Psychosocial Determinants of Burn-Related Suicide: Evidence From the National Violent Death Reporting System

2020 ◽  
Author(s):  
Thereasa E Abrams ◽  
Stephen V McGarity
Keyword(s):  
Public Health ◽  
Psychosocial Factors ◽  
Reporting System ◽  
Reference Group ◽  
Early Recognition ◽  
Rare Event ◽  
Public Health Problem ◽  
Small Sample ◽  
Violent Death ◽  
Health Crisis

Abstract Suicide is a unique phenomenon in humans. In 2017, over 47,000 Americans died by suicide, prompting a public health crisis. Suicide by burning, while one of the rarest forms of suicide, could be mitigated in part by early recognition and treatment of the underlying psychosocial factors. To date, investigators have attempted to tease out the risk factors associated with this phenomenon through the examination of burn center chart reviews and repository data, but these studies were limited by small sample sizes. In order to fill this gap in the literature, the authors analyzed 14 years of data (2003–2016) from the National Violent Death Reporting System. Suicides by burning (n = 722) were compared with a reference group containing all other suicide types (n = 166,949). Socio-demographic variables and psychosocial factors (eg, mental health, substance use, and alcohol use) were included in the model. Due to the imbalance between the target and reference groups, rare event data analysis was used to reduce potential small sample estimation bias. Results indicated that females (OR = 1.6, 95% CI: .50–2.83, P < .001), Caucasians (OR = 1.7, 95% CI: 1.1–2.7, P < .001), victims with schizophrenia (OR = 5.4, 95% CI: 3.7–7.8, P < .001), and victims with eating disorders (OR = 5.6, 95% CI: 1.9–8.6, P < .001) are significantly more likely to commit suicide by burning. These results contribute new knowledge to what is currently known about suicidal burn-related behaviors and supports interventions that focus on mitigating this insidious public health problem.

scholarly journals Examining differences between mass, multiple, and single-victim homicides to inform prevention: findings from the National Violent Death Reporting System

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Katherine A. Fowler ◽  
Rachel A. Leavitt ◽  
Carter J. Betz ◽  
Keming Yuan ◽  
Linda L. Dahlberg
Keyword(s):  
Public Health ◽  
Partner Violence ◽  
Reporting System ◽  
Public Health Problem ◽  
The United States ◽  
Medical Examiner ◽  
Violent Death ◽  
Homicide Rates ◽  
Shared Risk ◽  
The U.S

Abstract Background Multi-victim homicides are a persistent public health problem confronting the United States. Previous research shows that homicide rates in the U.S. are approximately seven times higher than those of other high-income countries, driven by firearm homicide rates that are 25 times higher; 31% of public mass shootings in the world also occur in the U.S.. The purpose of this analysis is to examine the characteristics of mass, multiple, and single homicides to help identify prevention points that may lead to a reduction in different types of homicides. Methods We used all available years (2003–2017) and U.S. states/jurisdictions (35 states, the District of Columbia, and Puerto Rico) included in CDC’s National Violent Death Reporting System (NVDRS), a public health surveillance system which combines death certificate, coroner/medical examiner, and law enforcement reports into victim- and incident-level data on violent deaths. NVDRS includes up to 600 standard variables per incident; further information on types of mental illness among suspected perpetrators and incident resolution was qualitatively coded from case narratives. Data regarding number of persons nonfatally shot within incidents were cross-validated when possible with several other resources, including government reports and the Gun Violence Archive. Mass homicides (4+ victims), multiple homicides (2-3 victims) and single homicides were analyzed to assess group differences using Chi-square tests with Bonferroni-corrected post-hoc comparisons. Results Mass homicides more often had female, child, and non-Hispanic white victims than other homicide types. Compared with victims of other homicide types, victims of mass homicides were more often killed by strangers or someone else they did not know well, or by family members. More than a third were related to intimate partner violence. Approximately one-third of mass homicide perpetrators had suicidal thoughts/behaviors noted in the time leading up to the incident. Multi-victim homicides were more often perpetrated with semi-automatic firearms than single homicides. When accounting for nonfatally shot victims, over 4 times as many incidents could have resulted in mass homicide. Conclusions These findings underscore the important interconnections among multiple forms of violence. Primary prevention strategies addressing shared risk and protective factors are key to reducing these incidents.

scholarly journals Correctional Work: Reflections Regarding Suicide

2021 ◽  
Vol 18 (8) ◽  
pp. 4280
Author(s):  
Christine Genest ◽  
Rosemary Ricciardelli ◽  
R. Nicholas Carleton
Keyword(s):  
Public Health ◽  
Suicidal Ideation ◽  
Family Doctor ◽  
Public Health Problem ◽  
Health Agency ◽  
Life Time ◽  
Psychological Theory ◽  
Small Sample ◽  
Employee Assistance Program ◽  
Assistance Program

