Child Injury Risk Research Articles

Elevated neuregulin-1β levels correlate with plasma biomarkers of cerebral injury and high stroke risk in children with sickle cell anemia

Stroke, or cerebral infarction, is one of the most serious complications of sickle cell anemia (SCA) in childhood, potentially leading to impaired development and life-long physical and cognitive disabilities. About one in ten children with SCA are at risk for developing overt stroke and an additional 25% may develop silent cerebral infarcts. This is largely due to underlying cerebral injury caused by chronic cerebral ischemia and vascular insult associated with SCA. We previously identified two elevated markers of cerebral injury, plasma brain-derived neurotropic factor (BDNF) and platelet-derived growth factor (PDGF)-AA, in children with SCA and high stroke risk. The objective of this study was to investigate whether neuregulin-1β (NRG-1), an endogenous neuroprotective polypeptide may also be elevated in children with SCA. Neuregulin-1β is involved in the preservation of blood brain barrier integrity and brain microvascular cell viability and is cytoprotective in conditions of heme-induced injury and ischemia. Since elevated plasma heme and ischemia are signature characteristics of SCA, we hypothesized that NRG-1 would be elevated in children with SCA, and that NRG-1 levels would also correlate with our biomarkers of cerebral injury. Plasma NRG-1, BDNF and PDGF-AA levels were measured in children with SCA and healthy Controls. Plasma NRG-1 was found to be nearly five-fold higher in those children with SCA compared to Controls. Neuregulin-1β was also positively correlated with both BDNF and PDGF-AA concentrations, but was not associated with degree of anemia, suggesting that NRG-1 production may be an endogenous response to subclinical cerebral ischemia in SCA warranting further exploration.

Accidental injury, self‐injury, and assault among children of women with schizophrenia: a population‐based cohort study

We aimed to compare the risk for injury overall and by intent (accidental injury, self-injury, and assault) among children born to women with versus without schizophrenia. Using health administrative data from Ontario, Canada, children born from 2003 to 2017 to mothers with (n=3769) and without (n=1,830,054) schizophrenia diagnosed prior to their birth were compared on their risk for child injury, captured via emergency department, hospitalization, and vital statistics databases up to age 15years. Cox proportional hazard models generated hazard ratios for time to first injury event (overall and by intent), adjusted for potential confounders (aHR). We stratified by child sex and age at follow-up: 0-1 (infancy), 2-5 (pre-school), 6-9 (primary school), and 10-15 (early adolescence) planning to collapse age categories as needed to obtain stable and reportable estimates. Maternal schizophrenia was associated with elevated risk for child injury overall (105.4 vs. 89.4/1000 person-years (py), aHR 1.08, 95% CI 1.03-1.14), accidental injury (104.7 vs. 88.1/1000py, 1.08, 1.03-1.14), for self-injury (0.4 vs. 0.2/1000py, 2.14 1.18-3.85), and assault (1.0 vs. 0.3/1000py, 2.29, 1.45-3.62). By child sex, point estimates were of similar magnitude and direction, though not all remained statistically significant. For accidental injury and self-injury, the risk associated with maternal schizophrenia was most elevated in 10-15-year-olds. For assault, the risk associated with maternal schizophrenia was most elevated among children in the 0-1 and 2-5-year-old age groups. The elevated risk of child injury associated with maternal schizophrenia, especially for self-injury and assault, suggests that targeted monitoring and preventive interventions are warranted.

Contrast media exposure in the perioperative period confers no additional risk of acute kidney injury in infants and young children undergoing cardiac surgery with cardiopulmonary bypass.

Recently, there has been an interest in the temporal relationship between contrast exposure (CM) and cardiac surgery suggesting that a "double hit" on the kidney function in close succession increases the risk of acute kidney injury (AKI) after cardiac surgery. However, data from young children is limited. The purpose of this study was to retrospectively evaluate the effects of preoperative CM exposure on postoperative AKI in infant and young children patients and to further analyze the influence of exposure time interval. Patients (age ≤ 3 years) who underwent diagnostic imaging within 14 days before on-pump cardiac surgery between 1 May 2017 and 31 May 2018 in Fuwai Hospital, Beijing, were analyzed. Kidney outcome was assessed according to Kidney Disease: Improving Global Outcomes creatinine-based criteria. One thousand four hundred pediatric patients (192 CM and 1,248 non-CM) were identified. Postoperative AKI occurred in 57 (29.7%) of the 192 patients who were exposed to CM. Following propensity score adjustment, no difference in risk for AKI was observed between the CM and non-CM groups (RR 1.142, 95% CI 0.916-1.424; P = 0.264). Multivariable logistic regression of the CM group indicated that independent predictors of postoperative AKI were lower weight, lower preoperative creatinine level, and longer CPB duration. Time interval between CM exposure and on-pump cardiac surgery was not significantly associated with increased risk of AKI (OR 0.853, 95% CI 0.265~2.747; P = 0.790). For pediatric patients who are soon to undergo on-pump cardiac procedures, there appears to be no need to hesitate in performing the diagnostic imaging investigations requiring CM, or delay CPB after CM exposure. These patients may benefit from increased diagnostic utility without increasing their risk of postoperative AKI.

