Journal of Injury and Violence Research
Volume:1 Issue: 1, Jul 2009

Paraffin (called kerosene in North America and other parts of the world) is the most commonly used fuel in non-electrified dwellings worldwide. It is especially popular in Africa and South Asia. Although paraffin offers many advantages – especially its comparatively low cost to produce – it poses two major risks of injury. First, paraffin poisoning is common, either through ingestion or through inhalation of smoke and fumes. Second, paraffin is highly flammable, and poses fire risk through multiple causes. This commentary discusses strategies to prevent paraffin-related injury. Prevention of paraffin-related injury must be through multiple strategies, and should include policy-oriented change, changes to the safety of home environments, and behavioral changes targeting how individuals store and use paraffin and paraffin appliances. We review successful prevention strategies in each of these domains and discuss appropriate research and community initiatives that should be implemented to improve paraffin safety among at-risk populations.

Suicides may be misclassified as accidental deaths in countries with strict legal definitions of suicide, with cultural and religious factors leading to poor registration of suicide and stigma attached to suicide. The concordance between four different definitions of suicides was evaluated by examining the relationship between pure suicide and accidental death rates, gender differences, age-associated trends and potential distil risk and protective factors by conducting secondary analysis of the latest World Health Organisation data on elderly death rates. The four definitions of suicide were: (i) one-year pure suicides rates; one-year combined suicide rates (pure suicide rates combined with accidental death rates); (iii) five-year average pure suicide rates; and (iv) five-year average combined suicides rates (pure suicides rates combined with accidental death rates). The predicted negative correlation between pure suicide and accidental death rates was not observed. Gender differences were similar for all four definitions of suicide. There was a highly significant concordance for the findings of age-associated trends between one-year pure and combined suicide rates, one-year and five-year average pure suicide rates, and five-year average pure and combined suicide rates. There was poor concordance between pure and combined suicide rates for both one-year and five-year average data for the 14 potential distil risk and protective factors, but this concordance between one-year and five-year average pure suicide rates was highly significant. The use of one-year pure suicide rates in cross-national ecological studies examining gender differences, age-associated trends and potential distil risk and protective factors is likely to be practical, pragmatic and resource-efficient.

Although much is known about risk for athletic injury, research on the roles of individual differences in personality and temperament on athletic injury has lagged. We hypothesized that professional athletes with high sensation-seeking and extraversion scores, and with low effortful control scores, would experience more injuries over the course of a season, would have more severe injuries, and would miss more total days of play. Prospective design with questionnaire report at time one and injury tracking throughout an 18-week athletic season. Setting: Professional hockey team in the United States. Participants: Eighteen professional hockey players (ages 21-33). Measurements: Players completed self-report personality (Sensation-Seeking Scale, Form V) and temperament (the Adult Temperament Questionnaire) measures. Quantity and severity of injury, as well as playing time missed, were tracked for 18 weeks. On average, players experienced almost 6 injuries causing a loss of 10 playing days through the season. Those players scoring high on Boredom Susceptibility and Total Sensation-Seeking incurred more total injuries. Those scoring high on temperamental neutral perceptual sensitivity suffered more severe injuries. Athletes who suffered more injuries reported a preference for stimulating environments and boredom with non-stimulating environments. Injury severity was not correlated with sensation-seeking but was related to temperamental perceptual sensitivity. Implications for identification of injury-prone athletes, pre-injury training, and post-injury treatment are discussed.

Unintentional injury is a leading threat to children's health. Some human factors have been determined as predictor of unintentional injury. Association between Health-Related Quality of Life (HRQOL) as a human factor and unintentional injuries is unclear. The objective of study is to examine the association between HRQOL and unintentional injuries among primary school children. This study was a cross-sectional conducted in Ahwaz, a city in Iran. Overall, 3375 children aged 6-10 years were randomly selected from primary school. HRQOL was measured by 56 items taken from seven domains of Netherlands Organization for Applied Scientific Research Academic Medical Center (TNO AZL) child quality of life (TACQOL) parent form. Parents were interviewed to collect information about incidence, cause and a brief description of injury within the past 12 months prior to the study. The response rate was 3375 of 3792 (89%). There was a significant trend for increasing occurrence of injury with decreasing of HRQOL score. Adjusted OR for injury was significantly higher in very low (2.38, 95% CI: 1.45-3.86), low (2.18, 95% CI: 1.34-3.56), and medium (1.73, 95%CI: 1.06-2.83) HRQOL groups compared to reference group (very high HRQOL). The median of total HRQOL and all its domains (P=0.017) (except autonomous functioning) was lower in injured group compared to uninjured one. This study found an association between HRQOL and unintentional injury among primary school children. This is a preliminary finding and further investigations with a well-defined analytical design are needed.

