Closing the Aboriginal child injury gap: targets for injury prevention

Objective : To describe the leading mechanisms of hospitalised unintentional injury in Australian Aboriginal children and identify the injury mechanisms with the largest inequalities between Aboriginal and non‐Aboriginal children. Methods : We used linked hospital and mortality data to construct a whole of population birth cohort including 1,124,717 children (1,088,645 non‐Aboriginal and 35,749 Aboriginal) born in the state of New South Wales (NSW), Australia, between 1 July 2000 and 31 December 2012. Injury hospitalisation rates were calculated per person years at risk for injury mechanisms coded according to the ICD10‐AM classification. Results : The leading injury mechanisms in both groups of children were falls from playground equipment. For 66 of the 69 injury mechanisms studied, Aboriginal children had a higher rate of hospitalisation compared with non‐Aboriginal children. The largest relative inequalities were observed for injuries due to exposure to fire and flame, and the largest absolute inequalities for injuries due to falls from playground equipment. Conclusion : Aboriginal children in NSW experience a significant higher burden of unintentional injury compared with their non‐Aboriginal counterparts. Implications for Public Health : We suggest the implementation of targeted injury prevention measures aimed at injury mechanism and age groups identified in this study.     

重视儿童伤害预防 落实有效干预措施

伤害是全球儿童面临的健康威胁,也是中国1~17岁儿童的首位死因。儿童伤害预防是非常具有投入产出效益的一项公共卫生措施,国内外多年的研究和实践也证明相关儿童伤害干预措施的有效性。建议加强伤害防控工作的部门分工与协调机制,确保必要的财政经费支持,以广泛实施各项有效的干预措施,保障儿童健康成长。     

Legislation seeks to exclude inmates from ADA coverage

U.S. Senator Strom Thurmond has revived legislation aimed at excluding inmates and pretrial detainees from protections under the Americans with Disabilities Act (ADA). S. 33 seeks to reverse a U.S. Supreme Court ruling that says inmates are covered under the act. The Senator introduced a similar bill in 1998, but it died when Congress adjourned. Thurmond was concerned that prisoners with AIDS and other disabilities would demand special privileges and tie up the courts with lawsuits related to their rights under ADA.     

中国中西部农村地区儿童基本免疫接种覆盖现状调查分析

目的 了解中西部农村地区近五年儿童计划免疫接种情况, 为制定针对性的接种策略提供参考依据。方法 选取甘肃、贵州、广西、陕西四省作为研究地点, 根据国际妇幼死亡预测软件LiST(the Lives Saved Tool), 开发“妇幼卫生干预覆盖调查问卷”, 采用一次性横断面抽样入户调查, 按照调查母亲提供的儿童免疫接种卡, 逐项填写相关信息。结果 2012年度调查地区儿童卡介苗接种覆盖率最高, 达到99%以上, 其次为麻疹疫苗, 达到95%以上;脊髓灰质炎疫苗、百白破疫苗、乙肝疫苗的覆盖率在80%左右, 国家计划外疫苗如流感嗜血杆菌疫苗、肺炎球菌疫苗、轮状病毒疫苗接种率均在10%以下;调查地区2012年出生儿童卡介苗、麻疹、乙肝疫苗的适龄接种覆盖率分别为96.4%、89.4%、79.3%, 其它疫苗适龄接种覆盖率均在60%以下。结论 免疫接种服务可以有效改善低龄儿机体免疫能力, 是农村儿童免疫工作质量提升的重要内容;在目标人群上, 少数民族、低教育程度家庭、低龄生育父母的儿童需得到更多关注;在接种范围上, 扩大农村地区B型流感嗜血杆菌、肺炎球菌的接种覆盖, 有待进一步论证和试点。     

我国暴力流行及预防控制现状分析

目的 分析我国暴力流行水平及预防和控制现状,为开展暴力预防工作提供依据。方法 利用2006-2013年全国疾病监测系统中的暴力死亡率数据和2013年全国伤害监测系统数据,分析暴力死亡和因暴力就诊病例的流行特征,梳理我国暴力预防的法律与政策、信息收集能力及暴力干预和受害者服务等工作现状。结果 我国暴力死亡粗率从2006年的1.21/10万下降至2013年的0.65/10万,下降了46.3%。2013年男性暴力死亡率在30～34岁年龄组出现1个峰值(1.42/10万),15岁以前暴力死亡处于较低水平;女性在婴儿、30～34岁以及≥85岁出现3个暴力死亡峰值,死亡率分别为0.84/10万、0.72/10万和1.18/10万,其他年龄段暴力死亡率较低。预防各类暴力的策略分散体现在我国法律、政策中,我国预防家庭暴力的法律尚不完善;尚缺乏各类暴力发生率数据;干预服务多基于规模、时间有限的项目开展。 结论 2006-2013年我国暴力死亡粗率及标化死亡率均呈下降趋势,预防暴力可根据性别差异采取不同策略,我国暴力预防和控制可在法律完善、数据收集、服务常规化等方面开展更多工作。     

Assessment of a pilot child playground injury prevention project in New York State.

Following a child playground equipment injury prevention project conducted in New York State in 1977, there was a 42 per cent reduction in playground equipment hazards, and a 22.4 per cent reduction in playground related injuries treated in the two largest hospitals of one of the program sites. Knowledge about unsafe playground practices and equipment hazards improved after the workshops for playground personnel. This approach to injury prevention deserves further study.     

