Volume 10 Issue 3
Community Action from Critical Issues in the Health of Saskatchewan Children and Youth
Between May 1996 and March 1998, the Saskatchewan Institute on Prevention of Handicaps published three reports:
These reports contain comprehensive information about the births, deaths and hospitalizations of children and youth in Saskatchewan. The source of the data is Saskatchewan Population Health Branch and Vital Statistics Branch. The information is provided for four population groups (urban, rural, Treaty Indian and northern), by age category (under 1, 1 - 4, 5 - 9, 10 - 14 male and female, and 15 - 19 male and female) and for the health districts in the province.
The reports have been widely distributed and are being used to help communities plan their prevention and intervention programming.
Currently, the Prevention Institute staff are preparing 1995-1996 Data Updates. The Updates will follow the same methodology as the earlier reports and will include data on deaths, live births, and hospitalizations, as well as specific information on child injuries. A report will be prepared for each health district, providing data for Saskatchewan and for the specific district.
The aim of the Saskatchewan Institute on Prevention of Handicaps in producing these reports was that community groups would use the actual information from their local areas to determine local needs for health promotion programming. Rather than responding to what is assumed to be the major health concerns for children and youth in a community, the reports allow programming around issues which actually cause the most hospitalizations and deaths in the community. This evidence-based programming is highly credible and can be designed to meet the needs of the community.
Throughout Saskatchewan, diverse community-based groups and professional organizations have been using the data contained in the reports to determine direction for their programming. Recently, groups of youth in communities such as La Ronge, Prince Albert, Davidson and Moose Jaw have received updated information from Critical Issues in Health for Saskatchewan Youth at roundtable meetings. The youth then discuss their health issues and determine and recommend strategies for dealing with these issues.
These meetings have been exciting and productive. The youth feel that their opinions are being heard with respect. The youth roundtables have been made possible through funding from Health Canada, Population Health Fund.
Because the data in the three reports can be broken down further to examine a particular community within a health district, there are many possibilities as to how the information can be used to benefit the local community. Individual communities within health districts may have different issues even though they may be only a few kilometres apart. The data allows the community to isolate its own particular area of concern and focus its health promotion planning around that issue.
The Saskatchewan Institute on Prevention of Handicaps is pleased that the data are being used. Using the data to assist in planning for the improvement of the health of a community is the reason the reports were developed.
Staff of the Prevention Institute are available to make presentations to community groups and others on the critical issues in the health of children and youth in their community and the province as a whole. Call 655-2512 for more information or to book a presentation.
Although it seems obvious, it is important to educate children and adults alike that the brain controls everything that we do. We must realize that we are who we are because of our brains and that every effort must be made to keep the brain safe. In order to explain the importance of the brain it may be necessary to understand what actually happens to the brain when it is injured.
The terms "head injury" and "brain injury" are often used interchangeably. "Head injury" is an encompassing term that includes injury to the scalp and skull as well as to the brain. The term "brain injury" is more specific and refers to an injury that causes a change in the structure and/or the functioning of the brain.
Brain injury can occur due to a traumatic incident such as sudden impact or violent shaking, from spontaneous bleeding, from lack of oxygen. This article will focus on brain injury due to trauma.
A traumatic brain injury is commonly divided into the primary and secondary events that cause the actual damage to the brain. The primary event is the injury that is caused at the time of the incident and the secondary event is the damage that occurs to the brain from only minutes to hours and days after the initial injury. These secondary injuries result because of the cycle of changes to the brain that begins because of the initial trauma.
Traumatic brain injury is a mechanical injury. Mechanical energy is the energy of motion that is not harmful on its own but becomes harmful when it is transferred to the body. The speed of the mechanical energy determines the damage that can be done. More speed means more energy can be transferred to the body and therefore more damage can be done.
There are three types of injuries to the head which can lead to brain injury: closed, open and crush injuries.
