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Peterson A, Smith-Morris C. Teen Perspectives on Suicides and Deaths in an Affluent Community: Perfectionism, Protection, and Exclusion. Int J Environ Res Public Health 2024; 21:456. [PMID: 38673367 PMCID: PMC11050056 DOI: 10.3390/ijerph21040456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 03/29/2024] [Accepted: 04/02/2024] [Indexed: 04/28/2024]
Abstract
Clusters of youth suicide and death are tragic for communities and present long-term consequences for the surviving youths. Despite an awareness of community-based patterns in youth suicide, our understanding of the social and community factors behind these events remains poor. While links between poverty and suicide have been well documented, wealthy communities are rarely targeted in suicide research. In response to this gap, we conducted ethnographic research in a wealthy U.S. town that, over a recent 10-year period, witnessed at least four youth suicides and seven more youth accidental deaths. Our interviews (n = 30) explored community values and stressors, interpersonal relationships, and high school experiences on participant perceptions of community deaths. Youth participants characterize their affluent community as having (1) perfectionist standards; (2) permissive and sometimes absent parents; (3) socially competitive and superficial relationships; and (4) a "bubble" that is protective but also exclusionary. Our qualitative findings reveal network influence in teen suicides and accidental deaths in a wealthy community. Greater attention paid to the negative effects of subcultural values and stressors in affluent communities is warranted. Further, our work promotes the value of ethnographic, community-based methodologies for suicidology and treatment.
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Affiliation(s)
- Abigail Peterson
- Department of Anthropology, Southern Methodist University, Dallas, TX 75275, USA
- School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Carolyn Smith-Morris
- Peter O’Donnell Jr. School of Public Health, UT Southwestern Medical Center, Dallas, TX 75390, USA;
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Eide D, Skurtveit S, Clausen T, Hesse M, Mravčík V, Nechanská B, Rolová G, Thylstrup B, Tjagvad C, Seid AK, Odsbu I, Gabrhelík R. Cause-Specific Mortality among Patients in Treatment for Opioid Use Disorder in Multiple Settings: A Prospective Comparative Cohort Study. Eur Addict Res 2023; 29:272-284. [PMID: 37385232 PMCID: PMC10614278 DOI: 10.1159/000530822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 04/18/2023] [Indexed: 07/01/2023]
Abstract
INTRODUCTION Among people receiving current or previous opioid maintenance treatment (OMT), the leading cause of premature death is an opioid overdose. However, other causes of mortality remain high in this group. An understanding of causes of deaths across multiple settings can be useful in informing more comprehensive prevention responses. The aim of this study was to describe all non-overdose causes of death in three national cohorts (Czechia, Denmark, and Norway) among OMT patients and to explore associations of non-overdose mortality with age and gender. METHODS This prospective comparative cohort study used national mortality registry databases for OMT patients from Czechia (2000-2019), Denmark (2000-2018), and Norway (2010-2019). Crude mortality rates and age-standardized mortality rates (ASMRs) were calculated as deaths per 1,000 person years for cause-specific mortality. RESULTS In total, 29,486 patients were included, with 5,322 deaths recorded (18%). We found variations in causes of death among the cohorts and within gender and age groups. The leading non-overdose causes of death were accidents in Czechia and Denmark, and neoplasms in Norway. Cardiovascular deaths were highest in Czechia, particularly for women in OMT (ASMR 3.59 vs. 1.24 in Norway and 1.87 in Denmark). CONCLUSION This study found high rates of preventable death among both genders and all age groups. Different demographic structures, variations in risk exposure, as well as variations in coding practices can explain the differences. The findings support increased efforts towards screening and preventative health initiatives among OMT patients specific to the demographic characteristics in different settings.
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Affiliation(s)
- Desiree Eide
- Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway
| | - Svetlana Skurtveit
- Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway
- Norwegian Institute of Public Health, Oslo, Norway
| | - Thomas Clausen
- Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway
| | - Morten Hesse
- Centre for Alcohol and Drug Research, Aarhus University, Aarhus, Denmark
| | - Viktor Mravčík
- Department of Addictology, First Faculty of Medicine, Charles University, Prague, Czech Republic
- Department of Addictology, General University Hospital in Prague, Prague, Czech Republic
| | - Blanka Nechanská
- Department of Addictology, First Faculty of Medicine, Charles University, Prague, Czech Republic
- Department of Addictology, General University Hospital in Prague, Prague, Czech Republic
| | - Gabriela Rolová
- Department of Addictology, First Faculty of Medicine, Charles University, Prague, Czech Republic
- Department of Addictology, General University Hospital in Prague, Prague, Czech Republic
| | - Birgitte Thylstrup
- Centre for Alcohol and Drug Research, Aarhus University, Aarhus, Denmark
| | - Christian Tjagvad
- Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway
| | - Abdu Kedir Seid
- Centre for Alcohol and Drug Research, Aarhus University, Aarhus, Denmark
| | - Ingvild Odsbu
- Norwegian Institute of Public Health, Oslo, Norway
- Department of Addictology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Roman Gabrhelík
- Department of Addictology, First Faculty of Medicine, Charles University, Prague, Czech Republic
- Department of Addictology, General University Hospital in Prague, Prague, Czech Republic
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Shen Q, Sjölander A, Sloan EK, Walker AK, Fall K, Valdimarsdottir U, Sparén P, Smedby KE, Fang F. NSAID use and unnatural deaths after cancer diagnosis: a nationwide cohort study in Sweden. BMC Cancer 2022; 22:75. [PMID: 35039006 PMCID: PMC8764760 DOI: 10.1186/s12885-021-09120-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 12/15/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Cancer patients experience increased risk of death from accident and suicide. Cognitive impairment induced by cancer-related inflammation and stress-related psychiatric symptoms may be underlying mechanisms. We therefore studied the association between use of nonsteroidal anti-inflammatory drugs (NSAIDs) and risk of these outcomes. METHODS Following a cohort of 388,443 cancer patients diagnosed between October 2005 and December 2014 in Sweden, we ascertained dispense of aspirin or non-aspirin NSAIDs from 3 months before cancer diagnosis onward and defined the on-medication period as from date of drug dispense until the prescribed dosage was consumed. Follow-up time outside medicated periods and time from unexposed patients were defined as off-medication periods. We used Cox models to estimate hazard ratios (HRs) of death due to suicide or accident, by comparing the on-medication periods with off-medication periods. RESULTS In total, 29.7% of the cancer patients had low-dose aspirin dispensed and 29.1% had non-aspirin NSAIDs dispensed. Patients with aspirin use were more likely to be male than patients without aspirin use. Compared with off-medication periods, there was a 22% lower risk of accidental death (N = 651; HR 0.78, 95% confidence interval [CI]: 0.70 to 0.87) during on-medication periods with aspirin. The use of aspirin was not associated with risk of suicide (N = 59; HR 0.96, 95% CI: 0.66 to 1.39). No association was noted between use of non-aspirin NSAIDs and the risk of suicide (N = 13; HR 0.95, 95% CI: 0.42 to 2.18) or accidental death (N = 59; HR 0.92, 95% CI: 0.68 to 1.26). CONCLUSIONS Intake of low-dose aspirin after cancer diagnosis was associated with a lower risk of unnatural deaths among cancer patients.
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Affiliation(s)
- Qing Shen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-171 77, Stockholm, Sweden.
| | - Arvid Sjölander
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-171 77, Stockholm, Sweden
| | - Erica K Sloan
- Drug Discovery Biology Theme, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, VIC, 5052, Australia
| | - Adam K Walker
- Drug Discovery Biology Theme, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, VIC, 5052, Australia
- Laboratory of ImmunoPsychiatry, Neuroscience Research Australia, Randwick, New South Wales, 2031, Australia
- School of Psychiatry, University of New South Wales, Sydney, 2052, Australia
| | - Katja Fall
- Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, SE-171 77, Stockholm, Sweden
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, SE-701 82, Örebro, Sweden
| | - Unnur Valdimarsdottir
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-171 77, Stockholm, Sweden
- Center of Public Health Sciences, University of Iceland, IS-101, Reykjavik, Iceland
- Department of Epidemiology, Harvard T. H. Chan. School of Public Health, Boston, MA, 02115, USA
| | - Pär Sparén
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-171 77, Stockholm, Sweden
| | - Karin E Smedby
- Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, SE-171 77, Stockholm, Sweden
- Center for Hematology, Karolinska University Hospital, SE-171 77, Stockholm, Sweden
| | - Fang Fang
- Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, SE-171 77, Stockholm, Sweden
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Kotwal RS, Mazuchowski EL, Janak JC, Howard JT, Harcke HT, Holcomb JB, Eastridge BJ, Gurney JM, Shackelford SA. United States military fatalities during Operation New Dawn. J Trauma Acute Care Surg 2021; 91:375-383. [PMID: 34397956 DOI: 10.1097/ta.0000000000003268] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Military operations vary by scope, purpose, and intensity, each having unique forces and actions to execute a mission. Evaluation of military operation fatalities guides current and future casualty care. METHODS A retrospective study was conducted of all US military fatalities from Operation New Dawn in Iraq, 2010 to 2011. Data were obtained from autopsies and other records. Population characteristics, manner of death, cause of death, and location of death were analyzed. All fatalities were evaluated for concomitant evidence of underlying atherosclerosis. Nonsuicide trauma fatalities were also reviewed for injury severity, mechanism of death, injury survivability, death preventability, and opportunities for improvement. RESULTS Of 74 US military Operation New Dawn fatalities (median age, 26 years; male, 98.6%; conventional forces, 100%; prehospital, 82.4%) the leading cause of death was injury (86.5%). The manner of death was primarily homicide (55.4%), followed by suicide (17.6%), natural (13.5%), and accident (9.5%). Fatalities were divided near evenly between combatants (52.7%) and support personnel (47.3%), and between battle injury (51.4%) and disease and nonbattle injury (48.6%). Natural and suicide death was higher (p < 0.01, 0.02) among support personnel who were older (p = 0.05) with more reserve/national guard personnel (p = 0.01). Total population prevalence of underlying atherosclerosis was 18.9%, with more among support personnel (64.3%). Of 46 nonsuicide trauma fatalities, most died of blast injury (67.4%) followed by gunshot wound (26.1%) and multiple/blunt force injury (6.5%). The leading mechanism of death was catastrophic tissue destruction (82.6%). Most had nonsurvivable injuries (82.6%) and nonpreventable deaths (93.5%). CONCLUSION Operation New Dawn fatalities were exclusively conventional forces divided between combatants and support personnel, the former succumbing more to battle injury and the latter to disease and nonbattle injury including self-inflicted injury. For nonsuicide trauma fatalities, none died from a survivable injury, and 17.4% died from potentially survivable injuries. Opportunities for improvement included providing earlier blood products and surgery. LEVEL OF EVIDENCE Therapeutic, level V and epidemiological, level IV.
