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Koehl J, Brown CS, Faine B, Rech MA, Zimmerman DE, Flack T, Gilbert BW, Howington GT, Laub J, Porter B, Slocum GW, Zepeski A, Feldman R, Santiago RD, Sarangarm P. EDucated: The emergency medicine pharmacotherapy literature of 2023. Am J Emerg Med 2024; 82:166-173. [PMID: 38909552 DOI: 10.1016/j.ajem.2024.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 05/01/2024] [Accepted: 06/06/2024] [Indexed: 06/25/2024] Open
Abstract
The purpose of this article is to summarize pharmacotherapy related emergency medicine (EM) literature indexed in 2023. Articles were selected utilizing a modified Delphi approach. The table of contents from pre-determined journals were reviewed and independently evaluated via the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system by paired authors. Pharmacotherapy-related publications deemed to be GRADE 1A and 1B were reviewed by the collective group for inclusion in the review. In all, this article summarizes and provides commentary on the potential clinical impact of 13 articles, 6 guidelines, and 5 meta-analyses covering topics including guideline releases and updates on rapid sequence intubation in the critically ill, managing cardiac arrest or life-threatening toxicity due to poisoning, and management of major bleeding following trauma. Also discussed are ongoing controversies surrounding fluid resuscitation, time and treatment modalities for ischemic stroke, steroid use in community-acquired pneumonia, targeted blood product administration, and much more.
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Affiliation(s)
- Jennifer Koehl
- Department of Pharmacy, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.
| | - Caitlin S Brown
- Department of Pharmacy, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Brett Faine
- Department of Emergency Medicine and Pharmacy Practice, University of Iowa, Iowa City, IA 52242, USA
| | - Megan A Rech
- Department of Veterans Affairs, Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. VA Hospital, Hines, IL 60141, United States of America
| | - David E Zimmerman
- Duquesne University School of Pharmacy, University of Pittsburgh Medical Center-Mercy Hospital, Pittsburgh, PA 15282, USA
| | - Tara Flack
- Department of Pharmacy, IU Health Methodist Hospital, Indianapolis, IN 46202, USA
| | - Brian W Gilbert
- Department of Pharmacy, Wesley Medical Center, Wichita, KS 67205, USA
| | - Gavin T Howington
- Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, Lexington, KY 40508, USA; Department of Pharmacy Services, University of Kentucky HealthCare, Lexington, KY 40506, USA
| | - Jessica Laub
- Department of Pharmacy, Ralph H. Johnson Department of Veterans Affairs Medical Center, Charleston, SC 2940, USA
| | - Blake Porter
- Department of Pharmacy, University of Vermont Medical Center, Burlington, VT 05401, USA
| | - Giles W Slocum
- Department of Emergency Medicine and Department of Pharmacy, Rush University Medical Center, Chicago, IL 60612, USA
| | - Anne Zepeski
- Department of Emergency Medicine and Pharmacy Practice, University of Iowa, Iowa City, IA 52242, USA
| | - Ryan Feldman
- The Medical College of Wisconsin School of Pharmacy & Department of Emergency Medicine Division of Medical Toxicology, Froedtert Hospital Department of Pharmacy, Wisconsin Poison Center, Milwaukee, WI 53226, USA
| | - Ruben D Santiago
- Department of Pharmacy, Jackson Memorial Hospital, Miami, FL 33136, USA
| | - Preeyaporn Sarangarm
- Department of Pharmacy, University of New Mexico Hospital, Albuquerque, NM 87106, USA
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Petreca VG, Dowdell EB, Harding SL, Mars M, Pudvah E, Jeune J, Burgess AW. Murdered Indigenous Women: A Comparison Study of Victim and Perpetrator Patterns and Characteristics. JOURNAL OF FORENSIC NURSING 2024; 20:174-184. [PMID: 38488389 DOI: 10.1097/jfn.0000000000000481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/21/2024]
Abstract
INTRODUCTION The rate of violent crimes against Indigenous people, including murder and rape, is significantly higher than national averages. Even more concerning, Indigenous women and girls represent a large proportion of murdered and missing individuals in the United States. In addition to the murder rate of Indigenous women being higher than the national average, they are significantly more likely to experience rape or other types of sexual violence. The main goal of this study was to gain a better understanding of cases involving the homicide of Indigenous women and identify patterns associated with the violence committed against them. METHODS Cases of Indigenous women between the ages of 18 and 55 years were pulled from the database. Cases were coded and analyzed for information pertaining to victim, perpetrator, and crime characteristics. Descriptive analysis and test of association were performed. RESULTS/FINDINGS There was a statistical association between the nature of the relationship between perpetrators and victims and whether the crime occurred on a reservation, the race/ethnicity of the perpetrator, a victim's history of domestic violence, and the method and motive of murder. DISCUSSION/CONCLUSION Indigenous women are at an increased risk of victimization, including intimate partner violence and homicide. They also represent a group that has been marginalized, receiving little attention from the media, clinicians, researchers, and policy makers. The findings in this study highlight specific factors that may help to mitigate risk factors and/or enhance culturally competent clinical and forensic nursing practice.