Violence is a public health problem in low and middle income countries. Our study attempted to define the circumstances, risk groups, extent and severity of firearm-related injuries in patients coming to the Aga Khan University Hospital (AKUH) Karachi, Paki­stan. This was a retrospective study conducted in the department of Emergency Medicine (EM) at AKUH Karachi, Pakistan. Past medical records of all patients who were injured by firearms and were presented to the AKUH Emergency Department (ED) from June 2002 till May 2007 were reviewed. Data were recorded on the basic demographics of injured, length of hospital stay, body parts injured and the outcome (alive vs. dead). Total of 286 patients with firearm injuries were identified. Majority of them were males (92%; n=264). More than half of the patients (63%) were in the age group of 21-40 years. Upon arrival to the hospital 85% (n=243) of patients had Glasgow Coma Scale (GCS) ≥ 13. The mean injury severity score (ISS) was found to be 6 (SD ±4). The length of hospital stay of patients ranged from 0 to 54 days with a mean of 7 days. Lower limb were the most affected body parts (30%, n=86) followed by abdomen pelvis (27%, n=77). Seven percent (n=21) of the patient who were brought to the hospital were labeled as "deceased on arrival". Most of the injuries were caused during the act of robbery (40%, n=103) in the city. Robbery was the most common cause of firearm inju­ries. Lower limb, abdomen and pelvis were the most affected body regions. Educational efforts, and individual, community and societal approaches are needed to alleviate firearm-related injuries.

Despite importance of chest tube insertion in chest trauma, there is no general agreement on the level of daily volume drainage from chest tube. This study was conducted to compare the effectiveness and safety of chest tube removal at the levels of 150 ml/day and 2oo ml/day. Eligible patients (138) who needed replacement of chest tube (because of trauma or malignancy) were randomized into two groups; control (removal of chest tube when drainage reached to 150 ml/day) and trial (removal of chest tube at the level of 200 ml/day). All patients received standard care during hospital admission and a follow-up visit after 7days of discharge from hospital. Patients were then compared in terms of major clinical outcomes using chi-squared and t-test. From the total of 138 patients, 70 and 68 patients were randomized to control (G150) and trial (G200) group, respectively. Baseline characteristics were comparable between the two groups. Although the trial group had a shorter mean for length of hospital stay (LOS) (4.1 compared to 4.8, p=0.04), their differences in drainage time did not reach to the level of statistical significance (p=0.1). Analysis of data showed no statistically significant differences between the rate of radiological reaccumulation, thoracentesis and decrease in pulmonary sounds (auscultatory), one week after discharge from hospital. Compared to a daily volume drainage of 150 ml, removal of chest tube when there is 200 ml/day is safe and will even result in a shorter hospital stay. This in turn leads to a lower cost.

Though the prevalence of Intimate Partner Violence (IPV) remains high in less developed countries, data suggest that these figures may represent an underestimation considering that many women are unwilling to disclose abuse. This paper aims to determine women's willingness to report abuse, factors determining willingness to disclose IPV, and to whom such disclosure is made. A total of 911 women visiting reproductive health facility responded to the questionnaire, and the collected data was analyzed using multivariate analysis. About 54% (n=443) of the participating women reported that would not disclose IPV. Among those willing to disclose abuse, 68% (n=221) would opt to disclose to close relatives in contrast to 37% (n=103) who would disclose to some form of institutions (i.e. religious leaders, law enforcement officers). Ethnicity, woman's own use of alcohol and autonomy in decision making such as having a say on household purchases, money use and visitation, independently predicted willingness to disclose IPV. The role of family is still important in the Nigeria context and the implications for research and intervention are discussed.

The relationship between suicide and involuntary admissions has been examined in younger and mixed age groups. These studies provide mixed results with some demonstrating no relationship and others reporting increased rates of suicides in involuntarily admitted patients. This relationship has not been examined in the elderly. Thus, an ecological study, over the 19-year period, to examine the relationship between rates of involuntary admissions and elderly suicide rates in England and Wales was undertaken using nationally collected data. Data on suicide rates for both sexes in the age-bands 65-74 years and 75+ years were ascertained from the World Health Organisation (WHO) website. Data on the number of detentions under the Mental Health Act were ascertained from the Office of National Statistics website. Data on the population size for the elderly age-bands were ascertained from the WHO website. Spearman's correlation coefficient was used to examine the relationship between suicide rates and rates of detention under the Mental Health Act. There were negative correlations between rates of involuntary admissions and suicide rates in both sexes in the age-bands 65-74 and 75+ years. A causal relationship and the direction of causality cannot be assumed because this was an ecological study. There is a need for sufficiently powered study to compare the number of suicides occurring in involuntarily and voluntarily admitted patients using a case-control or cohort design and survival analysis. If an inverse association can be demonstrated between suicide and involuntary admissions then it has important implications for the development of mental health legislation as an adjunct to national suicide prevention strategies