Evaluation of injury-related under-five mortality in Turkey between 2014-2017

Investigating nurses' attitudes towards the prevention of falls: A mixed-method study

The purpose of this study was to investigate nurses' attitudes towards prevention of falls using the Nurses Attitudes Towards Prevention of Falls Scale and to identify factors affecting these attitudes. A mixed-method design was applied and a convenience study was conducted. Six-hundred and thirty nurses participated. In the first stage of this study, the psychometric properties of the Nurses' Attitudes Towards Prevention of Falls Scale were tested. Quantitative data were collected using the Introductory Information Form and the Nurses' Attitudes Towards Prevention of Falls Scale. While collecting this data, 24 nurses were interviewed. The Nurses' Attitudes Towards Prevention of Falls Scale was determined to be a valid and reliable measurement tool. Most of the participating nurses did not complete a fall incident report when their patients experienced a fall, and that led to nurses experiencing remorse, fear, guilt, sadness, anxiety, and panic when their patients fell.

Characteristics of gut microbiota dysbiosis in patients with colorectal polyps

This editorial, inspired by a recent study published in the World Journal of Gastrointestinal Oncology, covers the research findings on microbiota changes in various diseases. In recurrent colorectal polyps, the abundances of Klebsiella, Parvimonas, and Clostridium increase, while those of Bifidobacterium and Lactobacillus decrease. This dysbiosis may promote the formation and recurrence of polyps. Similar microbial changes have also been observed in colorectal cancer, inflammatory bowel disease, autism spectrum disorder, and metabolic syndrome, indicating the role of increased pathogens and decreased probiotics in these conditions. Regulating the gut microbiota, particularly by increasing probiotic levels, may help prevent polyp recurrence and promote gut health. This microbial intervention strategy holds promise as an adjunctive treatment for patients with colorectal polyps.

The burden, risk factors and prevention strategies for drowning in Türkiye: a systematic literature review

INTRODUCTION

Drowning is a public health problem in Türkiye, as in the rest of the world. This study aims to systematically review the literature on drowning in Türkiye with a focus on data sources, epidemiology, risk factors and prevention strategies.

METHODS

Literature searches were conducted using PubMed, SPORTSDiscus, Scopus, Web of Science, Turk MEDLINE, Google Scholar and Google Akademik (Turkish language). Studies (limited to original research written in English and Turkish) reporting drowning (unintentional and intentional; fatal and non-fatal) of residents and tourists in Türkiye were independently dual screened at the title and abstract and full text stages. Study quality was assessed using JBI checklists and evidence level assessed based on study design.

RESULTS

From a total of 917 studies, 49 met the inclusion criteria. Most (51%) focused on unintentional fatal drowning. Included studies were most commonly analytical cross-sectional studies (n = 23) and case series (n = 20) meaning the evidence level was low or very low for 48 (98%) studies. Fifteen studies examined drowning at the national level, while sub-national studies (n = 30) focused on urban areas across three provinces: Antalya (n = 6), Istanbul (n = 6), Izmir (n = 4). There was little consensus on risk factors beyond male drowning risk, and no data reported on implemented or evaluated drowning prevention interventions.

DISCUSSION

There is a need for more national-level studies to identify the causes of drowning and to guide intervention implementation and evaluation to inform policy makers and donors. Currently official data is limited in its detail, providing age and gender data only, hampering efforts to identify, and thus address, causal factors for drowning.

PRACTICAL APPLICATIONS

There is currently very little evidence to inform investment in effective drowning prevention interventions in Türkiye. To improve this, data collection systems on drowning in Türkiye need to be strengthened via the development a national drowning registry.

TRIAL REGISTRATION

#CRD42022382615.

The trend of unintentional injury-related mortality among children aged under-five years in China, 2010-2020: a retrospective analysis from a national surveillance system

BACKGROUND

In this study, we estimated the trend of unintentional injury mortality among children aged under-five years in China during 2010-2020.

METHODS

Data were obtained from China's Under 5 Child Mortality Surveillance System (U5CMSS). The total unintentional injury mortality and all specific-causes unintentional injury mortality was calculated, annual numbers of deaths and live births were adjusted by a 3-year moving average under-reporting rate. The Poisson regression model and the Cochran-Mantel-Haenszel method were used to calculate the average annual decline rate (AADR) and the adjusted relative risk (aRR) of the unintentional injury mortality.

