فهرست مطالب

Injury and Violence Research - Volume:4 Issue: 1, Jan 2012

Journal of Injury and Violence Research
Volume:4 Issue: 1, Jan 2012

  • تاریخ انتشار: 1390/11/03
  • تعداد عناوین: 10
|
  • Homayoun Sadeghi-Bazargani Page 1
  • Amol R. Dongre, Prdeep R. Deshmukh Page 2
    Objective
    To explore the various perceived reasons for farmers’ suicides in the Vidarbha region of Maharashtra, their common factors, and to suggest solutions.
    Methods
    The present formative research was undertaken in the 23 villages surrounding the Anji Primary Health Centre, located in the Vidarbha region of Maharashtra, India. A triangulation of free list and pile sort exercises was used. The data was analyzed by Anthropac 4.98.1/X software. This was followed by a semi-structured focus group discussion. To increase the validity of the results, these findings were presented to the participants and later they were circulated to the 26 farmers’ clubs in the villages for comment and discussion during their monthly, village-based meetings.
    Results
    Farmers perceived debt, addiction, environmental problems, poor prices for farm produce, stress and family responsibilities, government apathy, poor irrigation, increased cost of cultivation, private money lenders, use of chemical fertilizers and crop failure as the reasons for farmers’ suicides. Participants suggested solutions such as self-reliance and capacity building among farmers, a monitoring and support system for vulnerable farmers, support and counseling services, a village-level, transparent system for the disbursement of relief packages.
    Conclusions
    Farmers’ suicides in Vidarbha are caused by the complex interplay of social, political and environmental constraints. Hence, a comprehensive intervention to ensure self-reliance and capacity building among farmers in modern farming techniques, monitoring and support system for vulnerable farmers, a village-level, transparent system for disbursement of relief packages is required to prevent farmer suicides in the near future. Apart from this, there is a need to strengthen the National Mental Health Program at primary health care level to offer support and counseling to vulnerable farmers in rural area.
  • Ajit Shah Page 7
    Background
    Although life-long adversity has been suggested as a protective factor for elderly suicides, studies examining protective factors for elderly suicides are scarce. A cross-national study examining the relationship between elderly suicide rates and several proxy measures of adversity earlier in life was undertaken to replicate earlier findings by using five consecutive years data on elderly suicide rates from a more recent data set and by adding two more proxy measures of adversity early in life.
    Methods
    The relationship between elderly suicide rates and five proxy measures of adversity earlier in life was examined using data from the World Health Organization and the United Nations data banks with Spearman’s correlation coefficient. The five proxy measures of adversity early in life were: the percentage of children under the age of 5 years who were under weight, the percentage of children under the age of 5 years who were under height, the percentage of infants with low birth weight babies, the percentage of the general population with sustainable access to improved sanitation and the percentage of the general population with sustainable access to an improved water source.
    Results
    Generally, elderly suicide rates were lower in countries with higher adversity early in life. The only exceptions were in females aged 75+ years where this association only approached statistical significance for the percentage of children under the age of 5 years who were under weight and the percentage of children under the age of 5 years who were under height.
    Conclusions
    The current study using a more recent data set and a five years data on elderly suicide rates along with two additional proxy measures of adversity early in life was able to replicate the findings of the earlier study. This suggests that the findings of the earlier study were accurate and robust.
  • Dora Petik, Barbara Czeizel, Ferenc B., Aacute, Nhidy, Andrew E. Czeizel Page 10
    Background
    The aim of the study was to estimate the effect on the fetal development of high doses of prescription drugs taken as a suicide attempt during pregnancy.
    Methods
    Pregnant women were identified among self-poisoned females in the toxicological inpatient clinic in Budapest between 1960 and 1993. Congenital abnormalities, intrauterine development based on birth weight and post-conceptional age, mental retardation, cognitive-behavioral status were compared in exposed children born to mothers who had attempted suicide by means of a drug overdose during pregnancy with their siblings, born either before or after the affected pregnancy, as sib controls.
    Results