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Affiliation(s)
- Russ S Kotwal
- From the Joint Trauma System (R.S.K., E.L.M., J.C.J., J.T.H., J.M.G., S.A.S.), Defense Health Agency, Joint Base San Antonio-Fort Sam Houston, Texas; Uniformed Services University (R.S.K., E.L.M., H.T.H., J.M.G., S.A.S.), Bethesda, Maryland; Texas A&M University (R.S.K.), College Station, Texas; Armed Forces Medical Examiner System (E.L.M., H.T.H.), Defense Health Agency, Dover Air Force Base, Delaware; University of Texas (J.T.H., B.J.E.), San Antonio, Texas; University of Alabama (J.B.H.), Birmingham, Alabama; and United States Army Institute of Surgical Research (J.M.G.), Joint Base San Antonio-Fort Sam Houston, Texas
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Clemens T, Moreland B, Lee R. Persistent Racial/Ethnic Disparities in Fatal Unintentional Drowning Rates Among Persons Aged ≤29 Years - United States, 1999-2019. MMWR Morb Mortal Wkly Rep 2021; 70:869-874. [PMID: 34138831 PMCID: PMC8220955 DOI: 10.15585/mmwr.mm7024a1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Affiliation(s)
- Miraç Özdemir
- Department of Forensic Medicine Marmara University School of Medicine Istanbul, Turkey
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Abstract
ABSTRACT Xylazine is an emerging adulterant with fentanyl in fatal drug intoxications, which has public health, safety, and criminal investigative implications. Xylazine is a nonnarcotic sedative used for analgesia and muscle relaxation exclusively in veterinary medicine. Its chemical structure is similar to clonidine and acts as a central α-2 agonist which may cause bradycardia and transient hypertension followed by hypotension. We report the detection of xylazine in 42 deaths in Connecticut from March to August 2019. Xylazine combined with an opioid or stimulant may affect the toxicity of these drugs. Detection of xylazine may help the forensic pathologist distinguish illicit from prescribed fentanyl, and law enforcement agents track the illicit drugs to a specific drug supplier. Because of its lack of response to naloxone, emergency medicine physicians need to be aware of its potential presence as it may affect therapy.
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Charvin-Fabre S, Stolte O, Lawrenson R. Amenable mortality within the New Zealand homeless population: we can do better! N Z Med J 2020; 133:26-38. [PMID: 33332326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
AIM To describe the context surrounding the deaths of homeless people in New Zealand and to determine the proportion of deaths that could be considered amenable to healthcare. METHOD We used coroners' findings related to 171 deaths of persons with "no fixed abode" at the time of death, from 2008 to 2019. Recent lists of amenable mortality from the New Zealand Ministry of Health and the Office of National Statistics in the UK were combined to determine the rate of amenable mortality. RESULTS The life expectancy of homeless persons identified in this sample was 30 years shorter than in the housed population, with a mean age of death of 45.7 years. Deaths occurred mainly alone, in public spaces (56.1%) or in private vehicles (14%). Three-quarters (75.8%) of homeless persons died from conditions amenable to timely and effective healthcare interventions, mostly from natural causes (45.7%) and suicide (41.5%). CONCLUSION Homeless people experience considerable challenges when accessing the healthcare system, as uncovered by the dramatic rate of amenable mortality. Our findings highlight the urgent need to implement specific models of care that are designed to meet the social and healthcare needs of homeless persons and address the significant health inequalities they experience.
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Affiliation(s)
- Sandrine Charvin-Fabre
- PhD Candidate in Health Development and Policy, Division of Arts, Law, Psychology and Social Sciences, University of Waikato, Hamilton
| | - Ottilie Stolte
- Senior Lecturer, School of Psychology, University of Waikato, Hamilton
| | - Ross Lawrenson
- Professor of Population Health, Medical Research Centre, University of Waikato, Hamilton
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Amaefule KE, Dahiru IL, Ejagwulu FS, Maitama MI. Trauma Mortality in The Emergency Department of a Tertiary Hospital in a Low-Income Country: It's Time To Walk The Talks. West Afr J Med 2020; 37:131-137. [PMID: 32150631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND Trauma in developing countries has assumed an epidemic proportion and is now a public health problem. This is largely due to the rising incidence of road traffic crashes (RTC), increasing urbanization, industrialization and armed conflicts including terrorism fuelled by political, ethnic and religious factors in most developing countries. Unfortunately, this public health menace has not gotten the attention it deserves from the governments of the low-income countries, global non-governmental organisations and the mass media compared to the infectious diseases. METHODS This was a 2-year retrospective cohort study of trauma patients who presented to our emergency department and died within 72 hours of admission. RESULTS Within the period, a total of 6,858 patients, consisting of 2,228 trauma patients were admitted into our emergency department. Out of the trauma admissions, 256 patients died; giving a mortality rate of 11.5%. However, only 237 of the dead patients' case files could be reviewed. There were 195 (82.3%) males and 42 (17.7%) females. Majority of the deaths were in the age group 31 years - 45 years, with a mean age of 33.6 years. Road traffic crash was the most common cause of trauma deaths, 194 (81.9%); followed by flame burn, 15 (6.3%). Traumatic brain injury with or without other associated lesser injuries was the predominant diagnosis at presentation, 157 (66.2%). Most of the patients presented within 4 hours of their injuries, 136 (57.4%). Majority of the patients were brought to hospital by other road users, 133 (56.1%); and commercial bus was the commonest mode of transportation of the patients to the hospital, 102 (43.1%). CONCLUSION The trauma mortality rate in our emergency department calls for urgent intervention measures. Critical amongst them is the need for establishment of a trauma system with an efficient pre-hospital emergency medical service component in our region.
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Affiliation(s)
- K E Amaefule
- Department of Orthopedics and Trauma Surgery,Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State, Nigeria
| | - I L Dahiru
- Department of Orthopedics and Trauma Surgery,Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State, Nigeria
| | - F S Ejagwulu
- Department of Orthopedics and Trauma Surgery,Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State, Nigeria
| | - M I Maitama
- Department of Orthopedics and Trauma Surgery,Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State, Nigeria
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Gerhart J, Duberstein P, Paull D, O'Mahony S, Burns J, DeNicolo M, Hoerger M. Geopersonality of Preventable Death in the United States: Anger-Prone States and Opioid Deaths. Am J Hosp Palliat Care 2020; 37:624-631. [PMID: 32008364 DOI: 10.1177/1049909120902808] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Opioid overdoses have reached epidemic levels in the United States and have clustered in Northeastern and "Rust Belt" states. Five Factor Model (FFM) personality traits also vary at the state level, with anger-prone traits clustered in the Northeast region. This study tested the hypothesis that state-level anger proneness would be associated with a greater increase in rates of opioid overdose death. METHODS This was a secondary analysis of state-level data on FFM traits, opioid overdose deaths, and other classes of preventable death. Robust mixed models tested whether change in rates of opioid overdose death from 2008 to 2016 was moderated by state-level anger proneness. RESULTS State-level anger proneness was significantly associated with greater increases in rates of opioid overdose deaths (B = 1.01, standard error = 0.19, P < .001, 95% confidence interval: 0.63-1.39). The slope of increase in opioid overdose death rates was 380% greater in anger-prone states and held after adjustment for potential confounders such as state-level prevalence of major depressive disorder, number of mental health facilities, and historical patterns of manufacturing decline. A similar pattern was observed between state-level anger proneness and benzodiazepine overdose deaths but was not significant for the latter after adjustment for potential confounders. CONCLUSION These findings suggest that states characterized as more anger prone have experienced greater increases in opioid overdose deaths.
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Affiliation(s)
- James Gerhart
- Department of Psychology, Central Michigan University, MI, USA
- Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Paul Duberstein
- Department of Health Behavior, Society, and Policy, Rutgers University School of Public Health, New Brunswick, NJ, USA
| | - Danielle Paull
- Department of Psychology, Central Michigan University, MI, USA
| | - Sean O'Mahony
- Department of Internal Medicine, Palliative Medicine Service, Rush University Medical Center, Chicago, IL, USA
| | - John Burns
- Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | | | - Michael Hoerger
- Department of Psychology, Tulane University, New Orleans, LA, USA
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Suzuki H, Tanifuji T, Kimura S, Fukunaga T. Epidemiology of alcohol-related accidental death in Tokyo Metropolitan area (2015). Med Sci Law 2020; 60:4-10. [PMID: 31500507 DOI: 10.1177/0025802419843457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Background Alcohol consumption may be a risk factor for accidental deaths; however, characteristics of alcohol-related deaths are unclear. We investigated characteristics of alcohol-related accidental deaths to facilitate target strategies. Methods In this article, 1060 cases of accidental deaths examined by the Tokyo Medical Examiner’s Office (2015) were divided into two groups: deceased individuals who drank alcohol (alcohol; n = 212) and those who did not (control; n = 848). Age, sex, alcohol consumption patterns, and manners/causes of deaths were compared. Places where individuals in the alcohol group met with an accident, and their blood alcohol concentration was assessed. Results Lower mean age (60.5 vs. 73.7 years) and a higher male ratio (75.9% vs. 58.5%) were observed in the alcohol group. Daily alcohol consumption was more common in the alcohol group (70.8% vs. 13.4%). Falling was the leading cause of death in the alcohol group, but without a significant difference (alcohol: 31.6%, control: 30.4%). Incidence rates of drowning (22.2% vs. 7.9%) and poisoning (11.3% vs. 2.0%) were significantly higher in the alcohol group. The mean blood alcohol concentration was 1.6 mg/mL. Of the total alcohol-related accidents, 60.8% occurred at home. Falling down the stairs was the primary type of falling, and majority of drownings occurred in a bathtub. Conclusion Male habitual drinkers (middle-aged to older adults) should be targeted to prevent alcohol-related accidental deaths. More than 50% of deaths occurred at home and care should be taken when performing daily activities, including using stairs and while bathing.
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Affiliation(s)
- Hideto Suzuki
- Tokyo Medical Examiner's Office, Tokyo Metropolitan Government, Japan
| | - Takanobu Tanifuji
- Tokyo Medical Examiner's Office, Tokyo Metropolitan Government, Japan
| | - Satoko Kimura
- Tokyo Medical Examiner's Office, Tokyo Metropolitan Government, Japan
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Koca E, Sam B, Arican N, Toklu A. Evaluation of fatal diving accidents in Turkey. Undersea Hyperb Med 2019; 45:633-638. [PMID: 31166684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
In any kind of diving there is a risk of accidents, as the move from the topside environment to underwater can affect a diver’s physiological and psychological condition. It is important to investigate dive accidents to clarify the causative factors and determine preventive measures. In this study, autopsy files of fatal dive accident cases were reviewed to evaluate demographic data, type of diving, purpose of dive, seasonal distribution, autopsy findings, and causes of death. We reviewed 56 fatal dive accident files from autopsy units in cities where dive activities are concentrated and from the archive of the Turkish Underwater Federation. Four cases were excluded from the study since we were unable to obtain autopsy reports. Of 52 cases there were 20 scuba divers, two surface-supplied divers and 30 breath-hold divers. The majority of cases involved males (94%). The average age of 50 cases was 38.6; age estimation for two cases could not be determined due to advanced putrefaction. Of these fatal dive accidents 75% took place over a period of six months between May and October. Drowning was recorded as the primary cause of death in these cases. X-ray imaging was used in four (8%) cases. A special autopsy technique was used for nine (17%) cases, to detect possible pulmonary barotrauma and arterial gas embolism. The forensic specialist who is planning to conduct the autopsy for a dive fatality should have knowledge and experience about dive physics and physiology as well as physiopathology of dysbaric injuries.
