National registry for sudden unexpected deaths of infants and children in England: why do we need one and do families want one?

The sudden and unexpected death of an infant or child is devastating. An inability to explain why an infant or child died is difficult to accept for both families and professionals. No reliable national dataset exists to estimate precisely how many infants and children die unexpectedly each year in England. This lack of accurate epidemiological data belies the scale of this public health problem. Detailed controlled observational studies of infant deaths identifying risk factors and providing evidence-based advice for parents has seen a dramatic reduction in incidence over the last 30 years by almost 80% but greater knowledge is needed if future deaths of infants and older children are to be prevented and families optimally supported. We propose that a national registry of sudden unexpected deaths in infancy and childhood would accurately determine incidence, identify unknown risk factors and highlight good care practices, ensuring these can be standardised nationally. For such a project to be successful, however, parents must be at the heart of it. We held a consultation day between families, professionals and supporting charities (The Lullaby Trust, Child Bereavement UK, SUDC UK and CRY) to seek opinion on the desire for a registry and how best to ensure families are engaged. Here, we summarise our rationale for a registry and the feedback we received from attendees regarding their views of the proposal and the practical aspects of administering it.

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The malaria burden of Amerindian groups of three Venezuelan states: a descriptive study based on programmatic data

Malaria Journal ◽

10.1186/s12936-021-03819-7 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Juan C. Gabaldón-Figueira ◽

Carlos Chaccour ◽

Jorge Moreno ◽

Maria Villegas ◽

Leopoldo Villegas

Keyword(s):

Risk Factors ◽

Plasmodium Falciparum ◽

Malaria Incidence ◽

Hot Spot ◽

Public Health Problem ◽

Epidemiological Data ◽

Descriptive Study ◽

Malaria Burden ◽

Indigenous Groups ◽

The Impact

Abstract Background Fifty-three percent of all cases of malaria in the Americas in 2019 came from Venezuela, where the epidemic is heavily focused south of the Orinoco river, and where most of the country’s Amerindian groups live. Although the disease is known to represent a significant public health problem among these populations, little epidemiological data exists on the subject. This study aims to provide information on malaria incidence, geospatial clustering, and risk factors associated to Plasmodium falciparum infection among these groups. Methods This is a descriptive study based on the analysis of published and unpublished programmatic data collected by Venezuelan health authorities and non-government organizations between 2014 and 2018. The Annual Parasite Index among indigenous groups (API-i) in municipalities of three states (Amazonas, Bolivar, and Sucre) were calculated and compared using the Kruskal Wallis test, risk factors for Plasmodium falciparum infection were identified via binomial logistic regression and maps were constructed to identify clusters of malaria cases among indigenous patients via Moran’s I and Getis-Ord’s hot spot analysis. Results 116,097 cases of malaria in Amerindian groups were registered during the study period. An increasing trend was observed between 2014 and 2016 but reverted in 2018. Malaria incidence remains higher than in 2014 and hot spots were identified in the three states, although more importantly in the south of Bolivar. Most cases (73.3%) were caused by Plasmodium vivax, but the Hoti, Yanomami, and Eñepa indigenous groups presented higher odds for infection with Plasmodium falciparum. Conclusion Malaria cases among Amerindian populations increased between 2014 and 2018 and seem to have a different geographic distribution than those among the general population. These findings suggest that tailored interventions will be necessary to curb the impact of malaria transmission in these groups.

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Vitamin D in Cardiovascular and Renal Disease Prevention / Vitamin D u Prevenciji Kardiovaskularne i Bubrežne Bolesti

Journal of Medical Biochemistry ◽

10.2478/v10011-012-0034-x ◽

2013 ◽

Vol 32 (1) ◽

pp. 11-15

Author(s):

Draško Pavlović ◽

Josipa Josipović ◽

Nikola Pavlović

Keyword(s):

Public Health ◽

Risk Factors ◽

Cardiovascular Disease ◽

Chronic Kidney Disease ◽

Vitamin D ◽

Renal Disease ◽

Health Problem ◽

Public Health Problem ◽

Epidemiological Data ◽

Biological Mechanism

Summary Cardiovascular disease is a well-known public health problem. In the last ten years nephrologists have recognized chronic kidney disease not only as a public health problem but also as one of the major cardiovascular risk factors. There are observational data that support the concept that vitamin D is involved in the pathogenesis of cardiovascular and renal disease or that at least vitamin D deficiency is a risk factor for these diseases. In this brief review epidemiological data will be presented and the biological mechanism of the vitamin D effect on cardiovascular and renal disease will be discussed.

