The association of infant feeding with parent-reported infections and hospitalisations in the West Australian Aboriginal Child Health Survey

OBJECTIVE: To examine infant feeding associations with parent-reported infections and hospitalisations in Western Australian Aboriginal infants and children. METHOD: Families in Western Australia with children under 18 years of Aboriginal or Torres Strait Islander descent were included. A stratified multi-stage sample using an area-based sampling frame was compiled. Survey weights produced unbiased estimates for the population of families with Aboriginal children. Data were collected on demographic variables, maternal and infant characteristics and parent-reported recurring chest, ear and gastrointestinal infections. The data were linked to the Hospital Morbidity System to identify hospitalisations for infections for the same children. RESULTS: Twenty-seven per cent of Aboriginal children were breastfed for less than three months. Parent-reported recurring chest, ear and gastrointestinal infections were reported in 47% of the 0-3 age group. Hospitalisations due to upper respiratory and gastrointestinal infections were most common in the older children, but wheezing lower respiratory infections were most common in younger children. Breastfeeding for less than three months and birth weight less than 2,500 g were risk factors for parent-reported chest infections and hospitalisations for upper and wheezing lower respiratory infections (p<0.05). CONCLUSION: Rates of parent-reported chest infections and hospitalisations due to these infections continue to be high in Aboriginal infants and children. Because breastfeeding for less than three months and low birth weight are risk factors for these infections, interventions to reduce the prevalence of low birth weight and to increase breastfeeding rates should be primary health goals in Aboriginal communities for the benefits of Aboriginal infants and children.     

A detailed analysis of work-related injury among youth treated in emergency departments

Telephone interviews were conducted with 146 14- to 16-year-olds who incurred an occupational injury treated in an emergency department during the period July through September 1992. Thirty-two percent of the injuries occurred as the result of using equipment. Over half the workers reported not having received prior training on how to avoid injury. The injury limited normal activities for at least 1 day for 68% of the youth and for more than a week for 25%, corresponding to an estimated 6,208 (95% CI: 4,277, 8,139) and 2,639 (95% CI: 1,580, 3,699) youths nationwide, respectively. Employment in retail trades, equipment use, lack of training, and burn injuries were associated with increased limitation of normal activities. Nineteen percent of the youths appear to have been injured in jobs declared to be hazardous, or typically prohibited for their age (14-and 15-year-olds) under federal child labor laws. The prohibited job directly contributed to the injury in 64% of these cases.     

Adolescent work patterns and work-related injury incidence in rural Minnesota

BACKGROUND: Although there have been many studies on working youth in the United States, we have noted none which have provided a broad picture of adolescent work practices in a rural community. METHODS: Six high schools in rural Minnesota were evaluated for adolescent work practices. Schools ranged in size from 173 to 525 students in grades 9 through 12. A 20 page self-administered survey examining work practices was administered to students. RESULTS: A total of 2,250 students completed the survey, representing 92% of the student body. Twenty-eight percent of students lived on a farm. Approximately 45% of the male students and slightly more than 21% of the females were involved in farm work. Only 2.6% of students were injured during this 8-month time period in farm-related activities, and 5.1% were injured doing non-farm work. Many students reported working long hours. CONCLUSIONS: Work represents a serious problem for rural youth. These data are significant in the context of national policy discussion concerning the failure of the Fair Labor Standards Act to regulate the agricultural environment.     

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.     

Patterns of injury in indigenous Australians admitted to Cairns Base Hospital

Aim:  To study and compare the type and frequency of injury to indigenous and non-indigenous patients admitted to the Orthopaedic Unit at Cairns Base Hospital.
Method and analysis:  Relevant statistics for all patients were entered or calculated: demographics, length of stay, comorbidity and complications were available. After Variance Analysis, age-standardised rates of trauma were tested using confidence intervals.
Results:  Of 2254 admissions for trauma in 32 months, 23% were indigenous (12% of the catchment population). Upper limb injuries were significantly higher for all indigenes, these males being admitted three times as frequently as non-indigenous males. Specific lesions showed greater differences and punch injuries were prominent in both indigenous sexes. Indigenous women were much more likely to be the victims of assault or fights than other groups.
Conclusions:  Personal injury costs are high in the indigenous community, in human and material terms. More resources should be directed towards injury prevention.     

