scholarly journals Suicides on the Austrian railway network: hotspot analysis and effect of proximity to psychiatric institutions

2017 ◽  
Vol 4 (3) ◽  
pp. 160711 ◽  
Author(s):  
Markus J. Strauss ◽  
Peter Klimek ◽  
Gernot Sonneck ◽  
Thomas Niederkrotenthaler
Keyword(s):  
Public Space ◽  
Public Health Problem ◽  
Track Length ◽  
Hotspot Analysis ◽  
Railway Network ◽  
Psychiatric Institutions ◽  
Spatial Risk ◽  
Significant Public Health ◽  
Railway Suicide ◽  
Psychiatric Beds

Railway suicide is a significant public health problem. In addition to the loss of lives, these suicides occur in public space, causing traumatization among train drivers and passengers, and significant public transport delays. Prevention efforts depend upon accurate knowledge of clustering phenomena across the railway network, and spatial risk factors. Factors such as proximity to psychiatric institutions have been discussed to impact on railway suicides, but analytic evaluations are scarce and limited. We identify 15 hotspots on the Austrian railway system while taking case location uncertainties into account. These hotspots represent 0.9% of the total track length (5916 km/3676 miles) that account for up to 17% of all railway suicides ( N =1130). We model suicide locations on the network using a smoothed inhomogeneous Poisson process and validate it using randomization tests. We find that the density of psychiatric beds is a significant predictor of railway suicide. Further predictors are population density, multitrack structure and—less consistently—spatial socio-economic factors including total suicide rates. We evaluate the model for the identified hotspots and show that the actual influence of these variables differs across individual hotspots. This analysis provides important information for suicide prevention research and practice. We recommend structural separation of railway tracks from nearby psychiatric institutions to prevent railway suicide.

Railway Suicide in Belgium 1998–2009

Crisis ◽  
2012 ◽  
Vol 33 (1) ◽  
pp. 39-45 ◽  
Author(s):  
Karl Andriessen ◽  
Karolina Krysinska
Keyword(s):  
Suicide Prevention ◽  
Suicide Rate ◽  
Prevention Program ◽  
Suicide Attempts ◽  
Regional Distribution ◽  
Public Health Problem ◽  
Economic Loss ◽  
Prevention Measures ◽  
Railway Network ◽  
Railway Suicide

Background: Belgium is a country with a high suicide rate (19.1/100,000 in 2004), and railway suicide poses a substantial safety and public health problem. This problem was addressed by the Suicide Prevention Unit of Infrabel (Manager of the Belgian Railway Infrastructure), which collects relevant data and implements a prevention program. Aims: To present data on fatal and nonfatal suicidal behavior on the Belgian railway network, including monthly and regional distribution and identification of hotspots; and to present the Infrabel suicide prevention program. Methods: Analysis of Infrabel data on railway suicide (1998–2009) and comparison with data on suicide in Belgium. Results: A total of 1,092 railway suicides (1998–2009) and 557 suicide attempts (2003–2009) in Belgium (fatality rate of 54%) were studied. Monthly fluctuations were observed, with the majority of suicides occurring in Flanders, followed by Wallonia and Brussels. We identified 34 hotspots accounting for 35% of cases, mostly in Flanders. Conclusions: In 2004 railway suicide accounted for 5.3% of all suicides in Belgium (railway suicide rate of 1.03/100,000). Such a major human and economic loss warrants implementation of prevention measures. Infrabel has initiated a comprehensive suicide prevention program which focuses mainly on safeguarding the suicide hotspots.

scholarly journals Suicide on the Railways in Belgium: A Typology of Locations and Potential for Prevention

2018 ◽  
Vol 15 (10) ◽  
pp. 2074
Author(s):  
Mathieu Strale ◽  
Karolina Krysinska ◽  
Gaëtan Van Overmeiren ◽  
Karl Andriessen
Keyword(s):  
Average Length ◽  
Public Health Problem ◽  
Principal Component ◽  
Traffic Density ◽  
Psychiatric Facility ◽  
Railway Network ◽  
Railway Traffic ◽  
Preventative Measures ◽  
Railway Suicide ◽  
Psychiatric Facilities

