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AMA Journal of Ethics Jun 2021This graphic narrative explores struggles with underinsurance, compromised access to indicated care, and intergenerational health inequity.
This graphic narrative explores struggles with underinsurance, compromised access to indicated care, and intergenerational health inequity.
Topics: Drowning; Humans; Insurance Pools; Insurance, Health; Narration
PubMed: 34212852
DOI: 10.1001/amajethics.2021.499 -
Journal of Affective Disorders Mar 2022The use of suicide methods largely determines the outcome of suicide acts. However, no existing meta-analysis has assessed the case fatality rates (CFRs) by different... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The use of suicide methods largely determines the outcome of suicide acts. However, no existing meta-analysis has assessed the case fatality rates (CFRs) by different suicide methods. The current study aimed to fill this gap.
METHODS
We searched Scopus, Web of Science, PubMed, ProQuest and Embase for studies reporting method-specific CFRs in suicide, published from inception to 31 December 2020. A random-effect model meta-analysis was applied to compute pooled estimates.
RESULTS
Of 10,708 studies screened, 34 studies were included in the meta-analysis. Based on the suicide acts that resulted in death or hospitalization, firearms were found to be the most lethal method (CFR:89.7%), followed by hanging/suffocation (84.5%), drowning (80.4%), gas poisoning (56.6%), jumping (46.7%), drug/liquid poisoning (8.0%) and cutting (4.0%). The rank of the lethality for different methods remained relatively stable across study setting, sex and age group. Method-specific CFRs for males and females were similar for most suicide methods, while method-CFRs were specifically higher in older adults.
CONCLUSIONS
This study is the first meta-analysis that provides significant evidence for the wide variation of the lethality of suicide methods. Restricting highly lethal methods based on local context is vital in suicide prevention.
Topics: Aged; Drowning; Female; Firearms; Gas Poisoning; Hospitalization; Humans; Male; Suicide
PubMed: 34953923
DOI: 10.1016/j.jad.2021.12.054 -
European Heart Journal Oct 2021
Topics: Drowning; Humans
PubMed: 34291791
DOI: 10.1093/eurheartj/ehab443 -
BMJ Global Health 2020Road traffic injuries are a neglected global public health problem. Over 1.25 million people are killed each year, and middle-income countries, which are motorising... (Review)
Review
Road traffic injuries are a neglected global public health problem. Over 1.25 million people are killed each year, and middle-income countries, which are motorising rapidly, are the hardest hit. Sri Lanka is dealing with an injury-related healthcare crisis, with a recent 85% increase in road traffic fatality rates. Road traffic crashes now account for 25 000 injuries annually and 10 deaths daily. Development of a trauma registry is the foundation for injury control, care and prevention. Five northern Sri Lankan provinces collaborated with Jaffna Teaching Hospital to develop a local electronic registry. The Centre for Clinical Excellence and Research was established to provide organisational leadership, hardware and software were purchased, and data collectors trained. Initial data collection was modified after implementation challenges were resolved. Between 1 June 2017 and 30 September 2017, 1708 injured patients were entered into the registry. Among these patients, 62% were male, 76% were aged 21-50, 71.3% were motorcyclists and 34% were in a collision with another motorcyclist. There were frequent collisions with uncontrolled livestock (12%) and with fixed objects (14%), and most patients were transported by private vehicles without prehospital care. Head (n=315) and lower extremity (n=497) injuries predominated. Establishment of a trauma registry in low-income and middle-income countries is a significant challenge and requires invested local leadership; the most challenging issue is ongoing funding. However, this pilot registry provides a valuable foundation, identifying unique injury mechanisms, establishing priorities for prevention and patient care, and introducing the concept of an organised system to this region.
Topics: Accidental Injuries; Accidents, Traffic; Adult; Aged; Female; Humans; Male; Middle Aged; Registries; Sri Lanka; Young Adult
PubMed: 32133167
DOI: 10.1136/bmjgh-2019-001818 -
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 -
Environmental Health Perspectives Apr 2022Although substantial evidence suggests that high and low temperatures are adversely associated with nonaccidental mortality, few studies have focused on exploring the...
BACKGROUND
Although substantial evidence suggests that high and low temperatures are adversely associated with nonaccidental mortality, few studies have focused on exploring the risks of temperature on external causes of death.
OBJECTIVES
We investigated the short-term associations between temperature and external causes of death and four specific categories (suicide, transport, falls, and drowning) in 47 prefectures of Japan from 1979 to 2015.
METHODS
We conducted a two-stage meta-regression analysis. First, we performed time-stratified case-crossover analyses with a distributed lag nonlinear model to examine the association between temperature and mortality due to external causes for each prefecture. We then used a multivariate meta-regression model to combine the association estimates across all prefectures in Japan. In addition, we performed stratified analyses for the associations by sex and age.
