1. PREVENTION OF INJURIES AND VIOLENCE IN CHILDREN AND ADOLESCENTS Tereza Koprivova Herotova, Ph.D. Eva Vaníčková, M.D., Ph.D. Department of Child and Youth Health

2. CLASSIFICATION OF INJURIES BY INTENTION - intentional and unintentional BY MECHANISM – traffic accidents, falls, gunshot, drowning, thermic accidents BY TYPE OF INJURY BY SEVERITY OF INJURY BY THE PLACE WHERE THE INJURY OCCURED BY CAUSES – e.g. alcohol, drugs BY ACTIVITY – e.g. sport, entertainment, job BY AGE

3. PREVALENCE OF INJURIES (Czech Republic) HOSPITALIZATION OF CHILDREN CAUSED BY INJURIES CCA 40 000 CASES PER YEAR 25 000 CHILDREN OF AGE BELOW 14 YEARS MOST SEVERE ARE TRAFFIC ACCIDENTS; THE NUMBER OF DEATHS CONTINUES TO DECLINE DROWNING CURRENTLY INCREASED IN TODDLERS AND ADOLESCENTS

4. MORTALITY External causes of death in children, year 2005 Traffic accidents 43% Other external causes 32% Electricity, fire 4% Intentional self-harm 6% Attack 1% Drowning 10% Falls 4%

5. TRAFFIC ACCIDENTS IN CHILDREN 2009 & 2011 TOTAL NUMBER OF PARTICIPANTS IN ACCIDENTS BELOW 15 YEARS WAS: 830 PEDESTRIANS - 5 – 3 KILLED 104 – 118 SERIOUSLY INJURED 687 – 667 LIGHTLY INJURED 3078 PASSENGERS – 8 – 1 KILLED 60 – 19 SERIOUSLY INJURED 921 – 448 LIGHTLY INJURED 327 CYCLISTS – 1- 3 KILLED 20 – 32 SERIOUSLY INJURED 254 – 265 LIGHTLY INJURED Since 2000 there has been a 70% reduction in child deaths - passengers in a car; 67% reduction in children - pedestrians.

6. CONSEQUENCES OF TRAFFIC ACCIDENTS IN CHILDREN

7. TRAFFIC INJURY PREVENTION INDIVIDUAL KNOWLEDGE OF TRAFFIC RULES, VISIBLE COLOURS, REFLECTIVE ELEMENTS, HELMETS VEHICLE CONTRUCTION OF A VEHICLE, CHILD SEAT AND BUILT-IN SAFETY ELEMENTS ENVIRONMENT SPEED- RETARDERS, TRAFFIC ROUNDABOUTS, TRAFFIC RULES, PROHIBITION OF ALCOHOL AND DRUGS, ROAD CONDITION

8. MOST FREQUENT INJURIES IN CHILDREN INFANTS – FALLS ON A HEAD PRESCHOOL AGE– FRACTURES, BURNS, POISONING, DROWNING SCHOOL AGE– FRACTURES AND CONTUSIONS OF SOFT PARTS GIRLS: 11 YEARS BOYS: 13 YEARS MOST SERIOUS INJURIES: 15 – 19 YEARS DOMESTIC INJURIES: 0 – 5 YEARS TRAFFIC ACCIDENTS: 10 – 14 YEARS SCHOOL INJURIES: 6 – 14 YEARS

9. POISONING IN CHILDREN CAUSES: MEDICAMENTS 38 % PLANTS 18 % CHEMICAL PRODUCTS 11 % CLEANING DETERGENTS 5 %

10. PREVENTION OF INJURIES IN CHILDREN PERMANENT SUPERVISION OF A CHILD AWARENESS OF A CHILD SAFETY AND SECURITY ELEMENTS, DESIGN AND LAYOUT OF INTERIOR AND EXTERIOR ENVIRONMENT PREVENT ACCESS TO ALCOHOL, DRUGS, DETERGENTS, WEAPONS, ETC. SAFE COMMUNITY, SCHOOL PROJECTS AND CHILDREN FRIENDLY SCHOOL MEDIA CAMPAIGNS