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Affiliation(s)
- Eylem Koca
- Department of Underwater and Hyperbaric Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Bulent Sam
- Council of Forensic Medicine, Istanbul, Turkey
| | - Nadir Arican
- Department of Forensic Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Akin Toklu
- Department of Underwater and Hyperbaric Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Abstract
A retrospective review was undertaken of 287 unnatural deaths undergoing medicolegal investigation over a 10-year period from January 2008 to December 2017 in Rio Grande, Tierra del Fuego, Argentina. There were 219 males and 68 females, age range 7 months to 88 years (average 38.4 years). The 135 accidental deaths (47%) were due mainly to vehicle crashes ( N = 62) and carbon monoxide toxicity from fires ( N = 31). The 115 cases of suicides (40.1%) were predominantly due to hanging ( N = 75) and gunshot wounds ( N = 20). The 37 cases of homicide (12.9%) were mainly due to stabbing/sharp force injury ( N = 20) and blunt force trauma ( N = 9). Carbon monoxide toxicity from faulty heating accounted for a substantial percentage (8.1%) of the accidental deaths. Firearm homicides and suicides related to drug toxicity and carbon monoxide inhalation were relatively uncommon medicolegal cases in this centre.
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Affiliation(s)
| | - Roger W Byard
- Forensic Science SA and School of Medicine, The University of Adelaide, Australia
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Shao B, Hu Z, Liu D. Using Improved Principal Component Analysis to Explore Construction Accident Situations from the Multi-Dimensional Perspective: A Chinese Study. Int J Environ Res Public Health 2019; 16:ijerph16183476. [PMID: 31540516 PMCID: PMC6766061 DOI: 10.3390/ijerph16183476] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Revised: 09/15/2019] [Accepted: 09/16/2019] [Indexed: 11/16/2022]
Abstract
The improvement of the macro-level accident situation in the Chinese construction industry is currently an urgent task for the government due to the high accident rate. This study intends to use improved principal component analysis to explore the accident situations in the Chinese construction industry from a multi-dimensional perspective, aiming at providing targeted direction on the improvement of the accident situation for the government. Six composite indicators that can quantify the accident situation are firstly selected based on a wide review of the literature and interviews with safety experts, with the original data collected from China institutions. The classical principal component analysis is then improved to examine the correlations between indicators, and further to evaluate accident situations in China provinces. Finally, the features of accident situations are explored and analyzed from a multi-dimensional perspective. The findings show that the improved principal component analysis can retain more dispersion degree information of the original data. Meanwhile, three principal components including the accident frequency, trend, and severity were extracted to quantify the accident situation, and a hierarchical indicator system for the comprehensive evaluation of the accident situation was constructed to deeper understand multi-dimensional characteristics of China’s accident situations. Furthermore, there exist great regional differences of accident situations in Chinese provinces. From the overall perspective, the accident situation shows a declining trend from the western backward region to the highly developed eastern coastal region. This study provides a multi-dimensional perspective for the government to formulate safety regulations and improve the accident situation.
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Affiliation(s)
- Bo Shao
- State Key Laboratory of Water Resources and Hydropower Engineering Science, Wuhan University, Wuhan 430072, China.
| | - Zhigen Hu
- State Key Laboratory of Water Resources and Hydropower Engineering Science, Wuhan University, Wuhan 430072, China.
| | - Dawei Liu
- State Key Laboratory of Water Resources and Hydropower Engineering Science, Wuhan University, Wuhan 430072, China.
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Abstract
OBJECTIVES To study the association between accidental opioid overdose and neurological, respiratory, cardiac and other serious adverse events and whether risk of these adverse events was elevated during hospital readmissions compared with initial admissions. DESIGN Retrospective cohort study. SETTING Population-based study using linked administrative data in British Columbia, Canada. PARTICIPANTS The primary analysis included 2433 patients with 2554 admissions for accidental opioid overdose between 2006 and 2015, including 121 readmissions within 1 year of initial admission. The secondary analysis included 538 patients discharged following a total of 552 accidental opioid overdose hospitalizations and 11 040 matched controls from a cohort of patients with ≥180 days of prescription opioid use. OUTCOME MEASURES The primary outcome was encephalopathy; secondary outcomes were adult respiratory distress syndrome, respiratory failure, pulmonary haemorrhage, aspiration pneumonia, cardiac arrest, ventricular arrhythmia, heart failure, rhabdomyolysis, paraplegia or tetraplegia, acute renal failure, death, a composite outcome of encephalopathy or any secondary outcome and total serious adverse events (all-cause hospitalisation or death). We analysed these outcomes using generalised linear models with a logistic link function. RESULTS 3% of accidental opioid overdose admissions included encephalopathy and 25% included one or more adverse events (composite outcome). We found no evidence of increased risk of encephalopathy (OR 0.57; 95% CI 0.13 to 2.49) or other outcomes during readmissions versus initial admissions. In the secondary analysis, <5 patients in each cohort experienced encephalopathy. Risk of the composite outcome (OR 2.15; 95% CI 1.48 to 3.12) and all-cause mortality (OR 2.13; 95% CI 1.18 to 3.86) were higher for patients in the year following overdose relative to controls. CONCLUSIONS We found no evidence that risk of encephalopathy or other adverse events was higher in readmissions compared with initial admissions for accidental opioid overdose. Risk of serious morbidity and mortality may be elevated in the year following an accidental opioid overdose.
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Affiliation(s)
- Richard L Morrow
- Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Ken Bassett
- Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada
| | - Malcolm Maclure
- Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Colin R Dormuth
- Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada
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Rønning TH, Grov EK, Wisborg T. Fatalities and personal injuries from the use of ATVs and snowmobiles in Northern Norway in 2013-14. Tidsskr Nor Laegeforen 2019; 139:18-0966. [PMID: 30969063 DOI: 10.4045/tidsskr.18.0966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND Previous studies have shown a high occurrence of injuries and deaths related to the use of snowmobiles and other off-road vehicles in Northern Norway. No public statistics are available to permit monitoring of these findings over time. The objective of our study was to provide new figures for the prevalence of injuries and deaths from the use of snowmobiles and other off-road vehicles, and assess the consistency between different sources of data. MATERIAL AND METHOD Information on registered deaths and personal injuries requiring hospitalisation in Northern Norway in the period 1 January 2013-31 December 2014 was collected from the police and hospitals. We also searched through open online sources. RESULTS We found 7 deaths and 87 personal injuries requiring hospitalisation: 13 incidents with ATVs and 81 involving snowmobiles. Median age was 31.5 years, and 41 (44 %) victims were below 30 years of age. All the fatalities and 66 (76 %) of those injured were men. Altogether 42 (45 %) of the incidents had occurred in Finnmark county. Of the seven fatalities, the police found six in their records and the hospitals found two. In searching through open online sources we found one further ATV-related and three snowmobile-related fatalities in the same region and period. INTERPRETATION No reliable records of fatalities and personal injuries resulting from the use of snowmobiles and ATVs are available. The findings of this study may serve as a reference point for preventive efforts by the police and health services and for purposes of further study.
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Yao M, Wu G, Zhao Z, Luo M, Zhang J. Unintentional injury mortality among children under age five in urban and rural areas in the Sichuan province of west China, 2009-2017. Sci Rep 2019; 9:2963. [PMID: 30814522 PMCID: PMC6393442 DOI: 10.1038/s41598-019-38936-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 01/15/2019] [Indexed: 11/08/2022] Open
Abstract
This study analysed trends in the unintentional injuries specific mortality rates among children under age five (UI-specific U5MRs) in urban and rural areas in the Sichuan province of western China. Data were obtained from the National Health Statistics Survey System. The Cochran-Armitage trend test was used to analyse the trends in UI-specific U5MRs and the proportion of unintentional injury deaths to total deaths. The Poisson regression model was used to compare the UI-specific U5MRs between rural and urban areas. The overall UI-specific U5MRs decreased from 3.8 to 1.7 per 1,000 live births from 2009 to 2017, with an average annual decline in the rates of 8.78% and 10.05% in urban and rural areas, respectively. The UI risk of death in rural areas was approximately 1.95 times that in urban areas (95% CI: 1.73-2.18; p < 0.01). A total of 49.9% of all the children in the study did not receive any treatment before death caused by UI. The UI-specific U5MRs significantly declined in Sichuan province from 2009 to 2017, but large disparities in UI-specific U5MRs in urban and rural areas still exist. Reducing the U5MRs due to UI should be a major public health concern in western China.
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Affiliation(s)
- Minghong Yao
- Department of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Gonghua Wu
- Department of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Ziling Zhao
- Sichuan Provincial Maternal and Child Health Hospital, Chengdu, Sichuan, People's Republic of China
| | - Min Luo
- Sichuan Provincial Maternal and Child Health Hospital, Chengdu, Sichuan, People's Republic of China
| | - Juying Zhang
- Department of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China.
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Karakasi MV, Tologkos S, Papadatou V, Raikos N, Lambropoulou M, Pavlidis P. Conium maculatum intoxication: Literature review and case report on hemlock poisoning. Forensic Sci Rev 2019; 31:23-36. [PMID: 30594904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The aim of this paper is to highlight the symptomatology in three Conium maculatum intoxication incidents, one of which was fatal. A number of studies were reviewed in order to update and summarize the relevant literature on the incidence, sociodemographic variables, method of poisoning, pathophysiology, diagnosis, variables associated with survival and fatality, management, and treatment of C. maculatum intoxication as well as the biosynthesis and biological effects of poison hemlock alkaloids. Results show that hemlock poisoning is relatively rare, although incidence varies in different regions, despite its worldwide distribution. Hemlock poisoning is more common in European and especially Mediterranean countries. The majority of the patients are adult males over 38 years of age. The clinical course of hemlock poisoning includes neurotoxicosis, tremor, vomiting, muscle paralysis, respiratory paralysis/failure, rhabdomyolysis, and acute renal failure. The therapeutic management focuses on absorption reduction, close observation for complications, and supportive therapy (especially for respiration). Acute occurrence is severe and life-threatening, but the survival rate is high if treatment is provided promptly. Recovery is rapid, generally taking only a few days.
