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Stronach O, Dietze P, Livingston M, Roxburgh A. 20-year trends in Australian methamphetamine-related deaths, 2001-2020. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 131:104548. [PMID: 39141956 DOI: 10.1016/j.drugpo.2024.104548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 07/23/2024] [Accepted: 07/28/2024] [Indexed: 08/16/2024]
Abstract
BACKGROUND Over the past two decades methamphetamine-related harms have increased in Australia. Previous analysis of methamphetamine-related deaths has covered limited timeframes, and largely focused on drug-toxicity deaths. This paper examines long-term trends in methamphetamine-related deaths over 20 years, including deaths due to a range of specific causes. METHODS Descriptive analyses were conducted on Australian methamphetamine-related deaths (2001-2023) by cause, extracted from the National Coronial Information System, an online database containing deaths reported to coroners in Australia and New Zealand. Joinpoint trend analyses were used to assess changes over time between 2001 and 2020 (with data from 2021 to 2023 likely incomplete and thus excluded). RESULTS Unintentional drug toxicity was the cause of 49.8 % of methamphetamine-related deaths, intentional self-harm (including toxicity) 23.3 %, unintentional injury 15.1 %, natural causes 9.6 %, and assaults 2.3 %. Between 2001 and 2020, joinpoint analysis showed three trend change points among all-cause methamphetamine-related mortality rates, resulting in four distinct periods: two periods where they increased (2001-2006 - annual percentage change (APC) = 15.4 %; 2009-2016 - APC 25.5 %), and two where they decreased (2006-2009 - APC = -11.8 %; 2017-2020 - APC = -2.9 %). Similar patterns were evident among rates of intentional self-harm and unintentional injury. Deaths caused by unintentional drug toxicity saw two trend change points (2011, 2016), and rates increased across all three periods. Natural cause deaths had three trend change points (2007, 2010, 2015), and rates continued to rise after 2015, largely driven by increases in circulatory diseases. CONCLUSION Cause-specific models highlighted diverse trends. Recent trends show unintentional drug toxicity deaths have slightly increased, intentional self-harm stabilised, and unintentional injury and assault deaths have declined. Deaths from natural causes involving methamphetamine continued to increase, highlighting a public health concern and a potential need for early circulatory disease screening among people who use methamphetamine.
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Affiliation(s)
- Oisin Stronach
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia; Harm and Risk Reduction Program, Burnet Institute, Melbourne, Australia.
| | - Paul Dietze
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia; Harm and Risk Reduction Program, Burnet Institute, Melbourne, Australia; National Drug Research Institute, Curtin University, Perth, Australia
| | - Michael Livingston
- Harm and Risk Reduction Program, Burnet Institute, Melbourne, Australia; National Drug Research Institute, Curtin University, Perth, Australia
| | - Amanda Roxburgh
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia; Harm and Risk Reduction Program, Burnet Institute, Melbourne, Australia
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Nevarez Flores AG, Martin A, Bartkowiak-Theron I, Makin J, Norris K, Castle D, Neil AL. The impact of suicide registers and other monitoring systems on suicide prevention: A scoping review. Int J Soc Psychiatry 2024:207640241261164. [PMID: 39076149 DOI: 10.1177/00207640241261164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/31/2024]
Abstract
BACKGROUND Decreasing suicide mortality has become an overarching goal for societies worldwide. Suicide registers and other monitoring systems are a valuable source of information that can be used for addressing the suicide phenomenon and evaluating preventative interventions. AIMS This scoping review provides an overview of literature published in the last decade that has focussed on the operations (functioning) and characteristics of suicide registers and other suicide monitoring systems. METHODS Four electronic databases were searched in 2020 for identifying published material from January 2010 to October 2020. The searches were updated in October 2023 to include material from 2020 to date. Grey literature through Google searches and mental health commissions websites and the reference lists of selected documents were also searched. RESULTS Twenty-five articles were included in this review. Nearly half the articles were from the United States, followed by Australia. Nine countries were identified as having used suicide registers or suicide-specific monitoring systems to inform suicide prevention. Monitoring mechanisms varied across the countries examined. No article provided evidence that definitively linked suicide registers or other monitoring systems for suicide with the prevention of suicide or reduction in suicide rates. However, a variety of benefits of suicide monitoring for preventative and public health interventions were identified. CONCLUSIONS The number of nations with surveillance systems for suicide prevention is low. Further, there is a lack of consistency in the systematic collection, analysis and interpretation of suicide-related information across the countries examined. Efforts to establish high-quality suicide surveillance systems that can be accessed in a timely and easy manner are needed to inform tailored strategies for suicide prevention.