A closed head injury occurs when there is a rapid acceleration of the brain inside the skull. This type of injury can occur from a sudden deceleration of the head (as in a car collision or fall), a violent rotation of the head (from a punch), from extreme whiplash (as in Shaken Baby Syndrome) or other means. The brain is forced to follow the direction of the skull and can become twisted and the blood vessels can tear causing bruising. The brain may also collide with the inside of the skull that is rough and jagged and more damage to the brain may result. Often, closed head injuries combine the acceleration with impact and the injuries may be even more severe.
An open head injury occurs when the brain is exposed through the skull due to the injury that has occurred. An open head injury can be the result of falling onto a sharp surface, being hit by a bullet or many other means. If the open head injury is not accompanied by an acceleration injury, often the damage to the brain is contained to the immediate area of the injury. Often, however, an open head injury is combined with an acceleration injury.
A crushing head injury occurs when the head is caught between or under something. These injuries are not very common but they are serious. Often the damage in a crushing head injury is to the base of the skull and the brain stem.
The secondary event of the injury is the damage that happens to the brain as a result of the initial injury. The secondary injury that occurs in the brain is at the cellular level and is chemical in nature. The secondary injury can result in bruising, swelling, infection, bleeding that leads to blood clots and increased pressure within the skull, and post-traumatic hydrocephalus (accumulation of cerebral fluid in the brain). Toxic processes that result from chemical changes and imbalance in the brain leads to the death of brain cells.
Depending on the severity of the injury the individual may experience effects ranging from a dizzy sensation to coma to death. With a severe head injury, the individual may also experience loss of the use of limbs, impaired speech, difficulty with swallowing and other significant problems. The brain injury may also lead to difficulties with breathing and with problems with the heart and with blood pressure. In the long term, the individual may also have significant changes with personality and thought processes.
Medical advances are providing better treatment and aftercare for those who have experienced a brain injury. Treatment is part of the prevention continuum, however, people must be convinced that the brain must be protected.
A head injury, leading to severe brain damage, can occur many ways including in a bicycle-related incident, a car crash or by shaking a baby. Prevention strategies for these types of injuries are in place.
The brain does not heal like other parts of the body. The improvement in the individual's condition comes as a result the undamaged parts of the brain compensating for the damaged areas. Depending on the extent of the damage to the brain, recovery may never be complete and the recovery that does occur depends on a long process of re-education and rehabilitation.
As individuals and as parents and caregivers of children, the aim should be prevention of brain injury. Protecting the brain should become second nature and the practices required to protect the brain, such as helmet use, seatbelt use and the development of safe environments should be used and respected by everyone.
Within the program focus area, the Prevention of Neglect and Abuse, the Prevention Institute has undertaken many initiatives. The promotion of healthy parenting --- the most important force in the prevention of neglect and abuse in children - has been an integral part of this program. For a number of years, the Nobody's Perfect Program has been reaching parents throughout Saskatchewan.
The Saskatchewan Institute on Prevention of Handicaps is pleased to announce an addition to the resources offered to promote healthy parenting - the Healthy Parenting Home Study Program.
Parenting is a learned skill. Parents and future parents need to learn to keep their homes and communities safe and free from abuse. Parents need resources that support positive parenting skills. Healthy Parenting Home Study Program is designed for parents who prefer to learn on their own. The correspondence-style course will also be useful for parents who live in locations where group parenting programs are not offered.
Healthy Parenting Home Study Program is a program for expectant parents and parents of children from infancy to age six. The program is a self-led study that enables parents to expand their knowledge on parenting in their own homes.
The home study program is divided into six age-related modules from birth to age six. Topics for each age include:
At the end of each module is an exercise that parents can complete and send in for review and comment. Parents are encouraged to contact the project coordinator with any questions or concerns.
The Healthy Parenting Home Study Program, developed by Saskatchewan Health, was first piloted in January 1996. The program was revised in 1998 in collaboration with the Saskatchewan Institute on Prevention of Handicaps. The program is coordinated through the Saskatchewan Institute on Prevention of Handicaps in partnership with Saskatchewan Health. There is no cost to Saskatchewan residents who would like to participate in the program.
Parent educators, health professionals, social workers and anyone else working with parents or expectant parents may order free brochures describing the program. While unable to provide complementary copies of the Home study program to service providers the Prevention Institute has several copies available for loan. Also each Health District Health Promotion contact has a copy.
