Lead specificity of the maximum ST/heart rate slope response.

Abstract

<h3>Background</h3> Injury remains the leading cause of childhood mortality and disability worldwide. This burden is greatest in communities of lower socioeconomic status (SES), especially in low and middle-income countries. Little appears known about injury outcomes in children in the context of equity. <h3>Objective</h3> To understand the burden of functional and health related quality of life outcomes in children after injury in relation to equity. <h3>Methods</h3> Key terms for intentional and unintentional injury were searched over 6 databases. Inclusion criteria focused records on injury research,&lt;16 years of age and observational studies with ≥3 outcome time points measured. PRISMA-E 2012 guidelines were followed, where a narrative base synthesis was applied to describe outcomes in the context of injury. PROGRESS-Plus and Equity Lens tools were used to examine the focus on equity in studies and outcomes, and the RTI Item Bank assessed the level of bias in articles. <h3>Findings</h3> A total of 3931 records were returned where screening resulted in 24 articles progressing to review. Most studies (88%) were conducted in high income countries, with a focus on traumatic brain injury (62.5%) and functional outcomes (56%). Preinjury functioning and Health Related Quality of Life (HRQoL) measures were key indicators of postinjury outcomes. Longer hospitalization was linked to poorer functional and HRQoL outcomes. The majority (80%) of studies had not considered equity factors, limited studies reported on the connection of low SES and poor outcomes. <h3>Conclusion</h3> Injury severity, longer hospitalisation and lower SES have a negative impact on injury recovery, reducing functional and HRQoL outcomes in children. Currently most outcome based injury research is conducted with a ‘privileged research lens’ excluding notions of health inequities, creating further population disparities and disadvantage. <h3>Policy implications</h3> Injury research agendas need reform, to focus research on improving health inequities and provide health gains for all children.