Risk and protective factors for falls on one level in young children: multicentre case-control study

Background: Childhood falls are an important global public health problem, but there is a lack of evidence about their prevention. Falls on one level result in considerable morbidity and they are costly to health services. Objective: To estimate odds ratios for falls on one level in children aged 0-4 years for a range of safety behaviours, safety equipment use and home hazards. Design, setting and participants: Multicentre case-control study at hospitals, minor injury units and general practices in and around 4 UK study centres. Participants included 582 children less than 5 years of age with a medically attended fall injury occurring at home and 2460 controls matched on age, sex, calendar time and study centre. Main outcome measure: Fall on one level. Results: Cases’ most common injuries were bangs on the head (52%), cuts or grazes not needing stitches (29%) or cuts or grazes needing stitches (17%). Comparing cases to community controls in the adjusted analyses, significant findings were observed for only 2 exposures. Injured children were significantly less likely to live in a household without furniture corner covers (adjusted odds ratio (AOR) 0.72, 95%CI 0.55, 0.95), or without rugs and carpets firmly fixed to the floor (AOR 0.76, 95% CI 0.59, 0.98). Conclusions: We did not find any safety practices, use of safety equipment or home hazards associated with a reduced risk of fall on one level. Our findings do not provide evidence to support changes to current injury prevention practice

Parental perceptions of barriers and facilitators to preventing child unintentional injuries within the home: a qualitative study

Background Childhood unintentional injury represents an important global health problem. Most of these injuries occur at home, and many are preventable. The main aim of this study was to identify key facilitators and barriers for parents in keeping their children safe from unintentional injury within their homes. A further aim was to develop an understanding of parents’ perceptions of what might help them to implement injury prevention activities. Methods Semi-structured interviews were conducted with sixty-four parents with a child aged less than five years at parent’s homes. Interview data was transcribed verbatim, and thematic analysis was undertaken. This was a Multi-centre qualitative study conducted in four study centres in England (Nottingham, Bristol, Norwich and Newcastle). Results Barriers to injury prevention included parents’ not anticipating injury risks nor the consequences of some risk-taking behaviours, a perception that some injuries were an inevitable part of child development, interrupted supervision due to distractions, maternal fatigue and the presence of older siblings, difficulties in adapting homes, unreliability and cost of safety equipment and provision of safety information later than needed in relation to child age and development. Facilitators for injury prevention included parental supervision and teaching children about injury risks. This included parents’ allowing children to learn about injury risks through controlled risk taking, using “safety rules” and supervising children to ensure that safety rules were adhered to. Adapting the home by installing safety equipment or removing hazards were also key facilitators. Some parents felt that learning about injury events through other parents’ experiences may help parents anticipate injury risks. Conclusions There are a range of barriers to, and facilitators for parents undertaking injury prevention that would be addressable during the design of home safety interventions. Addressing these in future studies may increase the effectiveness of interventions

Selective extraction of blood plasma exchangeable copper for isotope studies of dietary copper absorption

Measuring mineral absorption by fecal monitoring is labor-intensive and relies on good volunteer compliance. Blood indicators of absorption could be advantageous and we have developed a method for selective extraction-of recently absorbed (exchangeable) copper based on dialysis of plasma with histidine and subsequent copper extraction using Chelex resin. The potential for measuring copper absorption by transient enrichment of exchangeable copper with the stable isotope 65Cu from an ingested tracer, was also investigated. This method was compared with that of the fecal monitoring technique in a human volunteer, who consumed a 6 mg dose of 65Cu with inhibitors of copper absorption. Holmium was used as a non-absorbable rare-earth marker of unabsorbed tracer excretion, allowing estimation of re-secreted 65Cu (44 microg d(-1)), and hence calculation of true tracer absorption, which was only 10.8%. Monitoring plasma tracer kinetics showed potential for estimation of copper absorption without the need for fecal copper analysis