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International Journal of Environmental... Feb 2024Unintentional injuries significantly contribute to mortality and morbidity among children under five, with higher prevalence in low- and middle-income countries (LMICs)....
Unintentional injuries significantly contribute to mortality and morbidity among children under five, with higher prevalence in low- and middle-income countries (LMICs). Deprived communities in these regions face increased injury risks, yet there is limited research on child safety tailored to their unique challenges. To address this gap, we conducted focus group discussions in rural Uganda, involving parents, village health workers, community leaders, teachers, and maids. The objective was to understand community perceptions around child safety and determine what culturally and age-appropriate solutions may work to prevent child injuries. Analysis of discussions from ten focus groups revealed five main themes: injury causes, child development and behavior, adult behavior, environmental factors, and potential safety kit components. Common injuries included falls, burns, drowning, and poisoning, often linked to environmental hazards such as unsafe bunk beds and wet floors. Financial constraints and limited space emerged as cross-cutting issues. Participants suggested educational resources, first aid knowledge, and practical devices like solar lamps as potential solutions. The study presents invaluable insights into child safety in rural Ugandan homes, emphasizing the role of community awareness and engagement in designing effective, accessible interventions. It underscores the importance of context-specific strategies to prevent childhood injuries in similar resource-constrained environments.
Topics: Child; Adult; Humans; Drowning; Burns; Poverty; Accidental Injuries; First Aid; Wounds and Injuries
PubMed: 38541273
DOI: 10.3390/ijerph21030272 -
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue Mar 2024To investigate the therapeutic effect of high-flow nasal cannula oxygen therapy (HFNC) and non-invasive positive pressure ventilation (NPPV) on patients with pulmonary...
OBJECTIVE
To investigate the therapeutic effect of high-flow nasal cannula oxygen therapy (HFNC) and non-invasive positive pressure ventilation (NPPV) on patients with pulmonary edema caused by seawater drowning.
METHODS
A retrospective analysis method was used. Based on the Utstein database of emergency drowning in the First Hospital of Qinhuangdao, the clinical data of patients with seawater drowning pulmonary edema admitted to the emergency medicine department of the First Hospital of Qinhuangdao from January 1, 2019 to December 31, 2022 were collected. The patients were divided into NPPV group and HFNC group according to different ventilation methods. The general data, endotracheal intubation rate in 7 days, arterial blood gas analysis indexes [arterial partial pressure of oxygen (PaO), arterial partial pressure of carbon dioxide (PaCO), arterial oxygen saturation (SaO)] and hemodynamic indexes (systolic blood pressure, diastolic blood pressure, mean arterial pressure, heart rate, blood lactic acid) before and after treatment, length of stay in intensive care unit (ICU), oxygen therapy comfort of the two groups were compared.
RESULTS
A total of 54 patients were enrolled, including 21 patients in the NPPV group and 33 patients in the HFNC group. There were no significant differences in gender, age, state of consciousness and other general information between the two groups. Compared with NPPV group, the rate of endotracheal intubation in HFNC group within 7 days was significantly lower [24.2% (8/33) vs. 33.3% (7/21), P < 0.05]. Before treatment, there were no significant differences in arterial blood gas analysis and hemodynamics between the two groups. After treatment, the above indexes in both groups were significantly improved compared with those before treatment, and PaO, SaO, systolic blood pressure, diastolic blood pressure and mean arterial pressure in HFNC group were significantly higher than those in NPPV group [PaO (mmHg, 1 mmHg≈0.133kPa): 93.56±6.37 vs. 82.14±6.25, SaO: 1.02±0.09 vs. 0.95±0.11, systolic blood pressure (mmHg): 117.37±8.43 vs. 110.42±8.38, diastolic blood pressure (mmHg): 79.43±7.61 vs. 72.21±4.32, mean arterial pressure (mmHg): 92.34±6.32 vs. 85.12±5.38], PaCO, heart rate and blood lactic acid were significantly lower than those in NPPV group [PaCO (mmHg) : 34.26±5.63 vs. 37.24±6.22, heart rate (times/min): 73.38±7.56 vs. 86.25±5.41, blood lactic acid (mmol/L): 1.38±0.36 vs. 2.25±1.14], and the differences were statistically significant (all P < 0.05). In addition, the length of ICU stay in HFNC group was significantly shorter than that in NPPV group (days: 13.30±2.38 vs. 16.27±4.26), and the comfort rate of oxygen therapy was significantly higher than that in NPPV group [66.7% (22/33) vs. 42.8% (9/21)], with statistical significance (all P < 0.05).
CONCLUSIONS
HFNC can improve the oxygenation of patients with pulmonary edema caused by seawater drowning, improve hemodynamics, reduce the rate of tracheal intubation, shorten the length of ICU stay, and improve the comfort of oxygen therapy, which has certain clinical application value.
