trial was conducted, whereby parents were randomly assigned to either a control or one of two intervention groups. Parents completed questionnaires regarding safety behaviours and injuries at the 2 (baseline), 6 and 12 month immunization visit at the community health unit. During the 2 month visit to the health unit, the two intervention groups received a home safety kit containing nine items, an instructional brochure and a risk assessment checklist. Subjects randomized to the safety kit plus home visit group also received a standardized home visit from a community health nurse. Two of the 14 parental safety behaviours showed a significant increase in use among parents in the intervention groups. Neither of the interventions was associated with a reduction in parent-reported injuries among children. It was concluded that home visitation may provide a beneficial adjunct to the provision of safety devices and may increase use by parents.

The objective of this study was to assess the effectiveness of an emergency department (ED)-based home safety intervention on caregivers’ behaviors and practices related to home safety. The authors conducted a randomized, clinical trial of 96 consecutive caregivers of children who were younger than 5 years and presented to an urban pediatric ED for evaluation of an acute unintentional injury sustained in the home. After completing a structured home safety questionnaire via face-to-face interview, caregivers were randomly assigned to receive either comprehensive home safety education and free safety devices or focused, injury-specific ED discharge instructions. Participants were contacted by telephone 2 months after the initial ED visit for repeat administration of the safety questionnaire. The pretest and posttest questionnaires were scored such that the accrual of points correlated with reporting of safer practices. Scores were then normalized to a 100-point scale. The overall safety score reflected performance on the entire questionnaire, and the 8 category safety scores reflected performance in single areas of home injury prevention (fire, burn, poison, near-drowning, aspiration, cuts/piercings, falls, and safety device use). The main outcome was degree of improvement in safety practices as assessed by improvement in safety scores. Results showed that the intervention group demonstrated a significantly higher average overall safety score at follow- up than the control group (73.3% + or - 8.4% vs 66.8% + or - 11.1) and significant improvements in poison, cut/piercing, and burns category scores. Caregivers in the intervention group also demonstrated greater improvement in reported use of the distributed safety devices. In conclusion, this educational and device disbursement intervention was effective in improving the home safety practices of caregivers of young children. Moreover, the ED was used effectively to disseminate home injury prevention information.

A review of the Conference on Prevention of Injury in Childhood, Ottawa, November 1991.

This 2000-1 CAPFNZ Summer Research Scholarship report identifies and examines various issues related to the cycling safety of urban Hamilton (N.Z.) school children aged between eight and 15 years of age. The report "... outlines, discusses and evaluates the various negative and positive variables that affect the level of cycling safety experienced by urban school children. ... The underpinning objective of this report is to create an accessible resource of information and recommendations relevant to any party interested in the safety of child cyclists in urban areas".

This 1999-2000 CAPFNZ Summer Research Scholarship research investigated the issues involving dog attacks on children, specifically by dogs known to the child. The report identifies the circumstances and conditions which may result in an attack by a family dog. This report provides research-based recommendations to reduce the incidence and severity of dog attacks on children. A qualitative approach was applied, including examination of both New Zealand and overseas research on this issue.

This report backgrounds the establishment of the Eastern Bay of Plenty Child Injury Prevention Trust, the achievements, tasks completed and the future of the Trust.

The webpage for this US report states: "Helping Kids Play Safely ... Protecting kids from the potential risk of tip-overs by making sure furniture and TVs are secured is an important way to help keep them safe. Why it Matters Between 2000 and 2010, on average, every three weeks a child dies from a TV tipping over. And nearly 13,000 more children are injured each year in the U.S. Top-heavy furniture, TVs and appliances can be unsteady, and if pulled or climbed on, they can tip over and seriously injure young children. Over the last ten years, injuries from TV tip-overs have risen by 31 percent. Young children are at greatest risk and seven out of ten children injured by TV tip-overs are 5 years old or younger. These tragedies are completely preventable with just a few simple precautions. Much like childproofing with a toddler gate or electrical socket cover, TV mounts and furniture straps are important steps to keep your family safe. Remember, a curious, determined child can topple a TV. Children playing with friends or pets could knock a TV over, while other kids might be tempted to climb up to reach items placed on or near a TV, such as remote controls or candy." This item has loose in the front of it a "Tip Sheet" which includes some of this advice: "Top safety tips to help prevent tip-over hazards - Check TVs - Assess the stability of the TVs in your home. - Secure TVs - Mount flat screen TVs to the wall to reduce the risk of TVs toppling off stands. Follow the manufacturer’s instructions to ensure you protect your wall and have a secure fit. - If you have a large, heavy, old-style cathode ray tube (CRT) TV place it on a low, stable piece of furniture. - Secure Furniture - Use brackets, braces or wall straps to secure unstable or top-heavy furniture to the wall. - Install stops on dresser drawers to prevent them from being pulled all the way out. Multiple open drawers can cause the weight to shift, making it easier for a dresser to fall. - Rearrange Household Items - Keep heavier items on lower shelves or in lower drawers. - Avoid placing remote controls, food, toys or other items in places where kids might be tempted to climb up or reach for them." There is also a media release and infographic available. PDF available at: http://www.safekids.org/safety-basics/safety-spotlight/TV-and-furniture-tip-overs/

