BACKGROUND: In this study, we use the media-based database of Beterem-Safe Kids Israel, to provide a 15-year review of unintentional fatal childhood drowning in Israel, between 2008 and 2022.
METHODS: It total, we identified 257 cases of child mortality due to drowning during this period.
RESULTS: Our results demonstrate a gradual rise in childhood mortality due to drowning, from 72 cases in 2008-2012, to 85 cases in 2013-2017, and to 100 cases in 2018-2022. Especially worth noting is the increase in childhood drowning in domestic swimming pools. We point to a link between low socioeconomic status and cases of drowning, showing that the risk of drowning extends beyond a mere matter of caregiver inattention. We recommend a series of regulatory and legislative steps to reduce fatal childhood drowning, including fencing built around domestic swimming pools, extending lifeguard activity hours, adding declared beaches, forming programs of safe behavior in water environments for adolescents, and establishing swimming lessons during the 2nd grade, for all populations. We further recommend that a special focus will be put in municipalities situated at the bottom of the socioeconomic index.

UNASSIGNED: One of the main causes of death worldwide among young people are car crashes, and most of these fatalities occur to children who are seated in the front passenger seat and who, at the time of an accident, receive a direct impact from the airbags, which is lethal for children under 13 years of age. The present study seeks to raise awareness of this risk by interior monitoring with a child face detection system that serves to alert the driver that the child should not be sitting in the front passenger seat.
UNASSIGNED: The system incorporates processing of data collected, elements of deep learning such as transfer learning, fine-tunning and facial detection to identify the presence of children in a robust way, which was achieved by training with a dataset generated from scratch for this specific purpose. The MobileNetV2 architecture was used based on the good performance shown when compared with the Inception architecture for this task; and its low computational cost, which facilitates implementing the final model on a Raspberry Pi 4B.
UNASSIGNED: The resulting image dataset consisted of 102 empty seats, 71 children (0-13 years), and 96 adults (14-75 years). From the data augmentation, there were 2,496 images for adults and 2,310 for children. The classification of faces without sliding window gave a result of 98% accuracy and 100% precision. Finally, using the proposed methodology, it was possible to detect children in the front passenger seat in real time, with a delay of 1 s per decision and sliding window criterion, reaching an accuracy of 100%.
UNASSIGNED: Although our 100% accuracy in an experimental environment is somewhat idealized in that the sensor was not blocked by direct sunlight, nor was it partially or completely covered by dirt or other debris common in vehicles transporting children. The present study showed that is possible the implementation of a robust noninvasive classification system made on Raspberry Pi 4 Model B in any automobile for the detection of a child in the front seat through deep learning methods such as Deep CNN.

UNASSIGNED: Pedestrians are a vulnerable group at the roadside and previous research has identified that children with DCD and ADHD are at a heightened risk of pedestrian injuries. Despite this, limited research has explored parental perspectives of the pedestrian risks faced by children with DCD and/or ADHD. Understanding parents\' perspectives provides a unique insight into the challenges children face every day and the concerns that parents perceive regarding their children\'s safety as pedestrians. Therefore, the aim of this study was to explore parents\' perspectives of the pedestrian risks faced by their children with DCD and/or ADHD.
UNASSIGNED: Semi-structured interviews were conducted with 14 parents of primary school and early secondary school aged children with age range 7-17. The participants were divided into three groups based on their children\'s conditions: DCD group (10-17 years, n = 3), ADHD group (7-13 years, n = 5), and co-occurring group (7-16 years, n = 6). All parents confirmed an existing diagnosis and completed the SNAP-IV and DCDQ as screening tools. The interviews explored parents\' perspectives regarding their children\'s pedestrian behaviors, parents\' concerns and preventative measures taken to improve the pedestrian safety of their children with DCD and/or ADHD. Reflexive thematic analysis was undertaken to analyze the interviews, from which three themes were developed.
UNASSIGNED: The first theme related to the challenges experienced by children at the roadside; parents emphasized the significance of structured and controlled pedestrian crossing sites, underlining their preference for designated crossings as safer options due to their heightened perceptions of risk associated with other road-crossing locations. The second theme: parental concerns and influences on children\'s road safety referred to their children\'s performance and safety at the roadside, leading to increased monitoring and a more protective approach to road crossing. The third theme: road safety education related to various strategies parents implemented to mitigate risks, while balancing independence and prioritizing their safety.
UNASSIGNED: While there were commonalities in the challenges faced by children with DCD and/or ADHD at the roadside, there were also notable differences. Parents of children with DCD discussed challenges with spatial awareness and motor skills, whereas parents of children with ADHD discussed challenges with impulsivity and inattention. Parents of children with co-occurring DCD and ADHD described a complex interplay of these challenges. It is evident from the interviews that children with DCD and/or ADHD require a distinct approach to develop their pedestrian skills effectively and parents reported specific strategies they used to address the risks associated with their children\'s roadside behavior. Promoting pedestrian safety for children with DCD and/or ADHD necessitates collaboration among parents, schools and local authorities to implement comprehensive measures ensuring their safety. These findings contribute to understanding parental experiences and needs, providing valuable guidance for targeted interventions and policies to enhance the road safety of children with DCD and/or ADHD.

