Childhood Injury Risk and Socio-Demographic Risk Factors: Examining the Influence of Parental Executive Functioning

BackgroundAttention deficit-hyperactivity disorder (ADHD) is a common in children with a prevalence of 5%. Injuries are common and are a leading cause of morbidity and mortality in England and worldwide....

To study the effect of epilepsy on the risk of injury in children. All first-born singleton children (n=133055) born in 2001 - 2006 in Finland were included. Data was collected from national registers up to the first hospital-treated injury during the five years following the onset of epilepsy. Four matched controls were chosen for every subject. Epilepsy had been diagnosed in 0.66% of children. During follow-up, 12% of 884 children with epilepsy and 9% of 3536 controls were hospitalized for injuries (HR 1.387 [95% CI 1.115 - 1.725]; p=0.0033). Risk for injuries was higher in boys than girls (p=0.0057). Mean age at the first injury was 6.8years (SD 3.3, median 7, range 0-13) in subjects and 7.2years (SD 3.2, median 8, range 1-13) in controls (p=0.272). The rate of hospitalization did not differ according to the type of epilepsy. The risks of subjects compared to controls were not significantly different concerning the nature of injury or survival. Children with epilepsy are at increased risk for hospital-treated injuries. The spectrum of injuries and the risk for death due to injuries are not different in children with and without epilepsy.

To examine the association between sensory deficit and the risk of child pedestrian-motor vehicle collisions. The Auckland region of New Zealand. A community based case-control study was conducted. Cases (n = 190) were all children (< 15 years) killed or hospitalised as a result of a pedestrian injury occurring on a public road between 1 January 1992 and 1 March 1994. Controls (n = 479) were a random sample of the child population. The risk of pedestrian injury for children whose parents reported abnormal vision was over four times that of children with reported normal vision (odds ratio = 4.25, 95% confidence interval 1.68 to 10.8). The risk of injury for children whose parents reported abnormal hearing was close to twice that of children with reported normal hearing (odds ratio = 1.73, 95% confidence interval 0.83 to 3.61). Children with sensory deficits constitute a high risk group for pedestrian injuries. Paediatricians caring for children with sensory impairments should be aware of this increased risk.

Populations with Type 2 diabetes are exposed to many complications that are due to complex mechanisms combining hyperglycemia, insulin resistance, low-intensity inflammation and accelerated atherogenesis. Cardio-cerebrovascular complications affect the prognosis of diabetes. This study aims to identify sociodemographic and anthropometric risk factors for type 2 diabetes in the population of Nador located in the north of Morocco. This epidemiological study took place in a private medical analysis laboratory in the city of NADOR for a period of one year extending from 01/10/2018 to 01/10/2019. It focused on 830 male and female subjects over the age of 18, all residing in the city of NADOR. The subjects’ blood sugar levels were above 1.26 g / L, with the help of the laboratory reception and collection team of three secretaries and two nurses; we explained the purpose of the study to the population studied. Volunteers signed the consent form and then were interviewed using questionnaires; anthropometric measurements were taken in the sample collection room. Their confidentiality and privacy were respected. This study allowed us to shed light on certain socio-demographic and anthropometric characteristics as well as the problems from which the diabetic population suffers. The study found that female sex and old age are socio-demographic risk factors; it also found that waist circumference and BMI (body mass index) are anthropometric risk factors for T2D.

To assess the occurrence of child injury in four developing country settings and to explore potential risk factors for injury. Injury occurrence was studied in cohorts of 2000 children of age 6-17 months at enrolment, in each of Ethiopia, Peru, Vietnam and India (Andhra Pradesh). Generalized estimating equation models were used to explore potential risk factors for child injury. Occurrence of child injury was high in all countries. Caregiver depression emerged as a consistent risk factor for all types of injury measured (burns, serious falls, broken bones and near-fatal injury) across all countries. Other risk factors also showed consistent associations, including long-term child health problems, region of residence and the regular care of the child by a non-household member. This report provides further evidence of the importance of childhood injury in developing countries and emphasizes the importance of including infants in injury research and prevention strategies. It provides strong evidence of an association between caregiver mental health and child injury risk and contributes to the limited knowledge base on risk factors for child injury in developing countries.

ObjectivesThe Joint Committee on Infant Hearing (JCIH) risk factors have been recommended for use in screening for newborn hearing impairment (NBHI) in settings where universal screening is not practicable, but...