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Affiliation(s)
- Adriana G Nevarez Flores
- Tasmanian Centre for Mental Health Service Innovation, Tasmanian Health Service, Hobart, Australia
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Angela Martin
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Isabelle Bartkowiak-Theron
- School of Social Sciences, University of Tasmania, Hobart, Australia
- Tasmanian Institute of Law Enforcement Studies, University of Tasmania, Hobart, Australia
| | - Jennifer Makin
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Kimberley Norris
- School of Psychological Sciences, University of Tasmania, Hobart, Australia
| | - David Castle
- Tasmanian Centre for Mental Health Service Innovation, Tasmanian Health Service, Hobart, Australia
- School of Medicine, University of Tasmania, Hobart, Australia
| | - Amanda L Neil
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
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Bowes M, Strang R, Huyer D. Utilisation des données des systèmes d’investigations médicolégales pour favoriser la santé communautaire et prévenir les décès prématurés au Canada. CMAJ 2024; 196:E748-E750. [PMID: 38830675 PMCID: PMC11142032 DOI: 10.1503/cmaj.231386-f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024] Open
Affiliation(s)
- Matt Bowes
- Ministère de la Justice de la Nouvelle-Écosse (Bowes); ministère de la Santé et du Mieux-être de la Nouvelle-Écosse (Strang), Halifax, N.-É.; Bureau du coroner en chef de l'Ontario (Huyer), Toronto, Ont
| | - Robert Strang
- Ministère de la Justice de la Nouvelle-Écosse (Bowes); ministère de la Santé et du Mieux-être de la Nouvelle-Écosse (Strang), Halifax, N.-É.; Bureau du coroner en chef de l'Ontario (Huyer), Toronto, Ont.
| | - Dirk Huyer
- Ministère de la Justice de la Nouvelle-Écosse (Bowes); ministère de la Santé et du Mieux-être de la Nouvelle-Écosse (Strang), Halifax, N.-É.; Bureau du coroner en chef de l'Ontario (Huyer), Toronto, Ont
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Bowes M, Strang R, Huyer D. Use of data from death investigation systems to support community health and prevent premature deaths in Canada. CMAJ 2024; 196:E527-E529. [PMID: 38649164 PMCID: PMC11045229 DOI: 10.1503/cmaj.231386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024] Open
Affiliation(s)
- Matt Bowes
- Nova Scotia Department of Justice (Bowes); Nova Scotia Department of Health and Wellness (Strang), Halifax, NS; Office of the Chief Coroner of Ontario (Huyer), Toronto, Ont
| | - Robert Strang
- Nova Scotia Department of Justice (Bowes); Nova Scotia Department of Health and Wellness (Strang), Halifax, NS; Office of the Chief Coroner of Ontario (Huyer), Toronto, Ont.