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Thrombosis in Infants and Children

Hematology ◽

10.1182/asheducation-2006.1.86 ◽

2006 ◽

Vol 2006 (1) ◽

pp. 86-96 ◽

Cited By ~ 13

Author(s):

Reinhard Schneppenheim ◽

Jeanette Greiner

Keyword(s):

Risk Factors ◽

Clinical Presentation ◽

Infants And Children ◽

Therapeutic Interventions ◽

Older Children ◽

Thrombotic Risk ◽

Therapeutic Decisions ◽

Prophylactic Anticoagulation ◽

Clinical Conditions ◽

In Infants And Children

Abstract During the last decade much progress has been made toward better understanding of the underlying reasons causing thromboembolism in children. A considerable number of acquired and hereditary thrombotic risk factors have been identified which may also have an impact on therapeutic decisions and prognosis concerning outcome and the risk of a second event. However, indications for therapeutic interventions, such as thrombolysis and prophylactic anticoagulation with respect to the different clinical conditions and their combination with other risk factors, are not yet well defined. The following article describes the causes, clinical presentation and management of thrombosis in neonates, infants and older children, focusing on the clinically most relevant conditions.

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The malaria burden of Amerindian groups of three Venezuelan states: A descriptive study based on programmatic data

10.21203/rs.3.rs-288810/v1 ◽

2021 ◽

Author(s):

Juan Carlos Gabaldon-Figueira ◽

Carlos Chaccour ◽

Jorge E Moreno ◽

Maria Villegas ◽

Leopoldo Villegas

Keyword(s):

Risk Factors ◽

Negative Impact ◽

Malaria Incidence ◽

Hot Spot ◽

Public Health Problem ◽

Cost Effective ◽

Epidemiological Data ◽

Descriptive Study ◽

Malaria Burden ◽

Indigenous Groups

Abstract Background: Fifty-three percent of all cases of malaria in the Americas in 2019 came from Venezuela, where the epidemic is heavily focused south of the Orinoco river, and where most of the country’s Amerindian groups live. Despite the disease is known to represent a significant public health problem among these populations, little epidemiological data exists on the subject. This study aims to provide information on malaria incidence, geospatial clustering, and risk factors associated to Plasmodium falciparum infection among these groups.Methods: This is a descriptive study based on the analysis of published and unpublished programmatic data collected by Venezuelan health authorities and non-government organizations between 2014 and 2018. The Annual Parasite Index among indigenous groups (API-i) in municipalities of three states: Amazonas, Bolivar and Sucre was calculated and compared using the Kruskal Wallis test, risk factors for P. falciparum infection were identified via binomial logistic regression and maps were constructed to identify clusters of malaria cases among indigenous patients via Moran’s I and Getis-Ord’s hot spot analysis.Results: 116,097 cases of malaria in Amerindian groups were registered during the study period. An increasing trend was observed between 2014 and 2016 but reverted in 2018. Malaria incidence remains higher than in 2014 and hot spots were identified in the three states, although more importantly south of Bolivar. Most cases (73.3%) were caused by P. vivax, but the Hoti and Yanomami indigenous groups presented higher odds for infection with P. falciparum.Conclusion: Malaria cases among Amerindian populations increased between 2014 and 2018 and seem to have a different geographic distribution as those among the general population. Our findings suggest that tailored, cost-effective interventions will be needed to curb the negative impact of malaria transmission in these groups. Attention to the Hoti and Yanomami should be prioritized.

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Substance Abuse and Drug-Related Death, Suicidal Ideation, and Suicide: A Review

Crisis ◽

10.1027//0227-5910.20.1.28 ◽

1999 ◽

Vol 20 (1) ◽

pp. 28-35 ◽

Cited By ~ 29

Author(s):

Annie Mino ◽

Arnaud Bousquet ◽

Barbara Broers

Keyword(s):

Public Health ◽

Risk Factors ◽

Substance Abuse ◽

Suicidal Ideation ◽

Family Support ◽

Drug Users ◽

Suicide Attempts ◽

Public Health Problem ◽

Major Public Health Problem ◽

Hiv Epidemic

The high mortality rate among drug users, which is partly due to the HIV epidemic and partly due to drug-related accidental deaths and suicides, presents a major public health problem. Knowing more about prevalence, incidence, and risk factors is important for the development of rational preventive and therapeutic programs. This article attempts to give an overview of studies of the relations between substance abuse, suicidal ideation, suicide, and drug-related death. Research in this field is hampered by the absence of clear definitions, and results of studies are rarely comparable. There is, however, consensus about suicidal ideation being a risk factor for suicide attempts and suicide. Suicidal ideation is also a predictor of suicide, especially among drug users. It is correlated with an absence of family support, with the severity of the psychosocial dysfunctioning, and with multi-drug abuse, but also with requests for treatment. Every clinical examination of a drug user, not only of those who are depressed, should address the possible presence of suicidal ideation, as well as its intensity and duration.