OBJECTIVE: To evaluate whether child pedestrian safety training in a smartphone-based virtual reality (VR) environment is not inferior to training in a large, semi-immersive VR environment with demonstrated effectiveness.
METHODS: Five hundred 7- and 8-year-old children participated; 479 were randomized to one of two conditions: Learning to cross streets in a smartphone-based VR or learning in a semi-immersive kiosk VR. The systems used identical virtual environments and scenarios. At baseline, children\'s pedestrian skills were assessed in both VR systems and through a vehicle approach estimation task (judging speed/distance of oncoming traffic on monitor). Training in both conditions comprised at least six 30-min sessions in the randomly assigned VR platform and continued for up to 25 visits until adult-level proficiency was obtained. Following training and again 6 months later, children completed pedestrian safety assessments identical to baseline. Three outcomes were considered from assessments in each VR platform: Unsafe crossings (collisions plus close calls), time to contact (shortest time between child and oncoming simulated traffic), and missed opportunities (unselected safe opportunities to cross).
RESULTS: Participants achieved adult-level street-crossing skill through VR training. Training in a smartphone-based VR system was generally not inferior to training in a large semi-immersive VR system. There were no adverse effects.
CONCLUSIONS: Seven- and 8-year-old children can learn pedestrian safety through VR-based training, including training in a smartphone-based VR system. Combined with recent meta-analytic results, the present findings support broad implementation and dissemination of child pedestrian safety training through VR, including smartphone-based VR systems.

BACKGROUND: There have been sharp increases in antidepressant and opioid prescriptions over the last 10 years, as well as increased over-the-counter medicine availability. However, the impact on childhood medicinal poisonings rates, particularly by socioeconomic deprivation is unclear. This study reports population level medicinal poisoning substance patterns in England among children aged 0-11 years, helping inform safety advice and poisoning prevention interventions.
METHODS: An open cohort study of 1,489,620 0-11 year olds was conducted from 1998 to 2018, using the Clinical Practice Research Datalink, to examine inpatient hospital admissions for poisoning. Incidence rates and adjusted incidence rate ratios (aIRR) were calculated for poisoning substance groups by age, sex, socio-economic deprivation and year.
RESULTS: 3,685 medicinal poisoning hospital admissions were identified. The most common substances were paracetamol (33.2%), dependence/withdrawal risk drugs (DWRD - antidepressants, opioids, gabapentinoids, benzodiazepines) (13.5%) and other over-the-counter (OTC) analgesics/anti-common cold drugs (13.0%). Over the study period DWRD poisonings decreased 33% (aIRR 0.67, 95%CI 0.50-0.90 comparing 2013/14-2017/18 to 1998/99-2002/03), while paracetamol poisonings increased 43% (aIRR 1.43, 95%CI 1.20-1.70 for the same periods), with no change in incidence rates for other OTC drugs (aIRR 0.82, 95% CI 0.60-1.12) or all medications combined (aIRR 0.97, 95%CI 0.88-1.07). A gradient in poisonings by area-level socioeconomic deprivation was shown for all medications (aIRR 1.32, 95%CI 1.18-1.47 for most deprived compared to least deprived quintile), and DWRDs (aIRR 2.03, 95%CI 1.42-2.88 for 4th most deprived quintile and aIRR 1.88, 95%CI 1.32-2.66 for 5th most deprived quintile, compared to least deprived quintile), but not for paracetamol or other OTC drug poisonings.
CONCLUSIONS: Poisonings from DWRDs decreased by 33%, while paracetamol poisonings increased by 43% during the study period. There was a gradient by area-level socioeconomic deprivation in prescribed medication poisonings, including drugs with withdrawal/dependence risk, but not OTC medication poisonings. Households in more socioeconomically deprived areas have the potential to benefit most from measures to improve safe storage of medicines and are likely to require targeted interventions providing education and safety equipment. In addition, universal promotion of the safe storage of OTC and prescribed medicines must be provided by prescribers, community pharmacies and other outlets of such medication.