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Affiliation(s)
- M V Karakasi
- Laboratory of Forensic Sciences, School of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
- Emergency Department, General Hospital of Didymoteicho, Didymoteicho, Greece
- Adult Psychiatry, Psychiatric Department, G. Papanikolaou General Hospital of Thessaloniki, Thessaloniki, Greece
| | - S Tologkos
- Laboratory of Histology and Embryology, School of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - V Papadatou
- Laboratory of Histology and Embryology, School of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - N Raikos
- Laboratory of Forensic Medicine and Toxicology, Faculty of Medicine, Aristotle University, Thessaloniki, Greece
| | - M Lambropoulou
- Laboratory of Histology and Embryology, School of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - P Pavlidis
- Laboratory of Forensic Sciences, School of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
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Monasterio E, McKean A, Sinhalage V, Frampton C, Mulder R. Sudden death in patients with serious mental illness. N Z Med J 2018; 131:70-79. [PMID: 30543613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
AIM Sudden death is used to define a death under suspicious circumstances, where there is no clear indication of existing medical illness (natural cause) that accounts for the death or clear indication for the cause of death. This includes all deaths from suicide, unintentional poisoning, drowning, falls and violence. Sudden death contributes to the increased mortality in people with serious mental illness (premature mortality) but is far less frequently studied and understood. This study analyses data of all sudden deaths of patients who had been under the care of the Canterbury District Health Board's Specialist Mental Health Service, New Zealand's second-largest population region. The study identifies key sociodemographic, diagnostic, legal and causative factors in the study population. This study aims to identify targeted interventions to mitigate premature mortality in this population. METHOD Data was obtained from the clinical files and the coroner's findings for all sudden death patients with established contact with Specialist Mental Health Services in the Canterbury region of New Zealand, between 2005 and 2009. RESULTS A total of 313 patients were identified. The median age at the time of death was 42 years (IQ Range 32.5-53 years). Of these, 65% (n=203) were male. Seventy-six percent (n=239) were of European descent and 9% Māori (n=29); 68% (n=280) were under care at the time of their death and 15% (n=32) were under the Mental Health Act. The sudden death rate was 0.36% for those under voluntary care and 0.7% for those under compulsory care. The most common primary diagnoses were alcohol or other drug abuse (29%); depression (25%); psychotic disorders (18%); BPAD (9%) and personality disorder (5%). The most common cause of death was suicide (51.8%) followed by motor vehicle crashes and falls, (23.3%) medical causes (17.6%) and homicide (1.3%). Of those that died by suicide, 75% were male. Hanging was the most common method (48%) followed by carbon monoxide poisoning (9.3%); medication overdose (5.8%) and falls from a height (3.5%). CONCLUSIONS The most common cause of sudden death was suicide, which was overwhelmingly the leading cause of sudden death in patients discharged or lost to follow up. The most potent predisposing factor appeared to be drug and alcohol problems. Mental health services should therefore advocate for comprehensive and evidence-based alcohol and drug policies, including access and availability to treatment programmes.
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Affiliation(s)
- Erik Monasterio
- Consultant in Forensic Psychiatry and Senior Clinical Lecturer, University of Otago, Christchurch, Hillmorton Hospital, Christchurch
| | - Andrew McKean
- Senior Pharmacist, Hillmorton Hospital, Christchurch
| | | | | | - Roger Mulder
- Professor, Department of Psychological Medicine, University of Otago, Christchurch
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Abstract
A study was undertaken to investigate the range and nature of deaths that may result from explosions in a civilian population that has not been exposed to terrorist attacks or significant military activities. A search was conducted of autopsy files at Forensic Science SA, Adelaide, Australia, from July 2000 to June 2017 for all cases where death had been attributed to an explosion. Twenty cases were identified, consisting of 10 accidents, five suicides, two homicides, one murder-suicide with two decedents and one case where the manner of death was undetermined. Explosives were involved in nine deaths, petrol in seven and propane/butane/natural gas in a further four. Deaths caused by explosions were a rare event, with most cases being caused by accidents in a domestic or industrial environment. Although suicides formed the next most-common group, it is possible that explosions caused by petrol in cases of self-immolation were not intended.
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Affiliation(s)
- Roger W Byard
- Forensic Science SA, Discipline of Anatomy and Pathology, The University of Adelaide, Australia
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Ballesteros MF, Williams DD, Mack KA, Simon TR, Sleet DA. The Epidemiology of Unintentional and Violence-Related Injury Morbidity and Mortality among Children and Adolescents in the United States. Int J Environ Res Public Health 2018; 15:ijerph15040616. [PMID: 29597289 PMCID: PMC5923658 DOI: 10.3390/ijerph15040616] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 03/20/2018] [Accepted: 03/21/2018] [Indexed: 11/16/2022]
Abstract
Injuries and violence among young people have a substantial emotional, physical, and economic toll on society. Understanding the epidemiology of this public health problem can guide prevention efforts, help identify and reduce risk factors, and promote protective factors. We examined fatal and nonfatal unintentional injuries, injuries intentionally inflicted by other (i.e., assaults and homicides) among children ages 0–19, and intentionally self-inflicted injuries (i.e., self-harm and suicides) among children ages 10–19. We accessed deaths (1999–2015) and visits to emergency departments (2001–2015) for these age groups through the Centers for Disease Control and Prevention’s (CDC) Web-based Injury Statistics Query and Reporting System (WISQARS), and examined trends and differences by age, sex, race/ethnicity, rural/urban status, and injury mechanism. Almost 13,000 children and adolescents age 0–19 years died in 2015 from injury and violence compared to over 17,000 in 1999. While the overall number of deaths has decreased over time, there were increases in death rates among certain age groups for some categories of unintentional injury and for suicides. The leading causes of injury varied by age group. Our results indicate that efforts to reduce injuries to children and adolescents should consider cause, intent, age, sex, race, and regional factors to assure that prevention resources are directed at those at greatest risk.
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Affiliation(s)
- Michael F Ballesteros
- Division of Analysis, Research and Practice Integration, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.
| | - Dionne D Williams
- Division of Analysis, Research and Practice Integration, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.
| | - Karin A Mack
- Division of Analysis, Research and Practice Integration, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.
| | - Thomas R Simon
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.
| | - David A Sleet
- The Bizzell Group, LLC, Lanham, MD 20706, USA.
- Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.
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J Prakash Raju KN, Jagdish S, Anandhi D, Kumar GK, Pandit VR. Pediatric Trauma - An Emerging Epidemic. Indian Pediatr 2018; 55:259. [PMID: 29629703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
We enrolled 911 children aged <12 years presenting to the trauma center of a tertiary-care hospital (over a period of 18 months) with history of injuries. Majority (582; 63.9%) of children had sustained injuries at home; 56 (6.1%) had severe injuries based on Pediatric Trauma Score. Of road traffic accidents victims (n=232), majority (40.5%) were two-wheeler pillion riders or pedestrians (31.9%). More Indian data are required and efforts are needed to prioritize injury prevention efforts in children.
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Affiliation(s)
| | - S Jagdish
- Department of Emergency Medicine and Trauma, JIPMER, Puducherry, India
| | - D Anandhi
- Department of Emergency Medicine and Trauma, JIPMER, Puducherry, India
| | | | - Vinay R Pandit
- Department of Emergency Medicine and Trauma, JIPMER, Puducherry, India
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Li SH, Cai BG, Liu J, Wang J. Collision risk analysis based train collision early warning strategy. Accid Anal Prev 2018; 112:94-104. [PMID: 29324266 DOI: 10.1016/j.aap.2017.11.039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Revised: 10/26/2015] [Accepted: 11/27/2017] [Indexed: 06/07/2023]
Abstract
A Train Collision Early Warning System (TCEWS) has been developed for collision avoidance. However, there are few studies regarding how to evaluate the collision risk and provide an early warning concerning a preceding train on the railway. In this paper, we have found that the time for collision avoidance is constrained by the timing of events, such as wireless communication latency, driver reaction, safety protection distance and deceleration rate. Considering these timing components, the time to avoid a collision is calculated accurately. To evaluate the potential collision severity when the following train approaches, the collision risk is defined based on the time to avoid a collision. The train collision early warning signal is divided into a four-tier color-coded system based on the collision risk, with red representing the most severe collision risk, followed by orange, yellow and blue. A field test of the train collision early warning strategy on the Hankou-Yichang Railway is analysed. It is demonstrated that the strategy has sufficient capability to indicate a potential collision and warn the following train.
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Affiliation(s)
- Si-Hui Li
- School of Electronic and Information Engineering, Beijing Jiaontong University, No.3 Shangyuancun, Haidian District, Beijing, PR China; Beijing Engineering Research Center of EMC and GNSS Technology for Rail Transportation, No 3 Shangyuancun, Haidian District, 100044, Beijing, PR China
| | - Bai-Gen Cai
- School of Electronic and Information Engineering, Beijing Jiaontong University, No.3 Shangyuancun, Haidian District, Beijing, PR China; Beijing Engineering Research Center of EMC and GNSS Technology for Rail Transportation, No 3 Shangyuancun, Haidian District, 100044, Beijing, PR China.
| | - Jiang Liu
- School of Electronic and Information Engineering, Beijing Jiaontong University, No.3 Shangyuancun, Haidian District, Beijing, PR China; Beijing Engineering Research Center of EMC and GNSS Technology for Rail Transportation, No 3 Shangyuancun, Haidian District, 100044, Beijing, PR China
| | - Jian Wang
- School of Electronic and Information Engineering, Beijing Jiaontong University, No.3 Shangyuancun, Haidian District, Beijing, PR China; Beijing Engineering Research Center of EMC and GNSS Technology for Rail Transportation, No 3 Shangyuancun, Haidian District, 100044, Beijing, PR China
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Abstract
A child dying of heat injury due to being left unattended in a motor vehicle is a needless tragedy. Each year in the United States an average of 38 children mostly younger than age 2 years die of vehicular hyperthermia, frequently the result of a parental lapse of attention and not intentional neglect. Serious illness results quickly from exposure to rising heat within the passenger compartment, even on days when the temperature is fairly moderate. Prevention is paramount in addressing this problem and can best be accomplished by a combination of technological means, such as passive warning systems, laws that make leaving a child in a car alone illegal, and public education campaigns. [Pediatr Ann. 2018;47(3):e88-e90.].
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Abstract
A retrospective analysis of 208 flying squad attendances was performed to assess the effect of pre-hospital care by the team on outcome in emergency medical conditions, and in the trauma victim. Sixty-two (26%) of these cases were medical, but only 24 (11.5%) required immediate cardiopulmonary resuscitation. Only one out of the four successful resuscitations finally left hospital alive. In trauma, there was no significant enhancement of survival due to the presence of the team by comparing the expected against observed mortality and the injury severity score for age-matched groups. The value of flying squads as a training aid, perception of the local community and relationships with other emergency services are discussed. Alternative solutions to improving pre-hospital care include advanced trained ambulance and bystander resuscitation schemes. Although difficult to quantify the authors feel that flying squads are of benefit.