On November 13–14, 2003, a symposium on high-visibility safety belt use enforcement in Raleigh, NC: (a) celebrated the 10th anniversary of North Carolina’s Click It or Ticket program; (b) documented current knowledge regarding safety belt use; (c) proposed strategies to increase use further; and (d) discussed research to support these strategies.

Childhood injuries cause significant mortality and morbidity in Singapore. With injury surveillance, patterns of repeated injury can be identified and injury prevention strategies devised. The authors conducted a retrospective study of all children aged 12 and below seen for trauma in an Emergency Department over one year. Data captured in the real-time computer system was studied with regards to patient profile, mechanism of injury and patient disposition. Clinical summaries were extracted with follow-up telephone interviews done. Results showed that two thousand five hundred and seventeen children aged 12 and below were seen for accidental trauma in 1999, accounting for 37.1% of the total attendance for that age. Mean age was 7.7 years with males making up 62.7%. Home injuries (56.4%) were the most common, followed by road-related (14.4%), sports (8.2%) and playground injuries (7.4%). 48.5% sustained head and face injuries. Pre-school children (age <5) were more likely to sustain home injuries, a higher proportion of head injuries, foreign bodies, burns and poisoning compared to school-going children (age 6-12), who were more likely to sustain injuries in road accidents, sports, at playgrounds or schools, with more limb, trunk and multi-trauma. We highlight drownings, falls from height, rollover falls from beds, slamming door injuries, the low use of child car restraints, bicycle injuries and playground falls as areas of concern. In conclusion, several injury prevention strategies have been suggested and it is hoped these may contribute to addressing preventable childhood injuries in Singapore. The authors also advocate the establishment of a national childhood injury surveillance database.

This literature review identifies a selection of good practices associated with recent home visitation interventions reported to reduce childhood injury. This article also outlines a composite definition of home visitation for injury prevention and health promotion. The burgeoning injury surveillance and prevention sector has identified child injury in low-income South African communities as a public health priority, necessitating the identification, development and implementation of especially primary injury prevention interventions. Home visitation programmes have been implemented and evaluated for a number of decades. Essential good practices of home visitation are identified from these studies and publications. Initially, programme process and outcome evaluations were under utilised and poorly described. The more recent literature indicates that the success of home visitation programmes may depend on the following specific methodological components: (1) a supportive and trusting relationship between the visitor and the client; (2) a flexible and socially congruent approach to interaction with the client; (3) the contextualisation of the individual within his or her environment; (4) a long-term programme with frequent visits; and (5) the application of a multi-method injury prevention approach, incorporating epidemiological, environmental, enforcement, training as well as technological products into the initiative. The utilization of non-professional members of the community to perform home visits is also an important, but more contested issue identified in the literature. The article focuses on these good practice methodological elements, discusses possible useful combinations of these elements, but also points out some of their limitations. The results of some studies remain controversial, and further investigation is needed.

Globally, drowning is one of the ten leading causes of child mortality. Children aged <5 years are particularly at risk, and children and young people continue to be overrepresented in drowning statistics. Accordingly, evidence informed interventions to prevent children drowning are of global importance. This review aimed to identify, assess and analyse public health interventions to reduce child drowning and investigate the use of behavioural theories and evaluation frameworks to guide child drowning prevention. Thirteen databases were searched for relevant peer reviewed articles. The systematic review was guided by the PRISMA criteria and registered with PROSPERO. Fifteen articles were included in the final review. Studies were delivered in high, middle and low income countries. Intervention designs varied, one-third of studies targeted children under five. Almost half of the studies relied on education and information to reduce drowning deaths, only three studies used a multi-strategy approach. Minimal use of behavioural theories and/or frameworks was found and just one-third of the studies described formative evaluation. This review reveals an over reliance on education and information as a strategy to prevent drowning, despite evidence for comprehensive multi-strategy approaches. Accordingly, interventions must be supported that use a range of strategies, are shaped by theory and planning and evaluation frameworks, and are robust in intervention design, delivery and evaluation methodology. This approach will provide sound evidence that can be disseminated to inform future practice and policy for drowning prevention