11. PREVENTION LEGAL MEASURES USE OF CHILD DETAINEE SYSTEM LOCATED REARWARD FACING (current practice in Sweden and zero mortality of children) Mandatory USAGE OF CYCLING HELMETS Mandatory PRIVATE POOL FENCING Mandatory USAGE OF CHILD RESISTANT PACKAGING OF MEDICAMENTS CONSTRUCTION LAW treated to prevent children dropping out of the windows in upper floors

12. TYPES OF VIOLENCE ACCORDING TO WHO (World Health Organization) Interpersonal violence is a part of social communication in each environment (family, school, job, community, society). Self - directed violence refers to violence in which the perpetrator and the victim are the same individual and leads to a self-harm. Collective violence is an activity developed by organized and prepared activity against certain group of people.

13. INTERPERSONAL VIOLENCE IN CHILDREN DOMESTIC VIOLENCE 1. syndrome of a child abuse and neglect 2. child as a witness of domestic violence 3. aggressive behavior of a child against adult members of the household BULLYING AND CYBERBULLYING 1. school 2. hobby group 3. sport clubs 4. camps

14. PHYSICAL AND HUMILIATING PUNISHMENT 1. school 2. hobby group 3. sport clubs 4. camps MORAL AND SEXUAL HARASSMENT 1. family 2. school, hobby group, sport clubs, camps 3. virtual communication 4. community

15. MENTAL AND EMOTIONAL DEPRIVATION 1. longterm stays in an institutional care COMMERTIAL SEXUAL EXPLOITATION 1. child prostitution 2. child pornography 3. trafficking RISKY VIRTUAL COMMUNICATION 1. cyber grooming 2. happy slapping 3. sexting 4. flaming

16. SELF - DIRECTED VIOLENCE SUICIDAL BEHAVIOR 1. Suicidal ideas 2. Suicidal thoughts 3. Suicidal tendencies 4. Suicide in communication 5. Suicidial attempt 6. Consumated suicide INTENTIONAL SELF- HARM

17. ORGANIZED VIOLENCE CIVIL WAR, FAMINE TRAFFICKING IN CHILDREN 1. sexual exploitation 2. child labour 3. abuse of children as slaves in the household 4. child marriages 5. military conscription of children 6. illegal adoption 7. in sports 8. acquisition and sale of organs for transplantation 9. forcing to beg

18. HEALTH, ECONOMIC AND SOCIAL CONSEQUENCES OF VIOLENCE PHYSICAL DAMAGE STRESS AND IT’S BEHAVIORAL SYMPTOMS POST-TRAUMATIC STRESS FAILURE HIGHER MORBIDITY, LOWER PERFORMANCE, COST OF INVESTIGATION AND THE LAW PROCESSES ETC. LOSS OF SOCIAL CAPITAL IN FAMILY AND OTHER RELATIONSHIP, TRANSMISSION OF VIOLENCE, FAMILY BREAKDOWN, LACK OF CREATION OF COMMUNITY COHESION NEGATIVE OPINIONS AND ATTITUDES IN SOCIETY

19. ENVIRONMENTAL MODEL OF VIOLENCE AS A BACKGROUND FOR PREVENTION Individual personality Community Social environment Society Krug E. a kol. 2002

20. VIOLENCE PREVENTION IN SOCIETY IN COMMUNITY IN SCHOOL IN FAMILY PERSONAL SAFETY PLAN OF A CHILD

21. References http://www.who.int/violence_injury_prevent ion/child/injury/world_report/en/index.htmlhttp://www.who.int/violence_injury_prevent ion/child/injury/world_report/en/index.html http://www.who.int/violence_injury_prevent ion/publications/child_injuries/en/index.htm lhttp://www.who.int/violence_injury_prevent ion/publications/child_injuries/en/index.htm l