Show full item record Abstract It has been suggested that gender is a societal construct and as such its features can shift depending on the beliefs of society Connell If this is the case, then hegemonic masculinity, as defined by Raewyn Connell, should also shift its features based on societal changes.
For some injuries, the presenting problem text elaborated on the role of the parent, sibling or other family member in the injury. Discussion As was the case with younger children, the pattern of injuries in one-year olds continues to evolve over the course of the second year of life.
Mobility and competence develop rapidly in children of this age and this is reflected in the changing ways in which children are injured at this stage of their lives. If preventive efforts are to be effective these changes should be recognized and prevention strategies tailored to developmental stages.
Parents and caregivers should be provided with knowledge about child development and injury risk when they come into contact with health professionals or other service providers Knocked up textual analysis as to anticipate and prevent, or minimize these injuries.
While the incidence of some injury causes, such as falls, contact and foreign body injuries, remained more or less constant, others, notably burns and scalds, but also threats to breathing, decreased or, like poisonings, increased.
Even when the overall incidence of an injury class did not alter substantially, within that class there were some changes with age in the modes of injury; for instance, falls from play equipment and from high places other than furniture became more common, while falls down stairs or being dropped by someone became rarer.
Similarly in the injury category of contact, having a hand caught in a door or elsewhere became less common with age while injuries due to other persons became more common. The incidence of poisonings increased markedly with age among children aged one year, and this is consistent with the findings of a study of hospital admissions in another state [ 10 ].
In our data the increase was entirely due to the ingestion of medications and essential oils, with poisonings from other sources remaining more or less constant in absolute number.
While some text descriptions of the injury event reported that some children climbed on furniture to reach medications on tables or kitchen counters or medications were knocked down by older siblings, unfortunately the brevity of most of the text descriptions Knocked up textual analysis not permit a detailed examination of the ways in which the children gained access to the medications they swallowed.
At least one injury was described as having occurred because an older sibling administered a medication stored in the fridge door to a younger sibling.
These data also suggest that ingested medications were not in secure containers. Effectively this means that some children will always be able to open child resistant packaging and some adults will always find these closures difficult to access. Accordingly, there is a possibility that containers in regular use are not properly sealed after every opening Some support for this suggestion is provided by a study of childhood poisonings due to over-the-counter medications that found that where medications had been in a child-resistant container, in almost half of instances the container had not been properly secured after last use [ 12 ].
Parents and caregivers may not consider or realize that essential oils are as harmful as medications; they may not be sold in childproof packaging, may not always be stored in a safe place or toddlers may access them from easily accessible handbags of visitors or even from shopping bags before contents are put away and moved to safe storage places.
The exact ways in which toddlers access and are poisoned by medications or essential oils warrants detailed examination in its own right.
Although there are clear differences in some injuries in these data, details of caregiver supervision are not available to assist in interpreting the data. There is research demonstrating that children who have histories of child maltreatment are twice as likely to die of an unintentional injury than children who are not previously known to child protection authorities [ 4 ].
Studies investigating fatal neglect have found that one-off episodes of supervisory lapses are common [ 1415 ]. Several studies have pointed out that injury causation in toddlers is often the result of interplay between familial, circumstantial and individual factors [ 1617 ].
Similar risk factors have been identified in the child protection literature as associated with child maltreatment, particularly in association with neglect and supervisory neglect. In a workshop on child injury prevention in Canada in several experts on child injury pointed out that over-emphasis on keeping small children safe may result in compromising healthy development [ 21 ].
In particular one participant Dr. Sandseter from Norway distinguished between hazardous childhood activities to be avoided and risk-taking crucial to normal child development. Other participants commented that a similar effect might ensue from designing play areas with excessive concentration on safety rather than challenge.
Such considerations are necessarily absent from workplace and road safety thinking, but should perhaps play a greater role in designing injury prevention interventions for small children. It should however be noted that this point of view has not gone unchallenged [ 2223 ].
In respect of possible interventions, it is clear that regular reminders to care-givers about the importance of keeping hot or hazardous substances out of the reach of small children is fundamental, as is safety in and around motor vehicles and near stairs.
It is however worth noting that a recent systematic overview of the evidence of the effectiveness of interventions to prevent scalds in children found little to show for such interventions in reducing the incidence of scalds in children [ 2425 ], suggesting that the design of such interventions is challenging.
With regard to other modes of injury the position is more complex. Limitations As discussed in our previous paper, the sample is based on a relatively limited number of participating Queensland hospitals and may not be entirely representative of all injured children in the State.
Information on the injury background of transferred children is sometimes sketchy, and in a busy emergency department data collection and coding may on occasion be imperfectly done.
Nonetheless, as we reported in the previous paper, a prospective study has found data collected in this way to be reliable as an estimator of incidence and severity [ 26 ]. Conclusions Reporting injury patterns in very young children even by single year of age tends to obscure the significant changes in injury profiles which occur as children go through a period of rapid growth and development in the first two years of life and possibly longer.
Understanding the way the patterns alter with age can better inform interventions targeted specifically to the various phases of childhood. Where parents have information about the injury risks associated with increased mobility and independence of children they are better able to identify and minimize exposure to risk and prevent what may me a life threatening or limiting injury.
Wider dissemination of this understanding to parents, caregivers and health professionals will enable them to anticipate the sort of injuries that children in their care may incur and improve child safety, regardless of the type or intent of injury.
Acknowledgments The authors would like to acknowledge the staff at the Queensland Injury Surveillance Unit for their help in providing the data files in a form suitable for analysis and to the emergency department staff who collected the data.
Author Contributions Victor Siskind obtained, edited and analyzed the data, and contributed to the Discussion; Debbie Scott provided background to the data and contributed to the interpretation of the findings and to the Introduction and Discussion.
Conflicts of Interest The authors declare no conflict of interest. Age-related differences in outcomes following childhood brain insults:reportedly learned after a local priest knocked on his door the day of Swift’s a hoax shares many textual characteristics with satire.
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