Suicide on railway networks comprises a serious public health problem. However, the geographical distribution and the environmental risk factors remain unclear. This study analyzed the geographic distribution of railway suicides in Belgium from 2008–2013 at the level of a railway section (average length of 3.5 km). Principal component analysis (PCA) identified three groups of correlations that helped explain the variance of railway suicide. The three groups are related to characteristics of urban spaces, psychiatric facilities, and railway traffic density. Based on the PCA results, the study found four types of railway sections. The density of railway suicide was average and low in the urban and rural/industrial sections, respectively. However, it was high in the suburban sections and the sections close to psychiatric facilities. As the geographical proximity of a psychiatric facility comprises a specific risk factor for suicide on railways, preventative measures should target these sections and establish collaborations with psychiatric facilities. The typology of locations found in this study constitutes crucial information for national and local suicide prevention on the Belgian railway network.

scholarly journals A Fatal and Rare Case of Hydatid Cyst in the Pouch of Douglas

2021 ◽  
Author(s):  
Ritu Asnani ◽  
Sunil Kumar Yeshvanth ◽  
Lancelot Lobo ◽  
Shipra Sonkusare
Keyword(s):  
Hydatid Cyst ◽  
Rare Case ◽  
Frozen Section ◽  
Public Health Problem ◽  
Zoonotic Infection ◽  
Middle Income ◽  
Middle Income Countries ◽  
Significant Public Health Problem ◽  
Significant Public Health ◽  
Pouch Of Douglas

Abstract Hydatid cyst is a zoonotic infection and a significant public health problem in low- and middle-income countries. A 79-year-old female patient was presented to the gynecology outpatient department with complaints of pain in the abdomen and difficulty in micturition, with a mass palpable per speculum. The ultrasound was suggestive of an ovarian cystadenocarcinoma, whereas computed tomography of the abdomen favored hydatid cyst with adnexal neoplasm as a differential diagnosis. Considering the contradictory findings, a frozen section was sent to confirm the diagnosis, which showed hooklets of Echinococcus granulosus/hydatid cyst under the microscope. This was a rare case of pelvic hydatid cyst mimicking ovarian malignancy and was associated with a less-preferred mode of investigation (frozen section). This article focuses on how a frozen section, despite its limitations and being expensive, can still be considered for accurate patient management.

Possible role of Unani Pharmacology in COVID-19 – a narrative review

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Md Anzar Alam ◽  
Mohd Abdul Gani ◽  
G. Shama ◽  
Ghulamuddin Sofi ◽  
Mohd Aleemuddin Quamri
Keyword(s):  
Clinical Manifestations ◽  
Public Health Problem ◽  
World Health ◽  
Santalum Album ◽  
Boswellia Serrata ◽  
Unani Medicine ◽  
Significant Public Health Problem ◽  
Significant Public Health ◽  
Novel Coronavirus ◽  
Health Organization

AbstractAccording to the World Health Organization (WHO), viral diseases continue to rise, and pose a significant public health problem. Novel coronavirus disease (COVID-19) is an infectious disease caused by SARS-CoV-2. The pathogenesis and clinical manifestations of COVID-19 is close to Amraz-e-Wabai (epidemic diseases) which was described by Hippocrates, Galen, Aristotle, Razes, Haly Abbas, Avicenna, Jurjani etc. Presently, there is no specific or challenging treatment available for COVID-19. Renowned Unani Scholars recommended during epidemic situation to stay at home, and fumigate the shelters with aromatics herbs like Ood kham (Aquilaria agallocha Roxb.), Kundur (Boswellia serrata Roxb), Kafoor (Cinnamomum camphora L.), Sandal (Santalum album L), Hing (Ferula foetida L.) etc. Use of specific Unani formulations are claimed effective for the management of such epidemic or pandemic situation like antidotes (Tiryaqe Wabai, Tiryaqe Arba, Tiryaqe Azam, Gile Armani), Herbal Decoction (Joshandah), along with Sharbate Khaksi, Habbe Bukhar, Sharbate Zanjabeel, Khamira Marwareed, Jawarish Jalinus, and Sirka (vinegar). Such drugs are claimed for use as antioxidant, immunomodulatory, cardiotonic, and general tonic actions. The study enumerates the literature regarding management of epidemics in Unani medicine and attempts to look the same in the perspective of COVID-19 prevention and management.

