scholarly journals Self-harm and risk of motor vehicle crashes in youth: the DRIVE prospective cohort study

2010 ◽  
Vol 16 (Supplement 1) ◽  
pp. A100-A100 ◽  
Author(s):  
A. L. C. Martiniuk ◽  
R. Q. Ivers ◽  
N. Glozier ◽  
G. C. Patton ◽  
L. T. Lam ◽  
...  
2018 ◽  
Vol 101 ◽  
pp. 42-49 ◽  
Author(s):  
Paula A. Aduen ◽  
Michael J. Kofler ◽  
Dustin E. Sarver ◽  
Erica L. Wells ◽  
Elia F. Soto ◽  
...  

2017 ◽  
Vol 210 (6) ◽  
pp. 429-436 ◽  
Author(s):  
Leah Quinlivan ◽  
Jayne Cooper ◽  
Declan Meehan ◽  
Damien Longson ◽  
John Potokar ◽  
...  

BackgroundScales are widely used in psychiatric assessments following self-harm. Robust evidence for their diagnostic use is lacking.AimsTo evaluate the performance of risk scales (Manchester Self-Harm Rule, ReACT Self-Harm Rule, SAD PERSONS scale, Modified SAD PERSONS scale, Barratt Impulsiveness Scale); and patient and clinician estimates of risk in identifying patients who repeat self-harm within 6 months.MethodA multisite prospective cohort study was conducted of adults aged 18 years and over referred to liaison psychiatry services following self-harm. Scale a priori cut-offs were evaluated using diagnostic accuracy statistics. The area under the curve (AUC) was used to determine optimal cut-offs and compare global accuracy.ResultsIn total, 483 episodes of self-harm were included in the study. The episode-based 6-month repetition rate was 30% (n = 145). Sensitivity ranged from 1% (95% CI 0–5) for the SAD PERSONS scale, to 97% (95% CI 93–99) for the Manchester Self-Harm Rule. Positive predictive values ranged from 13% (95% CI 2–47) for the Modified SAD PERSONS Scale to 47% (95% CI 41–53) for the clinician assessment of risk. The AUC ranged from 0.55 (95% CI 0.50–0.61) for the SAD PERSONS scale to 0.74 (95% CI 0.69–0.79) for the clinician global scale. The remaining scales performed significantly worse than clinician and patient estimates of risk (P < 0.001).ConclusionsRisk scales following self-harm have limited clinical utility and may waste valuable resources. Most scales performed no better than clinician or patient ratings of risk. Some performed considerably worse. Positive predictive values were modest. In line with national guidelines, risk scales should not be used to determine patient management or predict self-harm.


2021 ◽  
Vol 20 (1) ◽  
pp. 88-95
Author(s):  
Kantenga Dieu Merci Kabulo ◽  
◽  
Ulrick Sidney Kanmounye ◽  
Sarah Mutomb ◽  
Patrice Ntenga ◽  
...  

Background. Traumatic brain injury (TBI) imposes an enormous burden on health systems and it is the most frequent cause of hospitalization in children. This study aimed at describing the causes, presentation, management, and outcome of children with TBI admitted at a tertiary referral hospital in Harare, Zimbabwe. Methods. This prospective cohort study was conducted with a convenience sample of children aged ≤ 12 years and admitted with TBI at the study site from June 2018 to May 2019. The children were followed from their admission to one-month post-discharge. Sociodemographic, clinical, and neuroimaging data were collected. The median length of stay was calculated and the Chi-square, Fisher’s exact, and Kruskal Wallis tests were used. Results. 84 children with TBI were recruited. Most were males (66.7%) and (56.0%) had sustained TBI following a motor vehicle accident. An initial period of loss of consciousness that lasted a median of 6.5 (IQR = 4.8) hours was noted in 60.7% of patients. The most common symptom at presentation was headache (61.9%), and mild TBI was the most common type of TBI. Skeletal injuries were the most encountered associated injuries (13.1%) and the majority of patients were managed non-operatively – 79 (94.0%). Most patients (56.0%) experienced upper good recovery at one-month follow-up. Conclusions. Motor vehicle accidents are the main cause of pediatric TBI in Zimbabwe. Most patients do not require surgical treatment and have a good recovery.


2009 ◽  
Vol 181 (11) ◽  
pp. 807-812 ◽  
Author(s):  
A. L.C. Martiniuk ◽  
R. Q. Ivers ◽  
N. Glozier ◽  
G. C. Patton ◽  
L. T. Lam ◽  
...  

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