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Archivos de Bronconeumologia Apr 2019
Topics: Accidents; Asphyxia; Humans; Male; Middle Aged; Sand
PubMed: 30049558
DOI: 10.1016/j.arbres.2018.06.011 -
Archives of Disease in Childhood Oct 2020To determine the rate of sudden unexpected death in infancy (SUDI) for infants born after a previous SUDI in the same family, and to establish the causes of death and... (Observational Study)
Observational Study
OBJECTIVES
To determine the rate of sudden unexpected death in infancy (SUDI) for infants born after a previous SUDI in the same family, and to establish the causes of death and the frequency of child protection concerns in families with recurrent SUDI.
DESIGN
Observational study using clinical case records.
SETTING
The UK's Care of Next Infant (CONI) programme, which provides additional care to families who have experienced SUDI with their subsequent children.
PATIENTS
Infants registered on CONI between January 2000 and December 2015.
MAIN OUTCOME MEASURES
Cause of death, presence of modifiable risk factors for SUDI and child protection concerns.
RESULTS
There were 6608 live-born infants registered in CONI with 29 deaths. 26 families had 2 deaths, and 3 families had 3 deaths. The SUDI rate for infants born after one SUDI is 3.93 (95% CI 2.7 to 5.8) per 1000 live births. Cause of death was unexplained for 19 first and 15 CONI deaths. Accidental asphyxia accounted for 2 first and 6 CONI deaths; medical causes for 3 first and 4 CONI deaths; and homicide for 2 first and 4 CONI deaths. 10 families had child protection concerns.
CONCLUSIONS
The SUDI rate for siblings is 10 times higher than the current UK SUDI rate. Homicide presenting as recurrent SUDI is very rare. Many parents continued to smoke and exposed infants to hazardous co-sleeping situations, with these directly leading to or contributing to the death of six siblings. SUDI parents need support to improve parenting skills and reduce risk to subsequent infants.
Topics: Accidents; Asphyxia; Child Abuse; Female; Humans; Infant; Infanticide; Maternal Health; Mental Disorders; Parenting; Registries; Risk Factors; Siblings; Smoking; Sudden Infant Death; United Kingdom
PubMed: 32527717
DOI: 10.1136/archdischild-2019-318379 -
Journal of Forensic and Legal Medicine Oct 2020Despite legislation, dowry is still widespread in many parts of India and adjacent countries. It refers to the transfer of goods, money, and property to a bridegroom,... (Review)
Review
Despite legislation, dowry is still widespread in many parts of India and adjacent countries. It refers to the transfer of goods, money, and property to a bridegroom, his parents, or his relatives from a bride's family as a condition of the marriage. One of the consequences of the dowry system has been the murder or abetted suicide of young wives, either because more dowry goods were not provided to her husband or his family, or to secure the goods after marriage. In 2015 7634 women died due to dowry harassment, representing approximately 21 cases per day in India. The majority of dowry deaths occur within the first three years of marriage. Common types of dowry death homicides involve fire ('bride burning', drowning, poisoning and hanging/strangulation. In addition to legislation, an organized and multipronged approach is need by investigating police officers, women's' welfare organizations, responsible public servants, and the judiciary with consistent applications of deterrent penalties. Full and properly conducted medicolegal investigation is mandatory which must include scene examinations, full autopsies with photographic documentation and ancillary investigations such as headspace analyses. Significant burns in young Indian women living in traditional circumstances should raise the possibility of dowry-related crime.
Topics: Asphyxia; Drowning; Female; Fires; Gender-Based Violence; Homicide; Humans; India; Male; Marriage; Poisoning
PubMed: 32871350
DOI: 10.1016/j.jflm.2020.102035 -
Traffic Injury Prevention 2023This study determined the risk for fetal death and maternal injury in the same sample of motor-vehicle crashes. The frequency and risk of serious injury (MAIS 3 + F)...
OBJECTIVE
This study determined the risk for fetal death and maternal injury in the same sample of motor-vehicle crashes. The frequency and risk of serious injury (MAIS 3 + F) were also assessed by sex, pregnancy, seating position and crash type.
METHOD
The 2008-2015 NASS-CDS and 2017-2020 CISS are representative samples that were analyzed for the risk of fetal death and the risk of maternal injury grouped by MAIS 0-2, MAIS 3 + F and death (F) in 2000+ model year (MY) light vehicles. All electronic cases involving fetal mortality were reviewed for mechanism of injury. Separately, the 2000-2015 NASS-CDS and 2017-2020 CISS data was analyzed for the risk of serious injury for male, female and pregnant female occupants by seating position and crash type in 2000+ MY light vehicles. All calculations are made with weighted data. The significance of differences in risk was determined by the Rao-Scott chi-square test in SAS and z-test for differences in proportions.