scholarly journals Self-harm among in-school and street-connected adolescents in Ghana: a cross-sectional survey in the Greater Accra region

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e041609
Author(s):  
Emmanuel Nii-Boye Quarshie ◽  
Farag Shuweihdi ◽  
Mitch Waterman ◽  
Allan House
Keyword(s):  
Public Health Problem ◽  
Self Report ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Self Injury ◽  
Significant Public Health Problem ◽  
Significant Public Health ◽  
Treatment Measures ◽  
Self Harm ◽  
Greater Accra Region

ObjectivesTo identify the prevalence, methods, associations and reported reasons for self-harm among in-school and street-connected adolescents in Ghana.DesignA cross-sectional survey. We applied multi-level regression models and model-based cluster analysis to the data.SettingThree contexts in the Greater Accra region were used: second cycle schools, facilities of charity organisations and street census enumeration areas (sleeping places of street-connected adolescents, street corners, quiet spots of restaurants, markets, train and bus stations, and lorry and car parks).ParticipantsA regionally representative sample of 2107 (1723 in-school and 384 street-connected) adolescents aged 13–21 years.Outcome measuresParticipants responded to a structured self-report anonymous questionnaire describing their experience of self-harm and eliciting demographic information and social and personal adversities.ResultsThe lifetime prevalence of self-harm was 20.2% (95% CI 19.0% to 22.0%), 12-month prevalence was 16.6% (95% CI 15.0% to 18.0%) and 1-month prevalence was 3.1% (95% CI 2.0% to 4.0%). Self-injury alone accounted for 54.5% episodes and self-poisoning alone for 16.2% episodes, with more than one method used in 26% of episodes. Self-cutting (38.7%) was the most common form of self-injury, whereas alcohol (39.2%) and medications (27.7%) were the most commonly reported means of self-poisoning. The factors associated with self-harm were interpersonal: conflict with parents (adjusted OR (aOR)=1.87, 95% CI 1.24 to 2.81), physical abuse victimisation (aOR=1.69, 95% CI 1.16 to 2.47), difficulty in making and keeping friends (aOR=1.24, 95% CI 0.85 to 1.80), sexual abuse victimisation (aOR=1.21, 95% CI 0.78 to 1.87) and conflict between parents (aOR=1.07, 95% CI 0.73 to 1.56).ConclusionsSelf-harm is a significant public health problem among in-school and street-connected adolescents in the Greater Accra region of Ghana. Its origins are very largely in social and familial adversity, and therefore prevention and treatment measures need to be focused in these areas.

scholarly journals Exploring spatial variation in BCG vaccination among children 0–35 months in Ethiopia: spatial analysis of Ethiopian Demographic and Health Survey 2016

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e043565
Author(s):  
Chilot Desta Agegnehu ◽  
Adugnaw Zeleke Alem
Keyword(s):  
Spatial Variation ◽  
Health Survey ◽  
Addis Ababa ◽  
Public Health Problem ◽  
Demographic And Health Survey ◽  
Scan Statistics ◽  
Major Public Health Problem ◽  
Hotspot Analysis ◽  
Bcg Vaccination ◽  
South West