进一步推动我国儿童伤害预防控制工作

伤害是危害我国儿童健康的重要公共卫生问题。我国已开展了大量预防儿童伤害的实践和科学研究，儿童伤害疾病负担已有所减轻，但伤害仍是造成儿童死亡的第1位原因，预防儿童伤害应被列为促进儿童健康的优先工作领域。健全和完善以政府为主导、多部门合作的儿童伤害预防机制，开展系统、全面、科学的儿童伤害预防控制工作，是降低我国儿童伤害疾病负担的重要策略。建议依托《"健康中国2030"规划纲要》完善伤害预防相关政策法规，制定和颁布实施儿童伤害预防行动计划，深入开展预防儿童伤害的实践和科学研究，加强儿童伤害防控的队伍建设和人才培养，以达到减少儿童伤害，促进儿童健康的目的。     

长风破浪会有时直挂云帆济沧海——中国伤害预防与控制的进程与展望

经历了四分之一世纪的探索和实践,中国的伤害预防与控制从高校的理论研究到疾病预防控制中心的现场实务,从地方到国家再回归到社区,快速赶上发达国家的步伐,形成具有中国特色的伤害控制模式：有伤害控制机构和专业队伍,有高校伤害研究中心,有伤害预防与控制专业委员会和6个专科委员会,召开了8次全国学术会议,出版一批伤害专著和《伤害医学》杂志。党的十九大的健康中国战略部署及中共中央和国务院2016年10月发布的《"健康中国2030"规划纲要》将为我国的伤害预防与控制带来第二个春天。     

我国伤害预防与控制工作的主要进展及展望

伤害是一个不容忽视的公共卫生问题,不仅严重威胁人民的生命健康,所造成的致死、致残及其他后果也给社会、家庭及个人带来了沉重的疾病负担和经济损失。20世纪80年代以来,在一大批矢志不移的专家和伤害防控人员的不断努力下,我国的伤害防控事业得以迅速壮大和发展。本文回顾了在这三十几年里,我国伤害预防与控制工作取得的成绩和存在的问题,并对今后一段时期的工作提出了建议。     

推进我国伤害预防策略研究与应用

@@     

兼程并进,开展我国伤害预防与控制研究

我国伤害死亡率为65.24/10万,每年大约有70万人死于各类伤害.在我国的死因构成中,伤害死亡率仅次于呼吸道疾病、恶性肿瘤和脑血管疾病居第四位,1990～1995年我国疾病监测资料表明,伤害死亡占全部死亡的11%,疾病负担占17%,潜在寿命损失年数占24%.在各类伤害中以自杀死亡率最高(19.58/10万),交通事故死亡率次之(13.55/10万),二者均高于世界其他各国,伤害的第三位致死原因是淹死(8.77/10万),是14岁以下儿童的首位死亡原因.     

Opportunities for prevention in primary care in a country with universal insurance coverage

Data from studies in the United States suggest that young people engaging in health-compromising behaviors have lower access to health care. Using data from a Swiss national survey we tested the hypothesis that in a country with universal insurance coverage, adolescents engaging in health-compromising behaviors access primary care to the same extent as those who do not engage in these behaviors.     

中国伤害防控工作面临的主要挑战与应对策略

随着中国经济的持续快速发展,伤害在20世纪后期就已成为威胁中国居民健康的重要疾病之一,其死因顺位排名一直靠前。尽管中国政府已将伤害防控工作纳入《“健康中国2030”规划纲要》《健康中国行动(2019―2030年)》《中国儿童发展纲要(2021―2030年)》等国家健康发展规划,但与中国总体卫生健康事业的快速发展相比,国内伤害防控工作发展速度滞后于传染性疾病和慢性非传染性疾病防控工作。目前,我国伤害防控工作面临的主要挑战包括：(1)伤害预防立法不完善,执法力度待加强;(2)缺乏牵头部门协调全国伤害防控工作;(3)缺乏专业队伍落实日常伤害预防工作;(4)伤害预防研究缺乏必要的支持。针对这些挑战,作者提出了相应的应对策略。     

The role of NGOs in child injury prevention: An organizational assessment of one network of NGOs

Unintentional injuries are estimated to claim the lives of more than 875,000 children each year; millions more live with long-term consequences and permanent disabilities. The epidemiology of injuries has become clearer in the past decade. NGOs need to work in concert with each other to address the global burden of injuries by sharing information. Several NGOs have heeded this call, and the field has seen the emergence of global organizations aimed at highlighting the burden of injuries and streamlining injury prevention activities worldwide. Safe Kids Worldwide Inc. (SKWW) is a global network in 16 countries whose mission is to address the burden of injuries in children under 15 by harnessing the potential of local NGOs. An organizational assessment was conducted of SKWW which included structured organizational assessment, functional organizational mapping and contextual analysis that allowed for an in-depth examination of the strengths and challenges of SKWW's injury prevention approach. Over one year, primary and secondary data were collected and analyzed from headquarters and individual country offices. SKWW appears to be an effective model and has experienced a strong momentum and growth over the last two decades. Global NGOs that address the burden of injuries should start by defining a clear and universal strategic goal, build on local successes, maximize their strengths, and create avenues for stronger country engagement.