RESULTS
A total of 2,416,707 external causes of death were included in the study. We found a J-shaped exposure-response curve for all external causes of death, in which the risks increased for mild cold temperatures [20th percentile; relative risk (95% confidence interval [CI]: 1.05,1.12)] and extreme heat [99th percentile; (95% CI: 1.20, 1.29)] compared with those for minimum mortality temperature (MMT). However, the shapes of the exposure-response curves varied according to four subcategories. The risks of suicide and transport monotonically increased as temperature increased, with RRs of 1.35 (95% CI: 1.26, 1.45) and 1.60 (95% CI: 1.35, 1.90), respectively, for heat, whereas J- and U-shaped curves were observed for falls and drowning, with RRs of 1.14 (95% CI: 1.03, 1.26) and 1.95 (95% CI: 1.70, 2.23) for heat and 1.13 (95% CI: 1.02, 1.26) and 2.33 (95% CI: 1.89, 2.88) for cold, respectively, compared with those for cause-specific MMTs. The sex- and age-specific associations varied considerably depending on the specific causes.
DISCUSSION
Both low and high temperatures may be important drivers of increased risk of external causes of death. We suggest that preventive measures against external causes of death should be considered in adaptation policies. https://doi.org/10.1289/EHP9943.
Topics: Cause of Death; Cold Temperature; Drowning; Hot Temperature; Humans; Japan; Temperature
PubMed: 35394808
DOI: 10.1289/EHP9943 -
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 -
Perceptions and Experiences of Caregivers on Child Injuries: A Qualitative Study from Central India.Journal of Prevention (2022) Aug 2022To explore caregivers' perceptions of childhood injuries in the rural and urban areas of India, with a focus on causes, consequences, prevention, and treatment. We...
To explore caregivers' perceptions of childhood injuries in the rural and urban areas of India, with a focus on causes, consequences, prevention, and treatment. We conducted eight focus group discussions with fifty female caregivers in rural and urban areas of Ujjain in Central India and used thematic content analysis. The caregivers identified how children injured themselves through falls, road traffic injuries, metallic nails and tool injuries, ingestions of foreign objects and poisons, burns, drowning, and suffocation. The reported consequences of injuries ranged from pain, infections, scar formation, phobia, stigma, and emotional stress to complications like physical disability, loss of eyesight, head injury, paralysis, and even death. Many caregivers blamed children and their mischievousness for the injuries and failed to realise/acknowledge the role of better supervision and environmental modifications in injury prevention. Caregivers used several first aid methods to respond to injuries. These included applying pressure to stop bleeding during fall and road traffic injuries, inducing vomiting by giving the poison victims saltwater to drink, and tobacco leaves to chew. In addition, some caregivers resorted to using coconut oil and toothpaste on burnt skin and giving back blows for choking. Caregivers in communities had experiences of different types of child injuries. Further education on need for better supervision, relevant environmental modification and appropriate first aid treatment of various injuries is required.
Topics: Burns; Caregivers; Child; Drowning; Female; First Aid; Humans; Qualitative Research
PubMed: 35624398
DOI: 10.1007/s10935-022-00682-3 -
Frontiers in Public Health 2022The main purpose of this study was to investigate children's swimming competence in primary schools of districts in Vojvodina, Serbia.
INTRODUCTION
The main purpose of this study was to investigate children's swimming competence in primary schools of districts in Vojvodina, Serbia.
METHODS
Included subjects were primary school students from first to eighth grade ( = 2,778; male = 1,454, female = 1,324; age = 10.73 ± 2.1 years). We used Swimming Competence Questionnaire to acquire and analyze their swimming experience, non-fatal aquatic events, and demographics. For the statistical analysis, logistic regression and hierarchical multiple regression were used to evaluate if the factors and SC and NFAE were associated. The analyses were carried out by using SPSS® software version 24.0 (SPSS, Inc., Chicago, Illinois, USA).
RESULTS
Families with more income and education generally have children with more swimming competence, experience, knowledge, and skills related to water safety. First step in analysis revealed that gender (β = 0.05, < 0.01), education level (β = 0.06, < 0.01) age (β = 0.171, < 0.01), and family income (β = 0.04, < 0.01) were significant swimming competence (SC) predictors (R2 = 0.04). Age (OR = 1.15, < 0.01) was the only significant predictor in Step 1 predicting non-fatal aquatic events (NFAE). In Step 2, variables associated with SC were swimming location (ΔR2 = 0.06, < 0.01), swimming experience (ΔR2 = 0.16, < 0.01), swimming accessibility (ΔR2 = 0.05, < 0.01), and learning experience (ΔR2 = 0.03, < 0.01) (total R2 = 0.26 to 0.47, < 0.01). Only a minority of participants reported that they could not swim further than 5 meters using general stroke (37.15%).
CONCLUSION
National education trainers programs must be prioritized with the primary strategy of transferring knowledge to swimming and water safety. Families with lower income must be included without exceptions. This is perhaps a key factor in preventing NFAE, increasing SC, and increasing water safety.
Topics: Child; Drowning; Educational Status; Female; Humans; Male; Surveys and Questionnaires; Swimming; Water
PubMed: 35937234
DOI: 10.3389/fpubh.2022.961342