Randomized Trial of Enhanced Anticipatory Guidance for Injury Prevention

Gielen, Andrea Carlson; Wilson, Michèle; McDonald, Eileen M.; Serwint, Janet R.; Andrews, John S.; Hwang, Wei–Ting; Wang, Mei‐Cheng

doi:10.1001/archpedi.155.1.42

Cited by 108 publications

(77 citation statements)

References 18 publications

(12 reference statements)

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“…19,20 For example, one study found that 38% to 55% of parents reported keeping poisons locked in a cabinet; however, home observations found that almost none of the families stored poisons correctly. 21 The rates of safe poison storage may be even lower in low-income, urban settings; a study by Santer and Stocking 22 found that few homes had a locked storage space for poisons and household cleaning products were stored "suboptimally. "…”

Section: Discussionmentioning

confidence: 99%

Household Cleaning Product-Related Injuries Treated in US Emergency Departments in 1990–2006

et al. 2010

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WHAT'S KNOWN ON THIS SUBJECT:Household cleaning products are responsible for many unintentional poisonings in children and are consistently in the top 5 categories for pediatric poisoning exposure. WHAT THIS STUDY ADDS:Rates of cleaning product-related injuries among children treated in EDs decreased 46% during the 17-year study period. The products associated most often with injuries were bleach (37.1%) and low-molecular weight hydrocarbons, acids/alkalis, and detergents (30.4%). abstract OBJECTIVE:The goal was to examine comprehensively the patterns and trends of household cleaning product-related injuries among children treated in US emergency departments. METHODS:Through use of the National Electronic Injury Surveillance System database, cases of unintentional, nonfatal, household cleaning product-related injuries were selected by using product codes for drain cleaners, ammonia, metal polishes/tarnish removers, turpentine, dishwasher detergents, acids, swimming pool chemicals, oven cleaners, pine oil cleaners/disinfectants, laundry soaps/detergents, toilet bowl products, abrasive cleaners, general-purpose household cleaners, noncosmetic bleaches, windshield wiper fluids, caustic agents, lye, wallpaper cleaners, room deodorizers/fresheners, spot removers, and dishwashing liquids. Products were categorized according to major toxic ingredients, mode of action, and exposure. RESULTS:An estimated 267 269 children Յ5 years of age were treated in US emergency departments for household cleaning product-related injuries. The number of injuries attributable to household cleaning product exposure decreased 46.0% from 22 141 in 1990 to 11 964 in 2006. The product most-commonly associated with injury was bleach (37.1%). Children 1 to 3 years of age accounted for 72.0% of cases. The primary mechanism of injury was ingestion (62.7%). The most common source or container was spray-bottles (40.1%). Although rates of household cleaner-related injuries from regular bottles or original containers and kitchenware decreased during the study period, spraybottle injury rates showed no decrease. CONCLUSION:Although national rates of household cleaning productrelated injuries in children decreased significantly over time, the number of injuries remains high. Pediatrics 2010;126:509-516

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Section: Discussionmentioning

confidence: 99%

Household Cleaning Product-Related Injuries Treated in US Emergency Departments in 1990–2006

et al. 2010

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“…Gielen, Wilson, and McDonald (2007) found that pediatricians trained in injury prevention provided significantly more injury prevention counseling than the control group, and parents were significantly more satisfied with the help that their physicians provided on safety topics than control group parents.…”

Section: Improving Assessment and Treatment Skills Of Nonmental Healtmentioning

confidence: 95%

Retraction: Improving Treatment of Adolescent Depression in Primary Care

2011

Child Adoles Psych Nursing

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TOPIC: Depression in adolescents is under-recognized and undertreated despite its poor long-term outcomes. Primary care nurses and other clinicians are ideally situated to identify and treat adolescent depression. PURPOSE: We examined the evidence for the treatment of depression in community settings, focusing on efforts in mental health training of primary care clinicians. We also reviewed evidence of outcomes of anticipatory guidance and treatment adherence strategies. SOURCES USED: Available data on psychosocial treatments for adolescent depression in community-based settings were reviewed. CONCLUSION: Educational efforts targeting nonpsychiatric mental health nurses and other clinicians, as well as anticipatory guidance and treatment adherence strategies have been shown to improve a range of outcomes.

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“…Enhanced anticipatory guidance for injury prevention is one of the ways to increase parental and child understanding of safety practices. 55 Interventions to reduce injury risk can be also done in other settings than the primary physician's office. Brief counseling in the EDs on behaviors and practices related to injury prevention leads to improved home safety, seatbelt, and bicycle helmet use.…”

Section: E548 Femur Fractures Associated Injuries Sociodemographic mentioning

confidence: 99%

Childhood Femur Fractures, Associated Injuries, and Sociodemographic Risk Factors: A Population-Based Study

Rewers¹,

et al. 2005

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ABSTRACT. Objective. The objectives of this study were to determine the incidence of femur fractures in Colorado children, to assess underlying causes, to determine the prevalence and predictors of associated injuries, and to identify potentially modifiable risk factors.Methods. The study population included all Colorado residents who were aged 0 to 17 years at the time of injury between January 1, 1998, and December 31, 2001. Cases of femur fracture were ascertained using the population-based Colorado Trauma Registry and International Classification of Diseases, Ninth Revision, Clinical Modification codes 820.0 to 821.39. Associated injuries with an Abbreviated Injury Scale of 2 or higher were classified into 5 categories. Poisson regression, small area analysis, and multivariate logistic regression were used to identify predictors of femur fractures and associated injuries, respectively.Results. During the study period, 1139 Colorado children (795 boys, 344 girls) sustained femur fractures, resulting in the incidence of 26.0 per 100 000 person-years. Rates were higher in boys than in girls in all age groups (overall risk ratio: 2.19; 95% confidence interval: 1.92-2.47) but did not differ by race/ethnicity. Femur fractures that were caused by nonaccidental trauma showed more distal and combined shaft ؉ distal pattern; their incidence did not differ by gender or race but was higher in census tracts with more single mothers and less crowded households. Associated injuries were present in 28.6% of the cases, more often in older children. Fatalities occurred only among children with associated injuries. Children who were involved in nonaccidental trauma, motor vehicle crashes, or auto-pedestrian accidents were 16 to 20 times more likely to have associated injuries than those with femur fractures as a result of a fall. In smallarea analysis, the incidence of femur fractures in infants and toddlers was higher in census tracts characterized by higher proportion of Hispanics, single mothers, and more crowded households. Among children 4 to 12 years of age, the incidence was higher in census tracts with fewer single-family houses and more crowded households. Finally, the incidence of femur fractures among teenagers was higher in rural tracts and those with a higher proportion of Hispanics. Conclusions

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Randomized Trial of Enhanced Anticipatory Guidance for Injury Prevention

Abstract: The frequency and impact of pediatric counseling can be enhanced by experiential training that targets specific injury hazards. Because low-income families face many barriers to carrying out the recommended safety practices, supplemental strategies are needed to ensure safer homes.

Cited by 108 publications

References 18 publications

Household Cleaning Product-Related Injuries Treated in US Emergency Departments in 1990–2006

Household Cleaning Product-Related Injuries Treated in US Emergency Departments in 1990–2006

Retraction: Improving Treatment of Adolescent Depression in Primary Care

Childhood Femur Fractures, Associated Injuries, and Sociodemographic Risk Factors: A Population-Based Study

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