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Affiliation(s)
- A R Cope
- Accident Emergency Department, Nottingham University Hospital
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Zonfrillo MR, Ramsay ML, Fennell JE, Andreasen A. Unintentional non-traffic injury and fatal events: Threats to children in and around vehicles. Traffic Inj Prev 2018; 19:184-188. [PMID: 28933560 DOI: 10.1080/15389588.2017.1369053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2016] [Accepted: 08/13/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE There have been substantial reductions in motor vehicle crash-related child fatalities due to advances in legislation, public safety campaigns, and engineering. Less is known about non-traffic injuries and fatalities to children in and around motor vehicles. The objective of this study was to describe the frequency of various non-traffic incidents, injuries, and fatalities to children using a unique surveillance system and database. METHODS Instances of non-traffic injuries and fatalities in the United States to children 0-14 years were tracked from January 1990 to December 2014 using a compilation of sources including media reports, individual accounts from families of affected children, medical examiner reports, police reports, child death review teams, coroner reports, medical professionals, legal professionals, and other various modes of publication. RESULTS Over the 25-year period, there were at least 11,759 events resulting in 3,396 deaths. The median age of the affected child was 3.7 years. The incident types included 3,115 children unattended in hot vehicles resulting in 729 deaths, 2,251 backovers resulting in 1,232 deaths, 1,439 frontovers resulting in 692 deaths, 777 vehicles knocked into motion resulting in 227 deaths, 415 underage drivers resulting in 203 deaths, 172 power window incidents resulting in 61 deaths, 134 falls resulting in 54 deaths, 79 fires resulting in 41 deaths, and 3,377 other incidents resulting in 157 deaths. CONCLUSIONS Non-traffic injuries and fatalities present an important threat to the safety and lives of very young children. Future efforts should consider complementary surveillance mechanisms to systematically and comprehensively capture all non-traffic incidents. Continued education, engineering modifications, advocacy, and legislation can help continue to prevent these incidents and must be incorporated in overall child vehicle safety initiatives.
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Affiliation(s)
- Mark R Zonfrillo
- a Injury Prevention Center , Rhode Island Hospital and Hasbro Children's Hospital , Providence , Rhode Island
- b Department of Emergency Medicine , Warren Alpert Medical School of Brown University , Providence , Rhode Island
| | - Mackenzie L Ramsay
- a Injury Prevention Center , Rhode Island Hospital and Hasbro Children's Hospital , Providence , Rhode Island
- c Behavioral Neuroscience , Northeastern University , Boston , Massachusetts
| | - Janette E Fennell
- d KidsAndCars.org , Philadelphia , Pennsylvania
- e KidsAndCars.org , Olathe , Kansas
| | - Amber Andreasen
- d KidsAndCars.org , Philadelphia , Pennsylvania
- e KidsAndCars.org , Olathe , Kansas
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Testerman GM, Prior DC, Wells TD, Rollins SE, Oesch SL. Helmets Matter: Kentucky All-Terrain Vehicle Crashes Seen at a Tennessee Trauma Center. Am Surg 2018; 84:289-293. [PMID: 29580360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
All-terrain vehicle (ATV) safety laws, including helmet use, vary by state and are sporadically enforced. Kentucky state laws require safety helmets only for younger riders. We hypothesized that ATV riders injured in Kentucky and seen at a Tennessee trauma center would more likely be unhelmeted, have more severe head injuries, and have higher mortality rates than those injured in Virginia or Tennessee. A Trauma Registry review of 750 injured ATV riders from June 1, 2005, through June 1, 2015 examined state location of accident, helmet use, markers of injury severity, and outcomes. Multiple logistic regression analysis examined predictors of severe head injuries and death with P < 0.05 significant. Unhelmeted ATV rider status predicted more severe head injuries (relative risk 23.5, P < 0.001) and death (relative risk 4.6, P < 0.001). ATV riders injured in the state of Kentucky were twice as numerous. In addition, they were more likely than ATV riders injured in Tennessee or Virginia to be unhelmeted, to have severe head injuries, and to sustain fatal injuries (all P < 0.001). This single trauma center study lends support for maintaining and enforcing current universal helmet laws for ATV riders of all ages in states where they are in effect and highlights the need to upgrade helmet laws that apply only to some riders.
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Doolin EG, Wall JF, Jeffery JR, Terrizzi VF. Recent Developments in Health Insurance, Life Insurance, and Disability Insurance Law. Tort Trial Insur Pract Law J 2018; 53:429-475. [PMID: 30024140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Ushakov IB, Voronkov YI, Bukhtiyarov IV, Tikhonova GI, Gorchakova TY, Bryleva MS. A Cohort Mortality Study Among Soviet and Russian Cosmonauts, 1961-2014. Aerosp Med Hum Perform 2017; 88:1060-1065. [PMID: 29157333 DOI: 10.3357/amhp.4701.2017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Over 500 people from different countries have been to space since the first manned spaceflight in 1961. Factors of space and spaceflights might cause functional and somatic disorders, leading to increased mortality. Our research goal was to assess cause-specific risk of death among Soviet and Russian cosmonauts who had at least one spaceflight. METHODS The epidemiological cohort study included 115 male cosmonauts. The observation period was 54 yr (January 1, 1961-December 31, 2014) and 2707 person-years of follow-up were obtained. By the end of the period, 84 cosmonauts were still alive and 31 were deceased. The reference groups were the male population of Russia and of the Moscow Region, where Zvezdny City (Star City) is located. Mortality risk was assessed by standardized mortality ratio (SMR) with 95% confidence intervals (95% CI). RESULTS Death risk in the cohort was significantly lower than that in both reference groups: for all causes (А00-Y98; SMR = 40), for diseases of the circulatory system (I00-I99; SMR = 37 and 35 compared to Russia and the Moscow Region, respectively), and for other causes, i.e., all causes except circulatory diseases, cancer, and accidents, (SMR = 8). Death risk for accidents (V01-Y98) in the cohort was 1.8-1.9 times lower than that in both reference groups: SMR = 52 (95% CI 19-139) and 56 (21-151), but was not statistically significant. SMR for cancer (C00-C97) was also below 100 (71 and 66), but insignificant. DISCUSSION Our findings mainly characterize mortality among the first cosmonauts who have flown to space from 1961 through the 1970s, which indicates the necessity of continuing research.Ushakov IB, Voronkov YI, Bukhtiyarov IV, Tikhonova GI, Gorchakova TYu, Bryleva MS. A cohort mortality study among Soviet and Russian cosmonauts, 1961-2014. Aerosp Med Hum Perform. 2017; 88(12):1060-1065.
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Cao H, Wang J, Li Y, Li D, Guo J, Hu Y, Meng K, He D, Liu B, Liu Z, Qi H, Zhang L. Trend analysis of mortality rates and causes of death in children under 5 years old in Beijing, China from 1992 to 2015 and forecast of mortality into the future: an entire population-based epidemiological study. BMJ Open 2017; 7:e015941. [PMID: 28928178 PMCID: PMC5623503 DOI: 10.1136/bmjopen-2017-015941] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To analyse trends in mortality and causes of death among children aged under 5 years in Beijing, China between 1992 and 2015 and to forecast under-5 mortality rates (U5MRs) for the period 2016-2020. METHODS An entire population-based epidemiological study was conducted. Data collection was based on the Child Death Reporting Card of the Beijing Under-5 Mortality Rate Surveillance Network. Trends in mortality and leading causes of death were analysed using the χ2 test and SPSS 19.0 software. An autoregressive integrated moving average (ARIMA) model was fitted to forecast U5MRs between 2016 and 2020 using the EViews 8.0 software. RESULTS Mortality in neonates, infants and children aged under 5 years decreased by 84.06%, 80.04% and 80.17% from 1992 to 2015, respectively. However, the U5MR increased by 7.20% from 2013 to 2015. Birth asphyxia, congenital heart disease, preterm/low birth weight and other congenital abnormalities comprised the top five causes of death. The greatest, most rapid reduction was that of pneumonia by 92.26%, with an annual average rate of reduction of 10.53%. The distribution of causes of death differed among children of different ages. Accidental asphyxia and sepsis were among the top five causes of death in children aged 28 days to 1 year and accident was among the top five causes in children aged 1-4 years. The U5MRs in Beijing are projected to be 2.88‰, 2.87‰, 2.90‰, 2.97‰ and 3.09‰ for the period 2016-2020, based on the predictive model. CONCLUSION Beijing has made considerable progress in reducing U5MRs from 1992 to 2015. However, U5MRs could show a slight upward trend from 2016 to 2020. Future considerations for child healthcare include the management of birth asphyxia, congenital heart disease, preterm/low birth weight and other congenital abnormalities. Specific preventative measures should be implemented for children of various age groups.
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Affiliation(s)
- Han Cao
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Jing Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Department of Children’s Health Care, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Yichen Li
- Department of Children’s Health Care, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Dongyang Li
- Department of Children’s Health Care, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Jin Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Yifei Hu
- Department of Child, Adolescent Health and Maternal Health, School of Public Health, Capital Medical University, Beijing, China
| | - Kai Meng
- Department of Hospital Management, School of Health Administration and Education, Capital Medical University, Beijing, China
| | - Dian He
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Bin Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Zheng Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Han Qi
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Ling Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Clinical Epidemiology, Beijing, China
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González-Santiago O, Morales-San Claudio PC, Cantú-Cárdenas LG, Favela-Hernández JMJ. Unintentional and self-poisoning mortalities in Mexico, 2000-2012. PLoS One 2017; 12:e0181708. [PMID: 28727851 PMCID: PMC5519209 DOI: 10.1371/journal.pone.0181708] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 07/05/2017] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Poisoning remains a major worldwide public health problem. Mortality varies by country, region and ethnicity. The objective of this study is to analyze recent trends in poisoning mortality in the Mexican population. METHODS Data regarding mortality induced by poisoning was obtained from a publicly available national database maintained by the National Institute of Statistics and Geography. RESULTS During the period from 2000 to 2012, average mortality rates for unintentional and self-poisoning were 1.09 and 0.41 per 100000 population, respectively. The highest mortality rate for unintentional poisoning was in older individuals of both genders while the highest mortality for self-poisoning was in older men and young women. Additional studies are needed in Mexico, especially those that analyze risk factors in older individuals and young women.
