BACKGROUND: A kids café is a popular indoor playground in Korea that combines a playground for young children and a café for their caregivers. There have been no national reports about kids café-related injuries in Korea. This study investigated kids café-related injuries in Korea registered in a multicenter injury surveillance database and analyzed the risk factors for significant kids café-related injuries.METHODS: A multicenter cross-sectional study was performed using the Emergency Department-based Injury In-depth Surveillance registry in Korea between 2011 and 2016. Significant injury was defined as an injury requiring hospitalization or surgery. A multivariable logistic regression model was used to obtain the adjusted odds ratios (aORs) for factors associated with significant kids café-related injuries.RESULTS: Among 1,537,617 injured patients, we extracted 891 patients who were injured in kids cafés. Of these, 46 (5.2%) were admitted, and 39 (4.4%) underwent surgery. The most common injured anatomical site, injury type, and mechanism were lower extremity (28.2%), superficial injury (27.2%), and slip (27.1%), respectively. Among injury-inducing factors, significant injuries were most commonly caused by a trampoline (28.1%), and rock climbing equipment was the only risk factor in a kids café that led to significant injury after adjusting for age, sex, injury mechanism, and injured anatomical sites (aOR, 14.94; 95% confidence interval, 1.51–147.72).CONCLUSION: The rock climbing equipment in a kids café can cause serious injury to children. Establishing safety regulations for rock climbing equipment in kids cafés may have the greatest impact in reducing significant injuries requiring hospitalization or surgery.
Caregivers ; Child ; Cross-Sectional Studies ; Emergencies ; Hospitalization ; Humans ; Korea ; Logistic Models ; Lower Extremity ; Odds Ratio ; Play and Playthings ; Risk Factors ; Social Control, Formal ; Wounds and Injuries

PURPOSE: The study aimed to develop a play toolkit to facilitate infants' and toddlers' symbolic thought and fine motor development. METHODS: This study used a methodological study design including two phases of development and evaluation. After reviewing the play culture and developmental health issues in Kyrgyzstan through a literature review and interviews with local experts and parents, the toolkit was developed and evaluated using content validity and utilization tests. RESULTS: The toolkit was based on Westby's symbolic play and the fine motor milestones in the Bright Futures Guidelines. The Toolkits were composed of an overall suggested play schedule according to the child's age, four kinds of play props, and a utilization guidebook for parents. The play props were a felt book, sorting and assembling blocks, cup blocks, and a tangram. The guidebook contained age-appropriate operating methods and alternative ways to use the materials. CONCLUSION: A play toolkit was developed to enhance nurturing practices among parents of infants and toddlers. The findings may help facilitate effective interactions between parents and their children. Considering that nurturing care is critical for achieving better child health outcomes, enhancing parenting resources and parent-child relations could function as an effective strategy for promoting child health.
Appointments and Schedules ; Child ; Child Development ; Child Health ; Humans ; Infant ; Kyrgyzstan ; Methods ; Parent-Child Relations ; Parenting ; Parents ; Play and Playthings

The causal relationship between cigarette smoking during pregnancy and adverse maternal and child health outcomes, such as preterm birth, low birth weight, and sudden infant death syndrome are well known. In addition, cigarette compounds are neurotoxic even at extremely low levels. Thirdhand smoke (THS) is the contamination that persists after secondhand tobacco smoke has been emitted into air. It refers to the tobacco-related gases and particles that become embedded in materials such as carpets, walls, furniture, blankets, and toys. THS is not strictly smoke but chemicals that adhere to surfaces from which they can be released back into the air, undergo chemical transformations, and/or accumulate. The concept of THS is a relatively new phenomenon in the environmental and public health field. Currently, the hazards of THS are not as well documented as the hazards of secondhand smoke. Furthermore, its health effects and biological effects are largely unknown. This review summarizes recent research progress in reproductive toxicology studies that use animal models and in vitro systems, studies of environmental contamination by THS, human exposure studies, and priorities for further research. Future research must be conducted to facilitate hazard identification, and exposure and risk assessment to address its health effect on susceptible populations, such as pregnant women and children. In addition, policies and laws concerning tobacco smoke will need to be reviewed and possibly revised with the role of THS considered as an indispensable component of a broader tobacco control strategy in maternal and child health.
Child Health ; Child ; Female ; Floors and Floorcoverings ; Gases ; Humans ; In Vitro Techniques ; Infant, Low Birth Weight ; Infant, Newborn ; Interior Design and Furnishings ; Jurisprudence ; Maternal Health ; Models, Animal ; Play and Playthings ; Pregnancy ; Pregnant Women ; Premature Birth ; Public Health ; Risk Assessment ; Smoke ; Smoking ; Sudden Infant Death ; Tobacco ; Tobacco Products ; Tobacco Smoke Pollution ; Toxicology

