Child and Adolescent Injury

 Lead:Julie Mytton with Alan Emond, Toity Deave, Jenny Ingram, Trudy Goodenough, Kate Beckett, Puspa Pant, Santosh Bhatta, Jocelyn Cherry, Linda Hollen, Moses Ikpeme and Steve Gregory.

 Collaborators: Jonathan Benger, Mark Lyttle, Giles Haythornthwait, Fergal Monsell, Amber Young (University Hospitals Bristol NHS Foundation Trust); Mike Hayes (Child Accident Prevention Trust); Alison Kemp (Cardiff University), Denise Kendrick (University of Nottingham, Mariana Brussoni, (University of British Columbia); Kamran ul Baset, Fazlur Rahman (Centre for Injury Prevention Research, Bangladesh).

 

Our main interests in this area are:

  • Evaluation of injury prevention interventions using qualitative and quantitative methods
  • Understanding the link between social deprivation and childhood injuries
  • Building up the evidence base on what works in childhood injury prevention

 Current Projects

Scar Free Foundation Children’s Burns Research Centre

The Children’s Burns Research Centre is part of the Burns Collective, a research initiative from the Scar Free Foundation, which aims to improve burn and scald care in the UK. The Centre is led by the University of Bristol in partnership with the Universities of the West of England, Cardiff and Bath and University Hospitals Bristol NHS Foundation Trust.

Our mission is to develop a UK research centre of world-leading excellence crossing clinical and academic boundaries for real patient benefit, to prevent burns and improve the outlook of children with burn injuries. The Centre’s research programme has 3 main themes: Clinical, Psychosocial and Prevention.

The Centre is funded by UK charity The Scar Free Foundation for five years from 2012, with additional support from the Welsh Assembly National Institute for Social Care and Health Research (NISCHR) and VTCT.

Supporting Action through First-aid Education (SAFE) study

This mixed methods study was funded by the British Red Cross and explored decision making in people using urgent care services across Bristol. The study aimed to understand the potential role for first aid education to support decision making. The project was led by Julie Mytton, in collaboration with researchers (Matthew Brooker, Helen Baxter, Leah Bowen and Ben Davies) from the University of Bristol.

Feasibility of using routine information to identify modifiable factors in children’s brain injuries

This study aims to explore the feasibility of using information that is routinely collected on children admitted to hospital following a traumatic brain injury (from ambulance services, emergency departments, intensive care and medical/surgical wards) to determine if it is possible to identify common factors across presentations that are potentially modifiable. The project is funded by the NIHR Brain Injury Healthcare Technology Cooperative and is led by Julie Mytton with Mark Lyttle and Peta Sharples at the Bristol Royal Hospital for Children.

Unintentional Injuries in Sensory Impaired Children

This PhD study, undertaken by Jocelyn Cherry, aims to describe the extent to which visual or hearing impairment affect a child's risk of unintentional injury, and to consider how that information could support parents and professionals involved in the care of children with sensory impairments to prevent unintentional injuries. Components of the study include:

  • A systematic review of studies reporting the frequency, mechanism and circumstances of unintentional injuries in children with visual or hearing impairment

  • An analysis of data from the ALSPAC cohort to describe the incidence of injuries in children with sensory impairments and explore associations between injuries and factors that may influence injury risk.

  • A qualitative study to inform how parents and professionals may best be supported to keep children with visual and hearing impairments safe from injuries.

"Nepal Injury Research Centre"

For information regarding this, please go to:-

http://www.bristol.ac.uk/ccah/research/internationalhealth/

Enhancing Post-Injury Intervention and Care (EPPIC) study

This study aiming to improve NHS trauma services management of the psychological needs of adult trauma patients is funded by a NIHR Knowledge Mobilisation Research Fellowship (KMRF) awarded to Kate Beckett (University of the West of England) based at CCAH. Evidence regarding the impact of common post-injury psychological disorders on the extent and duration of recovery (and costs) is pervasive, consistent and compelling yet not evident in practice; this was confirmed by the NIHR Impact of Injury Study. The NIHR KMRF award (https://www.nihr.ac.uk/funding-and-support/funding-for-training-and-career-development/training-programmes/knowledge-mobilisation-research-fellowships.htm) invites researchers to devise and test innovative means of sharing knowledge and bridging the research practice divide. This study explores patient, practitioner and expert/research perspectives on injured adults’ psychological needs and uses Forum theatre to help these stakeholders engage with this diverse evidence to effect change. This method will be evaluated in terms of knowledge transfer and practice change. The study is supported by an active patient practitioner advisory group and forum theatre expertise from Cardboard Citizens (https://www.cardboardcitizens.org.uk/) a leading UK proponent of this technique.