| | - Dirk Huyer
- Nova Scotia Department of Justice (Bowes); Nova Scotia Department of Health and Wellness (Strang), Halifax, NS; Office of the Chief Coroner of Ontario (Huyer), Toronto, Ont
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Hill NTM, Bouras H, Too LS, Perry Y, Lin A, Weiss D. Association between mental health workforce supply and clusters of high and low rates of youth suicide: An Australian study using suicide mortality data from 2016 to 2020. Aust N Z J Psychiatry 2023; 57:1465-1474. [PMID: 37608497 PMCID: PMC10619187 DOI: 10.1177/00048674231192764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
OBJECTIVE To examine the association between mental health workforce supply and spatial clusters of high versus low incidence of youth suicide. METHODS A cross-sectional analysis of spatial suicide clusters in young Australians (aged 10-25) from 2016 to 2020 was conducted using the scan statistic and suicide data from the National Coronial Information System. Mental health workforce was extracted from the 2020 National Health Workforce Dataset by local government areas. The Geographic Index of Relative Supply was used to estimate low and moderate-to-high mental health workforce supply for clusters characterised by a high and low incidence of suicide (termed suicide hotspots and coldspots, respectively). Univariate and multivariate logistic regression was used to determine the association between suicide clusters and a range of sociodemographic characteristics including mental health workforce supply. RESULTS Eight suicide hotspots and two suicide coldspots were identified. The multivariate analysis showed low mental health workforce supply was associated with increased odds of being involved in a suicide hotspot (adjusted odds ratio = 8.29; 95% confidence interval = 5.20-13.60), followed by residential remoteness (adjusted odds ratio = 2.85; 95% confidence interval = 1.68-4.89), and illicit drug consumption (adjusted odds ratio = 1.97; 1.24-3.11). Both coldspot clusters occurred in areas with moderate-to-high mental health workforce supply. CONCLUSION Findings highlight the potential risk and protective roles that mental health workforce supply may play in the spatial distributions of youth suicide clusters. These findings have important implications for the provision of postvention and the prevention of suicide clusters.
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Affiliation(s)
- NTM Hill
- Telethon Kids Institute, Nedlands, WA, Australia
- Centre for Child Health Research, The University of Western Australia, Crawley, WA, Australia
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
| | - H Bouras
- Telethon Kids Institute, Nedlands, WA, Australia
| | - LS Too
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
| | - Y Perry
- Telethon Kids Institute, Nedlands, WA, Australia
- Centre for Child Health Research, The University of Western Australia, Crawley, WA, Australia
| | - A Lin
- Telethon Kids Institute, Nedlands, WA, Australia
- Centre for Child Health Research, The University of Western Australia, Crawley, WA, Australia
| | - D Weiss
- Telethon Kids Institute, Nedlands, WA, Australia
- Curtin School of Population Health, Curtin University, Bentley, WA, Australia
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Ferner RE, Brittain R, Cox AR, Heneghan C, Richards GC, Aronson JK. Recognition of Coroners' Concerns to Prevent Future Deaths from Medicines: A Systematic Review. Pharmaceut Med 2023; 37:357-363. [PMID: 37421561 DOI: 10.1007/s40290-023-00486-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2023] [Indexed: 07/10/2023]
Abstract
BACKGROUND Coroners, who hold inquests to determine the causes of unnatural deaths in England and Wales, having recognised factors that could cause other deaths, are legally obliged to signal concerns by sending 'Reports to Prevent Future Deaths' (PFDs) to interested persons. We aimed to establish whether Coroners' concerns about medications are widely recognised. METHODS We searched MEDLINE, Embase and Web of Science up to 30 November, 2022 for publications linking PFDs and medications using a combination of search terms "coroner*", "inquest*", "medicine*", "medication*" and "prevent*". We also searched the BMJ, a UK journal that carries news items; and the databases Nexis Advance and News On the Web for reports in national newspapers between 2013 and 2022, using the search terms ("regulation 28" OR "prevent future deaths" OR "prevention of future deaths") AND "coroner". We recorded the number of publications, as well as their citations in Google Scholar at 23 May, 2023. RESULTS Only 11 published papers on medicines referenced UK PFDs, nine of which were from our group. The BMJ carried 23 articles mentioning PFDs, five related to medicines. Of 139 PFDs (out of over 4000) mentioned in national newspapers, only nine related to medicines. CONCLUSIONS The PFDs related to medicines are not widely referred to in medical journals or UK national newspapers. By contrast, the Australian and New Zealand National Coronial Information System has contributed cases to 206 publications cited in PubMed, of which 139 are related to medicines. Our search suggests that information from English and Welsh Coroners' PFDs is under-recognised, even though it should inform public health. The results of inquiries by Coroners and medical examiners worldwide into potentially preventable deaths involving medicines should be used to strengthen the safety of medicines.
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Affiliation(s)
- Robin E Ferner
- Institute of Clinical Sciences, University of Birmingham, Birmingham, B15 2TT, UK.