RESULTS
There were 2,467 ± 1,407 fetal deaths in light vehicle crashes from 2008-2015 and 2016-2020 with an annual occurrence of 206/yr. The risk for fetal death was 1.25% ± 0.74% of exposed pregnant females. There were 127 ± 67 deaths of pregnant females, or 11/yr in the same sample. The fatality risk was 0.065% ± 0.035%. The difference in proportions was statistically significant (z = 46.1, < 0.0001). Fetal deaths occurred 19.4-times more often than deaths of pregnant females. In 82.9% of the crashes with a fetal death, the pregnant female was not seriously injured (MAIS 3 + F). The most common mechanism of fetal death was a minor crash, in 80.1% of the weighted cases based on review of photos of the case vehicle and observing very minor structural damage to the vehicle. The minor crash involved either yaw of the occupant compartment with side loading of the pregnant female or her displacement into the restraint system and side interior in 71.7% of the crashes. A severe crash with intrusion at the seating position of the pregnant female occurred in only 11.5% of cases. It usually caused serious injury to the pregnant female and fetal death.
CONCLUSIONS
Fetal deaths occurred 19.4-times more often than deaths of pregnant females in a 12-year sample of motor-vehicle crashes. The most common mechanism was a minor crash that resulted in a fetal death without serious injury to the pregnant female and involved side or oblique loading of the pregnant female.
Topics: Humans; Female; Pregnancy; Accidents, Traffic; Restraint, Physical; Fetal Death; Wounds and Injuries
PubMed: 36318877
DOI: 10.1080/15389588.2022.2140409 -
Injury Prevention : Journal of the... Oct 2023To characterise risk factors for fatal drowning in California, USA to inform priorities for prevention, policy and research.
OBJECTIVE
To characterise risk factors for fatal drowning in California, USA to inform priorities for prevention, policy and research.
METHODS
This retrospective population-based epidemiological review of death certificate data evaluated fatal drowning events in California from 2005 to 2019. Unintentional, intentional, and undetermined drowning deaths and rates were described by person (age, sex, race) and context-based variables (region and body of water).
RESULTS
California's fatal drowning rate was 1.48 per 100 000 population (n=9237). Highest total fatal drowning rates occurred in the lower population density northern regions, among older adults (75-84 years: 2.54 per 100 000 population; 85+: 3.47 per 100 000 population) and non-Hispanic American Indian or Alaska Native persons (2.84 per 100 000 population). Male drowning deaths occurred at 2.7 times the rate of females; drowning deaths occurred mainly in swimming pools (27%), rivers/canals (22.4%) and coastal waters (20.2%). The intentional fatal drowning rate increased 89% during the study period.
CONCLUSIONS
California's overall fatal drowning rate was similar to the rest of the USA but differed among subpopulations. These divergences from national data, along with regional differences in drowning population and context-related characteristics, underscore the need for state and regional level analyses to inform drowning prevention policy, programmes and research.
Topics: Female; Humans; Male; Infant; Aged; Drowning; Retrospective Studies; Risk Factors; California; Rivers
PubMed: 37208006
DOI: 10.1136/ip-2023-044862 -
Injury Prevention : Journal of the... Jun 2016Drowning is a leading cause of unintentional death. Rivers are a common location for drowning. Unlike other location-specific prevention efforts (home swimming pools and... (Review)
Review
INTRODUCTION
Drowning is a leading cause of unintentional death. Rivers are a common location for drowning. Unlike other location-specific prevention efforts (home swimming pools and beaches), little is known about prevention targeting river drowning deaths.
METHODS
A systematic literature review was undertaken using English language papers published between 1980 and 2014, exploring gaps in the literature, with a focus on epidemiology, risk factors and prevention strategies for river drowning.
RESULTS
Twenty-nine papers were deemed relevant to the study design including 21 (72.4%) on epidemiology, 18 (62.1%) on risk factors and 10 (34.5%) that proposed strategies for prevention. Risk factors identified included age, falls into water, swimming, using watercraft, sex and alcohol.
DISCUSSION
Gaps were identified in the published literature. These included a lack of an agreed definition for rivers, rates for fatal river drowning (however, crude rates were calculated for 12 papers, ranging from 0.20 to 1.89 per 100 000 people per annum), and consensus around risk factors, especially age. There was only one paper that explored a prevention programme; the remaining nine outlined proposed prevention activities. There is a need for studies into exposure patterns for rivers and an agreed definition (with consistent coding).