BACKGROUND: Newborns of parents with intellectual disabilities face higher risks in their environment for child unsafety, despite parents\' good intentions. To help parents prevent unsafe circumstances, a good understanding of the risk factors faced by these parents is needed.
METHODS: This casefile study examined (1) which risk factors were present for expectant parents with intellectual disabilities in child protection, (2) which domains of risk factors, and (3) whether a cumulation of risk factors was related to child safety.
RESULTS: Expectant parents with intellectual disabilities in child protection before the child was born often experienced a cumulation of risk factors. Child, family, and care factors best predicted child safety. A cumulation of risk factors over multiple life domains increased the risks for child unsafety.
CONCLUSIONS: To reduce the risks of unsafe parenting conditions for newborns, preventive interventions for expectant parents with intellectual disabilities should address their needs from an ecological perspective.

UNASSIGNED: The initial frontal NCAP tests in 1979 included lap-shoulder belted driver and right-front passenger and lap belted 6-year-old (yo) in the rear. The 35 mph barrier tests were reviewed and analyzed for the restraint performance of the front occupants and child in the rear.
UNASSIGNED: The initial 100 crash tests (#1-#100) in the NHTSA database were searched for frontal barrier impacts. Fifteen tests met the criteria. There were three tests with the 1980 Chevrolet Citation at 35, 40 and 48 mph. There were 12 other tests with different passenger vehicles at 35 mph into the rigid barrier. The tests included a lap-shoulder belted Hybrid II (Part 572) dummy in the driver and right-front passenger seat and a lap belted 6 yo child dummy (Alderson VIP 6 C) in the center or right rear seat. Vehicle dynamics and occupant kinematics were analyzed, and dummy responses were compared.
UNASSIGNED: Vehicle deformation was progressive with impact speed for the Citation tests, leading NHTSA to settle on a 35 mph NCAP speed. The thirteen 35 mph NCAP tests had an average driver HIC of 1099 ± 381 (95th CI 207) and 3 ms chest acceleration of 55.7 ± 16.1 g (95th CI 8.8) with 7 of 13 vehicles failing FMVSS 208 injury criteria. The average right-front passenger HIC was 1179 ± 555 (95th CI 302) and 3 ms chest acceleration was 47.2 ± 14.6 g (95th CI 7.9) with 7 of 13 failing injury criteria. Only four tests (30.8%) passed driver and right-front passenger injury criteria.The responses in the rear seat were significantly worse. The average HIC was 2711 ± 1111 (95th CI 604) and 3 ms chest acceleration was 62.8 ± 10.6 g (95th CI 5.8). The films showed the child\'s upper body moved forward and rotated downward around the lap belt resulting in severe head impacts on the front seatback, floor, dummy legs or interior. All vehicles failed injury criteria by large margins. Submarining the lap belt was noted in 6 tests. HIC for the rear child was 2.47-times greater than the driver (t = 4.72, p < 0.001) and 2.30-times greater than the right-front passenger (t = 3.64, p < 0.005).
UNASSIGNED: In the 1979 NCAP tests, the child dummy experienced inadequate restraint by the lap belt in the rear seat. The child jackknifed around the lap belt, often submarined, with a severe head impact. No publication of the results has been found. NHTSA did not advise the public of the extremely poor restraint performance, even during the public discussions on the 1986 NTSB recommendation that U.S. vehicle manufacturers install lap-shoulder belts in rear outboard seats. None of the subsequent NCAP tests included a child or adult in the rear until nearly 25 years later.

