Scuba diving-related fatalities in New Zealand, 2007 to 2016

Author(s):  
John Lippmann ◽  
◽  
Christopher Lawrence ◽  
Michael Davis ◽  
◽  
...  

Introduction: New Zealand (NZ) diving-related fatalities have been reported since the 1960s. The aim is to identify contributing risk factors, including medical, and to inform appropriate preventative strategies. Methods: NZ scuba diving fatalities from 2007 to 2016 were searched from multiple sources – the National Coronial Information System (NCIS); the NZ Chief Coroner’s office; Water Safety NZ Drownbase™ and the NZ Police National Dive Squad records. For inclusion, a victim must have been wearing a scuba set (which may include a rebreather). A key word search of the NCIS was made and the results matched to the other databases. An Excel® database was created and a chain of events analysis (CEA) conducted. Results: Forty-eight scuba diving fatalities were identified, 40 men and eight women, average age 47 years (range 17−68), 20 of Māori ethnicity. Thirty-five were classified as overweight (14) or obese (21). Pre-existing medical risk factors were identified, either pre dive or at autopsy, in 37 divers, the commonest being ischaemic heart disease (IHD, 20), left ventricular hypertrophy (LVH, 18) and hypertension (seven). IHD, LVH and obesity were variously associated with each other. The likely commonest disabling conditions, identified in 32 cases, were asphyxia (15), cardiac (nine) and pulmonary barotrauma/cerebral arterial gas embolism (five). Multiple environmental and diving practice breaches and poor planning were identified in the CEA, similar to those seen in other studies. Thirty-eight divers had not released their weight belt. Information on resuscitation was limited. Conclusions: Obesity and cardiovascular disease were common and Māori appear to be over-represented, both as previously reported.

2003 ◽  
Vol 34 (2) ◽  
pp. 54-69 ◽  
Author(s):  
Frank H. Duffy ◽  
Heidelise Als ◽  
Gloria B. McAnulty

EEG spectral coherence data in quiet sleep of 312 infants were evaluated, at 42 weeks post-menstrual age. All were medically healthy and living at home by time of evaluation. The sample consisted of prematurely born infants with a wide spectrum of underlying risk factors, as well as healthy fullterm infants. Initial 3040 coherence variables were reduced by principal components analysis in an unrestricted manner, which avoided the folding of spectral and spatial information into among-subject variance. One hundred fifty factors explained 90% of the total variance; 40 Varimax rotated factors explained 65% of the variance yielding a 50:1 data reduction. Factor loading patterns ranged from multiple spectral bands for a single electrode pair to multiple electrode pairs for a single spectral band and all intermediate possibilities. Simple left-right and anterior-posterior pairings were not observed within the factor loadings. By multiple regression analysis, the 40 factors significantly predicted gestational age at birth. By canonical correlation, significant relationships were demonstrated between the coherence factors and medical risk factors as well as neurobehavioral factors. Using discriminant analysis, the coherence factors successfully discriminated between infants with high and low medical risk status and between those with the best and worst neurobehavioral status. The two factors accounting for the most variance, and chosen across several analyses, indicated increased left central-temporal coherence from 6–24 Hz, and increased frontal-occipital coherence at 10 Hz, for the infants born closest to term with lowest medical risk factors and best neurobehavioral performance.


2018 ◽  
pp. 36-39
Author(s):  
S.I. Zhuk ◽  
◽  
O.D. Shchurevska ◽  

One of the main markers of socially unfavorable pregnancy is anthropometric indicators of newborns. They reflect not only the narrow medical problems of complicated gestation but also social problems in general, the quality and access to the medical care. The objective: to determine the risk factors for fetal macrosomia in pregnancy with high levels of psychosocial stress. Materials and methods. The course of pregnancy and childbirth, demographic and medical risk factors for a fetal macrosomia were analyzed in 140 pregnant women with different levels of psychosocial stress. They were divided into 2 groups: 1 group (main) – 56 women-forced migrants from Luhansk and Donetsk regions, 2 group – 84 women with low and moderate level stress according to the questionnaires and psychological tests (L. Reeder, Spielberg–Khanin scale). Results. Gestational diabetes was the main reason for the birth of heavy children in both groups. Women–forced migrants had late manifestation of impaired tolerance to carbohydrates and a higher frequency of pathological weight gain. Male neonates are at risk for macrosomia. Childbirth in women with macrosomia is accompanied by a high frequency of complications and abnormal births. Conclusions. The frequency of births of macrosomic children in women - forced migrants is higher than in women at low risk of psychosocial stress. Risk factors in this group of pregnants include: the level of stress and behavioral responses to stress, impaired carbohydrate tolerance due to gestational diabetes, abnormal weight gain due to malnutrition and male sex of the fetus. Keywords: macrosomia, pregnancy, childbirth, women–forced migrants psychosocial stress, gestational diabetes, weight gain.


2021 ◽  
Vol 6 (5) ◽  
pp. 263-269
Author(s):  
V. O. Shuper ◽  
◽  
S. V. Shuper ◽  
I. V. Trefanenko ◽  
G. I. Shumko ◽  
...  

The purpose of the study was to investigate the adherence to secondary prevention medications among patients with coronary heart disease and identify factors associated with it. Materials and methods. We examined 40 patients diagnosed with coronary heart disease of more than 50 years old, who were prescribed with optimal medication for 1 year during hospitalization. Patients` adherence was defined according to MMS-8 Morisky values for secondary prevention medications prescribed by doctors. Also, questionnaires about individual reasons of non-compliance and for individual patient`s opinion about importance and usefulness of knowledge according to risk factors of the increase of cardiovascular mortality were designed and proposed to the patients. Simple descriptive statistics were used to elucidate the characteristics of the patient population and results from individual adherence tools. Final score was analyzed and correlation between patients’ data and level of adherence to prescribed treatment were identified. A correlation matrix (using Spearman’s coefficient) was reviewed for any evidence of collinearity. Results and discussion. Our study demonstrated higher level of non-adherence with secondary prevention medications in patients with coronary heart disease (60.0%). This fact can be explained by the socioeconomic reasons, less informative strategies from the medical staff to the patients. Severe regress of adherence was demonstrated after discharge from the hospital due to subjective improvement of the patients` condition with absence of supervision by out-patient specialists. Demographic characteristics of the patients suggested that some non-modified factors can affect compliance with the prescribed treatment. Better adherence was demonstrated by female married patients with higher educational level, with family history about cardiovascular death. Also, too much prescribed medications with difficult regime of usage with non-adequate out-patient supervision may significantly decrease adherence causing development of complications which may lead to re-hospitalizations and cardiovascular death. Our investigation demonstrated also non-complete information of the patients about lifestyle and medical risk factors of the cardiovascular mortality increase. Conclusion. The results of our study can provide useful practical information on the prevalence and severity of non-adherence among patients with coronary heart disease. Analysis of the factors influencing the adherence demonstrated the main reasons from patients and healthcare professionals affecting the level of compliance with the prescribed treatment. The step towards improving adherence can be initiated by the healthcare professional to overcome the patient's concerns about the prescribed medication. It is important to continue personal monitoring of patients by healthcare professionals in the form of regular inspections of intentional and unintentional non-adherence, including factors and reasons that may change and lead to such behavior


Cancer ◽  
1992 ◽  
Vol 69 (10) ◽  
pp. 2541-2547 ◽  
Author(s):  
Brigitte Schlehofer ◽  
Maria Blettner ◽  
Nikolaus Becker ◽  
Christine Martinsohn ◽  
Jiirgen Wahrendorf

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