Comparing foreign body injuries patterns between Turkey and European Countries: are female Turkish children more vulnerable?

OBJECTIVES: The present study aimed at analyzing and comparing Foreign Body (FB) injuries patterns in children from Turkey and other European countries in order to assess any country and culturally specific aspects of FB risk. METHODS: Data from Susy Safe register were included in the analysis. For this study, ICD-935 (mouth, esophagus and stomach) and ICD-934 (trachea, bronchus, and lung) cases from European countries and from a single center in the Istanbul Bahcelievler State Hospital, Turkey, were extracted from the Susy database. A Multiple Correspondence Analysis (MCA) approach was employed to identify differences or similarities between the groups of FB injuries. RESULTS: The Turkey dataset has a larger proportion of females in comparison to the European data (p-value 0.002). According to the MCA analysis, the first two dimensions are explaining 48.11% of the variability (dimension 1, 37.44%; dimension 2, 10.67%). The three largest contributions to dimension 1 are via naturalis removal, not hospitalized, and ICD-935. The greatest contributions to dimension 2 are FB type, and consistency. CONCLUSION: The most interesting study finding is the higher incidence of females suffering a FB injury in ICD-934-935 in the Turkey dataset compared to that seen in the European dataset and also higher than that for all ICD locations within the Susy Safe register. The higher incidence of females tends to go against the belief that boys suffer higher FB injuries and needs to be further investigated.

Increasing awareness of food-choking and nutrition in children through education of caregivers: the CHOP community intervention trial study protocol.

BACKGROUND: Choking is one of the leading causes of death among unintentional injuries in young children. Food choking represents a considerable public health burden, which might be reduced through increased effective preventative education programs. We present a protocol for a community intervention trial termed CHOP (CHOking Prevention project) that aimed to teach Italian families how to prevent food choking injuries and increase knowledge relating to nutrition. METHODS: Italian educational facilities were enrolled. Stratified randomization blocked by geographical area was performed. Each stratum was randomized to one of three different intervention strategies or to a control group. Educational intervention was delivered in the schools by experts and certified trainers as per the following three intervention strategies: directly to families (Strategy A); to teaching staff only, who subsequently delivered the same educational intervention to families (Strategy B); to health service staff only, who then delivered the educational intervention to teaching staff, who subsequently delivered the intervention to families (Strategy C). Participants completed a questionnaire about their knowledge on the topics presented during the educational interventions (pre-, post-, and follow-up of intervention). Information from the questionnaires was synthetized into 6 indicators in order to measure how effective each intervention strategy was. DISCUSSION: The issue of food choking injuries in children is relevant to public health. The protocol we present provides an opportunity to progress towards overcoming such challenges through a working model that can be implemented also in other countries. TRIAL REGISTRATION: ClinicalTrials.gov NCT03218618. The study was registered on 14 July 2017.

Foreign Body injuries in children in India: Recommendations for prevention from a comparative analysis with international experience.

OBJECTIVES: This study aims to identify specific patterns of risk in order to contribute to the prevention of Foreign Body (FB) injuries by assessing FB injury characteristics in Indian children. METHODS: Single center case series are included in the worldwide registry on Foreign Bodies Injuries www.susysafe.org. Statistical analysis performed on FB injury data (age, medical information, FB anatomical location (ICD) and characteristics, and situational data) from 252 Indian children (0-14 years) was used to identify FB risk patterns. RESULTS: The study included 252 FB injury cases, out of which 110 occurred in females (43.7%). Most of the reported FB injuries (N = 252) were located in the mouth, esophagus and stomach, or intestines and colon (34.5%), and in the nose (31.3%). The analysis of the median duration of all injuries (i.e., the difference between the reported injury time/date and the reported time/date of arrival at hospital) showed that children with a FB in the airways were those referred to the hospital latest (median of 332.50 min, p-value <0.001). With regards to FB type, the majority of FB objects were non-food items and ingestion of coins accounted for 25% of all FB injuries. CONCLUSIONS: Cultural differences may exist with regards to the Indian diet being conducive to lower choking food risk for children, and to acceptability and accessibility to objects such as coins and stationery. Such findings should be taken into account when developing primary and secondary prevention strategies aimed at reducing the burden of such injuries in India.

Development and performance of the diffusive gradients in thin-films technique for the measurement of technetium-99 in seawater.

A novel technique for obtaining time-integrated 99Tc concentrations in seawater has been developed, using diffusive gradients in thin films (DGT). The performance of TEVA resin as a binding agent for 99Tc was investigated via laboratory experiments. The accumulated 99Tc activity per unit area of resin-gel was proportional to both the bulk solution activity and the exposure time for deployments of up to 2 weeks. The response of DGT was found to be independent of solution chemistries over the pH range 3-8 and ionic strength range 0.01-1.3 M. Seawater has pH 8 and ionic strength of approximately 0.7 M; therefore, the potential of the technique for field deployment in seawater was demonstrated. Detection limits of 0.05 and 0.025 Bq L(-1), for 2- and 4-week DGT deployments, respectively, were calculated for 99Tc measurement by liquid scintillation spectrometry. Using quadrupole ICPMS to measure bound 99Tc could reduce these detection limits to 0.125 mBq L(-1) for a 4-week deployment. These detection limits are sufficiently low for monitoring contaminated environments, including the Irish Sea. This method is simpler and faster than other 99Tc analysis methods and represents the only means of obtaining time-integrated data.