BACKGROUND: Pediatric non-accidental trauma often necessitates the involvement of protective services. However, the subjectivity and lack of standardization of referral infrastructure may result in some discrepancies between referral patterns and instances of child abuse.
METHODS: An institutional retrospective chart review was conducted between 2015 and 2021, in which all cases of patients under the age of 14 who suffered a burn injury and received a child protective service (CPS) consult were reviewed. Baseline demographics and characteristics were defined. Multivariate analysis was utilized to identify predictors of CPS involvement, while the regression analysis was employed to parse associations between burn injuries and CPS involvement.
RESULTS: Between July 2015 and December 2021, 340 patients (median age two years, IQR: 1-6 years) under the age of 14 who experienced a burn injury were evaluated. Forty-four (12.9%) of the patients\' cases received a CPS referral, of which three (0.9%) resulted in a CPS intervention. The most common mechanism of burn within the cohort was scald (241 patients, 70.9%). The median total body surface area (TBSA) was 3.0% (IQR: 1.0%-6.0%), and 76 (22.4%) suffered a high TBSA (>75th percentile). Caucasian race (p < 0.001) and scald mechanisms (p = 0.014) were associated with higher TBSA. When considering how such injuries translated to CPS referrals, increasing age was found to be associated with a decreased likelihood of CPS involvement. Meanwhile, the Black race (p = 0.027) and increasing area deprivation index (ADI) (p = 0.038) were associated with CPS involvement. Those with CPS involvement experienced a greater length of hospital stay (p = 0.001). Black race and intensive care unit level of care were found to be positive predictors of CPS involvement. In total, three (6.82%) of the 44 cases with CPS involvement were found to be substantiated. The three children who required CPS intervention were discharged to foster care settings.
CONCLUSIONS: Hospitalized pediatric burn injuries must be investigated due to concern of child abuse, yet external factors such as race and socioeconomic status may play a role in the involvement of CPS. Such referrals may not always be substantiated and could lead to further injurious sequelae for children and their families.

UNASSIGNED: Participation in sports during youth is typically beneficial for mental health. However, it is unclear whether elite sport contexts contribute to greater risk of psychological distress or disorder. The aims of this paper are to highlight conceptual issues that require resolution in future research and practice, and to examine the key factors that may contribute to the mental health of elite youth athletes (EYAs).
UNASSIGNED: A narrative overview of the literature combined with the clinical and research expertise of the authors.
UNASSIGNED: Narrative overview.
UNASSIGNED: Level 5.
UNASSIGNED: EYAs experience a range of biopsychosocial developmental changes that interact with mental health in a multitude of ways. In addition, there are various sport-specific factors that contribute to the mental health of EYAs that may become more prominent in elite contexts. These include - but are not limited to - patterns relating to athlete coping and self-relating styles, the nature of peer, parental, and coach relationships, organizational culture and performance pressures, and mental health service provision and accessibility.
UNASSIGNED: A range of critical factors across individual, interpersonal, organizational, and societal domains have been shown to contribute to mental health among EYAs. However, this evidence is limited by heterogeneous samples and varied or imprecise terminology regarding what constitutes \"youth\" and \"elite\" in sport. Nevertheless, it is clear that EYAs face a range of risks that warrant careful consideration to progress to best practice principles and recommendations for mental health promotion and intervention in elite youth sport.
UNASSIGNED: Level C.

UNASSIGNED: Caregivers often have difficulty administering pediatric medications which frequently results in increased dosing error risk.
UNASSIGNED: We examined health literacy characteristics of pediatric over-the-counter (OTC) oral suspension acetaminophen and ibuprofen instructional materials and dosing instruments.
UNASSIGNED: We conducted a descriptive analysis of dosing instructions, measuring syringe characteristics, and internet-based resources among a sample of OTC pediatric oral suspension acetaminophen and ibuprofen products (n = 14).
UNASSIGNED: All products included Drug Facts Panels, employed consistent abbreviation use, and stated measuring dosage with syringe provided. However, oral syringe dosing increment markings did not match box or bottle dosing charts. Most products had supplemental English-language internet-based content resources available.
UNASSIGNED: While OTC pediatric oral suspension acetaminophen and ibuprofen products labeling included key drug fact elements, there were inconsistencies between medication dosing chart labeling guidelines and oral syringe dosing increments/markings. It is vital that oral dosing syringes are clearly marked to match product dosing chart labeling s as a means of potentially reducing caregiver dosing errors.