More effective prevention of suicide requires a comprehensive understanding of sociodemographic, psychiatric and somatic risk factors. Previous studies have been limited by incomplete ascertainment of these factors. We conducted the first study of this issue using sociodemographic and out-patient and in-patient health data for a national population. We used data from a national cohort study of 7,140,589 Swedish adults followed for 8 years for suicide mortality (2001-2008). Sociodemographic factors were identified from national census data, and psychiatric and somatic disorders were identified from all out-patient and in-patient diagnoses nationwide. There were 8721 (0.12%) deaths from suicide during 2001-2008. All psychiatric disorders were strong risk factors for suicide among both women and men. Depression was the strongest risk factor, with a greater than 15-fold risk among women or men and even higher risks (up to 32-fold) within the first 3 months of diagnosis. Chronic obstructive pulmonary disease (COPD), cancer, spine disorders, asthma and stroke were significant risk factors among both women and men (1.4-2.1-fold risks) whereas diabetes and ischemic heart disease were modest risk factors only among men (1.2-1.4-fold risks). Sociodemographic risk factors included male sex, unmarried status or non-employment; and low education or income among men. All psychiatric disorders, COPD, cancer, spine disorders, asthma, stroke, diabetes, ischemic heart disease and specific sociodemographic factors were independent risk factors for suicide during 8 years of follow-up. Effective prevention of suicide requires a multifaceted approach in both psychiatric and primary care settings, targeting mental disorders (especially depression), specific somatic disorders and indicators of social support.

Effect of positive airway pressure therapy in children with obstructive sleep apnea syndrome: does positive airway pressure use reduce pedestrian injury risk?

Motor impairment is common after extremely preterm (EPT, <28 weeks' gestational age (GA)) birth, with cerebral palsy (CP) affecting about 10% of children and non-CP movement difficulties (MD) up to 50%. This study investigated the sociodemographic, perinatal and neonatal risk factors for CP and non-CP MD. Data come from a European population-based cohort of children born EPT in 2011-2012 in 11 countries. We used multinomial logistic regression to assess risk factors for CP and non-CP MD (Movement Assessment Battery for Children - 2nd edition ≤5th percentile) compared to no MD (>15th percentile) among 5-year-old children. Compared to children without MD (n = 366), young maternal age, male sex and bronchopulmonary dysplasia were similarly associated with CP (n = 100) and non-CP MD (n = 224) with relative risk ratios (RRR) ranging from 2.3 to 3.6. CP was strongly related to severe brain lesions (RRR >10), other neonatal morbidities, congenital anomalies and low Apgar score (RRR: 2.4-3.3), while non-CP MD was associated with primiparity, maternal education, small for GA (RRR: 1.6-2.6) and severe brain lesions, but at a much lower order of magnitude. CP and non-CP MD have different risk factor profiles, with fewer clinical but more sociodemographic risk factors for non-CP MD. Young maternal age, male sex and bronchopulmonary dysplasia similarly increased risks of both cerebral palsy and non-cerebral palsy movement difficulties. Cerebral palsy was strongly related to clinical risk factors including severe brain lesions and other neonatal morbidities, while non-cerebral palsy movement difficulties were more associated with sociodemographic risk factors. These results on the similarities and differences in risk profiles of children with cerebral palsy and non-cerebral palsy movement difficulties raise questions for etiological research and provide a basis for improving the identification of children who may benefit from follow-up and early intervention.

Understanding factors that influence mothers’ beliefs about appropriate levels of supervision for their children may assist in efforts to reduce child injury rates. This study examined the interaction of child (i.e. age, gender, and injury risk behavior) and maternal perception of environmental hazard (i.e. hazard level, injury likelihood, and potential injury severity) variables in predicting mothers’ beliefs about appropriate levels of supervision for their children. Participants were 58 mothers of 2- to 8-year-old community children who were interviewed about their beliefs regarding child injury risk and appropriate supervision. Results indicated that perceived environmental hazard level interacted with child age, gender, and injury risk behavior to predict mothers’ beliefs about supervision. Perceived injury likelihood also interacted with child injury risk behavior to predict beliefs about supervision. Findings underscore the complexity of factors influencing mothers’ beliefs about appropriate supervision and indicate the importance of environmental hazard level in such beliefs.

Traumatologie du ski et du snowboard chez l’enfant et l’adolescent : épidémiologie, physiopathologie, prévention et principales lésions