Factors Associated With Dropout of Participants in an App-Based Child Injury Prevention Study: Secondary Data Analysis of a Cluster Randomized Controlled Trial.

BackgroundMobile health (mHealth) interventions offer great potential to reach large populations and improve public health. However, high attrition rates threaten evaluation and implementation of mHealth intervention studies.ObjectiveWe explored factors associated with attrition of study participants in an mHealth randomized controlled trial (RCT) evaluating an intervention to reduce unintentional child injury risk in China.MethodsThe cluster RCT compared two groups of an app-based intervention for caregivers of 3-6–year-old children (Bao Hu San). The intervention group received unintentional child injury and parenting education, whereas only parenting education was implemented in the control group. The trial included 2920 study participants in Changsha, China, and lasted 6 months. Data on participant engagement (using the app) were collected electronically throughout the 6-month period. Associations between participant attrition and demographic characteristics, and between attrition and intervention engagement were tested and quantified separately for the intervention and control groups using the adjusted odds ratio (aOR) based on generalized linear mixed models.ResultsIn total, 2920 caregivers from 20 eligible preschools participated, with 1510 in the intervention group and 1410 in the control group. The 6-month attrition rate differed significantly between the two groups (P<.001), at 28.9% (437/1510) in the intervention group and 35.7% (503/1410) in the control group. For the intervention group, the only significant predictor of attrition risk was participants who learned fewer knowledge segments (aOR 2.69, 95% CI 1.19-6.09). For the control group, significant predictors of attrition risk were lower monthly login frequency (aOR 1.48, 95% CI 1.00-2.18), learning fewer knowledge segments (aOR 1.70, 95% CI 1.02-2.81), and shorter learning durations during app engagement (aOR 2.39, 95% CI 1.11-5.15). Demographic characteristics were unrelated to attrition.ConclusionsEngagement in the app intervention was associated with participant attrition. Researchers and practitioners should consider how to best engage participants in app-based interventions to reduce attrition.Trial RegistrationChinese Clinical Trial Registry ChiCTR-IOR-17010438; http://www.chictr.org.cn/showproj.aspx?proj=17376International Registered Report Identifier (IRRID)RR2-10.1186/s12889-018-5790-1

Adolescent's perception of road risk on their routes to school in Makwanpur, Nepal; a qualitative study

BackgroundBusy and poor road infrastructure along routes to school poses high risk of traffic injury for children and adolescents. Ensuring every young person's safe journey to and from school is fundamental to achieving reductions in road injuries and Sustainable Development Goal 3.6. However, there is little evidence reporting adolescent's views about their school travel from low and middle income countries. This study aims to understand adolescent's perceptions of injury risks on their journey to school in Nepal. MethodsWe used Photo-Elicitation Interview (PEI) methods to collect data from fourteen purposively identified adolescents (12–16 years) who walk to Tribhuwan Secondary School along the East-West Highway which is known to be at high risk of crashes in Makwanpur, Nepal. The participants used a camera to record parts of their journey, which they perceived as dangerous or safe. Photographs were used as prompts during an interview afterwards. Interviews were audio-recorded, transcribed, translated and analysed thematically. ResultsThe identified themes were categorised as either environmental or behavioural factors. The adolescents were scared to walk on narrow roadsides because of speeding vehicles. They also found crossing the road dangerous because of the lack of designated pedestrian crossings and disregard shown by drivers. Poor visibility caused by random roadside parking and trees also increased the sense of road danger. ConclusionAdolescents expressed multiple concerns which made their journeys difficult and dangerous. They illustrated issues such as poor road condition, inadequate pedestrian crossings and traffic signs, narrow roadsides, vehicle speeding and overtaking, failing to obey traffic rules and regulation -providing evidence that could be shared with the authorities to improve road safety near schools.