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Affiliation(s)
- Omar González-Santiago
- Postgraduate Division, School of Chemical Sciences, Universidad Autónoma de Nuevo León, San Nicolás de los Garza, Nuevo León, México
| | - Pilar C. Morales-San Claudio
- Postgraduate Division, School of Chemical Sciences, Universidad Autónoma de Nuevo León, San Nicolás de los Garza, Nuevo León, México
| | - Lucia G. Cantú-Cárdenas
- Postgraduate Division, School of Chemical Sciences, Universidad Autónoma de Nuevo León, San Nicolás de los Garza, Nuevo León, México
| | - Juan M. J. Favela-Hernández
- Postgraduate Division, School of Chemical Sciences, Universidad Autónoma de Nuevo León, San Nicolás de los Garza, Nuevo León, México
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Kalesan B, Adhikarla C, Pressley JC, Fagan JA, Xuan Z, Siegel MB, Galea S. The Hidden Epidemic of Firearm Injury: Increasing Firearm Injury Rates During 2001-2013. Am J Epidemiol 2017; 185:546-553. [PMID: 28338922 DOI: 10.1093/aje/kww147] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2015] [Accepted: 03/11/2016] [Indexed: 11/12/2022] Open
Abstract
Investigating firearm injury trends over the past decade, we examined temporal trends overall and according to race/ethnicity and intent in fatal and nonfatal firearm injuries (FFIs and NFIs) in United States during 2001-2013. Counts of FFIs and estimated counts of NFIs were obtained from the Centers for Disease Control and Prevention's Web-based Injury Statistics Query and Reporting System. Poisson regression was used to analyze overall and subgroup temporal trends and to estimate annual change per 100,000 persons (change). Total firearm injuries (n = 1,328,109) increased annually by 0.36 (Ptrend < 0.0001). FFIs remained constant (change = 0.02; Ptrend = 0.22) while NFIs increased (change = 0.35; Ptrend < 0.0001). Homicide FFIs declined (change = -0.05; Ptrend < 0.0001) while homicide NFIs increased (change = 0.43; Ptrend < 0.0001). Suicide FFIs increased (change = 0.07; Ptrend < 0.0001) while unintentional FFIs and NFIs declined (changes = -0.01 and -0.09, respectively; Ptrend < 0.0001 and 0.005). Among whites, FFIs (change = 0.15; Ptrend < 0.0001) and NFIs (change = 0.13; Ptrend < 0.0001) increased; among blacks, FFIs declined (change = -0.20; Ptrend < 0.0001). Among Hispanics, FFIs declined (change = -0.28; Ptrend < 0.0001) while NFIs increased (change = 0.55; Ptrend = 0.014). The endemic firearm-related injury rates during the first decade of the 21st century mask a shift from firearm deaths towards a rapid rise in nonfatal injuries.
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Van Tilburg C, Grissom CK, Zafren K, McIntosh S, Radwin MI, Paal P, Haegeli P, Smith WWR, Wheeler AR, Weber D, Tremper B, Brugger H. Wilderness Medical Society Practice Guidelines for Prevention and Management of Avalanche and Nonavalanche Snow Burial Accidents. Wilderness Environ Med 2017; 28:23-42. [PMID: 28257714 DOI: 10.1016/j.wem.2016.10.004] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 09/14/2016] [Accepted: 10/12/2016] [Indexed: 10/20/2022]
Abstract
To provide guidance to clinicians and avalanche professionals about best practices, the Wilderness Medical Society convened an expert panel to develop evidence-based guidelines for the prevention, rescue, and medical management of avalanche and nonavalanche snow burial victims. Recommendations are graded on the basis of quality of supporting evidence according to the classification scheme of the American College of Chest Physicians.
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Affiliation(s)
- Christopher Van Tilburg
- Occupational, Travel, and Emergency Medicine Departments, Providence Hood River Memorial Hospital, Hood River, OR (Dr Van Tilburg); Mountain Rescue Association, San Diego, CA (Drs Van Tilburg, Zafren, Smith, and Wheeler).
| | - Colin K Grissom
- Division of Pulmonary and Critical Care Medicine, Intermountain Medical Center and the University of Utah, Salt Lake City, UT (Dr Grissom)
| | - Ken Zafren
- Mountain Rescue Association, San Diego, CA (Drs Van Tilburg, Zafren, Smith, and Wheeler); Department of Emergency Medicine, Stanford University School of Medicine, Stanford, CA (Dr Zafren); International Commission for Mountain Emergency Medicine (Drs Brugger, Paal, and Zafren)
| | - Scott McIntosh
- Division of Emergency Medicine, University of Utah, Salt Lake City, UT (Drs McIntosh and Wheeler)
| | - Martin I Radwin
- Iasis Healthcare Physician Group of Utah, Salt Lake City, UT (Dr Radwin)
| | - Peter Paal
- International Commission for Mountain Emergency Medicine (Drs Brugger, Paal, and Zafren); Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, Queen Mary University of London, London, United Kingdom (Dr Paal); Department of Anesthesiology and Critical Care Medicine, University Hospital, Innsbruck, Austria (Dr Paal)
| | - Pascal Haegeli
- School of Resource and Environmental Management, Simon Fraser University, Burnaby, BC (Dr Haegeli)
| | - William Will R Smith
- Mountain Rescue Association, San Diego, CA (Drs Van Tilburg, Zafren, Smith, and Wheeler); Department of Emergency Medicine, St. Johns Medical Center, Jackson, WY (Drs Smith and Wheeler); Clinical WWAMI Faculty, University of Washington School of Medicine, Seattle, WA (Dr Smith)
| | - Albert R Wheeler
- Mountain Rescue Association, San Diego, CA (Drs Van Tilburg, Zafren, Smith, and Wheeler); Division of Emergency Medicine, University of Utah, Salt Lake City, UT (Drs McIntosh and Wheeler); Department of Emergency Medicine, St. Johns Medical Center, Jackson, WY (Drs Smith and Wheeler)
| | - David Weber
- Denali National Park & Preserve, Talkeetna, AK (Mr Weber); Intermountain Life Flight, Salt Lake City, UT (Mr Weber)
| | - Bruce Tremper
- Utah Avalanche Center, Salt Lake City, UT (Mr Tremper)
| | - Hermann Brugger
- International Commission for Mountain Emergency Medicine (Drs Brugger, Paal, and Zafren); EURAC Institute of Mountain Emergency Medicine, Bolzano, Italy (Dr Brugger)
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Kee D, Jun GT, Waterson P, Haslam R. A systemic analysis of South Korea Sewol ferry accident - Striking a balance between learning and accountability. Appl Ergon 2017; 59:504-516. [PMID: 27526997 DOI: 10.1016/j.apergo.2016.07.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 03/22/2016] [Accepted: 07/25/2016] [Indexed: 06/06/2023]
Abstract
The South Korea Sewol ferry accident in April 2014 claimed the lives of over 300 passengers and led to criminal charges of 399 personnel concerned including imprisonment of 154 of them as of Oct 2014. Blame and punishment culture can be prevalent in a more hierarchical society like South Korea as shown in the aftermath of this disaster. This study aims to analyse the South Korea ferry accident using Rasmussen's risk management framework and the associated AcciMap technique and to propose recommendations drawn from an AcciMap-based focus group with systems safety experts. The data for the accident analysis were collected mainly from an interim investigation report by the Board of Audit and Inspection of Korea and major South Korean and foreign newspapers. The analysis showed that the accident was attributed to many contributing factors arising from front-line operators, management, regulators and government. It also showed how the multiple factors including economic, social and political pressures and individual workload contributed to the accident and how they affected each other. This AcciMap was presented to 27 safety researchers and experts at 'the legacy of Jens Rasmussen' symposium adjunct to ODAM2014. Their recommendations were captured through a focus group. The four main recommendations include forgive (no blame and punishment on individuals), analyse (socio-technical system-based), learn (from why things do not go wrong) and change (bottom-up safety culture and safety system management). The findings offer important insights into how this type of accident should be understood, analysed and the subsequent response.
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Affiliation(s)
- Dohyung Kee
- Department of Industrial Engineering and Management, Keimyung University, Daegu, South Korea
| | - Gyuchan Thomas Jun
- Human Factors and Complex Systems Group, Loughborough Design School, Loughborough University, Loughborough LE11 3TU, UK.
| | - Patrick Waterson
- Human Factors and Complex Systems Group, Loughborough Design School, Loughborough University, Loughborough LE11 3TU, UK
| | - Roger Haslam
- Human Factors and Complex Systems Group, Loughborough Design School, Loughborough University, Loughborough LE11 3TU, UK
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Xhemali B, Vyshka G, Sinamati A, Shaqiri E. Pattern of lethal trauma among swimmers colliding with a personal watercraft. Int Marit Health 2017; 68:187-189. [PMID: 29297568 DOI: 10.5603/imh.2017.0035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 11/29/2017] [Indexed: 02/05/2023] Open
Abstract
Personal watercrafts (otherwise known as Jet Skis or wave runners) possess powerful propelling engines that enable them to reach high velocities. In overcrowded sea shores, especially due to a diversity of human errors (inexperience, underage operator, alcohol-related errors and lack of training), these vessels might cause severe damage to the operator himself, to swimmers in the whereabouts but to the environment as well. We present three fatal victims that were struck and overrun by personal watercrafts used for recreational purposes. One of them had a deep skull trauma resulting from being hit by the hull of the vessel. The other two cases had an impressive and particular pattern of tissue trauma, with deep parallel cutting wounds due to the contact with the propeller helix. All cases were treated as accidental drowning, because even when rescue operations were immediate, the loss of conscience following the severe blunt trauma inside the water left few chances, if any, to survival.
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Affiliation(s)
| | - Gentian Vyshka
- Faculty of Medicine, University of Medicine in Tirana, Rr Dibres 371, 1001 Tirana, Albania.
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Séjourné C, Philbois O, Vercherin P, Patural H. [Circumstances of Trauma and Accidents in Children: A Thesaurus-based Survey]. Sante Publique 2016; 28:581-590. [PMID: 28155733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Introduction : Injuries and accidents are major causes of morbidity and mortality in children in France. Identification and description of the mechanisms of accidents are essential to develop adapted prevention methods. For this purpose, a specific thesaurus of ICD-10 codes relating to the circumstances of trauma and accidents in children was created in the French Loire department. The objective of this study was to evaluate the relevance and acceptability of the thesaurus in the pediatric emergency unit of Saint-Etienne university hospital.Material and Methods : This study was conducted in two phases. The first, longitudinal phase was conducted over three periods between May and October 2014 to compare codings by emergency room physicians before using the thesaurus with those defined on the basis of the thesaurus. The second phase retrospectively compared coding in July and August 2014 before introduction of the thesaurus with thesaurus-based coding in July and August 2015.Results : The first phase showed a loss of more than half of the information without the thesaurus. The circumstances of trauma can be described by an appropriate code in more than 90% of cases. The second phase showed a 13% increase in coding of the circumstances of trauma, which nevertheless remains insufficient.Discussion : The thesaurus facilitates coding and generally meets the coding physician’s expectations and should be used in large-scale epidemiological surveys.