10047 Background: Pediatric Hodgkin lymphoma (HL) is a highly curable disease. However, survivors are at high risk for long-term complications of therapy. The impact of sociodemographic and clinical factors on adherence to late effects surveillance guidelines is unknown. Methods: The CCSS is a retrospective cohort with prospective follow-up of survivors diagnosed from 1970-1999. HL survivors enrolled in CCSS who responded to a 2017 questionnaire were included. We assessed adherence to the Children’s Oncology Group surveillance guidelines for cardiomyopathy, breast cancer, colorectal cancer, and skin cancer. Multivariate logistic regression was used to estimate adjusted odds ratios and 95% confidence intervals (aOR [95% CI]) for sociodemographic and clinical risk factors associated with adherence. Estimates were adjusted for area deprivation index (ADI); chronic health conditions; recent (≤2 years) routine check-up, cancer center or survivorship clinic visit; and possession of a survivorship care plan (SCP). Results: 1,380 HL survivors (45.6% male; median age 43.6 years, range 21.6-65.9 years) responded, of whom 55.5% were at elevated risk for cardiac dysfunction, 71.0% for breast cancer, 83.5% for skin cancer, and 39.4% for colorectal cancer. Of those at elevated risk, 42.7%, 19.9%, 31.3% and 48.9% were adherent to the guidelines for cardiac, breast, skin, and colorectal screening, respectively. Predictors of adherence to cardiac dysfunction guidelines were male sex (aOR 1.7 [1.1-2.6]), having children (aOR 1.6 [1.1-2.4]), recent routine checkup (aOR 4.0 [1.3-13.1]), recent visit to a cancer center or survivorship clinic (aOR 6.2 [3.9-10.0]), and possession of a SCP (aOR 3.1 [1.9-5.0]). Adherence to breast cancer guidelines was higher in those who were unmarried (aOR 2.1 [1.0-4.1]), had a recent visit to a cancer center or survivorship clinic (aOR 3.7 [2.0-7.0]), and possessed a SCP (aOR 3.5 [1.5-8.3]). Adherence to skin cancer guidelines was higher in those &gt; 14 years at diagnosis (aOR 1.8 [1.3-2.4]), living in a low deprivation area (ADI 1-24.9) compared to a high deprivation area (ADI 75-100) (aOR 3.4 [1.9-5.9]), employed (aOR 1.8 [1.1-2.9]), &gt; 30 years from diagnosis (aOR 2.4 [1.6-3.6]), with a recent routine check-up (aOR 3.6 [1.1-12.5]), and recent cancer care (aOR 2.4 [1.6-3.5]). Adherence to colorectal cancer guidelines was higher in those with grade 3-4 chronic health conditions (aOR 1.9 [1.1-3.3]). Conclusions: Less than 50% of HL survivors are adherent to screening guidelines. Sociodemographic risk factors are significant predictors of non-adherence, particularly to skin cancer screening guidelines. This threatens to potentiate outcome disparities among HL survivors.

Background: Acute respiratory infections are a leading cause of morbidity and mortality in under-five chil-dren in developing countries. Hence, the present study was undertaken to study the various risk factors, clinical profile and outcome of acute lower respiratory tract infections (ALRI) in children aged 2 months to 5 years. To study the risk factors associated with ALRI in these children. To ascertain the association of the various cultural practices prevalent in this area with ALRI.Methods: 100 ALRI cases fulfilling WHO criteria for pneumonia, in the age group of 2 months to 5 years were evaluated for potential risk factors, clinical profile and outcome as per a predesigned proforma in a rural medical college.Results: Socio-demographic risk factors like parental illiteracy, overcrowding, partial immunization and low socioeconomic status were potential risk factors; similarly, nutritional risk factors like early and late weaning, anemia, and malnutrition were associated with ALRI. Significant environmental risk factors were the use of biomass fuels, inadequate ventilation at home, and lack of separate kitchen.Conclusions: The present study has identified various socio-demographic, nutritional and environmental risk factors for ALRI which can be tackled by effective health education of the community and effective training of peripheral health personnel.

There is an ongoing debate about the importance of biomedical and sociodemographic risk factors in the prediction of self-rated health. To compare the association of sociodemographic and cardiovascular risk factors and self-rated health in Sweden and the US. Data from two population-based cross-sectional health surveys, one in Sweden and one in the US. The surveys included questionnaire and measured data from 5,461 adults in Sweden and 7,643 in the US. Participants were between 35 and 65 years of age. The odds ratios for poor self-rated health for the included cardiovascular risk factors were greater in the US. Low education was significantly more prevalent among those with self-rated poor health in the US, but not in Sweden. Using Swedes with high education as reference group (OR = 1), adults in the US with low education and 2+ risk factors had a greater than threefold risk (OR = 6.3) of self-rated poor health compared with Swedish low-educated adults with the same risk factor burden (OR = 1.9). The better-educated US adults with 2+ risk factors were significantly more likely to report poor health (OR = 3.4) compared with their Swedish counterparts (OR = 2.4). The interaction between risk factors, education, and self-rated health suggests a frightening picture, especially for the US. Public health interventions for reducing cardiovascular risk factors need to include both population and individual measures. Taking people's overall evaluation of their health into account when assessing total health risk is important.

Background: Acute respiratory infections are a leading cause of morbidity and mortality in under-five children in developing countries. Hence, the present study was undertaken to study the various demographic risk factors which predispose to acute lower respiratory tract infections (ALRI) in children aged 2 month to 5 year. Objective; Demographic factors associated with acute lower respiratory tract infections in children aged 2 months to 5 years. Methods: 100 ALRI cases fulfilling WHO criteria for pneumonia, in the age group of 2 month to 5 years were evaluated for demographic risk factors and clinical profile as per a predesigned proforma in a rural medical college. Results: Socio-demographic risk factors like parental illiteracy, overcrowding, partial immunisation and low socioeconomic status were potential risk factors; similarly nutritional risk factors like early and late weaning, anaemia and malnutrition were associated with ALRI. Significant environmental risk factors were use of biomass fuels, inadequate ventilation at home, and lack of separate kitchen. Conclusion: The present study has identified various socio-demographic, nutritional and environmental risk factors for ALRI which can be tackled by effective health education of the community and effective training of peripheral health personnel.