When parents have access to up-to-date, practical information, they can make informed decisions. Healthy parenting is the most important factor in preventing neglect and abuse.
For more information, contact the Healthy Parenting Home Study Coordinator at the Saskatchewan Institute on the Prevention of Handicaps at (306) 655-6719.
The response to the poster Listen to the Inner Voice has been very positive. This poster is illustrated with a kangaroo and is in demand by professionals working in the areas of health, education, social services and community. A public service announcement promoting primary prevention of FAS has been developed by the Prevention Institute and began airing on CBC television November 15, 1999 during National Addictions Awareness Week and will air until January 2, 1999.
Twenty Community Development Projects focusing on activities relating to the prevention and management of FAS/FAE are now underway throughout Saskatchewan. Some examples of activities include: poster contests, development of logos on mugs and T-shirts, scripts for drama presentations, support groups for prenatal women, training sessions for parents on daily living strategies, and community forums. Staff of the Prevention Institute is providing support to these projects and delivering FAS/FAE awareness and prevention presentations to many communities.
Saskatchewan Education and the Prevention Institute have partnered to provide professional development workshops on FAS/ARBD for educators throughout Saskatchewan. Modules containing information on what is FAS/ARBD, general characteristics, learning styles and behavioral, visual and learning strategies have been developed to be delivered in sessions ranging from a half day to two days in length. Principals or Directors of Education may request a session by contacting the Special Education Unit, Saskatchewan Education at (306) 787-0561.
The three Prairie Provinces, Saskatchewan, Manitoba and Alberta have announced a new partnership which will focus on sharing information and pooling expertise and resources aimed at the prevention, intervention and management of FAS. Each province has committed to a pilot project over the next three years, as well as hosting a yearly symposium and follow-up conference. Alberta will host the first Interprovincial Conference on May 5-7, 1999 in Calgary.
The Prevention Institute was proud to display its work in the area of FAS during the National Conference on Fetal Alcohol Syndrome in Vancouver November 19 - 21, 1998. Many participants stopped by the poster session to chat about FAS awareness in Saskatchewan as well as to pick up resources and information.
Child Passenger Safety Trainer Workshop
The Saskatchewan Institute on Prevention of Handicaps is offering a Child Passenger Safety Trainer Workshop to be held in Saskatoon from April 12 - 16, 1999. This workshop is open to individuals who have experience in child safety seat inspections, whose employer will support their role as a child passenger safety (CPS) trainer and who will use the training to further the work in child passenger safety in the province.
In March 1998, 12 individuals from throughout the province were trained as Child Passenger Safety Trainers. Individuals from health districts and organizations that were not involved in the March 1998 training will be given priority in the upcoming session.
For more information about the Child Passenger Safety Trainer Workshop or to receive an application form call the Institute at (306)655-2515.
Teen Wellness Centres have proven to have had a very positive influence on decision making for youth in several Saskatchewan locations. Regina's Balfour Collegiate, Biggar, Prince Albert, and Moose Jaw have all had Teen Wellness Centres for approximately four years. One of their main goals is to give youth the skills they need to make healthy and life enhancing choices in all areas of their lives, including sexual and reproductive health.
The momentum has spread and other Saskatchewan communities have recognized the need for enhanced programming for their youth. The northern health districts of Mamawetan Churchill River and Keewatin Yathe have just undertaken a consultation process to assess how they can best serve their youth and to establish programming created for and by the youth, with input from all streams of the community. At the October 29 Northern Health Conference in Prince Albert, youth representatives from many northern communities told the audience that they feel the problems of violence, low self-esteem, sexually transmitted diseases, unemployment (among others) are very serious and action must be taken.
Lashburn High School has been using peer counsellors for several years, recognizing that peers talking to peers is a very important and powerful link when youth are struggling with issues such as drug and alcohol and relationship problems, feelings of depression and suicide. Youth at Lashburn are continuing to use their peer counsellors and are hiring a coordinator who will head up their Wellnness initiative. Other communities which are exploring how they can expand on their wellness and prevention efforts are Saskatoon, North Battleford, and Swift Current. All of these projects are placing youth participation, community involvement, choice in decision making, and positive approaches as their main goals.