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Therapeutic options in male osteoporosis

Osteologie/Osteology ◽

10.1055/s-0038-1630134 ◽

2013 ◽

Vol 22 (04) ◽

pp. 271-276 ◽

Cited By ~ 1

Author(s):

P. Farahmand ◽

J. D. Ringe

Keyword(s):

Risk Factors ◽

Vitamin D ◽

Public Health Problem ◽

Male Osteoporosis ◽

Individual Risk ◽

Modes Of Action ◽

Increased Risk ◽

Study Results ◽

Long Term Treatment ◽

Male Patients

SummaryOsteoporosis in men is increasingly recognized as an important public health problem but affected patients are still under-diagnosed and -treated. As in women the diagnostic and therapeutic strategy has to be adapted to the individual case. In the practical management it is very important to detect possible causes of secondary osteoporosis, to explain the possibilities of basic therapy counteracting individual risk factors and communicate that osteoporosis is a chronic disease and adherence to a long-term treatment is crucial. In established severe osteoporosis a careful analgesic therapy is important to avoid further bone loss related to immobility. In elderly men with increased risk of falling insufficient Vitamin D supply or impaired activation of Vitamin D due to renal insufficiency must be taken into consideration. Specific medications available today for the treatment of male osteoporosis comprise among antiresorptive drugs the bis phosphonates alendronate, risedronate and zoledronic acid. Denosumab, the first biological therapy is approved for men with androgen deprivation therapy for prostate cancer. An important advantage of this potent antiresorptive drug is the increased adherence due to the comfortable application by sixmonthly subcutaneous injections. Study results from the 2-year multi-center randomized controlled ADAMO-Study will very soon allow the use of denosumab in all types of male osteoporosis. Teriparatide, the 34 N-terminal amino acid sequence of parathyroid hormone was approved for men with osteoporosis as an anabolic agent based on proven efficacy by different studies. Among drugs with other modes of action the D-hormone pro-drug alfacalcidol can be used in men alone or in combination with the advantage of pleiotropic effects on calcium absorption, parathyroids, bone and muscle. Recently also Strontium-ranelate was approved for male patients with the limitation to exclude men with clinical relevant cardiovascular risk factors. In general the possibilities to treat male osteoporosis have considerably improved during recent years. Today there is a choice of a spectrum of drugs from mild to strong potency with different modes of action on bone turnover to design strategies for individual male patients.

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MEASLES OUTBREAK IN A RURAL AREA OF A DEVELOPING COUNTRY: A CASE CONTROL STUDY

Pakistan Journal of Public Health ◽

10.32413/pjph.v7i4.78 ◽

2018 ◽

Vol 7 (4) ◽

pp. 197-201

Author(s):

Mir M Hassan Bullo ◽

Mirza Amir Baig ◽

Jawad Faisal Malik ◽

Ejaz Ahmad Khan ◽

Muazam Abbas Ranjha ◽

...

Keyword(s):