The Public Health Agency of Canada declared suicide a public health problem in Canada (2016). Employees working in correctional services, researchers find, experience high rates of life-time suicidal ideation in comparison to other public safety professionals and the general population. Suicide behaviours (i.e., ideation, planning, attempts, death) are a multifactorial phenomenon, explained in part by the Interpersonal-Psychological Theory of Suicide that suggests attempted suicide is facilitated by perceived burdensomeness, a lost sense of belonging, a feeling of hopelessness, and a progressively reduced fear of death, as well as capacity and planning to engage a lethal attempt. In the current study, we unpack the factors that can influence suicide behaviours as reported by correctional workers. Our intent is to make explicit the experiences of a small sample (n = 25) of correctional workers in relation to suicidal behaviours, highlighting stories of recovery and acknowledging the importance of facilitating psychologically safe workplaces. Analysis entailed an inductive semi-grounded emergent theme approach. Participants identified certain risk factors as being able to induce suicidal ideation, such as marital or family problems as well as difficulties at work (i.e., bullying or difficult working conditions). Having children and a partner may act as factors preventing suicide for those with ideation. Participants sought help from professionals, such as their family doctor, a psychologist, or the Employee Assistance Program (EAP); however, the lack of perceived organisational supports and recognition of the issue of suicide by the employer are two elements that can hinder the search for help.

scholarly journals Knee Joint Tuberculosis Presenting as Immune Thrombocytopenia

1970 ◽  
Vol 10 (1) ◽  
pp. 28-30
Author(s):  
Mohammad Abdullah Az Zubayer Khan ◽  
Fazle Rabbi Mohammed ◽  
Md Ziaus Shams ◽  
Shaymal Sarker ◽  
Md Billal Alam
Keyword(s):  
Public Health ◽  
Knee Joint ◽  
Immune Thrombocytopenia ◽  
Case Reports ◽  
Rare Event ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Immune Mechanism ◽  
Thrombocytopenic Purpura ◽  
Case Documentation

Tuberculosis (TB) is a major public health problem of increasing proportions in Bangladesh for last several decades. A total of 350,641 cases were reported in Bangladesh in 2006 representing an incidence of 225 per 100,000 population for that year. Many hematological derangements such as anaemia, leukocytosis or pancytopenia can occur in association with TB. However isolated thrombocytopenia is rare and most commonly occur via a non immune mechanism in the setting of pancytopenia that develop secondary to granulomatous infiltration of the bone marrow.  However immune thrombocytopenic purpura (ITP) in a patient with TB is exceedingly a rare event. Here we report a case of ITP associated with TB of knee joint in whom thrombocytopenia and TB were successfully treated. A casual association between joint TB and ITP is extraordinarily rare and to our knowledge this is the first such case documentation in Bangladesh, although a few case reports citing association of TB and ITP are found in literature.   doi:10.3329/jom.v10i1.2001 J Medicine 2009; 10: 28-30

Health Literacy, Opioid Misuse, and Pain Experience Among Adults with Chronic Pain

Pain Medicine ◽  
2019 ◽  
Vol 21 (4) ◽  
pp. 670-676 ◽  
Author(s):  
Andrew H Rogers ◽  
Jafar Bakhshaie ◽  
Michael F Orr ◽  
Joseph W Ditre ◽  
Michael J Zvolensky
Keyword(s):  
Public Health ◽  
Chronic Pain ◽  
Health Literacy ◽  
Health Care Cost ◽  
Public Health Problem ◽  
The United States ◽  
Prescription Opioid ◽  
Opioid Misuse ◽  
Health Crisis ◽  
Pain Experience

Abstract Background Chronic pain is a significant public health problem that is associated with several negative health outcomes, including increased health care cost, decreased productivity, and prescription opioid misuse. Although efforts have been made to curb the growing opioid epidemic in the United States, further research is needed to better understand individual difference factors that may be associated with greater pain and opioid misuse. Lower levels of health literacy, defined as the ability to obtain, understand, and use health information to make important decisions regarding health and medical care, has been associated with several chronic illnesses. Yet little work has examined the relationship between health literacy, pain, and opioid misuse among individuals with chronic pain. Methods The current study examined health literacy in relation to current opioid misuse, severity of opioid dependence, pain severity, and pain disability among 445 adults with chronic pain (74.6% female, Mage [SD] = 38.45 [11.06] years). Results Results indicated that health literacy was significantly negatively associated with each of the criterion variables. Conclusions These results suggest that health literacy may contribute to opioid misuse and pain experience among individuals with chronic pain. Interventions targeting health literacy among individuals with chronic illness may help to address the opioid public health crisis.