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Affiliation(s)
| | | | | | - Mak Mars
- Justice for Native People, Oneida Nation of Wisconsin, Fond du Lac Ojibwe
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Bertuccio P, Amerio A, Grande E, La Vecchia C, Costanza A, Aguglia A, Berardelli I, Serafini G, Amore M, Pompili M, Odone A. Global trends in youth suicide from 1990 to 2020: an analysis of data from the WHO mortality database. EClinicalMedicine 2024; 70:102506. [PMID: 38440131 PMCID: PMC10911948 DOI: 10.1016/j.eclinm.2024.102506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 02/06/2024] [Accepted: 02/15/2024] [Indexed: 03/06/2024] Open
Abstract
Background Suicide is a serious but preventable public health concern at the global level, showing relevant geographical differences. This study aims to monitor global temporal and geographical patterns in suicide mortality in pre-adolescents, adolescents, and young adults (i.e., aged 10-24 years), from 1990 to 2020 or the most recent available year. Methods Using the World Health Organisation mortality database, we conducted an analysis on a subset of 52 countries with valid and high-quality data. We computed age-standardised suicide rates (ASR) by sex, country, and calendar year, and performed a joinpoint regression analysis to identify significant changes in the temporal suicide trends over the studied period. Findings High variability in suicide rates and trends was observed, with a male-to-female ratio of two to five. Between 1990 and 2020, most European countries reported declining suicide trends, with some exceptions. In particular, alarming trends emerged in the United Kingdom, with annual rises of 2.5% (95% CI: 1.6-3.5) since 2005 among males and 8.5% (95% CI: 4.7-12.6) since 2012 among females. The most favorable trends and lowest suicide rates were in Southern Europe, with 3.1/100,000 persons in Italy (2020) and 3.5/100,000 persons in Spain (2021) among males, and 0.9/100,000 persons in Italy (2020) and 1.1/100,000 persons in Romania (2019) among females. Conversely, the highest rates were in Central-Eastern Europe, with 10.2/100,000 males in the Russian Federation (2019) and 10.0/100,000 males in Poland (2002). Higher suicide rates and significant increases were reported in not European areas. The highest ASR was 15.5/100,000 males in the United States of America, with an annual increase of 3.8% (95% CI: 3.1-4.5) among males in 2009-2020 and 6.7% (95% CI: 5.6-7.8) among females in 2007-2017, followed by a levelling off. Interpretation Temporal and geographical comparisons of suicide mortality should be interpreted with caution due to potential misclassification or under-reporting of suicide deaths in some countries. Funding None.
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Affiliation(s)
- Paola Bertuccio
- School of Public Health, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Andrea Amerio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Enrico Grande
- Integrated System for Health, Social Assistance and Welfare, National Institute of Statistics, Rome, Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Alessandra Costanza
- Department of Psychiatry, Faculty of Medicine, Geneva University (UNIGE), Geneva, Switzerland
- Department of Psychiatry, Adult Psychiatry Service (SPA), University Hospitals of Geneva (HUG), Geneva, Switzerland
- Department of Psychiatry, Faculty of Biomedical Sciences, University of Italian Switzerland, Lugano, Switzerland
| | - Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Isabella Berardelli
- Department of Neuroscience, Mental Health and Sensory Organs, Sant’Andrea Hospital Sapienza University, Rome, Italy
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Maurizio Pompili
- Department of Neuroscience, Mental Health and Sensory Organs, Sant’Andrea Hospital Sapienza University, Rome, Italy
- International Consortium for Mood & Psychotic Disorder Research, Mailman Research Center, McLean Hospital, Belmont, MA, United States of America
| | - Anna Odone
- School of Public Health, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
- Medical Direction, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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Ormiston CK, Lawrence WR, Sulley S, Shiels MS, Haozous EA, Pichardo CM, Stephens ES, Thomas AL, Adzrago D, Williams DR, Williams F. Trends in Adolescent Suicide by Method in the US, 1999-2020. JAMA Netw Open 2024; 7:e244427. [PMID: 38551558 PMCID: PMC10980967 DOI: 10.1001/jamanetworkopen.2024.4427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 02/03/2024] [Indexed: 04/01/2024] Open
Abstract
Importance Adolescent suicide in the US is a major public health problem, yet temporal trends in suicide methods by demographics are understudied. Objective To examine national trends in suicide mortality by method (firearm, poisoning, hanging and asphyxiation, and all other means) from 1999 to 2020 by demographic characteristics. Design, Setting, and Participants This serial cross-sectional study used national death certificate data of adolescent (aged 10-19 years) suicide decedents compiled by the National Center for Health Statistics from January 1, 1999, to December 31, 2020. Data analysis was performed from April 1, 2023, to July 9, 2023. Exposures Age, sex, and race and ethnicity. Main Outcomes and Measures Trends in age-standardized mortality rates and average annual percent change (AAPC) in rates were estimated by age, sex, and race and ethnicity for each suicide method. Results This study assessed data from 47 217 adolescent suicide decedents. From 1999 to 2020, suicide by firearm (AAPC, 1.0; 95% CI, 0.1-1.9), poisoning (AAPC, 2.7; 95% CI, 1.0-4.4), hanging and asphyxiation (AAPC, 2.4; 95% CI, 0.2-4.6), and other means (AAPC, 2.9; 95% CI, 