The new brochure "When Your Baby Won't Stop Crying" is now available for distribution. It is colourful, easy to read, and includes information on why babies cry, ideas to help parents and caregivers cope with a crying baby, and basic information on Shaken Baby Syndrome.
An evaluation of the brochure is presently underway through a partnership with Public Health Services in Saskatoon and the surrounding rural health districts. Preliminary analysis of evaluation results is very positive. The recipients of the brochure have found the information on coping with crying and Shaken Baby Syndrome to be helpful. Most of them plan to share the information with family members, friends and their child's caregivers.
A new video on Shaken Baby Syndrome is now available. "Never Shake a Baby - An Educational Video for Parents and Caregivers" was produced by Health Television System for use on the Parent Channel in hospitals. Many Canadian organizations including the Saskatchewan Institute on Prevention of Handicaps were involved in the development of this Canadian video.
The Saskatchewan Institute on Prevention of Handicaps is taking a leadership role in the prevention of Shaken Baby Syndrome. Staff at the Prevention Institute, together with representatives of Health Canada and several key national organizations will officially kick off the development of a national strategy on the prevention of SBS at the First Canadian Conference on Shaken Baby Syndrome in May 1999.
Planning for the First Canadian Conference on Shaken Baby Syndrome is progressing well. The registration packages will be ready for distribution by early January. Confirmed speakers include Jacy Showers, Director of SBS Prevention Plus, Dr. Charles Smith, Director of the Pediatric Forensic Pathology Unit of Ontario, and Cynthia Morton, Children's Commissioner of British Columbia. To receive registration information, please fax a request to the Prevention Institute at (306) 655-2511.
Recent Nobody's Perfect Training Session:
A facilitator training session was held in North Battleford on September 28 to October 1 with Jackie Flamond of Fort Battleford Urban Metis Development Inc. and Rhonda Patterson of Battleford District Health as co-trainers. Welcome to 12 new Nobody's Perfect facilitators in the North Battleford, Lloydminster and Saskatoon areas. Please contact the Prevention Institute for information on upcoming training sessions in your area.
At the recent Early Childhood Network Conference held in Saskatoon in November, a workshop was presented on incorporating parenting education into existing programming, using the Nobody's Perfect program as an example. Sixty participants looked at their programs and worked in groups to identify what it would take to institute parenting programming in terms of resources and barriers to be overcome.
Parent Book Revisions - "Mind"
The revised "Mind" book of the Nobody's Perfect resources for parents continues to emphasize the importance of the emotional development of children. In order for children to become happy, independent and loving, they need to feel safe, secure and loved. For a child's mind to develop, he needs stimulation and encouragement. The parent's role is vital.
The "Mind" book is divided into age stages:
For each stage helpful suggestions are given for what parents can do to help their child feel safe, secure and loved. To encourage a child's learning processes, suggestions are given for stimulation and play. As the child gets older, normal developmental stages are explored (e.g., the negative two year old or the toddler who needs to learn to share) and suggestions for positive discipline are given.
Play is the way children learn about the world around them and their place in it. Through play, children learn socialization skills and physical dexterity. The "Mind" book emphasizes the importance of reading to children in order for them to develop the skills necessary to learn to be able to read for themselves.
The "Mind" book is one of five books that parents receive when they take the Nobody's Perfect program. For more information about the program, call the Healthy Parenting Coordinator at the Prevention Institute at (306) 655-2529.
Registrations for the Healthy Parenting Home Study Program are starting to come in. Parents and caregivers throughout Saskatchewan are reading about the program in Health District newsletters, school newsletters and hearing about it by word of mouth. If you would like to include information on the program in your community or school newsletter contact the Healthy Parenting Home Study Program Coordinator at (306) 655-6719. Brochures for the Healthy Parenting Home Study Program are now available for professionals to distribute to parents and caregivers throughout Saskatchewan. To order these free brochures contact the Prevention Institute. More information on the program and a poster to display in your office or clinic are available on page 9 and 10.