 

Recent Projects

Keeping Children Safe at Home

The Keeping Children Safe at Home (KCS) research programme, led by Prof Denise Kendrick at Nottingham University, aimed to find the best advice about preventing accidents in young children at home, and to work with children’s centres to find suitable ways of passing on this advice to parents. The programme comprised 16 separate studies undertaken between 2009 and 2015 in study centres in Nottingham, Bristol, Norwich and Newcastle.  A key output from the study was a guidance document, an “Injury Prevention Briefing”, for organisations and practitioners who work with young children. The briefing contained evidence-based home safety advice for families, and the best way in which to provide this. This information has been disseminated to approximately 500 community staff at workshops, mainly around the Bristol area.

Information about the KCS programme and a list of publications associated with the programme, can be found at:http://www.nottingham.ac.uk/research/groups/injuryresearch/projects/kcs/index.aspx

A parent programme for the prevention of recurrent injuries in preschool children

This study, led by Dr Julie Mytton and funded by the NIHR HTA programme, developed a parenting programme designed to support parents to keep their preschool children safe at home through a combination of first aid and safety awareness. The intervention was tested in a feasibility study. The study was in collaboration with University of Nottingham, University of Warwick, The Institute of Education, North Bristol NHS Trust, Whoops!, Child Safety Project and Parenting UK. The final report (PDF, 6,846kB) of the study is available.

ALSPAC and childhood injuries

The Department for Transport funded two linked studies to examine road traffic injury risk using the ALSPAC cohort at the ages of 13/14 and 16/17 years. The projects explored the relationship between exposure to injury risk in the road environment, reported road traffic injuries and a range of personal and family risk factors in adolescents at these two age groups.  The final reports 13/14 yrs (PDF, 400kB) (pdf 400kb) and 16/17 yrs (PDF, 215kB) (pdf 215kb)‌ are now available. Professor Julie Mytton explored the relationship between child, family and environmental variables using data collected during the ALSPAC study, concentrating on the primary school age children, using injury data collected by questionnaires between 5 and 11 years.

The Impact of Injuries Study

This longitudinal mixed methods multicentre study measured the impact of unintentional injuries on physical, psychological, social and occupational functioning and the costs of unintentional injuries to individuals, the NHS and society (Kendrick et al, 2011). It was funded by the NIHR (as part of the NIHR CLAHRC Nottinghamshire, Derbyshire and Lincolnshire) and involved collaboration between academic & clinical teams in Bristol, Nottingham, Leicester and Surrey. The study included a nested qualitative study to identify service use, gaps in provision, information needs, and barriers and drivers to access services from the perspective of those with injuries, their carers and service providers. Data collection was completed in 2013 and study teams are currently analysing results in preparation for dissemination

Childhood Deaths

Since 1992, Peter Fleming has been the lead clinician and principal investigator in studies of childhood deaths (CESDI and CEMACH) in the Southwest Region. He is editor of an annual report on CESDI in the Southwest, each report containing data on five years’ rolling results of perinatal mortality and infant mortality in the Region (population 5 million people).  From April 2003 CESDI was incorporated into the Confidential Enquiry into Maternal and Child Health (CEMACH); with effect from August 2013 academic leadership of the Child Death review work has been taken over by Dr Karen Luyt.

Community-Based Home Injury Risk Assessment in Rural Nepal

The aim of this PhD study undertaken by Santosh Bhatta is to explore the environmental risks associated with unintentional injuries among children aged 0-17 years in a rural district of Nepal and the potential for environmental change at a community level to prevent injury occurrence. This study is using both quantitative and qualitative methods to help us understand the problem of child injuries in Nepal. Information will be collected through a community-based household survey to identify household risks for child injuries, focus groups for community views regarding cause and solution for child injury and systematic review to evaluate the effectiveness of environmental change intervention to prevent the child injury in LMICs.

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