UNINTENTIONAL INJURY MORTALITY IN INDIA, 2005: NATIONALLY REPRESENTATIVE MORTALITY SURVEY OF 1.1 MILLION HOMES

Background: Previous research has shown a significant association between psychological distress (PD) and cause-specific mortality, but contributions of sociodemographic and behavioral characteristics to mortality differences by PD are not fully explored. Methods: The Blinder-Oaxaca decomposition analysis was used to quantify the contributions of individual sociodemographic and behavioral characteristics to the observed cardiovascular disease (CVD), cancer, chronic obstructive pulmonary disease (COPD), and unintentional-injury mortality disparities between United States (US) adults with no PD and those with serious psychological distress (SPD), using the pooled 1997-2014 data from the National Health Interview Survey prospectively linked to the National Death Index (N=263,825). Results: Lower levels of education and household income, and higher proportions of current smokers, former drinkers, non-married adults, US-born, and renters contributed to higher mortality for adults with SPD. The relative percentage of mortality explained by sociodemographic and behavioral factors was highest for cancer mortality (71.25%) and lowest for unintentional-injury mortality (20.19%). Enhancing education level among adults with SPD would decrease approximately 30% of cancer or CVD mortality disparity, and around 10% of COPD and unintentional-injury mortality disparities. Half of the cancer mortality disparity (47.4%) could be attributed to a single factor, smoking. Increasing income level will decrease 7 to 13% of the disparity in cause-specific mortality. Higher proportions of renters explained higher CVD and COPD mortality among adults with SPD by 7% and 3%, respectively. Higher proportions of former drinkers explained higher CVD, cancer, and COPD mortality among adults with SPD by 6%, 7%, and 3%, respectively. Younger age, higher proportion of females, and higher BMI among adults with SPD mitigated the mortality disparities. Conclusions and Implications for Translational Research: Improved education and income levels, and reduced smoking among US adults with SPD would eliminate around 90% of the cancer mortality disparity by SPD, and half of the CVD mortality disparity. Copyright © 2021 Lee and Singh. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License CC BY 4.0.

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Flexible Bronchoscopy for the Pediatric Intensivist: A New Tool in the Handbag?

Journal of Pediatric Intensive Care ◽

10.1055/s-0040-1713616 ◽

2020 ◽

Author(s):

Harsha K. Chandnani ◽

Raul Rodriguez

Keyword(s):

Unintentional Injury ◽

Diagnostic Information ◽

Foreign Body Aspiration ◽

Flexible Bronchoscopy ◽

Proper Treatment ◽

Common Cause ◽

X Ray ◽

Injury Mortality ◽

Chest X Ray ◽

Delays In Diagnosis

AbstractForeign body aspiration (FBA) is a common cause of unintentional-injury mortality. Modern bronchoscopy techniques have reduced mortality in children with FBA. We describe a case of a 16-month-old child with refractory hypoxia where flexible bronchoscopy performed by the intensivist led to prompt etiology recognition and proper treatment. Patients presenting with respiratory distress with persistent hypoxia should be evaluated for FBA, considering initial chest X-ray can be normal in at least 30% of the cases. Intensivists trained in flexible bronchoscopy techniques possess a valuable tool to obtain diagnostic information avoiding delays in diagnosis and initiation of unnecessary therapies, such as extracorporeal membrane oxygenation.

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Unintentional injury mortality among indigenous communities of Taiwan: trends from 2002 to 2013 and evaluation of a community-based intervention

Injury Prevention ◽

10.1136/injuryprev-2017-042321 ◽

2017 ◽

Vol 25 (1) ◽

pp. 26-30 ◽

Cited By ~ 1

Author(s):

Stephen W Pan ◽

Hiu Ha Chong ◽

Hui-Chuan Kao

Keyword(s):

Mortality Rate ◽

Indigenous Population ◽

Unintentional Injury ◽

Indigenous Communities ◽

Mortality Rates ◽

Community Based ◽

Injury Death ◽

Injury Mortality ◽

Injury Prevention Programme ◽

Disproportionate Burden

IntroductionIndigenous communities in Taiwan shoulder a disproportionate burden of unintentional injury fatalities. We compare unintentional injury mortality rate trends among Taiwan’s indigenous communities and the general population from 2002 to 2013, and evaluate potential impact of a community-based injury prevention programme on indigenous unintentional injury death rates.MethodsStandardised and crude unintentional injury mortality rates were obtained from Taiwan government reports. Segmented linear regression was used to estimate and compare unintentional injury mortality rate trends before and after the intervention.ResultsBetween 2002 and 2013, unintentional injury mortality rates among Taiwan’s indigenous population significantly declined by about 4.5 deaths per 100 000 each year (p<0.0001). During that time, the unintentional injury mortality rate ratio between indigenous Taiwanese and the general population significantly decreased by approximately 1% each successive year (p=0.02). However, we were unable to detect evidence that the ‘Healthy and Safe Tribe’ programme was associated with a statistically significant decrease in the unintentional injury mortality rate trend among indigenous persons (p=0.81).ConclusionTaiwanese indigenous communities remain at significantly higher risk of unintentional injury death, though the gap may be slowly narrowing. We found no evidence that the ‘Healthy and Safe Tribe’ indigenous injury-prevention programme significantly contributed to the nationwide decline in unintentional injury mortality among indigenous Taiwanese communities from 2009 to 2013. Future interventions to address the disproportionate burden of unintentional injury fatalities among indigenous Taiwanese should consider interventions with wider coverage of the indigenous population, and complementing grass roots led community-based interventions with structural policy interventions as well.

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