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Biomedical subjects

D Kendrick

Publications and source records attributed to D Kendrick.

49 records · Page 3Linked to original sources
PubMed1997

Accidental injury: risk and preventative interventions.

OBJECTIVE: To evaluate the relation between risk factors for childhood unintentional injury and requests for injury prevention interventions as part of the Nottingham Safe at Home project, a primary care based controlled intervention study assessing the effectiveness of a package of injury prevention interventions. SETTING: 17 practices in Nottingham randomly selected from 55 practices volunteering to take part in the study. METHODS: Postal questionnaire to all parents of children aged 3 to 12 months registered with the intervention practices (n = 1124) to assess risk factors for injury and to elicit requests for three injury prevention interventions: free home safety checks, low cost safety equipment, and free first aid training. RESULTS: 73% of parents responded to the questionnaire. The distribution of sociodemographic variables among responders was similar to that for the population of Nottingham. One third of parents (34%) requested one intervention, 21% requested two interventions, and 10% requested three. Receipt of means tested benefits, ethnicity, and residence in a deprived area were independently associated with requesting home safety checks. Non-owner occupation, lack of access to a car, receipt of means tested benefits, ethnicity, and unemployment were independently associated with requesting low cost safety equipment. Non-owner occupants were less likely to request first aid training. CONCLUSIONS: Families with risk factors for childhood unintentional injury do request home safety checks and low cost safety equipment, but they are less likely to request first aid training. Other methods for providing first aid advice may be needed to reach such families.

Accident Prevention↗
PubMed1997

Injury prevention programmes in primary care: a high risk group or a whole population approach?

OBJECTIVE: To examine the relationship between risk factors for childhood unintentional injury and injury outcome and to assess the feasibility of using risk factors to identify children at high risk of injury. SETTING: One general practice in Nottingham, UK. METHOD: A postal questionnaire survey to all parents of children registered with the practice (n = 771) to obtain data on risk and sociodemographic factors. All children still registered with the practice one year later were followed up for occurrence of a medically attended injury. RESULTS: The response rate was 78%. The injury rate over the follow up year was 246 injuries per 1000 children. Previous medically attended injury was associated with each of the injury outcomes (odds ratio (confidence interval) for all attendances, 2.33 (1.37 to 4.05); for accident and emergency attendances, 2.27 (1.15 to 4.4); and for primary health care team attendances, 2.58 (1.33 to 5.0)). Male sex was associated only with accident and emergency department attendance (odds ratio 2.13 (1.06 to 4.2)). Maternal age and previous injury were associated with a higher number of injuries in the subsequent year on univariate and multivariate analyses. The sensitivity and positive predictive value of the risk factors were low, except for previous injury and male sex. The number of children needing an injury prevention intervention to prevent one injury as identified by the risk factors was not significantly different from that required if a whole population approach were to be used. CONCLUSION: Primary care based injury prevention programmes, at present, should not be targeted at children identified as being at 'high risk' of injury. Nevertheless, a larger study using a wider cross section of the population is needed to address this issue further.

Adolescent↗
PubMed1995

Health visitors' knowledge, attitudes and practices in childhood accident prevention.

BACKGROUND: The importance of the health visitor's role in childhood accident prevention has long been recognized, although previous work suggests that many health visitors are unsure of that role, feel inadequately prepared for it and recognize significant constraints on their accident prevention activity. The Health of the nation suggested that specific accident prevention activities should be undertaken by health visitors. This study aims to assess whether those activities are currently part of routine health visiting practice, as well as the attitudes towards accident prevention and knowledge of childhood accidental injury epidemiology. METHOD: A postal questionnaire survey covering knowledge, attitudes and practices in accident prevention as well as personal characteristics was sent to all health visitors in Nottinghamshire, using the community unit trusts' list of employees as the sampling frame. RESULTS: A response rate of 88.5 per cent was obtained. The majority of health visitors were aware that accidental injuries are the most common cause of death in childhood above the age of one year. The majority of health visitors were also aware of the types of accident most likely to be fatal, and aware of the risk factors for childhood accidental injuries. Many health visitors held positive attitudes towards all accident prevention activities covered in the questionnaire. There was a positive correlation between attitude and knowledge scores (p < 0.01). There were some discrepancies between attitudes and current practices, particularly in the areas of teaching first aid to parents' groups and lobbying or campaigning on local safety issues. CONCLUSIONS: Although many health visitors hold positive attitudes towards, and currently undertake many of the accident prevention activities suggested in the Health of the nation, there are areas where practice could be improved, such as giving advice about stockists of safety equipment including local loan schemes, undertaking first aid sessions in parents' groups and lobbying or campaigning on local safety issues.

Accident Prevention↗
PubMed1995

How do practice nurses see their role in childhood injury prevention?

OBJECTIVES: To assess the knowledge of unintentional injury epidemiology, the attitudes towards, and current practices in injury prevention among practice nurses. SETTING: Practice nurses employed by general practitioners in Nottinghamshire, United Kingdom. METHOD: A postal questionnaire was sent to all practice nurses on the Family Health Services Authority list (n = 322) with questions covering sociodemographic details, occupational details, unintentional injury epidemiology, attitudes towards the injury prevention activities suggested by a government report as part of the role of the primary health care team, and current practices in injury prevention. RESULTS: A response rate of 71.1% was achieved. More than 50% knew that unintentional injuries were the most common cause of death in childhood. A similar per cent knew the site of most fatal injuries in the under 1 and 5-16 year age groups. More than two thirds correctly identified a range of risk factors for unintentional injury. However, only two fifths of nurses believed they could be effective in preventing injuries. There were considerable gaps between attitudes and practice for most activities. The activities most commonly undertaken include displaying posters and leaflets (69.4%), giving advice on prevention (51.1%), and advice on first aid (45.0%) during injury consultations. CONCLUSIONS: Most practice nurses hold positive attitudes towards injury prevention activities, but fewer undertake these activities regularly. The activities most commonly undertaken employ an educational model. Further research is needed on the barriers to practice nurses undertaking more injury prevention work, the effectiveness of systems to overcome such barriers, and the effectiveness of these injury prevention activities.