Maternal depression and childhood injury risk: A population-based cohort study in Denmark.

AimsTo assess the association between different stages of maternal depression and injury risk in offspring aged 0–10 years.MethodsPopulation‐based cohort study of all live‐born children in Denmark from 1 January 1997 until 31 December 2013 (n = 1,064,387). Main outcome measure was emergency department contacts with a main diagnosis of injury coded as DS00‐DT98 (chapter XIX) according to the ICD‐10. All information was obtained from Danish national registries.ResultsMaternal depression was associated with higher injury hazard in the offspring throughout childhood compared to offspring of mothers with no history of depression. The strongest association was seen for the first year of life. First‐time maternal depression was most strongly associated with injury in the child, especially in the first year of life (aHR = 1.70, 95% CI: 1.48–1.96). Children of mothers with relapse depression had 1.57 higher hazard of injury in the first year of life (aHR: 1.57, 95% CI: 1.44–1.70). Children of mothers with previously treated depression (postdepression) had 1.13 higher hazard of injury in the first year of life (aHR: 1.13, 95% CI: 1.09–1.17). Continuous treatment for depression was associated with a nonsignificant higher hazard of injuries in the first year of life (aHR: 1.06, 95% CI: 0.91–1.23).ConclusionsMaternal depression was associated with higher injury risk in the offspring, particularly in early childhood. The association persisted in children of mothers with relapse depression. Our results suggest that children of mothers with depression are vulnerable several years after depression onset and treatment cessation.

Using kinetic eGFR to identify acute kidney injury risk in children undergoing cardiac transplantation.

Acute kidney injury (AKI) is common following pediatric cardiac transplantation. Since no treatments exist, strategies focus on early identification and prevention. Kinetic glomerular filtration rate (kGFR) was developed to assess renal function in the non-steady state. Although used to predict AKI in adults, kGFR has not been explored in children. Our study examines AKI and the ability of kGFR to identify AKI risk in pediatric heart transplant recipients. One hundred and seventy-five patients under 21 years who underwent cardiac transplantation at Lucile Packard Children's Hospital between September 2007-December 2017 were included. kGFR1 was calculated using pre-operative and immediate post-operative creatinines; kGFR2 was calculated with the first two post-operative creatinines. The primary outcome was AKI as defined by the Kidney Disease: Improving Global Outcomes criteria. One hundred and thirty-one (75%) and 78 (45%) patients developed AKI and severe AKI, respectively; 5 (2.9%) required dialysis. kGFR was moderately associated with post-operative AKI risk. The adjusted area under the curve (AUC) for kGFR1 was 0.72 (discovery) and 0.65 (validation). The AUC for kGFR2 was 0.72 (discovery) and 0.68 (validation). AKI is pervasive in children undergoing cardiac transplant, particularly in the 24 h after surgery. kGFR moderately identifies AKI risk and may represent a novel risk stratification technique. Our research suggests that kGFR, a dynamic assessment of renal function that uses readily available laboratory values, can moderately identify AKI risk in children undergoing cardiac transplantation. Current published studies on kGFR are in adult populations; this study represents the first formal study of kGFR in a pediatric population. kGFR may serve as an early AKI indicator, allowing providers to implement preventative strategies sooner in a patient's clinical course.

Redesigning the Door Reduces the Potential for Finger Injuries in Children

The standard door is a safety hazard for young children often resulting in crush injuries, nail avulsions, fractures, lacerations, and amputations. This type of injury occurs mostly in households and may sometimes happen to adults, although this is less common. The simplicity of the door’s design has continually become a concern mostly due to its potential to cause injury. The purpose of this study is to redesign the door to reduce the risk of finger injuries in children. A safety door was designed and a model of it was constructed for study. Its two major features utilize silicone rubber fins at the pinch points and a “piano” hinge running the entire door length (instead of the conventional two or three separate hinges) to eliminate the space between the hinges. Ten door closures using five finger models (beef stick, green beans, string cheese, crayons, red licorice twists) were performed to observe and assess the resulting injuries from the safety door compared to a standard door. The severity of the resulting injuries was scored using a 0 – 8 numerical score. The collected data were recorded in a computer spreadsheet for statistical analysis. The safety door resulted in 1 amputation (0.7%) compared to 120 amputations (out of 200 door closures) in the standard door (60%, p<0.0001) and had significantly lower numerical injury scores (0.2 vs 4.8, p=0.0001). The safety door is less injurious than the conventional door and re-designing the door will likely lower the risk of finger injuries in young children.