- West Midlands Centre for Adverse Drug Reactions, City Hospital, Birmingham, B18 7QH, UK.
| | | | - Anthony R Cox
- Institute of Clinical Sciences, University of Birmingham, Birmingham, B15 2TT, UK
| | - Carl Heneghan
- Centre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK
| | - Georgia C Richards
- Centre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK
| | - Jeffrey K Aronson
- Centre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK
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King T, Maheen H, Taouk Y, LaMontagne A. Suicide in the Australian mining industry: assessment of rates among male workers using 19 years of Coronial data. Saf Health Work 2023. [DOI: 10.1016/j.shaw.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023] Open
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Hill NTM, Walker R, Andriessen K, Bouras H, Tan SR, Amaratia P, Woolard A, Strauss P, Perry Y, Lin A. Reach and perceived effectiveness of a community-led active outreach postvention intervention for people bereaved by suicide. Front Public Health 2022; 10:1040323. [PMID: 36620290 PMCID: PMC9815599 DOI: 10.3389/fpubh.2022.1040323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 11/28/2022] [Indexed: 12/24/2022] Open
Abstract
Background Postvention is a core component of suicide prevention strategies, internationally. However, the types of supports provided to people impacted by suicide vary widely. This study examines the perceived effectiveness of the Primary Care Navigator (PCN) model for people bereaved by suicide. The PCN model was implemented in response to a suicide cluster. It is an active outreach postvention intervention, initiated by police in response to a suspected suicide and links individuals to support in the immediate aftermath of their loss. Methods A retrospective cross-sectional mixed methods approach was used to (1) identify the reach of the PCN model, (2) describe the type of support provided to people bereaved by a suspected suicide and (3) identify the perceived effectiveness of the PCN model from the perspective of WA police, postvention stakeholders and individuals bereaved by suicide. Quantitative data was used to examine the characteristics of suicide in the region, the characteristics of people who received bereavement support, and the types of support that were provided. Interviews with police, postvention stakeholders, and people bereaved by a suspected suicide were conducted to identify the perceived effectiveness of the intervention. Results Between 1 January 2019 and 31 March 2021 there were 80 suspected suicides. Active outreach was provided to 347 bereaved individuals via the PCN model. Just under half of those who were offered outreach accepted further support (N = 164) in the form of suicide bereavement information (98%), mental health or clinical support (49.6%), specialized postvention counseling (38.4%), financial assistance (16%) and assistance with meals (16%), followed by housing assistance (14%) and referral to community services (11%). Police, stakeholders, and people with lived experience of a suspected suicide perceived the PCN model to be effective at connecting them to the community, linking people to support, and preventing suicide. Conclusion The results provide evidence supporting the perceived effectiveness of an active outreach approach to postvention that provides acute support to people bereaved by suicide. Findings highlight important practical areas of support such as providing referral pathways and information on grief and suicide loss in the immediate aftermath of a suicide loss.
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Affiliation(s)
- Nicole T. M. Hill
- Telethon Kids Institute, Nedlands, WA, Australia,Centre for Child Health Research, University of Western Australia, Nedlands, WA, Australia,School of Population and Global Health, University of Western Australia, Nedlands, WA, Australia,*Correspondence: Nicole T. M. Hill
| | - Roz Walker
- School of Population and Global Health, University of Western Australia, Nedlands, WA, Australia,Ngangk Yira Institute for Change, Murdoch University, Murdoch, WA, Australia,School of Indigenous Studies, University of Western Australia, Perth, WA, Australia
| | - Karl Andriessen
- Melbourne School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia
| | - Hamza Bouras
- Telethon Kids Institute, Nedlands, WA, Australia
| | - Shawn R. Tan
- Telethon Kids Institute, Nedlands, WA, Australia
| | | | - Alix Woolard
- Telethon Kids Institute, Nedlands, WA, Australia,Centre for Child Health Research, University of Western Australia, Nedlands, WA, Australia
| | - Penelope Strauss
- Telethon Kids Institute, Nedlands, WA, Australia,School of Population and Global Health, University of Western Australia, Nedlands, WA, Australia
| | - Yael Perry
- Telethon Kids Institute, Nedlands, WA, Australia,Centre for Child Health Research, University of Western Australia, Nedlands, WA, Australia
| | - Ashleigh Lin
- Telethon Kids Institute, Nedlands, WA, Australia,Centre for Child Health Research, University of Western Australia, Nedlands, WA, Australia