Adolescent↗
PubMed1995

Does routine child health surveillance reach children most at risk of accidental injury?

BACKGROUND: There is currently an increasing emphasis on accident prevention as part of routine child health surveillance, which unlike opportunistic accident prevention has the potential to reach the whole population. However, non-attenders at routine child health surveillance may also be children at higher risk of accidental injury, as there is some evidence that non-attenders may be more likely to live in socio-economic disadvantage, which is a risk factor for accidental injury. METHODS: A case control study was carried out in one general practice in Nottingham with 253 cases and 243 controls, aged four years and under, obtained from the practice age-sex register. Cases were defined as children who had attended the accident and emergency department, the general practitioner or the practice nurse after an accidental injury at any time during their life. Controls were children who had not had a medically attended accidental injury. Attendance at routine child health surveillance, before the date of the case's accidental injury, was assessed by attendance at the eight-month hearing test, immunization status, child health clinic visits and home visits by the health visitor. RESULTS: There was no significant difference between cases and controls in attendance for the hearing test, or immunization status. Cases received significantly more home visits after adjusting for confounding variables (odds ratio 2.44, 95 per cent confidence intervals 1.28-4.66). CONCLUSIONS: These findings suggest that non-attenders at routine child health surveillance activities are not at an increased risk of medically attended accidental injury. They also suggest that health visitors can identify those children most at risk of accidental injury using criteria for classifying priorities in caseloads.

Accident Prevention↗
PubMed1994

Children's safety in the home: parents' possession and perceptions of the importance of safety equipment.

A parental survey was administered by health visitors at the eight-month hearing test in five areas of Nottingham in order to examine possession and perceptions of the importance of safety equipment. The response rate was 82.2%. A sizeable proportion of families were found not to possess items of safety equipment thought to be appropriate for an eight-month-old child. Most items were perceived to be very important with a significant association between perceived importance and possession of equipment (P = 0.008). Perceptions of importance did not vary by socio-demographic variables but families on benefit, single-parent families, non-owner-occupiers and families with only one child possessed significantly fewer items. It is concluded that there is considerable scope for educating parents about safety equipment and that the provision of affordable safety equipment schemes should be considered by agencies implementing The Health of the Nation.

Accidents, Home↗
PubMed1994

Role of the primary health care team in preventing accidents to children.

Accidents are the most common cause of mortality in children and account for considerable childhood morbidity. The identification of risk factors for childhood accidents suggests that many are predictable and therefore preventable. Numerous interventions have been found to be effective in reducing the morbidity and mortality from childhood accidents. The scope for accident prevention within the primary care setting and the roles of the members of the primary health care team are discussed. Finally, the problems associated with the team undertaking accident prevention work are explored and solutions suggested.

Accident Prevention↗
PubMed1993

An audit of the complications of paediatric tonsillectomy, adenoidectomy and adenotonsillectomy.

Tonsillectomy, adenoidectomy and adenotonsillectomy are among the commonest surgical procedures undertaken in children. The notes of 413 consecutive children having tonsillectomy, adenoidectomy or adenotonsillectomy were analysed retrospectively to determine complication rates. Of the total number of children, 5.6% had at least one complication, the most common of which was haemorrhage occurring as a first complication in 3.9% (16 children). Three children with bleeding required active treatment (0.7%), one requiring transfusion and two requiring a return to theatre, all within 3 1/2 hours of operation. The incidence of reactionary bleeding was not associated with the grade or seniority of the surgeon. Six children (1.5%) developed a fever post-operatively, of which one required antibiotic treatment. On the basis of these results it is feasible for such procedures to be carried out on a day-care basis.

Adenoidectomy↗
PubMed1993

Prevention of pedestrian accidents.

Child pedestrian accidents are the most common road traffic accident resulting in injury. Much of the existing work on road traffic accidents is based on analysing clusters of accidents despite evidence that child pedestrian accidents tend to be more dispersed than this. This paper analyses pedestrian accidents in 573 children aged 0-11 years by a locally derived deprivation score for the years 1988-90. The analysis shows a significantly higher accident rate in deprived areas and a dose response relationship between degree of deprivation and accident rates. At the level of individual deprivation zones a strong correlation between accident rates and the degree of deprivation has been demonstrated. It is suggested that area wide engineering and educational schemes should be targeted at areas with high accident rates. Environmental improvements based on analysis of clusters of accidents may not be the most suitable method for reducing child pedestrian accidents.

Accidents, Traffic↗
PubMed1993

Accidental injury attendances as predictors of future admission.

A case-control study was carried out in Nottingham Health District, to establish whether children under five years of age admitted to hospital after a accidental injury were more likely to have previously attended the accident and emergency (A & E) department than community controls. The subjects were 342 case-control pairs matched on sex and date of birth, consisting of children under five years resident in the Health District, and the main exposure measures were attendance at the A & E department before the case's first admission, type of injury and number of earlier attendances. It was found that, after adjusting for social deprivation score and proximity to hospital, children who had been admitted after an accidental injury were twice as likely to have attended the A & E department than community controls, and were more likely to have had more than one earlier attendance. Odds ratios were significantly raised for soft-tissue injuries and lacerations. It is concluded that accidental injuries in pre-school children that require attendance at the A & E department predict accidental injuries requiring admission. Making attendances at A & E departments notifiable to health visitors would facilitate the undertaking of accident prevention work.

Accident Prevention↗