1.2-4.6) increased. Rapidly increasing rates were observed among female adolescents for poisoning (AAPC, 4.5; 95% CI, 2.3-6.7) and hanging and asphyxiation (AAPC, 5.9; 95% CI, 5.0-6.8) suicides. From 2007 to 2020, firearm suicides sharply increased among female (annual percent change [APC], 7.8; 95% CI, 6.0-9.5) and male (APC, 5.3; 95% CI, 4.3-6.3) adolescents. Firearm suicide rates increased among Black adolescents from 2012 to 2020 (APC, 14.5; 95% CI, 9.7-19.5), Asian and Pacific Islander adolescents from 2008 to 2020 (APC, 12.0; 95% CI, 9.7-14.5), American Indian and Alaska Native adolescents from 2014 to 2020 (APC, 10.6; 95% CI, 2.6-19.3), and Hispanic or Latino adolescents from 2011 to 2020 (APC, 10.2; 95% CI, 6.3-13.8). During the study period, Black adolescents had the highest average increase in hanging and asphyxiation suicides (AAPC, 4.2; 95% CI, 3.2-5.2). From 2011 to 2020, poisoning suicide deaths increased (APC, 12.6; 95% CI, 8.5-16.7) among female adolescents. Conclusions and Relevance Suicide rates increased across all methods from 1999 to 2020. Differences were noted by sex, age, and race and ethnicity. Increasing suicide rates among racial and ethnic minoritized youth are especially concerning, and effective prevention strategies are urgently needed.
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Affiliation(s)
- Cameron K. Ormiston
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland
- Icahn School of Medicine at Mount Sinai, New York, New York
| | - Wayne R. Lawrence
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | | | - Meredith S. Shiels
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Emily A. Haozous
- Pacific Institute for Research and Evaluation, Albuquerque, New Mexico
| | - Catherine M. Pichardo
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Erica S. Stephens
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Aleah L. Thomas
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - David Adzrago
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland
| | - David R. Williams
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Faustine Williams
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland
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Smart R, Barnes-Proby D, Holmes P, Schell TL, Morral AR. Racial and ethnic differences in the effects of state firearm laws: a systematic review subgroup analysis. Inj Epidemiol 2023; 10:67. [PMID: 38098076 PMCID: PMC10722776 DOI: 10.1186/s40621-023-00477-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 12/04/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Despite growing evidence about how state-level firearm regulations affect overall rates of injury and death, little is known about whether potential harms or benefits of firearm laws are evenly distributed across demographic subgroups. In this systematic review, we synthesized available evidence on the extent to which firearm policies produce differential effects by race and ethnicity on injury, recreational or defensive gun use, and gun ownership or purchasing behaviors. MAIN BODY We searched 13 databases for English-language studies published between 1995 and February 28, 2023 that estimated a relationship between firearm policy in the USA and one of eight outcomes, included a comparison group, evaluated time series data, and provided estimated policy effects differentiated by race or ethnicity. We used pre-specified criteria to evaluate the quality of inference and causal effect identification. By policy and outcome, we compared policy effects across studies and across racial/ethnic groups using two different ways to express effect sizes: incidence rate ratios (IRRs) and rate differences. Of 182 studies that used quasi-experimental methods to evaluate firearm policy effects, only 15 estimated policy effects differentiated by race or ethnicity. These 15 eligible studies provided 57 separate policy effect comparisons across race/ethnicity, 51 of which evaluated interpersonal violence. In IRR terms, there was little consistent evidence that policies produced significantly different effects for different racial/ethnic groups. However, because of different baseline homicide rates, similar relative effects for some policies (e.g., universal background checks) translated into significantly greater absolute differences in homicide rates among Black compared to white victims. CONCLUSIONS The current literature does not support strong conclusions about whether state firearm policies differentially benefit or harm particular racial/ethnic groups. This largely reflects limited attention to these questions in the literature and challenges with detecting such effects given existing data availability and statistical power. Findings also emphasize the need for additional rigorous research that adopts a more explicit focus on testing for racial differences in firearm policy effects and that assesses the quality of race/ethnicity information in firearm injury and crime datasets.
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Affiliation(s)
- Rosanna Smart
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA.
| | - Dionne Barnes-Proby
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA
| | | | - Terry L Schell
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA
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Galea S, Woolf SH. The Persistent Challenge of Preventable Death in the US. JAMA Intern Med 2023; 183:856-857. [PMID: 37399034 DOI: 10.1001/jamainternmed.2023.2518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Affiliation(s)
- Sandro Galea
- School of Public Health, Boston University, Boston, Massachusetts
| | - Steven H Woolf
- Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond
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