Caregiver worry and injury hazards in the daily lives of Ugandan children

:Background:Over 95% of unintentional injury-related childhood deaths globally occur in low- and middle-income countries, such as Uganda. Risks for injury in settings like rural Uganda are vastly understudied despite differing patterns of child injury risk. The present study investigated the prevalence and type of hazards in children’s environments in rural Uganda, as well as the relationship between hazard exposure and parent attitudes and perceptions regarding unintentional injury.Methods:Our sample included 152 primary caregivers in Eastern Rural Uganda who had children in either 1st or 6th grade. All parents/guardians completed caregiver surveys following verbal instructions. Surveys assessed demographic information, child hazard exposure, and parent beliefs regarding child injury. Results:Almost all parents (98.5%) reported daily exposure for their children to at least one of the hazards assessed. Caregiver's perceived likelihood of child injury was positively related to hazard exposure (r = .21, p less than .05). This relationship remained significant when controlling for family demographics, child grade level, and child injury history (F (7, 126) = 2.25, p less than .05).Conclusions:Our results suggest that Ugandan parents are aware of the risks of children’s exposure to hazards, but may lack the tools to address it. Development of injury prevention interventions focusing on behavioral change techniques may help reduce childhood injury and injury-related deaths in Uganda.

Proton pump inhibitors and the risk of hospital-acquired acute kidney injury in children.

BackgroundTo evaluate the association between use of proton pump inhibitor (PPI) and the risk of hospital-acquired acute kidney injury (HA-AKI) in hospitalized children.MethodsWe conducted a multicenter retrospective cohort study in hospitalized children aged 1 month to 18 years from 25 tertiary hospitals across China from 2013 to 2015. Patient-level data were obtained from the electronic hospitalization databases. AKI was defined and staged using the serum creatinine (SCr) data according to the Kidney Disease Improving Global Outcomes (KDIGO) criteria.ResultsAmong 42,232 children analyzed, 11,496 (27.2%) used PPI, 1,760 (4.2%) used histamine 2 receptor antagonist (H2RA), and 3,514 (8.3%) had HA-AKI during hospitalization. Over 85% of PPIs were prescribed for prophylaxis of gastro-duodenal lesions in children. The use of PPI was associated with a significantly increased risk of HA-AKI compared with both non-users [odds ratio (OR), 1.37; 95% confidence interval (CI), 1.23–1.53)] and H2RA users (OR, 1.24; 95% CI, 1.01–1.52). The associations were consistent across children of different age range, gender, subtypes of PPIs and methods of administration. A larger effect was observed in children with chronic kidney disease (OR, 3.37; 95% CI, 2.46–4.62) and those needed intensive care (OR, 1.54; 95% CI, 1.33–1.78). The risk of HA-AKI was increased even within the recommended dosage range of PPI.ConclusionsPPIs were widely used and associated with an increased risk of HA-AKI in hospitalized children in China.

Evaluation of the effectiveness, implementation and cost-effectiveness of the Stay One Step Ahead home safety promotion intervention for pre-school children: a study protocol

BackgroundUnintentional injuries in children under the age of 5 years commonly occur in the home and disproportionately affect those living in disadvantaged circumstances. Targeted home safety promotion should be offered...

Prophylactic premedication can reduce Emergence Agitation after Sevoflurane Anesthesia in Pediatrics: A placebo-controlled prospective trial.

Sevoflurane is an inhaled anesthetic widely used for pediatric anesthesia, but emergence agitation (EA) or emergence delirium (ED) is a common sevoflurane anesthesia recovery-associated problem.1 Emergence agitation is associated with increased risk of injury in children and parents' dissatisfaction with anesthesia care.2 In a web-based survey of pediatric anesthesiologists in Canadian Pediatric Anesthesia Society, 42% felt that EA was a significant problem and 45% of them were giving medication before or during anesthesia to prevent its development.