Topics: Humans; Pulmonary Edema; Drowning; Cannula; Retrospective Studies; Oxygen Inhalation Therapy; Oxygen; Lactic Acid
PubMed: 38538353
DOI: 10.3760/cma.j.cn121430-20231225-01109 -
ACS Chemical Biology Apr 2024
PubMed: 38532633
DOI: 10.1021/acschembio.4c00159 -
Forensic Science International Apr 2024
Topics: Humans; Diving; Accidents; Drowning
PubMed: 38522321
DOI: 10.1016/j.forsciint.2024.112004 -
Australian and New Zealand Journal of... Jun 2024Drowning has been the focus of coastal safety, but a notable proportion of coastal mortality is due to other causes of death. This study describes that burden and...
OBJECTIVES
Drowning has been the focus of coastal safety, but a notable proportion of coastal mortality is due to other causes of death. This study describes that burden and quantifies the impact of exposure on Australian unintentional coastal fatalities not due to drowning.
METHODS
Analyses of Australian non-drowning coastal fatalities (NDCF) between July 2012 and June 2022 were conducted. Population and exposure-based rates were calculated for Australians 16+ years and compared to all-cause mortality rates. Time series analysis was performed using Joinpoint regression.
RESULTS
616 NDCFs were recorded (0.27/100,000 pop.), with a decreasing average annual percent change of -5.1% (95% CI:-9.5 to -0.4). Cardiac conditions were the primary causal factor, involved in 52% of deaths. Higher fatality rates were seen among men and for incidents occurring in rural and remote areas. Fatality rates were disproportionately high among young adults when compared to all-cause mortality.
CONCLUSIONS
Men, young adults, and those living in/visiting regional and remote areas represent high-risk populations. Proximity to emergency services and extended response times represent major determinants of NDCF.
IMPLICATIONS FOR PUBLIC HEALTH
Due to the high prevalence of NDCF, coastal safety practitioners should expand their attention beyond drowning to consider the broader range of coastal hazards and fatality types.
Topics: Humans; Male; Female; Drowning; Adult; Australia; Middle Aged; Adolescent; Young Adult; Aged; Cause of Death; Aged, 80 and over; Mortality; Risk Factors
PubMed: 38519347
DOI: 10.1016/j.anzjph.2023.100113 -
Suicide & Life-threatening Behavior Mar 2024Inpatient suicide remains difficult to predict. This study aimed to identify individual patient predictors to help identify those at greater risk.
OBJECTIVE
Inpatient suicide remains difficult to predict. This study aimed to identify individual patient predictors to help identify those at greater risk.
METHODS
This case-control study was undertaken in an independent mental health service in Ireland. Cases were drawn from all admissions to the service between March 2004 and February 2019. Controls were matched for date of admission. Univariate and multivariate analyses were conducted.
RESULTS
Thirty-three cases of inpatient suicide were compared to 132 controls. The inpatient suicide rate was 76.2 per 100,000 admissions. The rate of inpatient suicide fell in line with national rates despite less restrictive practices being implemented in the service. Males accounted for 66% of cases. Hanging was the most common method of suicide overall and among male patients, and drowning was the most common among females. Male gender, tertiary referral, an adverse psychosocial event during admission, a period of absence without leave and expressing hopelessness were identified as independent risk factors for inpatient suicide. Substance use, involuntary detention, family history of suicide, and number of previous admissions were not significant.
CONCLUSIONS
While not highly sensitive, a period of absence without leave, tertiary referral and hopelessness are important predictors of inpatient suicide risk that treating teams should consider in care planning.
PubMed: 38517159
DOI: 10.1111/sltb.13073 -
BMC Infectious Diseases Mar 2024Scedosporium apiospermum species complex are widely distributed fungi that can be found in a variety of polluted environments, including soil, sewage, and decaying... (Review)
Review
Scedosporium apiospermum species complex are widely distributed fungi that can be found in a variety of polluted environments, including soil, sewage, and decaying vegetation. Those opportunistic pathogens with strong potential of invasion commonly affect immunosuppressed populations However, few cases of scedosporiosis are reported in immunocompetent individuals, who might be misdiagnosed, leading to a high mortality rate. Here, we reported an immunocompetent case of systemtic infection involved in lung, brain and spine, caused by S. apiospermum species complex (S. apiospermum and S. boydii). The patient was an elderly male with persistent fever and systemtic infection after near-drowning. In the two tertiary hospitals he visited, definite diagnosis was extremely difficult. After being admitted to our hospital, he was misdiagnosed as tuberculosis infection, before diagnosis of S. apiospermum species complex infection by the metagenomic next-generation sequencing. His symptoms were alleviated after voriconazole treatment. In the present case, the details associated with its course were reported and published studies on Scedosporium spp. infection were also reviewed, for a better understanding of this disease and reducing the misdiagnosis rate.