ObjectiveTuberculosis is a major public health problem and is the second leading cause of death worldwide. BCG vaccination is a life-saving and important part of standard tuberculosis control measures, particularly in Ethiopia where tuberculosis is endemic. The End Tuberculosis Strategy targets of 2020 have not been achieved. Exploring spatial variations in BCG vaccination among children is vital to designing and monitoring effective intervention programmes. Therefore, this study aimed to explore the spatial variation in BCG vaccination among children in Ethiopia.DesignCross-sectional study design.SettingEthiopia.ParticipantsChildren aged 0–35 months.Primary outcomeBCG vaccination coverage.MethodsData from the 2016 Ethiopian Demographic and Health Survey were used and a total of 4453 children aged 0–35 months were included. Spatial autocorrelation analysis, cluster and outlier analysis, hotspot analysis, spatial interpolation, and spatial scan statistics were carried out to identify geographical risk areas for BCG vaccine utilisation. ArcGIS V.10.6 and SaTScan V.9.6 statistical software were employed to explore spatial pattern and significant hotspot areas for BCG vaccination among children.ResultsBCG vaccination was spatially clustered in Ethiopia at the regional level (Global Moran’s I=0.516, p<0.001). A total of 51 most likely clusters of low BCG vaccination were identified in the Somali and Afar regions (log-likelihood ratio=136.58, p<0.001). Significant secondary clusters were also identified in North West Gambela, South Amhara, South West Addis Ababa, North East Southern Nations, Nationalities, and People’s Region, and South West Oromia.ConclusionA low probability of receiving BCG vaccination was found among children in the Somali and Afar regions. Therefore, these areas should be given attention when designing effective immunisation strategies to improve BCG vaccination among children in order to reduce the burden of tuberculosis in Ethiopia.

Female sexual dysfunction: a problem hidden in the shadows

2021 ◽  
Vol 27 ◽  
Author(s):  
Konstantinos P. Imprialos ◽  
Konstantinos Koutsampasopoulos ◽  
Aleksandra Katsimardou ◽  
Sofia Bouloukou ◽  
Iakovos Theodoulidis ◽  
...  
Keyword(s):  
Risk Factors ◽  
Sexual Dysfunction ◽  
Female Sexual Dysfunction ◽  
Treatment Options ◽  
Public Health Problem ◽  
Management Options ◽  
Significant Public Health Problem ◽  
Significant Public Health ◽  
Cv Disease

Background: Female sexual dysfunction (FSD) has mainly been underdiagnosed and undertreated due to the lack of concrete definitions, validated assessment methods, and efficient treatments. However, during the last few decades, there has been significant progress in the clinical management and research of FSD. Objective: The purpose of this review is to describe the pathophysiology of FSD, report the prevalence of the disease in the setting of cardiovascular (CV) risk factors and disease, and review current and under investigation treatment options. Methods: A comprehensive literature review was performed to identify studies examining the association of FSD with CV risk factors and/or disease and studies reporting appropriate management options. Results: The prevalence of FSD is increased in the general population (approximately 40%) and is significantly higher in patients with hypertension, diabetes mellitus, and dyslipidemia. In patients with overt CV disease, FSD is even more prevalent (up to 90%). The cause of FSD is multifactorial and includes various vascular, hormonal, interpersonal, and psychological factors, which are all intertwined. Several treatment options exist that are efficient in improving female sexual function, while a cluster of other alternatives has been shown to offer benefits. Conclusion: FSD is a significant public health problem with a great impact on the patients’ quality of life. In the setting of increased CV burden, FSD is even more prevalent. Increased awareness is needed for the physician to establish a trustful environment with the patient, discuss such issues, and offer suitable management options.

scholarly journals Hepatitis E: an underestimated emerging threat

2019 ◽  
Vol 6 ◽  
pp. 204993611983716 ◽  
Author(s):  
Glynn W. Webb ◽  
Harry R. Dalton
Keyword(s):  
Burden Of Disease ◽  
Public Health Problem ◽  
Hepatitis E ◽  
Industrialized Countries ◽  
Zoonotic Infections ◽  
Wide Range ◽  
The World ◽  
Significant Public Health ◽  
History Of