CONCLUSIONS
This systematic review has identified that river drowning deaths are an issue in many regions and countries around the world. Further work to address gaps in the published research to date would benefit prevention efforts.
Topics: Accident Prevention; Accidents; Drowning; Environment Design; Health Knowledge, Attitudes, Practice; Humans; International Classification of Diseases; Preventive Health Services; Risk Factors; Rivers; Swimming
PubMed: 26728005
DOI: 10.1136/injuryprev-2015-041750 -
Fa Yi Xue Za Zhi Feb 2022To study the phenomenon of pulmonary hypostasis in corpses of various causes of death, and to explore the potential value of this phenomenon in assisting forensic...
OBJECTIVES
To study the phenomenon of pulmonary hypostasis in corpses of various causes of death, and to explore the potential value of this phenomenon in assisting forensic pathological diagnosis of drowning.
METHODS
A total of 235 cases with clear cause of death through systematic autopsy were collected from January 2011 to June 2021 in Guangzhou. According to the location of body discovery, the cases were divided into the water body group (97 cases) and the nonwater body group (138 cases), and the water body group was further divided into the water drowning group (90 cases) and the water nondrowning group (7 cases). Non-water body group was further divided into the nonwater drowning group (1 case) and the nonwater nondrowning group (137 cases). Three senior forensic pathologists independently reviewed autopsy photos to determine whether there was hypostasis in the lungs. The detection rate of pulmonary hypostasis was calculated.
RESULTS
The detection rate of pulmonary hypostasis in the water drowning group (90 cases) was 0, and the negative rate was 100%. The detection rate of pulmonary hypostasis in the water nondrowning group (7 cases) was 100% and the negative rate was 0. The detection rate of pulmonary hypostasis in the water body group and in the nonwater body group (after excluding 2 cases, 136 cases were calculated) was 7.22% and 87.50%, respectively. There were statistically significant differences in the detection rate of pulmonary hypostasis between water body group and nonwater body group, and between water drowning group and water nondrowning group (<0.05).
CONCLUSIONS
The disappearance of pulmonary hypostasis can be used as a specific cadaveric sign to assist in the forensic pathological diagnosis of drowning.
Topics: Autopsy; Drowning; Forensic Pathology; Humans; Lung; Water
PubMed: 35725707
DOI: 10.12116/j.issn.1004-5619.2021.410920 -
Traffic Injury Prevention 2021Anthropomorphic test devices (ATD) are used in crashworthiness studies to advance safety in automotive, military, aviation, and other environments. The Test Device for...
OBJECTIVE
Anthropomorphic test devices (ATD) are used in crashworthiness studies to advance safety in automotive, military, aviation, and other environments. The Test Device for Human Occupant Restraint (THOR) is an advancement over the widely used Hybrid III ATD. The female version THOR-05F is different from the male as it is not a scaled-down version of the male, and it is based on the recognition that the cervical spines (necks) of females have a different response than males. The objective of this study is to evaluate its response at dynamic rates of loading and compare it with previous postmortem human surrogate (PMHS) responses under sagittal plane bending.
METHODS
The head/neck assembly was separated from the thorax, and a lower neck plate was attached to the head/neck assembly to mount the preparation to the frame of an electro-hydraulic testing device. A custom upper neck interface plate was attached to a novel angular displacement test device that converted the linear motion of the vertical electrohydraulic piston to moment loading at the occipital condyle joint. The neck was preconditioned by applying a sinusoidal 10-degree flexion-extension cycle for 90 s and then three repeat dynamic tests at a target rate of 90 Nm/s. Flexion and extension tests were performed with and without the front and rear neck cables of the THOR-05F neck. Targets were fixed to the upper neck adapter plate, occipital condyle joint, mid-spine aluminum puck, and lower neck adapter plate. The targets' three-dimensional positions were measured using a seven-camera optical motion capture system. Upper neck load cell and occipital condyle potentiometer data were sampled at 20 kHz, and loading rates were determined by calculating the sagittal moment slope between 15% and 85% of the signal.
RESULTS
The mean occipital condyle angle versus sagittal moment response from the 12 tests (three tests each with and without cables and under flexion and extension) are given in the body of the manuscript. With and without cables, the loading rates for flexion tests were 89.3 ± 0.5 Nm/s and 86.3 ± 0.4 Nm/s, and for extension tests they were 90.8 ± 1.2 Nm/s and 88.0 ± 1.5 Nm/s. The average peak sagittal moments were 34.2 ± 0.3 Nm and 30.3 ± 0.2 Nm for flexion and 50.6 ± 0.3 Nm and 47.0 ± 0.3 Nm for extension tests. The mean peak occipital condyle angles were 23.5 ± 0.2 deg and 25.3 ± 0.1 deg for flexion and 22.7 ± 0.2 deg and 25.8 ± 0.1 deg for extension.