Risk Factors ◽

Vaccine Coverage ◽

Significant Risk ◽

Public Health Problem ◽

Maculopapular Rash ◽

Healthcare Facility ◽

Control Measures ◽

Major Public Health Problem ◽

District Health ◽

Active Case

Background: Measles is highly contagious vaccine preventable disease (VPD), and a major public health problem considered as leading cause of morbidity and mortality in developing countries like Pakistan. An outbreak of measles was reported in Sharifabad Islamabad on 15th of April 2017, and an investigation was launched to assess the magnitude of outbreak, evaluate risk factors and recommend control measures. Methods: A comprehensive house to house active case search along with vaccine coverage survey was conducted from April 19-22, 2017. A case was defined as "onset of maculopapular rash with fever in a resident of Sharifabad with at least one of the following signs/ symptoms, Coryza, Conjunctivitis, Cough, Otitis media or Pneumonia present in between 19 March to 22nd April 2017". Four age & sex matched controls were selected from the neighborhood. Data was collected through interview method using structured questionnaire and vaccination coverage was determined by using Epi survey form. Blood samples were sent for laboratory confirmation. Results: A total of eight cases were identified through active case finding while three were reported by local practitioner. Mean age of cases were 20 months (range 8-36 months). Severely affected age-group was 1-2 years with attack rate of 46%. Around two-third (64%) of cases and a few (16%) of controls were unvaccinated against measles. Contact with measles patient [OR 25.2, CI 3.9-160.1, P=0.00], unvaccinated children [OR 9.2 CI 2.12-40.4, P=0.000], social misconception regarding vaccination [OR 7.8 CI 1.42-42.6, P=0.00], and distance from healthcare facility [OR 5.7 CI 1.15-28.35, P=0.02] were significant risk factors. Vaccine efficacy was 90%. Conclusion: Main reasons of the outbreak were contact with the cases, and low vaccination status. We recommended comprehensive measles vaccination and community awareness sessions. On our recommendations district health authority Islamabad carried out mop up of whole area.

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Characteristics and risk factors associated with stroke subtypes among adult patients admitted to stroke unit of JUMC

Current Hypertension Reviews ◽

10.2174/1573402115666191121120228 ◽

2019 ◽

Vol 15 ◽

Author(s):

Bekalu Getachew Gebreegziabher ◽

Tesema Etefa Birhanu ◽

Diriba Dereje Olana ◽

Behailu Terefe Tesfaye

Keyword(s):

Risk Factors ◽

Stroke Unit ◽

Medical Center ◽

Data Entry ◽

Public Health Problem ◽

Cross Sectional Study ◽

Chi Square ◽

Cross Sectional ◽

Factors Associated ◽

Stroke Subtypes

Background: Stroke is a great public health problem in Ethiopia. According to reports, in-hospital stroke mortality was estimated to be 14.7% in Ethiopia. Despite this, in this country researches done on factors associated with stroke sub-types were inadequate. Objective: To assess the Characteristics and risk factors associated with stroke sub-types among patients admitted to JUMC. Methods and materials: A retrospective cross sectional study was conducted from May 2017 to May 2018 in stroke unit of Jimma University Medical Center. A total of 106 medical charts of patients diagnosed with stroke were reviewed. Checklist comprising of relevant variables was used to collect data. SPSS version 21 was employed for data entry and analysis. Chi-square test was used to point-out association and difference among stroke sub-types. The data was presented using text, tables and figures. Result: From a total of 106 patients, 67(63.2%) were men. The mean ± SD of age was 52.67±12.46 years, and no significant association was found. Of all the patients, 59(55.6%) had ischemic strokes and 47(44.4%) had hemorrhagic strokes. The most common risk factor in the patients was alcohol use with a prevalence of 69.9%. Of all the risk factors, only sex, cigarettes smoking and dyslipidemia were significantly associated to sub-types of stroke. Conclusion: Ischemic stroke was the most common subtype of stroke. Sex of patient, cigarette smoking and dyslipidemia are significantly associated with the two stroke subtypes.

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Ten Percent of SIDS Cases are Murder — or are They?

Academic Forensic Pathology ◽

10.23907/2017.018 ◽

2017 ◽

Vol 7 (2) ◽

pp. 163-170 ◽

Cited By ~ 2

Author(s):

Christopher M. Milroy ◽

Charis Kepron

Keyword(s):

Sudden Infant Death ◽

Current Data ◽

Should we change the focus of health promotion in sexual health clinics?

Sexual Health ◽

10.1071/sh09107 ◽

2010 ◽

Vol 7 (4) ◽

pp. 407 ◽

Cited By ~ 6

Author(s):

Rudiger Pittrof ◽

Elizabeth Goodburn

Keyword(s):

Risk Factors ◽

Health Promotion ◽

Cost Effectiveness ◽

Reproductive Health ◽

Sexual Health ◽

Sexual And Reproductive Health ◽

Health Clinics ◽

Unknown Risk ◽

Sexual Health Clinics ◽

The Cost

The effectiveness of sexual behaviour change interventions in sexual health clinics is unknown. Risk factors for poor sexual and reproductive health such as depression, violence, alcohol and smoking in sexual health clinics are all common and can be identified easily in sexual health services. Targeting these risk factors could be as effective as traditional sexual health promotion and could have additional benefits. The authors propose a pilot to assess the cost-effectiveness and acceptability of incorporating screening and interventions for these risk factors.

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