scholarly journals Integrated digital system for community engagement and community-based surveillance during the 2014–2016 Ebola outbreak in Sierra Leone: lessons for future health emergencies

2020 ◽  
Vol 5 (12) ◽  
pp. e003936
Author(s):  
Mohamed F Jalloh ◽  
Paul Sengeh ◽  
Nyuma James ◽  
Saiku Bah ◽  
Mohammad B Jalloh ◽  
...  
Keyword(s):  
Public Health ◽  
Community Engagement ◽  
Sierra Leone ◽  
Reporting System ◽  
Scale Up ◽  
Time Data ◽  
Community Based ◽  
Health Crisis ◽  
Lessons Learnt ◽  
Essential Components

Community engagement and community-based surveillance are essential components of responding to infectious disease outbreaks, but real-time data reporting remains a challenge. In the 2014–2016 Ebola outbreak in Sierra Leone, the Social Mobilisation Action Consortium was formed to scale-up structured, data-driven community engagement. The consortium became operational across all 14 districts and supported an expansive network of 2500 community mobilisers, 6000 faith leaders and 42 partner radio stations. The benefit of a more agile digital reporting system became apparent within few months of implementing paper-based reporting given the need to rapidly use the data to inform the fast-evolving epidemic. In this paper, we aim to document the design, deployment and implementation of a digital reporting system used in six high transmission districts. We highlight lessons learnt from our experience in scaling up the digital reporting system during an unprecedented public health crisis. The lessons learnt from our experience in Sierra Leone have important implications for designing and implementing similar digital reporting systems for community engagement and community-based surveillance during public health emergencies.

Bleeding Disorders in Premenopausal Women: (Another) Public Health Crisis for Hematology?

Hematology ◽  
2006 ◽  
Vol 2006 (1) ◽  
pp. 474-485 ◽  
Author(s):  
Andra H. James ◽  
Margaret V. Ragni ◽  
Vincent J. Picozzi
Keyword(s):  
Public Health ◽  
Public Health Problem ◽  
Premenopausal Women ◽  
Bleeding Disorder ◽  
Von Willebrand Disease ◽  
Deficiency Anemia ◽  
Public Health Approach ◽  
Major Public Health Problem ◽  
Bleeding Disorders ◽  
Health Crisis

Abstract Premenopausal women with bleeding disorders represent a major public health problem. Estimates suggest up to 20% of women with menorrhagia have an underlying bleeding disorder (corresponding to a prevalence of 1.5–4 million American women). Von Willebrand disease (VWD) is the most common bleeding disorder among women with menorrhagia, affecting up to 20% of such patients. Besides menorrhagia, important consequences of bleeding disorders in premenopausal women include iron deficiency anemia, miscarriage, postpartum bleeding, uterine bleeding and hysterectomy. These patients face many obstacles in achieving optimum care. Recognition is difficult as women may consider their symptoms “normal” and come to attention only after serious bleeding events. Symptoms of VWD may also overlap with benign conditions, primary providers may not suspect the diagnosis, and convenient hematologic input may be unavailable. Diagnosis is difficult as there is no single definitive test for VWD, and test results are variable, often being affected by extragenic factors, including stress, contraceptives, hormones, and pregnancy. Hemostatic treatment is limited by DDAVP tachyphylaxis, the lack of recombinant VWD concentrates, and the ineffectiveness of hormonal therapy, leading to unnecessary procedures and early hysterectomy. Finally, significant controversy exists regarding classification of type 1 VWD as a disease: given the overlap in symptoms and laboratory assays within the normal population, evaluation for those with VWD might be seen as identification of potential bleeding risk rather than detection of a disease. This symposium seeks to explore these issues in greater detail from the combined perspectives of the obstetrician-gynecologist and the hematologist to promote a better public health approach to this problem.

scholarly journals How Prepared Are We for Possible Bioterrorist Attacks: An Approach from Emergency Medicine Perspective

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Ali Kemal Erenler ◽  
Murat Güzel ◽  
Ahmet Baydin
Keyword(s):  
Public Health ◽  
Emergency Medicine ◽  
Health Problem ◽  
Emergency Departments ◽  
Early Recognition ◽  
Public Health Problem ◽  
Public Health Emergency ◽  
Mass Casualties ◽  
Mortality And Morbidity ◽  
Civil Unrest

Preparedness for bioterrorist attacks and early recognition of specific agents are essential for public health. Emergency departments may play an important role in this field. The large spectrum of bioterrorism involves not only disastrous terrorism with mass casualties, but also microevents using low technology but producing civil unrest, disruption, disease, disabilities, and death. It aims not only to cause mortality and morbidity, but also to lead to social and political disruption. Preparedness appears to be the most potent defense against possible bioterrorist events. In this article, we aim to create awareness against biological agents and underline the importance of emergency departments in this public health problem.