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Abstract
BACKGROUND Historically, women have lower all-cause mortality than men. It is less understood that sex differences have been converging, particularly among certain subgroups and causes. This has implications for public health and health system planning. Our objective was to analyse contemporary sex differences over a 20-year period. METHODS We analysed data from a population-based death registry, the Ontario Registrar's General Death file, which includes all deaths recorded in Canada's most populous province, from 1992 to 2012 (N=1 710 080 deaths). We calculated absolute and relative mortality sex differences for all-cause and cause-specific mortality, age-adjusted and age-specific, including the following causes: circulatory, cancers, respiratory and injuries. We used negative-binomial regression of mortality on socioeconomic status with direct age adjustment for the overall population. RESULTS In the 20-year period, age-adjusted mortality dropped 39.2% and 29.8%, respectively, among men and women. The age-adjusted male-to-female mortality ratio dropped 41.4%, falling from 1.47 to 1.28. From 2000 onwards, all-cause mortality rates of high-income men were lower than those seen among low-income women. Relative mortality declines were greater among men than women for cancer, respiratory and injury-related deaths. The absolute decline in circulatory deaths was greater among men, although relative deciles were similar to women. The largest absolute mortality gains were seen among men over the age of 85 years. CONCLUSIONS The large decline in mortality sex ratios in a Canadian province with universal healthcare over two decades signals an important population shift. These narrowing trends varied according to cause of death and age. In addition, persistent social inequalities in mortality exist and differentially affect men and women. The observed change in sex ratios has implications for healthcare and social systems.
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Affiliation(s)
- Laura C Rosella
- Public Health Ontario, Toronto, Ontario, Canada
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Andrew Calzavara
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - John W Frank
- Public Health Research and Policy, Usher Institute of Population Health Sciences and Informatics, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
| | - Tiffany Fitzpatrick
- Ontario Strategy for Patient-Oriented Research (SPOR) SUPPORT Unit (OSSU), Toronto, Ontario, Canada
| | | | - David Henry
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Ontario Strategy for Patient-Oriented Research (SPOR) SUPPORT Unit (OSSU), Toronto, Ontario, Canada
- Institute of Health Management Policy and Evaluation, University of Toronto, Toronto, Ontario, Canada
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Laukkala T, Parkkola K, Henriksson M, Pirkola S, Kaikkonen N, Pukkala E, Jousilahti P. Total and cause-specific mortality of Finnish military personnel following service in international peacekeeping operations 1990-2010: a comprehensive register-based cohort study. BMJ Open 2016; 6:e012146. [PMID: 27799241 PMCID: PMC5093393 DOI: 10.1136/bmjopen-2016-012146] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 09/23/2016] [Accepted: 09/30/2016] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To estimate total and cause-specific mortality after international peacekeeping deployments among the Finnish military peacekeeping personnel in comparison to the general population of similar age and sex. DESIGN A register-based study of a cohort of military peacekeeping personnel in 1990-2010 followed for mortality until the end of 2013. Causes of death were obtained from the national Causes of Death Register. The standardised mortality ratio (SMR) for total and cause-specific mortality was calculated as the ratio of observed and expected number of deaths. SETTING Finland (peacekeeping operations in different countries in Africa, Asia and in an area of former Yugoslavia in Europe). PARTICIPANTS 14 584 men and 418 women who had participated in international military peacekeeping operations ending between 1990 and 2010. INTERVENTIONS Participation in military peacekeeping operations. MAIN OUTCOME Total and cause-specific mortality. RESULTS 209 men and 3 women died after their peacekeeping service. The SMR for all-cause mortality was 0.55 (95% CI 0.48 to 0.62). For the male peacekeeping personnel, the SMR for all diseases was 0.44 (95% CI 0.35 to 0.53) and for accidental and violent deaths 0.69 (95% CI 0.57 to 0.82). The SMR for suicides was 0.71 (95% CI 0.53 to 0.92). CONCLUSIONS Even though military peacekeeping personnel are working in unique and often stressful conditions, their mortality after their service is lower compared with the general population. Military peacekeeping personnel appear to be a selected population group with low general mortality and no excess risk of any cause of death after peacekeeping service.
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Affiliation(s)
- T Laukkala
- Centre for Military Medicine, Finnish Defence Forces, Helsinki, Finland
| | - K Parkkola
- School of Medicine, University of Tampere, Tampere, Finland
| | - M Henriksson
- National Supervisory Authority for Welfare and Health, Helsinki, Finland
- Centre for Military Medicine, Finnish Defence Forces, Helsinki, Finland
| | - S Pirkola
- School of Health Sciences, University of Tampere, and Tampere University Hospital, Tampere, Finland
| | - N Kaikkonen
- Centre for Military Medicine, Finnish Defence Forces, Helsinki, Finland
| | - E Pukkala
- School of Health Sciences, University of Tampere, Tampere Finland and the Finnish Cancer Registry, Helsinki, Finland
| | - P Jousilahti
- National Institute for Health and Welfare, Helsinki, Finland
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Tamosiunas A, Reklaitiene R, Radisauskas R, Jureniene K. Prognosis of risk factors and trends in mortality from external causes among middle-aged men in Lithuania. Scand J Public Health 2016; 33:190-6. [PMID: 16040459 DOI: 10.1080/14034940510005707] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Aims: The aims of this study were to investigate the risk of death and time trends from external causes, and to evaluate the significance of the effects of age, period and birth cohort on suicide mortality among middle-aged men during the period 1971—2000 in Lithuania. Methods: Random samples of men aged 45—59 years from the Kaunas Rotterdam Intervention Study (conducted in 1972—74) and Study of Multifactorial Prevention of CHD (conducted in 1977—80) were examined (n=6,480). The participants of the two surveys were observed until 1 January 2001. Over this time 2,841 men had died, 230 of these from external causes. The Cox proportional hazards model was used to evaluate the risk of death from external causes. Trends in mortality from external causes and average annual changes were based on logarithmic regression analysis. For assessment of the effects of age, period, and birth cohort the Poisson regression model was applied. Results: The risk of mortality from external causes among men was positively related to smoking habits and arterial hypertension and negatively related to education level and total serum cholesterol concentration but there was no association with consumption of alcohol. The risk of suicide mortality was associated with family status and occupation only. Trends in mortality from all external causes showed no significant changes during the period 1971—2000. After adjusting for age and cohort effects, the period effect was statistically significant. Conclusion: Prognosis of risk factors for mortality from external causes and period effect on suicide mortality rates will form important parts of future research agendas.
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Affiliation(s)
- Abdonas Tamosiunas
- Institute of Cardiology, Kaunas University of Medicine, Kaunas, Lithuania.
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Naznin F, Currie G, Logan D. Exploring the impacts of factors contributing to tram-involved serious injury crashes on Melbourne tram routes. Accid Anal Prev 2016; 94:238-244. [PMID: 27352035 DOI: 10.1016/j.aap.2016.06.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 06/10/2016] [Accepted: 06/14/2016] [Indexed: 06/06/2023]
Abstract
Previous research is limited regarding factors influencing tram-involved serious injury crashes. The aim of this study is to identify key vehicle, road, environment and driver related factors associated with tram-involved serious injury crashes. Using a binary logistic regression modelling approach, the following factors were identified to be significant in influencing tram-involved fatal crashes in Melbourne: tram floor height, tram age, season, traffic volume, tram lane priority and tram travel speed. Low floor trams, older trams, tram priority lanes and higher tram travelling speeds are more likely to increase tram-involved fatal crashes. Higher traffic volume decreases the likelihood of serious crashes. Fatal crashes are more likely to occur during spring and summer. Findings from this study may offer ideas for future research in the area of tram safety and help to develop countermeasures to prevent specific fatality types from occurring.
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Affiliation(s)
- Farhana Naznin
- Public Transport Research Group, Institute of Transport Studies, Department of Civil Engineering, Building 60, Monash University, Clayton, Victoria 3800, Australia.
| | - Graham Currie
- Public Transport Research Group, Institute of Transport Studies, Department of Civil Engineering, Building 60, Monash University, Clayton, Victoria 3800, Australia.
| | - David Logan
- Monash University Accident Research Centre, Building 70, Monash University, Clayton, Victoria 3800, Australia.
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Abstract
The purpose was to assess whether adoption of potentially dangerous skydiving gear and skydiving practices has led to an increase in fatalities. Beginning in the early 1990s, civilian skydivers began to utilize high performance parachutes that fly much faster and are much more responsive than older style parachutes. Also, skydivers began to fly these parachutes in a more aggressive manner. An analysis of data from the 507 skydiving fatalities in the USA between 1986 and 2001 indicated that this shift toward high performance parachutes and aggressive flying techniques was temporally associated with an increase in parachute-landing deaths. During the same time period, the total number of fatalities remained fairly stable.
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Affiliation(s)
- Christian L Hart
- Department of Psychology, East Central University, Ada, OK 74820, USA.
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Abstract
This study reviews firearm-related deaths (homicidal, suicidal and accidental) from 1994 to 2003 in the Western Sidney area, Australia, serviced by the Westmead Department of Forensic Medicine, in order to document the features of the cases and to assess the effect of the introduction of the NSW Firearms Act in 1996. There were 211 fatalities involving firearms (1.8% of all of the Coroner's cases for the period); firearm deaths were classified as homicide (75), suicide (134) or accidental (2). There was a clear peak of homicide deaths by firearm in the 20-29 age group, whereas the suicide peak was broad, spanning the ages 20-69 years. More suicides occurred at home than homicides and a higher proportion of suicides were by rifle than homicides, which favoured hand guns. Entry wounds in suicides mostly involved the head, with the chest being the commonest entry site in homicides. The only statistically significant trend was for an increase in the number of firearm-related suicides in males, comparing the number of deaths pre- and post-firearm law introduction. The study includes reports of two suicides by unusual weapons: a home-made pipe gun and a spear gun.
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Affiliation(s)
- A Jeffery
- Forensic Pathology Unit, University of Leicester, Leicester, UK
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Holakouie-Naieni K, Koehler SA, Karimi R, Mardani F, Karimi J. Unnatural Deaths Among Children and Adolescents in Isfahan Province, Iran: A Forensic Epidemiology Study of Postmortem Data. J Forensic Nurs 2016; 12:90-94. [PMID: 27195930 DOI: 10.1097/jfn.0000000000000114] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
INTRODUCTION The issue of child and adolescent injury and violence is often absent from discussions and is largely invisible in public health policies. The purpose of this study was to describe the frequency and pattern of unnatural deaths during childhood and adolescence in Isfahan province in Iran. MATERIALS AND METHODS This retrospective, descriptive study involved unnatural deaths among individuals under the age of 20 years who died from unnatural causes as determined by a forensic autopsy at the Legal Medicine Center of Isfahan. During the study period, 8,010 unnatural deaths occurred, 1,222 of which were individuals under 20 years old. RESULTS All 1,222 of these unnatural deaths were identified through autopsy. Among the 1,222 cases, 895 (73.2%) were male, and 327 were female (26.8%). Accidental deaths were found to be the most frequent manner of death comprising 1,029 (83.96%) cases, followed by suicide (120, 9.82%), undetermined cause of death (39, 3.19%), and homicide (9, 2.86%) cases. Road traffic accidents were the number 1 cause of death (597, 49%), followed by burns (122, 10%) and hanging (90, 7.4%). DISCUSSION Injuries and violence that occur during childhood and adolescence represent a global public health problem, especially in low- and middle-income regions, and require urgent action.