Arthroscopy has become an attractive modality in the diagnosis and treatment of joint diseases in toy breed dogs. However, the application of arthroscopy is limited by small joint space. Our objective was to evaluate the efficacy of a stifle lever for joint distraction during stifle arthroscopy in toy breed dogs. Paired stifles (n = 32 each) collected from 16 cadavers of toy breed dogs were randomly assigned to one of two groups: the stifle lever group or the external manipulation group. All stifles underwent arthroscopic cranial cruciate ligament transection, and the visualization of the medial meniscus was evaluated. Medial meniscal release (MMR) was then performed. Following arthroscopic examination, the success rates of MMR and damages of tibial and femoral cartilages were evaluated. Visualization of the medial meniscus was significantly better, and meniscal probing was significantly easier, in the stifle lever group than in the external manipulation group (p = 0.001). There were no significant differences between groups for MMR success or articular cartilage damage. Using the stifle lever on arthroscopic examination improved visualization and probing on the medial meniscus in toy breed dogs. The stifle lever can be used as a good modality in assessing medial meniscal pathology in toy breed dogs.
Animals ; Anterior Cruciate Ligament ; Arthroscopy ; Cadaver ; Cartilage ; Cartilage, Articular ; Diagnosis ; Dogs ; Joint Diseases ; Joints ; Menisci, Tibial ; Pathology ; Play and Playthings ; Stifle

In this study, we investigated playground equipment related injuries in preschool-aged children. This was a retrospective observational study using Emergency Department based Injury In-depth Surveillance, (2011–2014). We included the preschool-aged children with playground equipment related injuries. We surveyed the mechanism and incidence of injuries, and estimated the odds ratio (OR) of traumatic brain injury (TBI) and upper/lower extremities fracture. There were 6,110 patients, mean age was 4.14 ± 1.95 years old. Slide and swing related injuries were 2,475 (40.5%) and 1,102 (18.0%). Fall down (48.5%) was the most common mechanism. The OR of TBI in children 0–2 years old was 1.88 times higher than children 3–7 years old, and in swing was 4.72 (OR, 4.72; 95% confidence interval [CI], 2.37–9.40) times higher than seesaw. The OR of upper extremity fracture in children 3–7 years old was 3.07 times higher than children 0–2 years old, and in climbing was 2.03 (OR, 2.03; 95% CI, 1.63–2.52) times higher than swing. The OR of lower extremity fractures in horizontal bars, tightropes, and trampolines was 2.95 (OR, 2.95; 95% CI, 1.55–5.61) times higher than swing. The most common mechanism and playground equipment were fall down and slide. TBI was associated to younger children (0–2 years old) and swing. Fracture of upper extremities was associated to older children (3–7 years old) and climbing. Fracture of lower extremities was associated to others such as horizontal bars, tightropes, and trampolines.
Brain Injuries ; Child* ; Child, Preschool ; Emergencies* ; Emergency Service, Hospital ; Extremities ; Fractures, Bone ; Humans ; Incidence ; Lower Extremity ; Observational Study ; Odds Ratio ; Play and Playthings ; Retrospective Studies ; Upper Extremity ; Wounds and Injuries

A 12-year-old castrated Toy Poodle was referred to the Kangwon National University Animal Hospital with an oligotrophic nonunion fracture in the distal 1/3 of the left radius and an intact ulna. After fixation by a locking plate and screws, adipose-derived mesenchymal stem-cell sheets expressing bone morphogenetic protein 7 (BMP-7) were transplanted to the fracture site to enhance the healing activity. The fracture was healed at 9 weeks after surgery. In the present case, the mesenchymal stem-cell sheets expressing BMP-7 promoted bone regeneration and healing in a nonunion fracture.
Animals ; Bone Morphogenetic Protein 7 ; Bone Regeneration ; Child ; Dogs ; Fractures, Ununited ; Gangwon-do ; Hospitals, Animal ; Humans ; Play and Playthings* ; Radius ; Ulna

PURPOSE: Adolescents who experienced the alcohol consumption have gradually increased. Adolescence is a critical period of the neural plasticity in the brain. Neural plasticity is mediated by neurotrophins and has an impact on cognitive function. Environmental enrichment ameliorates the cognitive function and increases neurotrophins. Thus, we investigated the neuroprotective effect of environmental enrichment on ethanol induced cognitive impairment in adolescent rats. METHODS: The ethanol groups and the controls groups were injected with ethanol (0.5g/kg) and phosphate buffered saline, respectively, through intraperitoneal from 28th day of birth for 11 days. The environmental enrichment groups were provided larger cages containing toys than the standard cage . Passive avoidance test and Y-maze test were performed to evaluate the spatial memory. RESULTS: Environmental enrichment+ethanol group showed higher alterations than the standard environment+ethanol group in Y-maze test (p<.05). In hippocampus, The environmental enrichment+ethanol group showed significantly higher level of the number of c-fos positive celsl and density of tropomyosin receptors kinase B receptor than the standard environment+ethanol group (p<.05). CONCLUSION: So, we suggested that the environmental enrichment played a role as a prophylaxis for prevention of memory impairment induced by ethanol exposure in adolescence.
Adolescent* ; Alcohol Drinking ; Animals ; Brain ; Cognition ; Cognition Disorders ; Critical Period (Psychology) ; Ethanol* ; Hippocampus ; Humans ; Memory ; Nerve Growth Factors ; Neuroprotective Agents ; Parturition ; Phosphotransferases ; Plastics ; Play and Playthings ; Rats* ; Spatial Memory ; Tropomyosin

