title: Is perceived failure in school performance a trigger of physical injury? A case-crossover study of children in Stockholm County.
abstract: OBJECTIVE
  To investigate whether perceived failure in school performance increases the potential for children to be physically injured.
  
  
  METHODS
  Children aged 10-15 years residing in the Stockholm County and hospitalised or called back for a medical check up because of a physical injury during the school years 2000-2001 and 2001-2002 (n = 592).
  
  
  METHODS
  A case-crossover design was used and information on potential injury triggers was gathered by interview. Information about family socioeconomic circumstances was gathered by a questionnaire filled in by parents during the child interview (response rate 87%).
  
  
  RESULTS
  Perceived failure in school performance has the potential to trigger injury within up to 10 hours subsequent to exposure (relative risk = 2.70; 95% confidence intervals = 1.2 to 5.8). The risk is significantly higher among pre-adolescents and among children from families at a higher education level.
  
  
  CONCLUSIONS
  Experiencing feelings of failure may affect children's physical safety, in particular among pre-adolescents. Possible mechanisms are perceptual deficits and response changes occasioned by the stress experienced after exposure.
authors.affiliation: Department of Public Health Sciences, Division of Social Medicine, Karolinska Institutet, S-171 76 Stockholm, Sweden. lucie.laflamme@phs.ki.se
authors.forename: L
authors.initials: L
authors.lastname: Laflamme
authors.forename: K
authors.initials: K
authors.lastname: Engström
authors.forename: J
authors.initials: J
authors.lastname: Möller
authors.forename: J
authors.initials: J
authors.lastname: Hallqvist
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D002648:Child; D018592:Cross-Over Studies; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D012307:Risk Factors; D012649:Self Concept; D013315:Stress, Psychological; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D014947:Wounds and Injuries / Q000453:epidemiology / Q000523:psychology*