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Batson A, Newnam S, Koppel S. Examining Coroners' Recommendations for Health and Safety Management of Ageing Heavy Vehicle Drivers: A STAMP Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16112. [PMID: 36498186 PMCID: PMC9740677 DOI: 10.3390/ijerph192316112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/27/2022] [Accepted: 11/27/2022] [Indexed: 06/17/2023]
Abstract
Recommendations were analysed from coronial cases involving ageing heavy vehicle drivers (≥55 years) and mapped onto a Systems Theoretic Accident Model and Processes (STAMP) control structure to identify the controllers and control actions influential in the heavy vehicle industry with regard to health and safety. A National Coronial Information System (NCIS) database search revealed 38 coroners' recommendations arising from 14 unique cases of ageing driver involvement. There were no ageing themes identified in the analysis of coroners' findings and recommendations. An examination of the STAMP control structure identified that the highest concentration of recommendations was in the level of regulation, the second most senior level of control, although safety constraints were advised for all five levels of the system. In regard to identifying themes of control flaws in the recommendations, the study found that "unidentified hazards" were the most common type of safety failure in the analysis of cases of ageing drivers, concentrated at the regulatory level, which indicates that additional risk identification methods by upper levels of control are needed. Therefore, a recommendation arising from the current study is that additional controls in safety intervention are necessitated in the upper and middle levels of the road freight transportation system; in particular, formalising health and safety education for organisational managers, with a focus on identifying ageing issues, would fill a gap in the system for managing ageing heavy vehicle drivers. In conclusion, this study has found that improving the health and safety of ageing heavy vehicle drivers necessitates additional safety constraints with a focus on formalised safety education for organisational managers, in addition to a means to detect emerging and unforeseen hazards in the road freight transportation industry.
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Affiliation(s)
- Angela Batson
- Monash University Accident Research Centre, Monash University, 21 Alliance Lane, Melbourne, VIC 3800, Australia
| | - Sharon Newnam
- School of Psychology and Counselling, Queensland University of Technology, Brisbane City, QLD 4000, Australia
| | - Sjaan Koppel
- Monash University Accident Research Centre, Monash University, 21 Alliance Lane, Melbourne, VIC 3800, Australia
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Femoral fractures are an indicator of increased severity of injury for road traffic collision victims: an autopsy-based case-control study on 4895 fatalities. Arch Orthop Trauma Surg 2022; 142:2645-2658. [PMID: 34196773 DOI: 10.1007/s00402-021-03997-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 06/12/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION The course of road traffic collision (RTC) victims with femoral fractures (FFx) from injury to death was reviewed. We sought to correlate the presence of femoral fractures with the overall severity of injury from RTCs using objective indices and to identify statistically significant associations with injuries in other organs. PATIENTS AND METHODS A case-control study based on forensic material from 4895 consecutive RTC-induced fatalities, between 1996 and 2005. Injuries were coded according to the Abbreviated Injury Scale-1990 Revision (AIS-90), and the Injury Severity Score (ISS) was calculated. Victims were divided according to the presence of femoral fractures in all possible anatomic locations or not. Univariate comparisons and logistic regression analysis for probabilities of association as odds ratios (OR) were performed. RESULTS The FFx group comprised 788 (16.1%) victims. The remaining 4107 victims constituted the controls. The FFx group demonstrated higher ISS (median 48 vs 36, p < 0.001) and shorter post-injury survival times (median 60 vs 85 min, p < 0.001). Presence of bilateral fractures (15.5%) potentiated this effect (median ISS 50 vs 43, p = 0.006; median survival time 40 vs 65, p = 0.0025; compared to unilateral fractures). Statistically significant associations of FFx were identified with AIS2-5 thoracic trauma (OR 1.43), AIS2-5 abdominal visceral injuries (OR 1.89), AIS1-3 skeletal injuries of the upper (OR 2.7) and lower limbs (OR 3.99) and AIS2-5 of the pelvis (OR 2.75) (p < 0.001). In the FFx group, 218 (27.7%) victims survived past the emergency department and 116 (53.2%) underwent at least one surgical procedure. Complications occurred in 45.4% of hospitalized victims, the most common being pneumonia (34.8%). CONCLUSION This study has documented that femoral fractures are associated with increased severity of injury, shorter survival times and higher incidence of associated thoracic, abdominal and skeletal extremity injuries, compared to controls. These findings should be considered for an evidence-based upgrading of trauma care.