PURPOSE: The purpose was to evaluate the effects of a transtheoretical model (TTM) based exercise counseling offered with music skipping rope exercise on components of the TTM (stages of change, decisional balance, and self-efficacy), body mass index, glucose, and lipid profile of overweight/obese children in Korea. METHODS: This study used a nonequivalent pretest and posttest experimental study design. A total of 75 overweight/obese children participated in the study. Eight sessions of exercise counseling combined with music skipping rope exercise for 12 weeks were offered for children in the experimental group, while one session of exercise counseling with music skipping rope exercise for 12 weeks was offered for children in the control group. Outcomes were measured at baseline, and 6 months after the intervention. RESULTS: After the intervention, self-efficacy significantly improved among children in the experimental group (p = .049), while these children maintained their baseline BMI at 6-month follow-up (p > .05). Among children in the control group, BMI significantly increased (p < .05). Fasting blood sugar significantly increased for both groups after the intervention (p < .05). However, a greater increase was observed for the control group. CONCLUSIONS: Our study partially supports the hypothesis that a TTM-based exercise intervention is effective in maintaining BMI and improving self-efficacy of overweight/obese children. The TTM-based counseling combined with exercise classes has potential to control weight among overweight/obese children, while involvement of parents and children in the development of the theory-based intervention may generate further benefits regarding health and well-being of overweight/obese children.
Adolescent ; Attitude to Health ; Body Mass Index ; Child ; Combined Modality Therapy ; Counseling/*methods ; Exercise Therapy/*methods ; Female ; Humans ; Male ; Music Therapy/*methods ; Pediatric Obesity/*prevention & control ; Play and Playthings ; Self Efficacy ; Treatment Outcome

Foreign bodies in the nasal cavity are commonly encountered in otorhinolaryngologic practice, particularly among children and mentally handicapped patients. Such foreign bodies include plastic toys, pebbles, seeds, buttons, and many others. Many of these foreign bodies can be easily removed with simple tools. However, some of them adhere to the nasal mucosa, resulting in complications such as necrosis or neurovascular injury of the nasal mucosa. Polyurethane foam in the nasal cavity has never been reported in Korea. Furthermore, the complications caused by polyurethane foam in the nasal cavity have not yet been reported. In this article, we report a man who presented with polyurethane foam that had spread into both nasal cavity and nasopharynx by inhalation and adhered to the nasal cavity and sinuses.
Child ; Foreign Bodies* ; Humans ; Inhalation* ; Korea ; Mentally Disabled Persons ; Nasal Cavity* ; Nasal Mucosa ; Nasopharynx ; Necrosis ; Plastics ; Play and Playthings ; Polyurethanes*

INTRODUCTIONToy-related injuries, a common reason for emergency department visits in the paediatric population, constitute a significant health burden in Singapore. Although government regulations imposed on toys and childcare-related items are in place, parents and caregivers still play a pivotal role in ensuring toy safety in children. We hypothesised that deficiencies in knowledge surrounding toy safety issues exist in our adult population.

METHODSWe conducted a cross-sectional questionnaire study at KK Women's and Children's Hospital, Singapore, to examine the current attitudes, knowledge and practices of the local population regarding toy safety. Hypothetical questions on toy selection were included in the questionnaire to assess respondents' ability to identify appropriate toys and discern potentially dangerous toys for a specified age group.

RESULTSThe scores of the 93 respondents showed that they were less able to identify appropriate toys for children in the 1-2 years (66.7%; 95% confidence interval [CI] 61.4%-72.0%) and 2-3 years age groups (69.9%; 95% CI 65.5%-74.3%) than for children in the 0-1 year (82.8%; 95% CI 79.9%-85.7%) and 3-5 years age groups (85.2%; 95% CI 81.2%-89.2%). Our survey also identified key areas for improvement (e.g. educational efforts and government regulation) in current practices in order to attain a higher level of toy safety.

CONCLUSIONOur study highlights the current knowledge deficit in toy safety issues and the need for improvements in regulation, education and surveillance in order to minimise the risk of toy-related injuries in children.

Adult ; Age Factors ; Child ; Child Welfare ; Child, Preschool ; Confidence Intervals ; Consumer Product Safety ; Cross-Sectional Studies ; Female ; Humans ; Incidence ; Needs Assessment ; Play and Playthings ; injuries ; Singapore ; Surveys and Questionnaires ; Wounds and Injuries ; etiology ; physiopathology