RESULTS

In 2010-2020, a total of 7,925 unintentional injury-related deaths were reported in U5CMSS, accounting for 18.7% of all reported deaths. The overall proportion of unintentional injury-related deaths to total under-five children deaths has increased from 15.2% to 2010 to 23.8% in 2020 (χ2 = 227.0, p < 0.001), the unintentional injury mortality significantly decreased from 249.3 deaths per 100,000 live births in 2010 to 178.8 deaths per 100,000 live births in 2020, with an AADR 3.7% (95%CI 3.1-4.4). The unintentional injury mortality rate decreased from 2010 to 2020 in both urban (from 68.1 to 59.7 per 100,000 live births) and rural (from 323.1 to 230.0 per 100,000 live births) areas (urban: χ2 = 3.1, p < 0.08; rural: χ2 = 113.5, p < 0.001). The annual rates of decline in rural areas and urban areas were 4.2% (95%CI 3.4-4.9) and 1.5% (95%CI 0.1-3.3), respectively. The leading causes of unintentional injury mortality were suffocation (2,611, 32.9%), drowning (2,398, 30.3%), and traffic injury (1,428, 12.8%) in 2010-2020. The cause-specific of unintentional injury mortality rates decreased with varying AADRs in 2010-2020, except for traffic injury. The composition of unintentional injury-related deaths also varied by age group. Suffocation was the leading cause in infants, drowning and traffic injury were the leading causes in children aged 1-4 years. Suffocation and poisoning has high incidence in October to March and drowning has high in June to August.

CONCLUSION

The unintentional injury mortality rate of children aged under-five years decreased significantly from 2010 to 2020 in China, but great inequity exists in unintentional injury mortality in urban and rural areas. Unintentional injuries are still an important public health problem affecting the health of Chinese children. Effective strategies should be strengthened to reduce unintentional injury in children and these policies and programmes should be targeted to more specific populations, such as rural areas and males.

Using online social networks to provide a parental health-education intervention for preventing unintentional injuries among children aged 0-3 years: A randomized controlled trial and social network analysis in Shanghai, China

Introduction

Unintentional injury among children represents a major public health problem. Online-social-network-based parental-health-education is a potential way to reduce child unintentional injuries. The study aimed to explore the mechanisms by which online-social-network-based health education may reduce the unintentional injuries among children aged 0-3 years.

Methods

We conducted a participant-blinded, randomized controlled, online-social-network-based health-education intervention study from March 2019 to February 2020 in Shanghai. We established four WeChat groups (two intervention groups and two control groups). For the intervention groups, a doctor's assistant regularly delivered information regarding unintentional injuries among children, and community childcare doctors answered parents' questions concerning their children's health, including unintentional injuries. Meanwhile, the control groups did not receive any information from the assistant. The study selected one intervention group and one control group and compared the ego network and whole network indicators to determine the differences between the intervention and control groups.

Results

In the intervention and control groups, 64.5% and 31.9% of the members, respectively, engaged in communication, and 1,736 and 273 records, respectively, were obtained. Regarding ego network, the doctor showed the largest network in the intervention group, and the size of the intervention group's network was twice that of the control group; the number of ties in the intervention group was nine times that of the control group. Fourteen and four parents in the intervention and control group played an active role, respectively. Regarding centrality, all WeChat groups were loose and multiple centers existed. Regarding subgroup cohesion, the intervention group had 28 cliques with 27 members, and the control group had 4 cliques with 4 members. For structural hole, 23.7% and 7.5% members in the intervention and control group actively participated in interactions, respectively, having strong control and influence over other parents; 69.2% and 59.1% members in the intervention and control group, respectively, had values of < 1.000, showing that they had strong ability to cross-jump structural holes.

Discussion

Online-social-networks-based health education interventions could enhance communication among parents, and between parents and community childcare doctors, and also shorten the social distance between them. Thus, online-social-network-based parental-health-education-intervention can be a feasible and generalizable means of preventing unintentional injuries among children.

Assessing variations in estimates of drowning mortality in Turkey from 2013 to 2019

Introduction

Drowning is an under-recognised public health threat and a leading cause of injury-related mortality and morbidity. However, in many countries, including Turkey, limited data impair understanding of drowning burden and Global Burden of Disease (GBD) Study drowning estimates (defined using International Classification of Diseases [ICD] codes W65–74) do not include flood-related deaths (X38) and water transportation related drownings (V90, V92). A lack of accessible and reliable country-level data impacts a country’s ability to develop appropriate drowning prevention interventions and measure efficacy. This retrospective population-based study aimed to explore differences between two datasets in fatal drowning in Turkey between 2013 and 2019.

Methods

National, all-age data on fatal drownings (restrictive definition: ICD-10 codes W65–74) were sourced from the Turkish Statistical Institute (TurkStat) and the Global Burden of Disease (GBD) study. In addition, a broader definition of drowning including water transport, flood-related deaths and drowning due to undetermined intent (ICD-10 codes W65–74, V90, V92, X38, Y21, T751) were sourced from TurkStat. Numeric and percentage differences in number of drowning deaths were calculated overall and by sex, age group and death year. Chi square (p < 0.05) and relative risk (95% confidence intervals) using crude drowning rates per 100,000 population were also calculated for TurkStat data.