This review article looks at the campaigns and programmes that have been put in place to encourage the use of bicycle helmets. it then considers future challenges

The authors provide a brief critical review and assessment of engineering modifications to the built environment that can reduce the risk of pedestrian injuries. In this review, they used the Transportation Research Information Services database to conduct a search for studies on engineering countermeasures documented in the scientific literature. They classified countermeasures into 3 categories- speed control, separation of pedestrians from vehicles, and measures that increase the visibility and conspicuity of pedestrians. They determined the measures and settings with the greatest potential for crash prevention. Their review, which emphasized inclusion of studies with adequate methodological designs, showed that modification of the built environment can substantially reduce the risk of pedestrian-vehicle crashes.

The purpose of this report is to provide an overview of research studies on pedestrian safety in the United States; some foreign research also is included. Readers will find details of pedestrian crash characteristics, measures of pedestrian exposure and hazard, and specific roadway features and their effects on pedestrian safety. Such features include crosswalks and alternative crossing treatments, signalization, signing, pedestrian refuge islands, provisions for pedestrians with disabilities, bus stop location, school crossing measures, reflectorization and conspicuity, grade separated crossings, traffic-calming measures, and sidewalks and paths. Pedestrian educational and enforcement programs also are discussed.

A review of studies examining risk factors for child pedestrians over a ten year period classified the risks into child, social and cultural, physical environment and driver.

The main problems facing child pedestrians are summarised and the solutions currently open to researchers, policy makers and practitioners discussed. Methods of increasing safety include educational programmes, engineering techniques and enforcement of speed limits and appropriate driver behaviour.

Prams and strollers are commonly used in daily childcare. We aim to study the type and severity of injuries associated with prams and strollers in an Asian population. We performed a retrospective review of children below the age of 6 who presented to a tertiary paediatric hospital in Singapore, from January 2012 to June 2015, with such injuries. There were 248 pram-related and stroller-related injuries. The median age was 12.5 months old. 69 (27.8%) sustained open wounds, 17 (6.9%) suffered fractures or dislocations and 2 children had significant head injuries. 29 patients (11.7%) sustained injuries while on stairs or escalators. Most of the injuries (197 cases, 79.4%) occurred despite adult supervision. The need for intervention was associated with older age and entrapment injuries (p<0.001). Only appropriately sized prams and strollers without exposed hinges should be used. These should not be deployed on stairs and escalators.

This plan is an attempt by the Waitakere City Council to reduce the cost of road injury through greater coordination between agencies and with the community. More specifically, the plan is a means of articulating the Council's guiding principles for health and safety in relation to road safety, under the broader context of it's Transport and Communications Strategy.

This is a fold out pamphlet from the LTSA which introduces the Crash Analysis System (CAS) and contact information for the CAS helpdesk. The Land Transport Safety Authority’s CAS is a vital tool in New Zealand’s drive to reduce road trauma. CAS is a tool that manages, analyses and maps traffic crash and related data. It is a computer system in which people can:; enter road crash data; select crashes for analysis; map crashes; view images of the crash report diagrams; locate and map crash clusters; report on crashes or crash clusters; monitor trends at crash sites; automate the production of collision diagrams; identify high-risk locations. The information CAS provides is used to help analyse and determine road safety funding allocations. It is also used in the targeting of road safety programmes and the monitoring of their performance. In this way CAS provides a platform for the development and implementation of new road safety initiatives, making a significant contribution to crash prevention in New Zealand. Because it integrates mapping with other functions, CAS represents a significant advance over previous crash analysis systems. A key innovation is the ability to link crash and roading data.

This paper highlights the need for increased awareness in schools regarding the vulnerability of injured children and adolescents and the role school health professionals can play as important resources for injured students and their families. Useful list of recommendations.

This printout of a webpage contains information about caring for nursery furniture to ensure it remains safe to use and some general comments about: keeping nursery furniture away from strangulation hazards like curtain cords and electrical cords, the value of the use of safety barriers, etc. See: http://www.consumeraffairs.govt.nz/productsafety/consumerinfo/safehome.html

Pamphlet urging cyclists to report problems encountered while cycling in Auckland city eg. poor road surface, service covers loose, missing signs etc. Also asks for suggestions for their Cycling and Walking Strategy with the aim of making cycling and walking in Auckland city safe, viable and easy to do.