Comparative surgical risk between type of trampoline (size and place) and type of patients (age and sex) in trampoline related injury: a systematic review and indirect meta-analysis

BackgroundDespite its high risk of injury, many people are still favor trampolining. However, currently there is no consensus as to which type of trampoline and which type of participant is more likely to have a trampoline related injury that will require surgical management.MethodsThis systematic review and meta-analysis aims to assess and compare the factors that cause trampoline injuries requiring surgical treatment. These include the place of the trampoline (park versus home), size of the trampoline (full versus mini), the age of the participant (child versus adult) and the sex of the participant (male versus female). The clinical outcomes measured are surgical management after trampoline injury. This systematic review was conducted according to the PRISMA guidelines.ResultsRelevant studies that reported surgery after trampoline injury of either group were identified from Medline and Scopus from inception to May 14, 2019. Sixteen studies were included for the analysis of surgery after trampoline injury; a total of 4491 and 1121 patients were treated conservatively and surgically. The total surgery rate per patient was 31% (95% CI: 16, 46%) in all patients. The surgery rate was 0.3 (95% CI: 0.03, 0.58) and 0.06 (95% CI: 0.04, 0.09) in the full and mini size trampoline groups. There were 0.36 (95% CI: 0.06, 0.67) and 0.11 (95% CI: 0.0, 0.22) in the park and home trampoline groups. The surgery rates were 0.33 (95% CI: 0.14, 0.53), 0.24 (95% CI: 0.07, 0.11), 0.49 (95% CI: 0.47, 0.51) and 0.38 (95% CI: 0.22, 0.53) in children, adults, females and males respectively. Indirect meta-analysis shows that full size trampolines provided a 6.0 times higher risk of surgery (95% CI: 3.7, 9.7) when compared to mini size trampolines. Park trampolines had a higher risk of surgery of 2.17 (95% CI: 1.70, 2.78) when compared to home trampolines. In terms of age and sex of participants, there value was significantly higher at 1.65 (95% CI: 1.35, 2.01) and 1.54 (95% CI: 1.36, 1.74) in children compared to adults and females compared to males. From all the statistical data we summarized that the full size trampoline injuries have a 6 times higher risk of requiring surgery when compared to mini size trampoline injuries. Park trampoline use carries a 2 times higher risk of requiring surgery when compared to home trampoline use. In terms of age and sex of the participant, there is a 1.5 times significantly higher risk of injury in children compared to adults, and females when compared to males.ConclusionIn trampoline related injuries, full size, park trampoline, children and females had higher surgery rates when compared to mini size, home trampoline, adult and male majority in indirect meta-analysis methods.

Assessment of Neighborhood Influence on Pediatric Trauma Outcome

Introduction: The Child Opportunity Index (COI) is a new measure that combines educational, health and environmental, and socioeconomic variables that have previously been associated with childhood development. This metric is publicly available for 100 US metropolitan areas. It is known that lower socioeconomic status is associated with increased risk of traumatic injury in children. To our knowledge, a multi-factorial comparison such as the COI has not been used to assess associations between neighborhood opportunity and outcomes of pediatric traumatic …

Association between maternal and paternal mental illness and risk of injuries in children and adolescents: nationwide register based cohort study in Sweden

ObjectiveTo determine the association between parental mental illness and the risk of injuries among offspring.DesignRetrospective cohort study.SettingSwedish population based registers.Participants1 542 000 children born in 1996-2011 linked to 893 334...

Factors Affecting Child Injury Risk in Motor-Vehicle Crashes.

Current recommendations for restraining child occupants are based on biomechanical testing and data from national and international field studies primarily conducted prior to 2011. We hypothesized that analysis to identify factors associated with pediatric injury in motor-vehicle crashes using a national database of more recent police-reported crashes in the United States involving children under age 13 where type of child restraint system (CRS) is recorded would support previous recommendations. Weighted data were extracted from the National Automotive Sampling System General Estimates System (NASS-GES) for crash years 2010 to 2015. Injury outcomes were grouped as CO (possible and no injury) or KAB (killed, incapacitating injury, nonincapacitating injury). Restraint was characterized as optimal, suboptimal, or unrestrained based on current best practice recommendations. Analysis used survey methods to identify factors associated with injury. Factors with significant effect on pediatric injury risk include restraint type, child age, driver injury, driver alcohol use, seating position, and crash direction. Compared to children using optimal restraint, unrestrained children have 4.9 (13-year-old) to 5.6 (< 1-year-old) times higher odds of injury, while suboptimally restrained children have 1.1 (13-year-old) to 1.9 (< 1-year-old) times higher odds of injury. As indicated by the differences in odds ratios, effects of restraint type attenuate with age. Results support current best practice recommendations to use each stage of child restraint (rear-facing CRS, forward-facing harnessed CRS, belt-positioning booster seat, lap and shoulder belt) as long as possible before switching to the next step.