Father–child interactions and children's risk of injury

Unintentional injury is an important cause of infant and child hospitalisation and parents play a key role in reducing children's risk-taking behaviour. Studies show that maternal and paternal parenting and supervision of children differ, but there is little research showing how fathers’ parenting may influence children's tendency to engage in risk-taking behaviour. Recent theoretical developments suggest that father's parenting may be particularly effective in encouraging safe risk taking. In this study, we examine how well parenting practices typically undertaken by fathers predict rates of children's injury risk at three years. Questionnaire data were collected from 46 fathers. Results show that both duration of rough-and-tumble play and fathers’ encouragement of perseverance predicted lower rates of injury behaviours, while their stimulation of risk taking predicted higher rates of injury behaviours. The results are discussed in the light of developmentally appropriate risk taking and fathering.     

Accreditation trends in Spain

The profound political changes that followed the Spanish Constitution of 1978 have had a major influence in the healthcare offered to the Spanish population. The healthcare provision once centred in a single government agency, the Instituto Nacional de la Salud (INSALUD), is now being decentralized to the 17 autonomous regions established by the Constitution. Existing Spanish legislation, traditional accountability and established professional roles are determinant factors in defining the boundaries amongst the main stakeholders in the healthcare accreditation issue. Hospital accreditation has been traditionally understood by the central government agency as a way to assure regulated standards for licensing the operations of healthcare facilities. However, recent public concern over the quality of healthcare, health departments' accountability and health professional technical knowledge are now creating the search for a common approach to accreditation in Spain.     

The mediating role of hyperactivity and inattention on sex differences in paediatric injury risk

Background Extensive research suggests that risk of injury is higher among young boys versus young girls. The present study examined a mediational model to identify mechanisms that may explain differences in injury risk. Methods Reports of child behaviour and two indices of injury risk among 114 children in early childhood were obtained from parents in community‐based paediatric medical centres. Results Regression analyses and post‐hoc examination of indirect effects supported a mediation model in which the relationship between child sex and child injury risk was explained by hyperactivity and inattention. Conclusions Interventions that promote child well‐being by targeting constellations of externalizing behaviour problems may simultaneously decrease paediatric injury risk.     

珠海市城区幼儿园儿童伤害现况及影响因素分析

【目的】 了解珠海市城区幼儿园儿童意外伤害现况,明确儿童意外伤害的影响因素,为开展伤害的预防工作提供依据。 【方法】 分层随机整群抽取12所幼儿园,对1 428名2~6岁儿童的父母进行回顾性调查,了解研究对象在2010年3月-2011年3月期间的意外伤害情况。 【结果】 珠海市城区幼儿园儿童的意外伤害发生率为53.2%。常见的伤害种类是跌伤(26.8%)、碰伤(16.1%)、咬伤和抓伤(13.0%)。伤害发生的危险因素为儿童左利手、母亲不良管教方式、儿童骑童车母亲未监管、儿童坐立不定、家庭月总收入、家里有玻璃家具;保护因素为家庭备有急救小药箱、母亲对伤害认识正确、母亲定期检查玩具。 【结论】 应针对儿童意外伤害发生的影响因素,采取综合安全防范措施。     

2002-2011年中国1~14岁儿童伤害死亡率水平和变化趋势

目的 分析中国1~14岁儿童伤害主要死因及死亡率变化趋势,为制定更有针对性的干预措施提供科学依据。方法 利用公开发表的2003-2012年中国卫生统计年鉴居民病伤死亡原因报表资料进行分析。结果 2002-2011年全国1~14岁儿童总标化伤害死亡率在13.97/10⁵~23.24/10⁵之间,呈逐年下降趋势;溺水身亡和车祸是儿童主要伤害死亡原因,占儿童历年伤害死亡的70%以上;农村儿童总伤害死亡率约为城市儿童的1.7倍,并且车祸死亡率在农村呈上升趋势;1～4岁儿童总伤害标化死亡率和溺水身亡率明显高于5～9岁以及10～14岁儿童;男性儿童总伤害标化死亡率是女性儿童的1.8倍,溺水身亡率是女性儿童的2.0倍。结论 中国1～14岁儿童伤害死亡率逐年下降,溺水身亡和车祸是主要死亡原因,农村儿童车祸死亡率有上升趋势;农村儿童伤害死亡率高于城市,男性儿童高于女性儿童,1～4岁儿童高于5～9岁和10～14岁。     

澳大利亚双生子登记系统概述

双生子研究是遗传流行病学复杂疾病研究的一种非常独特的方法.同卵双生子有着相同的基因,而异卵双生子平均有50%相同的基因,因此可以通过比较同卵双生子和异卵双生子疾病或性状的一致性,来确定其是否受遗传的作用,以及遗传和环境作用的相对大小.     