Topics: Humans; Male; Aged; Antifungal Agents; Scedosporium; Near Drowning; Voriconazole; Lung; Brain; Invasive Fungal Infections
PubMed: 38515075
DOI: 10.1186/s12879-023-08279-9 -
Zhonghua Liu Xing Bing Xue Za Zhi =... Mar 2024To analyze the characteristics, change of injury death spectrum in children aged 0-14 years and its urban-rural difference in Tianjin. The incidence data of injury...
To analyze the characteristics, change of injury death spectrum in children aged 0-14 years and its urban-rural difference in Tianjin. The incidence data of injury death in children aged 0-14 years in Tianjin from 1999 to 2021 were collected from the "Population Based Mortality Surveillance System in Tianjin". We calculated constituent ratio, crude and standardized mortality rates in different subgroups of the population and major injury subtypes, and compared the rural-urban differences. The Cochran-Armitage trend test was used to analyze temporal trends in cause-of-death component ratios. Joinpoint regression model was used to calculate average annual percent change (AAPC). Seasonal difference in injury mortality risk were expressed as mortality ratio and 95% confidence interval. From 1999 to 2021, injury was the third cause of death in children aged 0-14 years in Tianjin. The percentage of children who died in health-care facilities in rural area was 31.08%, which was lower than 37.82% in urban area. There was a downward trend in the standardized mortality rate of injury in children (AAPC=-5.54%, <0.001). The standardized mortality rates of drowning and road traffic injury declined in both urban area and rural area (<0.001). The mortality rate of accidental poisoning decreased in rural area (AAPC=-8.09%, <0.001), but showed no significant change trend in urban area (>0.05). The standardized mortality rate of suicide showed no significant change trend in urban area, but there was an increasing trend in the standardized mortality rate of suicide in rural children aged 10-14 years (AAPC=4.58%). No significant change trend was observed in mortality rate of falls in urban and rural children (>0.05). The injury mortality rate showed obvious seasonality in children in Tianjin. Overall injury death risk and risk for drowning-caused death were highest in summer in both urban area and rural area. The risk for road traffic injury-related death was highest in autumn in urban area and in summer in rural area. The risk for death caused by accidental poisoning was highest in winter in both urban area and rural area. In recent decades, the injury mortality rate in children aged 0-14 years in Tianjin showed a decreasing trend. There is still a significant difference in the injury mortality level between urban area and rural area, to which close attention needs to be paid in the future policy development.
Topics: Child; Humans; Drowning; Rural Population; Incidence; Population Surveillance; Seasons; China; Urban Population
PubMed: 38514314
DOI: 10.3760/cma.j.cn112338-20230831-00115 -
Internal and Emergency Medicine Mar 2024
PubMed: 38502465
DOI: 10.1007/s11739-024-03585-9 -
Academic Emergency Medicine : Official... Jun 2024A better characterization of deaths in children following emergency care is needed to inform timely interventions. This study aimed to describe the timing, location, and...
BACKGROUND AND OBJECTIVES
A better characterization of deaths in children following emergency care is needed to inform timely interventions. This study aimed to describe the timing, location, and causes of death to 1 year among a cohort of injured and medically ill children.
METHODS
We conducted a retrospective cohort study of children <18 years requiring emergency care in six states from January 1, 2012, through December 31, 2017, with follow-up through December 31, 2018, for patients who were not discharged from the emergency department (ED). In this cohort, 1-year mortality, time to death within 1 year, and causes of death were assessed from ED, inpatient, and vital status records.
RESULTS
There were 546,044 children during the 6-year period. The 1-year mortality rate was 2.2% (n = 1356) for injured children and 1.4% (n = 6687) for medically ill children. Matched death certificates were available for 861 (63.5%) of 1356 deaths in the injury cohort and for 4712 (70.5%) of 6687 deaths in the medical cohort. Among deaths in the injury cohort, 1274 (94.0%) occurred in the ED or hospital. The most common causes of death were motor vehicle collisions, firearm injuries, and pedestrian injuries. Among the 6687 deaths in the medical cohort, 5081 (76.0%) children died in the ED or hospital (primarily in the ED) and 1606 (24.0%) occurred after hospital discharge. The most common causes of death were sudden infant death syndrome, suffocation and drowning, and congenital conditions.
CONCLUSIONS
The 1-year mortality of children presenting to an ED is 2.2% for injured children and 1.4% for medically ill children with most deaths occurring in the ED. Future interventional trials, quality improvement efforts, and health policy focused in the ED could have the potential to improve outcomes of pediatric patients.
Topics: Humans; Emergency Service, Hospital; Retrospective Studies; Female; Male; Child, Preschool; Child; Infant; Cause of Death; Adolescent; Wounds and Injuries; Time Factors; United States; Cohort Studies; Infant, Newborn
PubMed: 38499441
DOI: 10.1111/acem.14875