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Ghassempour N, Tannous WK, Agho KE, Avsar G, Harvey LA. The Impact of Reduced Fire Risk Cigarettes Regulation on Residential Fire Incidents, Mortality and Health Service Utilisation in New South Wales, Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12481. [PMID: 36231780 PMCID: PMC9566670 DOI: 10.3390/ijerph191912481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 09/26/2022] [Accepted: 09/26/2022] [Indexed: 06/16/2023]
Abstract
Smoking materials are a common ignition source for residential fires. In Australia, reduced fire risk (RFR) cigarettes regulation was implemented in 2010. However, the impact of this regulation on residential fires is unknown. This paper examines the impact of the RFR cigarettes regulation on the severity and health outcomes of fire incidents in New South Wales (NSW), Australia, from 2005 to 2014. Fire department data from 2005 to 2014 were linked with ambulance, emergency department, hospital, outpatient burns clinic and mortality datasets for NSW. Negative binomial regression analysis was performed to assess the changes to fire incidents' severity pre- and post-RFR cigarettes regulation. There was an 8% reduction in total fire incidents caused by smokers' materials post-RFR cigarettes regulation. Smokers' materials fire incidents that damaged both contents and structure of the building, where fire flames extended beyond the room of fire origin, with over AUD 1000 monetary damage loss, decreased by 18, 22 and 12%, respectively. RFR cigarettes regulation as a fire risk mitigation has positively impacted the residential fire incident outcomes. This provides support for regulation of fire risk protective measures and bestows some direction for other fire safety policies and regulations.
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Affiliation(s)
- Nargess Ghassempour
- School of Business, Western Sydney University, Parramatta, NSW 2150, Australia
- Rozetta Institute Group, The Rocks, NSW 2000, Australia
| | - Wadad Kathy Tannous
- School of Business, Western Sydney University, Parramatta, NSW 2150, Australia
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW 2560, Australia
| | - Kingsley Emwinyore Agho
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW 2560, Australia
- School of Health Sciences, Western Sydney University, Penrith, NSW 2751, Australia
| | - Gulay Avsar
- School of Business, Western Sydney University, Parramatta, NSW 2150, Australia
| | - Lara Ann Harvey
- Fall, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, NSW 2031, Australia
- School of Population Health, University of New South Wales, Kensington, NSW 2033, Australia
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Prahladh S, van Wyk J. Introductory evidence on data management and practice systems of forensic autopsies in sudden and unnatural deaths: a scoping review. EGYPTIAN JOURNAL OF FORENSIC SCIENCES 2022; 12:38. [PMID: 36158168 PMCID: PMC9484346 DOI: 10.1186/s41935-022-00293-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 08/14/2022] [Indexed: 11/15/2022] Open
Abstract
Background The investigation into sudden unexpected and unnatural deaths supports criminal justice, aids in litigation, and provides important information for public health including surveillance, epidemiology, and prevention programs. The use of mortality data to convey trends can inform policy development and resource allocations. Hence, data practices/management systems in Forensic Medicine are critical. This study scoped literature and described the body of knowledge on data management and practice systems in Forensic Medicine. Methods Five steps of the methodological framework of Arksey and O’Malley guided this scoping review. A combination of keywords, Boolean terms, and Medical Subject Headings was used to search PubMed, EBSCOhost (CINAHL with full text and Health Sources), Cochrane Library, Scopus, Web of Science, Science Direct, WorldCat, and Google Scholar from the 18th to 24th of June 2020 and updated in November 2021 for peer review papers. This study included articles involving unnatural deaths, focused on data practice or data management systems, relating to Forensic Medicine, all study designs, and published in English. Screening and selection and data extraction were conducted by two reviews. Thematic analysis was conducted, and the results were reported using both quantitatively and qualitatively. Results Of the 23,059 articles, 16 met this study’s inclusion criteria. The included articles were published between 2008 and 2019. Eight of the 16 articles were published between 2017 and 2019. Most of the included studies were conducted in the USA (5) and Australia/New Zealand (4). Only two publications were from lower- and middle-income countries (Nigeria, Mexico), and the remaining 14 were from high-income countries (Italy, Denmark, USA, Australia, and New Zealand, Japan, Switzerland, Canada). The data management systems found in this study were as follows: Virtopsy, Canadian Coroner and Medical Examiner Database, Infant Injury Database, Fatal injury surveillance system, Medical Examiners and Coroners Alert System, National Violent Deaths Reporting System, AM/PM Database, Tokyo CDISC/ODM, and National Coronial Information System. Conclusions This study’s results revealed limited articles relating to data management and practice systems in Forensic Medicine, particularly in LMICs through literature indicating there is a prevalence of unnatural deaths in LMICs. This study, therefore, recommends research on data management and practice systems relating to forensic medicine in LMICs to inform policy decisions. Supplementary Information The online version contains supplementary material available at 10.1186/s41935-022-00293-3.