scholarly journals Aggression, Escalation, and Other Latent Themes in Legal Intervention Deaths of Non-Hispanic Black and White Men: Results From the 2003‒2017 National Violent Death Reporting System

2021 ◽  
pp. e1-e9
Author(s):  
Alina Arseniev-Koehler ◽  
Jacob Gates Foster ◽  
Vickie M. Mays ◽  
Kai-Wei Chang ◽  
Susan D. Cochran
Keyword(s):  
Public Health ◽  
Ethnic Differences ◽  
Topic Modeling ◽  
Reporting System ◽  
Health Workers ◽  
Violent Death ◽  
Legal Intervention ◽  
Black And White ◽  
Public Health Workers ◽  
Racial Ethnic

Objectives. To investigate racial/ethnic differences in legal intervention‒related deaths using state-of-the-art topic modeling of law enforcement and coroner text summaries drawn from the 2003–2017 US National Violent Death Reporting System (NVDRS). Methods. Employing advanced topic modeling, we identified 8 topics consistent with dangerousness in death incidents in the NVDRS death narratives written by public health workers (PHWs). Using logistic regression, we then evaluated racial/ethnic differences in PHW-coded variables and narrative topics among 4981 males killed by legal intervention, while adjusting for age, county-level characteristics, and year. Results. Black, as compared with White, decedents were younger and their deaths were less likely to include PHW-coded mental health or substance use histories, weapon use, or positive toxicology for alcohol or psychoactive drugs, but more likely to include “gangs-as-an-incident-precipitant” coding. Topic modeling revealed less frequent thematic representation of “physical aggression” or “escalation” but more of “gangs or criminal networks” among Black versus White decedents. Conclusions. While Black males were more likely to be victims of legal intervention deaths, PHW-coded variables in the NVDRS and death narratives suggest lower threat profiles among Black versus similar White decedents. The source of this greater risk remains undetermined. (Am J Public Health. Published online ahead of print May 13, 2021: e1–e9. https://doi.org/10.2105/AJPH.2021.306312 )

scholarly journals Obesity blocks oligodendrocyte precursor cell differentiation and impedes repair after white matter stroke

2018 ◽  
Author(s):  
Guanxi Xiao ◽  
Jasmine Burguet ◽  
Riki Kawaguchi ◽  
Leif A. Havton ◽  
Jason D. Hinman
Keyword(s):  
Public Health ◽  
White Matter ◽  
Molecular Mechanisms ◽  
Public Health Problem ◽  
White Matter Lesions ◽  
Obese Mice ◽  
Ischemic Lesion ◽  
Health Crisis ◽  
Time Points ◽  
Oligodendrocyte Precursor

AbstractObesity is a growing public health problem that increases rates of white matter atrophy and increases the likelihood of ischemic lesions within white matter. However, the cellular and molecular mechanisms that regulate these changes are unknown. We hypothesized that obesity may alter oligodendrocytes and myelin priming white matter for worsening injury and repair responses after ischemia. C57Bl/6 mice fed a high fat diet (60% kcal from fat) show increased numbers of oligodendrocyte precursor cells (OPCs), decreased myelin thickness with elevated g-ratios, and shorter paranodal axonal segments, indicating accelerated myelin turnover. Fate mapping of OPCs in PDGFRα-CreERT;Rpl22tm1.1Psam mice demonstrated that OPC differentiation rates are enhanced by obesity. Gene expression analyses using a novel oligodendrocyte staging assay demonstrated OPC differentiation is blocked by obesity in between the pre-myelinating and myelinating stage. Using a model of subcortical white matter stroke, the number of stroke-responsive OPCs in obese mice was increased after stroke. At early time points after ischemic white matter stroke, spatial mapping of stroke-responsive OPCs indicates that obesity leads to increased OPCs at the edge of ischemic white matter lesions. At later time points, obesity results in increased OPCs within the ischemic lesion while reducing the number of GST-π-positive mature oligodendrocytes in the lesion core. These data indicate that obesity disrupts normal white matter biology by blocking oligodendrocyte differentiation, leads to an exaggerated response of OPCs to white matter ischemia, and limits remyelination after stroke.Significance StatementObesity is a growing public health crisis that specifically increases the development of white matter lesions and silent brain infarcts. This relationship implies a direct cellular effect on white matter yet direct evidence is limited. We modeled diet-induced obesity in mice and studied the effect on oligodendrocyte biology and the response to focal white matter stroke. Adult-onset obesity results in thinner myelin, compromised axonal microdomain structure, and blocks the differentiation of OPCs, leaving the white matter with increased numbers of OPCs. After focal white matter stroke in obese mice, the early OPC response to stroke is exaggerated while late reparative OPC differentiation is blocked. These results suggest that obesity specifically blocks OPC differentiation with consequence on brain repair after stroke.

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