Nature and incidence of self-reported adolescent work injury in minnesota

Most studies of adolescent work-related injury that have been published to date have been confined to administratively collected data available through state or national departments of labor and industry and/or occupational safety and health administrations. These data do not contain information on the severity or the sequelae of injuries. In addition, estimates of incidence may be biased due to inadequate data on the nature, amount, and seasonal variability of work done by adolescent workers. The present study is a cross-sectional survey of work and work injuries of 3,051 10th through 12th grade students from 39 high schools throughout Minnesota. Injury was defined as an event which caused any of the following: loss of consciousness, seeking medical care, and/or restricting normal activities for at least 1 day. The average hours of work per week during the summer and during the school year were 30 (95% Confidence Interval [CI] = 27,33) and 16 (95% CI = 15, 17), respectively. There was no difference in hours worked between ethnic minorities and white students. The rate of reportable injuries was 12 per 100,000 hr worked (95% CI = 7, 18) for rural and 13 per 100,000 hr worked (95% CI = 7, 28) for urban females, 16 (95% CI = 9, 22) per 100,000 hr for urban males, and 20 (95% CI = 12, 28) per 100,000 hr for rural males. Ongoing medical problems were reported by 26% of the injured workers. Previous estimates of work-related injury to adolescents may have been low. More study is required to clearly define the incidence of injury and risk factors for these injuries.     

Heritage-specific oral microbiota in Indigenous Australian dental calculus

Background and objectivesAboriginal Australians and Torres Strait Islanders (hereafter respectfully referred to as Indigenous Australians) experience a high burden of chronic non-communicable diseases (NCDs). Increased NCD risk is linked to oral diseases mediated by the oral microbiota, a microbial community influenced by both vertical transmission and lifestyle factors. As an initial step towards understanding the oral microbiota as a factor in Indigenous health, we present the first investigation of oral microbiota in Indigenous Australian adults.MethodologyDental calculus samples from Indigenous Australians with periodontal disease (PD; n = 13) and non-Indigenous individuals both with (n = 19) and without PD (n = 20) were characterized using 16S ribosomal RNA gene amplicon sequencing. Alpha and beta diversity, differentially abundant microbial taxa and taxa unique to different participant groups were analysed using QIIME2.ResultsSamples from Indigenous Australians were more phylogenetically diverse (Kruskal–Wallis H = 19.86, P = 8.3 × 10⁻⁶), differed significantly in composition from non-Indigenous samples (PERMANOVA pseudo-F = 10.42, P = 0.001) and contained a relatively high proportion of unique taxa not previously reported in the human oral microbiota (e.g. Endomicrobia). These patterns were robust to stratification by PD status. Oral microbiota diversity and composition also differed between Indigenous individuals living in different geographic regions.Conclusions and implicationsIndigenous Australians may harbour unique oral microbiota shaped by their long relationships with Country (ancestral homelands). Our findings have implications for understanding the origins of oral and systemic NCDs and for the inclusion of Indigenous peoples in microbiota research, highlighting the microbiota as a novel field of enquiry to improve Indigenous health.     

农村儿童伤害综合性干预效果评价

目的评价农村儿童伤害综合性干预效果。方法整群抽取干预县3个乡(镇)3 834名学龄前儿童、2946名儿童看护人和667名学龄儿童,于2007年9月—2010年8月实施为期3年的综合性干预,包括发展政策、伤害监测、安全宣传、知识培训、村医入户安全隐患排查等,并对干预过程和结果进行评估。结果 0～6岁儿童非致死性伤害发生率从干预前的21.86%下降到干预后的9.58%;在伤害相关知识的12个指标中,干预后儿童看护人对其中9个指标正确认知的比例较干预前有明显提高;幼龄儿童住所附近有防护的水源比例从干预前的26.69%增加到干预后的75.88%;学校、儿童家庭及住宅附近环境安全隐患状况有效改善;以上差异均有统计学意义(P<0.01)。结论综合性干预是预防社区儿童伤害的重要措施和有效途径。