Hepatitis E virus (HEV) is the most common cause of viral hepatitis in the world. It is estimated that millions of people are infected every year, resulting in tens of thousands of deaths. However, these estimates do not include industrialized regions and are based on studies which employ assays now known to have inferior sensitivity. As such, this is likely to represent a massive underestimate of the true global burden of disease. In the developing world, HEV causes large outbreaks and presents a significant public-health problem. Until recently HEV was thought to be uncommon in industrialized countries, and of little relevance to clinicians in these settings. We now know that this is incorrect, and that HEV is actually very common in developed regions. HEV has proved difficult to study in vitro, with reliable models only recently becoming available. Our understanding of the lifecycle of HEV is therefore incomplete. Routes of transmission vary by genotype and location: endemic regions experience large waterborne epidemics, while sporadic cases in industrialized regions are zoonotic infections likely spread via the food chain. Both acute and chronic infection has been observed, and a wide range of extrahepatic manifestations have been reported. This includes neurological, haematological and renal conditions. As the complete clinical phenotype of HEV infection is yet to be characterized, a large proportion of cases go unrecognized or misdiagnosed. In many cases HEV infection does not feature in the differential diagnosis due to a lack of knowledge and awareness of the disease amongst clinicians. In combination, these factors have contributed to an underestimation of the threat posed by HEV. Improvements are required in terms of recognition and diagnosis of HEV infection if we are to understand the natural history of the disease, improve management and reduce the burden of disease around the world.

scholarly journals Trends, Coverage and Influencing Determinants of Influenza Vaccination in the Elderly: A Population-Based National Survey in Spain (2006–2017)

Vaccines ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 327
Author(s):  
Silvia Portero de la Cruz ◽  
Jesús Cebrino
Keyword(s):  
Influenza Vaccination ◽  
Chronic Diseases ◽  
Vaccination Coverage ◽  
Public Health Problem ◽  
Risk Groups ◽  
The Elderly ◽  
Population Based ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Significant Public Health

Influenza is a significant public health problem and the elderly are at a greater risk of contracting the disease. The vaccination coverage of the elderly is below the Spanish target of 65% for each influenza season. The aims of this study were to report the coverage of influenza vaccination in Spain among the population aged ≥65 years and high-risk groups for suffering chronic diseases, to analyze the time trends from 2006 to 2017 and to identify the factors which affect vaccination coverage. A nationwide cross-sectional study was conducted including 20,753 non-institutionalized individuals aged ≥65 years who had participated in the Spanish National Health Surveys in 2006, 2011/2012, and 2017. Sociodemographic, health-related variables, and influenza vaccination data were used. A logistic regression analysis was performed to determine the variables associated with influenza vaccination. Influenza vaccination coverage was 60%. By chronic condition, older people with high cholesterol levels and cancer had the lowest vaccination coverage (62.41% and 60.73%, respectively). This coverage declined from 2006 to 2017 in both groups. Higher influenza vaccination was associated with males, Spanish nationality, normal social support perceived, polypharmacy, worse perceived health, participation in other preventive measures, and increasing age and the number of chronic diseases.

Towards Prevention and Early Recognition of Stroke: The Australian Context

2011 ◽  
Vol 12 (3) ◽  
pp. 223-230
Author(s):  
Evrim G. March
Keyword(s):  
At Risk ◽  
Stroke Prevention ◽  
Early Recognition ◽  
Public Health Problem ◽  
Risk Groups ◽  
Effective Prevention ◽  
Australian Context ◽  
The Status ◽  
Significant Public Health ◽  
Policies And Programs

AbstractStroke is a preventable disease leading to physical, cognitive and emotional disability. Its high prevalence and poor outcome shifts this disease from the clinical, medical realm to a significant public health problem. This article provides an overview of the problem, and the status of stroke prevention in the Australian context. To achieve this, it first examines the recent Australian surveillance data on stroke, identifying the at-risk groups. It then argues for targeted stroke prevention, assesses relevant policies and programs in the international and Australian contexts, and briefly reviews approaches for increased awareness and recognition of stroke symptoms. The article concludes by emphasising the need to account for the at-risk-groups when developing targeted health promotion campaigns for effective prevention of stroke in Australia.

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