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Affiliation(s)
- Kourosh Holakouie-Naieni
- Author Affiliations: 1Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences; 2Forensic Medical Investigations, Pittsburgh, PA; 3Scholl of Public Health, Medical University of Isfahan; 4Legal Medicine Center of Isfahan Province; and 5Department of Epidemiology and Biostatistics,Tehran University of Medical Sciences
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Abstract
Decapitation is the separation of the head from the neck. Accidental decapitation is rare, and very few cases are cited in the literature. In this case, the victim was asleep during an overnight trip with her head sticking out of the window, and she was decapitated by a truck travelling in the opposite direction. Lack of security grilles on windows, high-speed driving, narrow roads and night travel were contributing factors. This case is presented for its rarity and pattern of injuries during the fatal mishap and to consider possible preventive measures.
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Affiliation(s)
- Manoj Bhausaheb Parchake
- Department of Forensic Medicine, Seth Gordhandas Sunderdas Medical College and King Edward Memorial Hospital, Parel, Mumbai, India
| | - Nilesh K Tumram
- Department of Forensic Medicine, Indira Gandhi Government Medical College and Hospital, Nagpur, Maharashtra, India
| | - Rahul Umbare
- Department of Forensic Medicine, Government Medical College, Latur, Maharashtra, India
| | - R V Kachare
- Department of Forensic Medicine, SRT Rural Government Medical College, Ambajogai, Maharashtra, India
| | - C R Dode
- Department of Forensic Medicine, Government Medical College, Latur, Maharashtra, India
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Martins SS, Sampson L, Cerdá M, Galea S. Worldwide Prevalence and Trends in Unintentional Drug Overdose: A Systematic Review of the Literature. Am J Public Health 2016; 105:2373. [PMID: 26451757 DOI: 10.2105/ajph.2015.302843a] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Drug overdose is an important, yet an inadequately understood, public health problem. Global attention to unintentional drug overdose has been limited by comparison with the scope of the problem. There has been a substantial increase in drug overdose incidence and prevalence in several countries worldwide over the past decade, contributing to both increased costs and mortality. OBJECTIVES The aim of this study was to systematically synthesize the peer-reviewed literature to document the global epidemiological profile of unintentional drug overdoses and the prevalence, time trends, mortality rates, and correlates of drug overdoses. We searched different combinations of Medical Subject Headings (MeSH) terms in PubMed for articles published from 1980 until July 2013, and we organized these results in tabular spreadsheets and compared them. We restricted the search to English-language articles that deal with unintentional overdose, focusing on 1 or more of the following key constructs: prevalence, time trends, mortality rates, and correlates. The term "overdose" as a MeSH major topic yielded 1076 publications. In addition, we searched the following combinations of nonmajor MeSH terms: "street drugs" and "overdose" yielded 180, "death" and "overdose" yielded 114, and "poisoning" and "drug users" yielded 17. There was some overlap among the searches. Based on the search and inclusion and exclusion criteria, we selected a total of 169 relevant articles for this article based on a close review of abstracts. RESULTS We found wide variability in lifetime prevalence of experiencing a nonfatal overdose or witnessing an overdose, and in mortality rates attributable to overdose. Lifetime prevalence of witnessed overdose among drug users (n = 17 samples) ranged from 50% to 96%, with a mean of 73.3%, a median of 70%, and a standard deviation of 14.1%. Lifetime prevalence of drug users personally experiencing a nonfatal overdose (n = 27 samples), ranged from 16.6% to 68.0% with a mean of 45.4%, a median of 47%, and a standard deviation of 14.4%. Population-based crude overdose mortality rates (n = 28 samples) ranged from 0.04 to 46.6 per 100 000 person-years. This range is likely attributable to the diversity in regions, time periods, and samples. Most studies on longitudinal trends of overdose death rates or overdose-related hospitalization rates showed increases in overdose death rates and in overdose-related hospitalization rates across time, which have led to peaks in these rates at the present time. An overall trend of increasing deaths from prescription opioid use and decreasing deaths from illicit drug use in the past several years has been noted across most of the literature. With the increase in prescription opioid overdose deaths, drug overdose is not just an urban problem: rural areas have seen an important increase in overdose deaths. Lastly, cocaine, prescription opioids, and heroin are the drugs most commonly associated with unintentional drug overdoses worldwide and the demographic and psychiatric correlates associated with unintentional drug overdoses are similar globally. CONCLUSIONS There is a need to invest in research to understand the distinct determinants of prescription drug overdose worldwide. Several other countries need to collect in a systematic and continuous fashion such data on sales of prescription opioids and other prescription drugs, nonmedical use of prescription drugs, and hospitalization secondary to overdoses on prescription drugs. The sparse evidence on the environmental determinants of overdose suggests a need for research that will inform the types of environmental interventions we can use to prevent drug overdose. Methodological issues for future studies include enhancing data collection methods on unintentional fatal and nonfatal overdoses, and collecting more detailed information on drug use history, source of drug use (for prescription drugs), and demographic and psychiatric history characteristics of the individual who overdosed.
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Tøllefsen IM, Helweg-Larsen K, Thiblin I, Hem E, Kastrup MC, Nyberg U, Rogde S, Zahl PH, Østevold G, Ekeberg Ø. Are suicide deaths under-reported? Nationwide re-evaluations of 1800 deaths in Scandinavia. BMJ Open 2015; 5:e009120. [PMID: 26608638 PMCID: PMC4663440 DOI: 10.1136/bmjopen-2015-009120] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE Valid mortality statistics are important for healthcare planning and research. Suicides and accidents often present a challenge in the classification of the manner of death. The aim of this study was to analyse the reliability of the national suicide statistics by comparing the classification of suicide in the Scandinavian cause of death registers with a reclassification by 8 persons with different medical expertise (psychiatry, forensic pathology and public health) from each of the 3 Scandinavian countries. METHODS The cause of death registers in Norway, Sweden and Denmark retrieved available information on a sample of 600 deaths in 2008 from each country. 200 were classified in the registers as suicides, 200 as accidents or undetermined and 200 as natural deaths. The reclassification comprised an assessment of the manner and cause of death as well as the level of certainty. RESULTS In total, 81%, 88% and 90% of deaths registered as suicide in the official mortality statistics were confirmed by experts using the Swedish, Norwegian and Danish data sets, respectively. About 3% of deaths classified as accidents or natural deaths in the cause of death registers were reclassified as suicides. However, after a second reclassification based on additional information, 9% of the natural deaths and accidents were reclassified as suicides in the Norwegian data set, and 21% of the undetermined deaths were reclassified as suicides in the Swedish data set. In total, the levels of certainty of the experts were 87% of suicides in the Norwegian data set, 77% in the Swedish data set and 92% in Danish data set; the uncertainty was highest in poisoning suicides. CONCLUSIONS A high percentage of reported suicides were confirmed as being suicides. Few accidents and natural deaths were reclassified as suicides. Hence, reclassification did not increase the overall official suicide statistics of the 3 Scandinavian countries.
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Affiliation(s)
- Ingvild Maria Tøllefsen
- Department of Acute Medicine, Oslo University Hospital Ullevaal, Oslo, Norway
- Faculty of Medicine, Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Karin Helweg-Larsen
- Department of Social Medicine and Public Health Research, Copenhagen University, Copenhagen, Denmark
| | - Ingemar Thiblin
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Erlend Hem
- Faculty of Medicine, Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital Ullevaal, Oslo, Norway
| | | | - Ullakarin Nyberg
- Department of Clinical Neuroscience, Stockholm Centre for Psychiatric Research and Education, Karolinska Institutet, Stockholm, Sweden
| | - Sidsel Rogde
- Norwegian Institute of Public Health, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | | | | | - Øivind Ekeberg
- Faculty of Medicine, Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital Ullevaal, Oslo, Norway
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Wilson AL, Sideras J. Regional Infant and Child Mortality Review Committee 2014 Final Report. S D Med 2015; 68:443-447. [PMID: 26630833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The Regional Infant and Child Mortality Review Committee serves 10 counties in southeastern South Dakota with the aim of using its reviews to prevent future loss of life during childhood. In 2014, the committee reviewed 25 deaths. Consistent with observations made in previous years, in 2014 all infants who died during sleep did so with risks present in the sleep environment. Concern persists about progress in decreasing these infant deaths during sleep in the region. The two teen suicides in 2014 marked a decrease in the number observed in 2013, but represent an ongoing concern. Four deaths involved auto crashes with three of these involving a teen driver. A child homicide did not occur in the region in 2014. The report provides the committee's recommendations for community action that could prevent future deaths of infants and children.
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Budnik A, Liczbińska G. Biological and Cultural Causes of Seasonality of Deaths in Historical Populations From Poland. Coll Antropol 2015; 39:491-499. [PMID: 26898041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Seasonal fluctuations in mortality and their causes in the nineteenth century Polish rural populations: wealthy, agriculturally and economically advanced populations from Wielkopolska, and poor populations from Silesia and Galicia (southern Poland) were described. Data-sources included parish death registers from the Roman Catholic parish of Dziekanowice in the region of Wielkopolska, Prussian statistical yearbooks for the Pozna Province as well as information from previous publications regarding Silesia and Galicia. The 19th century patterns were compared with those in present-day Poland. The occurrence of seasonality of deaths was assessed with: the Chi-squared test, the Kolmogorov-Smirnov test, and the Autoregressive Integrated Moving Average Models (ARIMA). In all populations there was a winter maximum of the number of deaths, while the minimum occurred in early summer. In the poor populations of Silesia and Galicia another statistically significant increase in the incidence of deaths was observed in the early spring. In the rich and modern villages of Wielkopolska there was no spring increase in the number of deaths, however, in all populations of Wielkopolska, irrespective of a particular pattern, a secondary mortality peak occurred in the late summer and autumn. Statistical tests used in this study did not show any clear differences in the distribution of the seasonality of deaths between the populations of Wielkopolska on the one hand, and the populations from Galicia and Silesia, on the other hand. The statistical significance of differences was, however, evident between populations representing the two distinguished by secondary peaks death seasonality patterns. Seasonal death increase split the populations under study into two groups according to the criterion of wealth.
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