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Investigating the Source of Fatal Pulmonary Thromboembolism in a Coronial Postmortem Population. Am J Forensic Med Pathol 2022; 43:117-120. [PMID: 35102008 DOI: 10.1097/paf.0000000000000746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT The incidence of how often a deep vein thrombosis is found in the calves of the legs at coronial postmortem examination is unclear. This study retrospectively examined postmortem examination reports from Australian Coronial investigations of sudden death resulting from pulmonary thromboembolism to determine the likelihood of dissection of the deep veins of calves of the legs revealing the source of a pulmonary thromboembolism. From 450 cases taken from the National Coronial Information System (NCIS) for 2016, the postmortem reports of 327 cases were reviewed to provide demographic details of victims of sudden death from pulmonary thromboembolism. In 235 cases, it was possible to determine in 76.6% a thrombus had been found in the deep veins of the calves of the legs after dissection. In 141 cases, it was documented that both sides had been examined. From these, it was determined there was no statistically significant difference in the prevalence of thrombus in either side. However, it was shown that the presence of an abnormality of a lower limb (such as leg or hip infection, burns, surgery and nonoperated fractures, or a larger circumference) increased the likelihood that a deep vein thrombus would be found on that side.
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Eynstone-Hinkins J, Moran L. Enhancing Australian Mortality Data to Meet Future Health Information Demands. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19010603. [PMID: 35010855 PMCID: PMC8744765 DOI: 10.3390/ijerph19010603] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/22/2021] [Accepted: 12/31/2021] [Indexed: 11/16/2022]
Abstract
The Australian mortality data are a foundational health dataset which supports research, policy and planning. The COVID-19 pandemic necessitated the need for more timely mortality data that could assist in monitoring direct mortality from the virus as well as indirect mortality due to social and economic societal change. This paper discusses the evolution of mortality data in Australia during the pandemic and looks at emerging opportunities associated with electronic infrastructure such as electronic Medical Certificates of Cause of Death (eMCCDs), ICD-11 and automated coding tools that will form the foundations of a more responsive and comprehensive future mortality dataset.