CONCLUSION
Using the angular motion as a basis and comparing it with the previously conducted PMHS tests, the THOR-05F neck has approximately twice the stiffness of the human under sagittal plane bending.
Topics: Accidents, Traffic; Biomechanical Phenomena; Cadaver; Female; Head; Humans; Male; Neck
PubMed: 34686084
DOI: 10.1080/15389588.2021.1982602 -
Pediatrics Mar 2018Sharp declines in sudden unexpected infant death (SUID) in the 1990s and a diagnostic shift from sudden infant death syndrome (SIDS) to unknown cause and accidental...
BACKGROUND
Sharp declines in sudden unexpected infant death (SUID) in the 1990s and a diagnostic shift from sudden infant death syndrome (SIDS) to unknown cause and accidental suffocation and strangulation in bed (ASSB) in 1999-2001 have been documented. We examined trends in SUID and SIDS, unknown cause, and ASSB from 1990 to 2015 and compared state-specific SUID rates to identify significant trends that may be used to inform SUID prevention efforts.
METHODS
We used data from US mortality files to evaluate national and state-specific SUID rates (deaths per 100 000 live births) for 1990-2015. SUID included infants with an underlying cause of death, SIDS, unknown cause, or ASSB. To examine overall US rates for SUID and SUID subtypes, we calculated the percent change by fitting Poisson regression models. We report state differences in SUID and compared state-specific rates from 2000-2002 to 2013-2015 by calculating the percent change.
RESULTS
SUID rates declined from 154.6 per 100 000 live births in 1990 to 92.4 in 2015, declining 44.6% from 1990 to 1998 and 7% from 1999 to 2015. From 1999 to 2015, SIDS rates decreased 35.8%, ASSB rates increased 183.8%, and there was no significant change in unknown cause rates. SUID trends among states varied widely from 41.5 to 184.3 in 2000-2002 and from 33.2 to 202.2 in 2013-2015.
CONCLUSIONS
Reductions in SUID rates since 1999 have been minimal, and wide variations in state-specific rates remain. States with significant declines in SUID rates might have SUID risk-reduction programs that could serve as models for other states.
Topics: Accidents, Home; Asphyxia; Cause of Death; Humans; Infant; Risk Factors; Sudden Infant Death; United States
PubMed: 29440504
DOI: 10.1542/peds.2017-3519 -
PloS One 2021Coastal drowning is a global public health problem which requires evidence to support safety initiatives. The growing multidisciplinary body of coastal drowning research... (Review)
Review
OBJECTIVE
Coastal drowning is a global public health problem which requires evidence to support safety initiatives. The growing multidisciplinary body of coastal drowning research and associated prevention countermeasures is diverse and has not been characterised as a whole. The objective of this scoping review was to identify key concepts, findings, evidence and research gaps in the coastal drowning literature to guide future research and inform prevention activities.
METHODS
We conducted a scoping review to identify peer reviewed studies published before May 2020 reporting either (i) fatal unintentional coastal drowning statistics from non-boating, -disaster or -occupational aetiologies; (ii) risk factors for unintentional fatal coastal drowning; or (iii) coastal drowning prevention strategies. Systematic searches were conducted in six databases, two authors independently screened studies for inclusion and one author extracted data using a standardised data charting form developed by the study team.
RESULTS
Of the 146 included studies, the majority (76.7%) were from high income countries, 87 (59.6%) reported coastal drowning deaths, 61 (41.8%) reported risk factors, and 88 (60.3%) reported prevention strategies. Populations, data sources and coastal water site terminology in the studies varied widely; as did reported risk factors, which most frequently related to demographics such as gender and age. Prevention strategies were commonly based on survey data or expert opinion and primarily focused on education, lifeguards and signage. Few studies (n = 10) evaluated coastal drowning prevention strategies.
DISCUSSION
Coastal drowning is an expansive, multidisciplinary field that demands cross-sector collaborative research. Gaps to be addressed in coastal safety research include the lack of research from lower resourced settings, unclear and inconsistent terminology and reporting, and the lack of evaluation for prevention strategies. Advancing coastal drowning science will result in a stronger evidence base from which to design and implement effective countermeasures that ultimately save lives and keep people safe.
Topics: Drowning; Humans; Risk Factors
PubMed: 33524054
DOI: 10.1371/journal.pone.0246034