Pediatric Head Injuries in Summer Camps

Summer camps have a unique supervisory environment that may lead to increased head injury risk for children. The epidemiology of head injuries in camps is unclear. We partnered with CampDoc.com to review head injury reports from camp nurses in 2016 from 197 camps in 36 states. A total of 4290 (92%) reports were coded as definite head injuries, 47% (n = 2002) in female campers, with median camper age of 10 years. Head injury severity was coded as mild (94%, n = 4040), moderate (6%, n = 248), or severe (<1%, n = 2). Only 3% (n = 134) were medically evaluated, and 29% (n = 1221) were sports-related. Head injuries were categorized as definite (3%, n = 137) and probable (13%, n = 572) concussions, with 39% (n = 277) being sports-related and 61% (n = 83) of definite concussions incurred by female campers. Summer camps, while an important location of head injury risk, appear to be a safe environment for youth.

Use of Chest Computed Tomography for Blunt Pediatric Chest Trauma: Does It Change Clinical Course?

Given the concern for radiation-induced malignancy in children and the fact that risk of severe chest injury in children is low, the risk/benefit ratio must be considered in each child when ordering a computed tomography (CT) scan after blunt chest trauma. The study included pediatric blunt trauma patients (age, <15 years) with chest radiograph (CR) before chest CT on admission to our adult and pediatric level I trauma center. Surgeons were asked to view the blinded images and reads and indicate if they felt CT was warranted based on CR findings, if their clinical management change based on additional findings on chest CT, and how they might change management. Of the 127 patients identified, 64.6% had no discrepancy between their initial CR and chest CT and 35.4% of the children's imaging contained a discrepancy. The majority of the pediatric and general trauma surgeons felt CT was indicated in 6 of 45 patients based on CR. In 87% of patients with a discrepancy in findings on CR and CT, the majority of surgeons agreed that their management would not change based on the additional information. In the 6 patients in which the CT was considered indicated, 4 of the 6 would have triggered a management change. Our study suggests that chest CT scans frequently serve as confirmatory diagnostic tools and in the pediatric blunt chest trauma patient and can be withheld in many cases without hindering the management of an injured child.

Methylphenidate and the risk of burn injury among children with attention-deficit/hyperactivity disorder.

Attention-deficit/hyperactivity disorder (ADHD) is associated with a higher risk of burn injury than in the normal population. Nevertheless, the influence of methylphenidate (MPH) on the risk of burn injury remains unclear. This retrospective cohort study analysed the effect of MPH on the risk of burn injury in children with ADHD. Data were from Taiwan's National Health Insurance Research Database (NHIRD). The sample comprised individuals younger than 18 years with a diagnosis of ADHD (n = 90 634) in Taiwan's NHIRD between January 1996 and December 2013. We examined the cumulative effect of MPH on burn injury risk using Cox proportional hazards models. We conducted a sensitivity analysis for immortal time bias using a time-dependent Cox model and within-patient comparisons using the self-controlled case series model. Children with ADHD taking MPH had a reduced risk of burn injury, with a cumulative duration of treatment dose-related effect, compared with those not taking MPH. Compared with children with ADHD not taking MPH, the adjusted hazard ratio for burn injury was 0.70 in children taking MPH for <90 days (95% confidence interval (CI) 0.64-0.77) and 0.43 in children taking MPH for ≥90 days (95% CI 0.40-0.47), with a 50.8% preventable fraction. The negative association of MPH was replicated in age-stratified analysis using time-dependent Cox regression and self-controlled case series models. This study showed that MPH treatment was associated with a lower risk of burn injury in a cumulative duration of treatment dose-related effect manner.

Award for Distinguished Professional Contributions to Applied Research: David C. Schwebel.

The Award for Distinguished Professional Contributions to Applied Research is given to a psychologist whose research has led to important discoveries or developments in the field of applied psychology. The 2019 recipient is David C. Schwebel, "for achievements using psychological theory and science to reduce the leading cause of child death in the United States and much of the world: unintentional injury. David C. Schwebel has published article after article introducing, evaluating, and disseminating creative and novel ways to reduce child injury risk through behavioral changes among children, among adult supervisors of children, and via manipulation of the environments with which children and youth engage. He hallmarks the act of "giving psychology away" by implementing behavioral strategies to address acts that might be considered "accidental" but can-and should-be prevented to improve human health and happiness." (PsycINFO Database Record (c) 2019 APA, all rights reserved).