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Understanding the characteristics and mechanisms underlying suicide clusters in Australian youth: a comparison of cluster detection methods. Epidemiol Psychiatr Sci 2020; 29:e151. [PMID: 32758330 PMCID: PMC7443820 DOI: 10.1017/s2045796020000645] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
AIMS There is currently no gold-standard definition or method for identifying suicide clusters, resulting in considerable heterogeneity in the types of suicide clusters that are detected. This study sought to identify the characteristics, mechanisms and parameters of suicide clusters using three cluster detection methods. Specifically, the study aimed to: (1) determine the overlap in suicide clusters among each method, (2) compare the spatial and temporal parameters associated with different suicide clusters and (3) identify the demographic characteristics and rates of exposure to suicide among cluster and non-cluster members. METHODS Suicide data were obtained from the National Coronial Information System. N = 3027 Australians, aged 10-24 who died by suicide in 2006-2015 were included. Suicide clusters were determined using: (1) poisson scan statistics, (2) a systematic search of coronial inquests and (3) descriptive network analysis. These methods were chosen to operationalise three different definitions of suicide clusters, namely clusters that are: (1) statistically significant, (2) perceived to be significant and (3) characterised by social links among three or more suicide descendants. For each method, the demographic characteristics and rates of exposure to suicide were identified, in addition to the maximum duration of suicide clusters, the geospatial overlap between suicide clusters, and the overlap of individual cluster members. RESULTS Eight suicide clusters (69 suicides) were identified from the scan statistic, seven (40 suicides) from coronial inquests; and 11 (37 suicides) from the descriptive network analysis. Of the eight clusters detected using the scan statistic, two overlapped with clusters detected using the descriptive network analysis and one with clusters identified from coronial inquests. Of the seven clusters from coronial inquests, four overlapped with clusters from the descriptive network analysis and one with clusters from the scan statistic. Overall, 9.2% (12 suicides) of individuals were identified by more than one method. Prior exposure to suicide was 10.1% (N = 7) in clusters from the scan statistic, 32.5% (N = 13) in clusters from coronial inquest and 56.8% (N = 21) in clusters from the descriptive network analysis. CONCLUSION Each method identified markedly different suicide clusters. Evidence of social links between cluster members typically involved clusters detected using the descriptive network analysis. However, these data were limited to the availability information collected as part of the police and coroner investigation. Communities tasked with detecting and responding to suicide clusters may benefit from using the spatial and temporal parameters revealed in descriptive studies to inform analyses of suicide clusters using inferential methods.
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Langlois NEI, Sully CJ, Edwards S. Turnaround time data for Coronial autopsies - time to complete forensic post-mortem examination reports and influencing factors for Australia and New Zealand in 2015 and 2010. Forensic Sci Med Pathol 2019; 15:56-66. [PMID: 30627976 DOI: 10.1007/s12024-018-0074-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2018] [Indexed: 11/21/2022]
Abstract
This study aimed to provide information regarding key performance indicators (KPIs) for forensic pathology in Australia and New Zealand, focusing on the time to complete a Coronial post-mortem examination report. Data was obtained from the National Coronial Information System (NCIS). The mean and median time to complete a post-mortem examination report in 2015 was determined from a sample of 100 cases from each of the nine Coronial jurisdictions. Results of univariate and multivariable analysis of factors potentially influencing the completion time are presented. The multivariable analysis indicated the time to complete a post-mortem examination report was significantly dependent on if any internal examination had been performed, the Coronial jurisdiction and requesting toxicological analysis. The number of days for Coroners to close cases is also presented as well as the number of days for a post-mortem examination to be performed. A comparison between 2015 and 2010 was instigated. However, this data had to be constrained to eight of the Coronial jurisdictions. Within this dataset, the time to complete a post-mortem examination report when an internal examination had been performed was statistically significant greater in 2015. However, the time to complete reports for all Coronial post-mortem examinations in 2015 was not statistically significantly different to 2010. This could be attributed to a higher proportion of post-mortem examinations without internal examination ('external only') in 2015. The time to perform a post-mortem examination following the death being reported to a Coroner increased, but the time for Coroners to close a case decreased.
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Affiliation(s)
- Neil E I Langlois
- Forensic Science SA, GPO Box 2790, Adelaide, SA, 5001, Australia. .,University of Adelaide, School of Medicine, Adelaide Health & Medical Sciences (AHMS), North Terrace, South Australia, 5000, Australia.
| | - Claire J Sully
- Forensic Science SA, GPO Box 2790, Adelaide, SA, 5001, Australia
| | - Suzanne Edwards
- University of Adelaide, Adelaide Health Technology Assessment / School of Public Health, Adelaide Health & Medical Sciences (AHMS), North Terrace, South Australia, 5000, Australia
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Olds K, Rodriguez M, Langlois N. The Australian National Coronial Information System: Limited by Quality of Data. Acad Forensic Pathol 2018; 8:180-181. [PMID: 31240034 PMCID: PMC6474456 DOI: 10.23907/2018.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/12/2023]
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