Results

From 2013 to 2019, TurkStat reported a total of 5004 drowning deaths (coded W65–74) were reported, compared to 5252 (5% difference; n = 248) using the broader definition. A restrictive definition underreported drowning most significantly in females (9.5%; n = 97), 5–9 year-olds (8.9%; n = 31) and in the 2015 calendar year (30.2%; n = 226). Males accounted for 78.8% of drowning in Turkey, with females significantly (p < 0.001) more at risk under 10 years of age (0–4 years X² = 67.9; 5–9 years X² = 23.9) and aged 65+ years (X² = 29.7). GBD data overestimated a restrictive definition of drowning by 3.2% overall (7.6% for females, 52.5% for 0–4 year-olds) and underreported drowning for 65+ year-olds by 17% when compared to TurkStat restrictive definition of drowning.

Conclusions

Although a restrictive definition of drowning doesn’t greatly impact estimates at a population level in Turkey, there are variations. This highlights the importance of accurate country-level drowning data to guide decision making for prevention.

Analysis of characteristics and forecast of unintentional injury deaths of children under age 5 from 2013 to 2019 in Sichuan, China

OBJECTIVE

Through the study of death characteristics and trend prediction, it is hoped that key populations, regions and seasons can be identified, thereby providing evidence support for the efficient prevention and control management of unintentional injury deaths.

METHOD

We collected information on 8630 unintentional deaths of children under age 5 from local surveillance systems, analyzed by chi-square test and predicted by the seasonal ARIMA model.

RESULTS

About 33.1% of child deaths were under the age of 1, 60.5% were boys, 37.6% were in urban areas, 2.6% were among ethnic Tibetans, 6.8% were among ethnic Yi, and 46.6% died inside houses. The top three of total deaths were accidental drowning (35.0%), accidental suffocation (32.7%) and traffic accident (15.5%). The ratio of males to females in traffic accidents (1.28:1) and poisoning (1.30:1) deaths was relatively lower than accidental falls (1.62:1) and drowning (1.85:1). The causes of death ratio in rural and urban areas were: drowning (1.83:1), poisoning (1.75:1), suffocation (1.62:1), traffic (1.41:1), and falling (1.24:1). Children's deaths of ethnic minority groups of Tibetan and Yi increased year by year (χ²=75.261, P< 0.001). Tibetan and Yi groups had the most deaths in summer, and Han in winter (χ²=29.093, P< 0.001). Accidental suffocation accounted for 78.2 percent of the total unintentional deaths of children under age 1. And drowning accounted for only 2.4 percent. The model SERIMA (1, 1, 2) (2, 0, 0) [12] is suitable for describing and predicting unintentional injury deaths of children under age 5.

CONCLUSION

We should combine death surveillance with qualitative investigation or in-depth quantitative investigation to further analyze unintentional injury deaths in children.

Assessing the Possible Effect of Depression on Driving Behavior: A Cross-sectional Study

Background: Driving as a complex behavior pattern is influenced by a set of conscious and unconscious factors. One of the most important causes of traffic accidents in Iran is human factors, which include the driver's mental status, personality traits, mental illnesses, or psychiatric disorders. Depression is one of the most common psychiatric disorders affecting driving behavior. Objectives: The aim of this study was to examine whether depression may affect driving performance. Methods: This cross-sectional study was done on 100 participants who were divided into two groups, patients with major depressive disorder (MDD) and the healthy control group. Driving behavior was assessed by the Manchester Driving Behavior Questionnaire (MDBQ), and three computerized tests [Tower of London Test, Wisconsin Card Sorting Test (WCST), and reaction time] were used to evaluate the participants’ neuropsychiatric characteristics. The results were compared between the two groups using SPSS version 19. Results: There were 51 cases in the MDD group (male = 59%, female = 41%) and 50 patients in the non-depressed group (male = 22%, female = 78%). The mean age of the group with MDD and the control group was 38 ± 8 and 36 ± 9 years, respectively, with no significant differences (P = 0.23). The results showed that the highest mean reaction time (875 ± 198, P = 0.018) was related to the depressed non-risky drivers, and the depressed risky drivers showed the worse function in all domains of WCST (trials to complete first category: 28 ± 23, P = 0.002, total error: 33 ± 9, P = 0.001, and perseveration error: 15 ± 9, P = 0.009) in comparison with another group. Considering the mean score of the tower of London test, the non-depressed non-risky drivers showed the shortest time (219 ± 172, P = 0.001) spent on doing the task, while the depressed non-risky drivers showed the longest mean latency time (213 ± 96, P = 0.001). Conclusions: The findings of the present study showed that depression is associated with deficits in multiple cognitive domains, such as executive function, which may lead to a significant decline in different aspects of driving behavior.