AimTo undertake a comprehensive review of the best available evidence related to risk factors for child pedestrian motor vehicle collision (PMVC), as well as identification of established and emerging prevention strategies.MethodsArticles on risk factors were identified through a search of English language publications listed in Medline, Embase, Transport, SafetyLit, Web of Science, CINHAL, Scopus and PsycINFO within the last 30 years (~1989 onwards).ResultsThis state-of-the-art review uses the road safety Safe System approach as a new lens to examine three risk factor domains affecting child pedestrian safety (built environment, drivers and vehicles) and four cross-cutting critical issues (reliable collision and exposure data, evaluation of interventions, evidence-based policy and intersectoral collaboration).ConclusionsResearch conducted over the past 30 years has reported extensively on child PMVC risk factors. The challenge facing us now is how to move these findings into action and intervene to reduce the child PMVC injury and fatality rates worldwide.
IntroductionEvidence suggests the presence of deficiencies in the quality of care provided to up to half of all paediatric trauma patients in Canada, the USA and Australia. Lack of adherence to evidence-based recommendations may be driven by lack of knowledge of clinical practice guidelines (CPGs), heterogeneity in recommendations or concerns about their quality. We aim to systematically review CPG recommendations for paediatric injury care and appraise their quality.Methods and analysisWe will identify CPG recommendations through a comprehensive search strategy including Medical Literature Analysis and Retrieval System Online, Excerpta Medica dataBASE, Cochrane library, Web of Science, ClinicalTrials and websites of organisations publishing recommendations on paediatric injury care. We will consider CPGs including at least one recommendation targeting paediatric injury populations on any diagnostic or therapeutic intervention from the acute phase of care with any comparator developed in high-income countries in the last 15 years (January 2007 to a maximum of 6 months prior to submission). Pairs of reviewers will independently screen titles, abstracts and full text of eligible articles, extract data and evaluate the quality of CPGs and their recommendations using Appraisal of Guidelines Research and Evaluation (AGREE) II and AGREE Recommendations Excellence instruments, respectively. We will synthesise evidence on recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) Evidence-to-Decision framework and present results within a recommendations matrix.Ethics and disseminationEthics approval is not a requirement as this study is based on available published data. The results of this systematic review will be published in a peer-reviewed journal, presented at international scientific meetings and distributed to healthcare providers.PROSPERO registration numberInternational Prospective Register of Systematic Reviews (CRD42021226934).
Objectives: To explore the relationship between neighborhood social and material deprivation and the rates of abusive head trauma (AHT), and whether it differs according to sex, and following the implementation of the Period of PURPLE Crying ( PURPLE) program. Method: A cross-sectional study design was applied to data from children 0 to 24 months old with a confirmed AHT diagnosis between 2005 and 2017 in British Columbia. Dissemination area–based social and material deprivation scores were assigned to residential areas, where AHT cases were recorded. Poisson regression models tested the relationship between deprivation scores and AHT rates, adding sex and pre–post program implementation as interaction terms. Results: With each increase in material and social deprivation quintiles, AHT rates increased by 42% (95% CI [1.18, 1.72]) and 25% (95% CI [1.06, 1.51]), respectively, following a social gradient. AHT rate disparities between neighborhoods did not change following the PURPLE program implementation. Conclusions: This study stresses the need to provide additional AHT prevention services proportionately to the levels of neighborhood disadvantage, in addition to universal AHT programs, to successfully protect all children.
In a review of guidelines for pediatric solid organ injuries, we identified 5 recommendations based on moderate quality evidence or rated as strong; these reflected non-operative management and angioembolization for renal injuries and hospital stay for liver and spleen injuries.
Substantial efforts devoted to decreasing the burden of transport-related injuries (TRIs) in Canada, including public awareness campaigns aiming to influence attitudes and behaviors, may lead the public to perceive other types of injuries differently. This study examined the relationship between public perception of the preventability of injuries and the type of injury (TRIs vs. non-transport unintentional injuries (NTUIs)); and assessed whether exposure to a social marketing campaign (Preventable) influenced this association. A cross-sectional study design employed survey data collected by Preventable between 2015 and 2016 from 1501 British Columbians aged 25–54 years. A multiple linear regression model was applied to examine the relationship between the type of injury (TRIs vs. NTUIs) and attitudes towards preventability, controlling for socio-demographic variables. Exposure to the campaign was tested as an effect modifier. On a scale from 1 to 10, respondents perceived TRIs to be 1.08 points more preventable than NTUIs (95% CI: 1.00 to 1.16, p-value < 0.0001). Campaign-exposed participants scored 0.31 points higher on preventability of injuries overall (95% CI: 0.16 to 0.47, p-value < 0.0001); and recorded a smaller difference between the perceived preventability of TRIs and NTUIs, relative to those not exposed to the campaign (B = −0.163, 95% CI: –0.28 to −0.04, p-value = 0.008). While respondents believed that most injuries are preventable, exposure to considerable road traffic interventions in Canada may have influenced public attitudes towards a higher perceived preventability of TRIs. Social marketing may be a useful tool to emphasize the preventability of all injuries to further reduce their burden in Canada.
Regardless of age or sex, teenagers considered themselves to be at ease discussing sexuality with their doctor and found it an important topic best brought up by their practitioner.
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