    Of a total of 1 044 pregnant women, 74 used the combination of amobarbital, glutethimide and promethazine (Tardyl®, one of the most popular drugs for treatment of insomnia in Hungary) for suicide attempt. Of these 74 women, 27 delivered live-born babies. The mean dose of Tardyl® used for suicide attempts was 24 times the usually prescribed clinical dose. The rate of congenital abnormalities and intrauterine retardation was not higher in exposed children than in their sib controls. However, of the 27 exposed children, eight (29.6%) were mentally retarded (Χ21=79.7, p= Sig) while mental retardation did not occur among 46 sib controls. These exposed children were born to mothers who attempted suicide with Tardyl® between the 14th and 20th post-conceptional weeks. The components of Tardyl® used separately for a suicide attempt during pregnancy were not associated with a higher risk of mental retardation. Therefore the high doses of Tardyl® associated with the high risk for mental retardation may be due to the interaction of its three drug components.
    Conclusions
    The findings of the study showed that the high doses of a drug containing three components may be associated with a significantly increased risk for mental retardation without any structural defects, whereas each of these three component drugs taken alone was not associated with this adverse effect.
  • Kent Lindqvist, Koustuv Dalal Page 20
    Background
    The objective of the current study was to evaluate outcomes of a program to prevent severe and less severe unintentional child injuries among the different social strata under WHO Safe Community program. Specifically, the aim was to study effectiveness of Safe Community program for reducing child injury.
    Methods
    A quasi-experimental design was used, with pre- and post-implementation registrations covering the children (0 -15 years) in the program implementation area (population 41,000) and in a neighboring control municipality (population 26,000) in Östergötland County, Sweden.
    Results
    Boys from not vocationally active households displayed the highest pre-intervention injury rate in both the control and intervention areas. Also in households in which the vocationally significant member was employed, boys showed higher injury rates than girls. Households in which the vocationally significant member was self-employed, girls exhibited higher injury rates than boys in the intervention area. After 6 years of program activity, the injury rates for boys and girls in employed category and injury rates for girls in self-employed category displayed a decreasing trend in the intervention area. However, in the control area injury rate decreased only for boys of employed families.
    Conclusion
    The study indicated that almost no changes in injury rates in the control area suggested that the reduction of child injuries in the intervention area between 1983 and 1989 was likely to be attributable to the safety promotion program. Therefore, the current study indicates that Safe Community program seems to be successful for reducing child injuries.
  • Ajit Shah Page 26
    Background
    The relationship between suicide and involuntary admissions has been mainly 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. However, the association between the utility of the Mental Health Act with general population suicide rates in England and Wales has not been formally studied.
    Methods
    Thus, an ecological study, over the 19-year period, to examine the relationship between rates of involuntary admissions and general population suicide rates in England and Wales was undertaken using nationally collected data. Data on general population suicide rates for both sexes were ascertained from the World Health Organization (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.
    Results
    There were negative correlations between rates of involuntary admissions and general population suicide rates in both sexes.
    Conclusions
    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 suicide 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.
  • Seter Siziya, Emmanuel Rudatsikira, Adamson Sinjani Muula Page 30
    Background
    Among school- attending adolescents, victimization from bullying is associated with anxiety, depression and poor academic performance. There are limited reports on victimization from bullying in Zambia; we therefore conducted this study to determine the prevalence and correlates for victimization from bullying among adolescents in grades 7 to 10 in the country in order to add information on the body of knowledge on victimization from bullying.
    Methods
    The 2004 Zambia Global School-based Health Survey (GSHS) data among adolescents in grades 7 to 10 were obtained from the World Health Organization. We estimated the prevalence of victimization from bullying. We also conducted weighted multivariate logistic regression analysis to determine independent factors associated with victimization from bullying, and report adjusted odds ratios (AOR) and their 95% confidence intervals (CI).
    Results
    Of 2136 students who participated in the 2004 Zambia GSHS, 1559 had information on whether they were bullied or not. Of these, 1559 students, 62.8% (60.0% of male and 65.0% of female) participants reported having been bullied in the previous 30 days to the survey. We found that respondents of age less than 14 years were 7% (AOR=0.93; 95%CI [0.91, 0.95]) less likely to have been bullied compared to those aged 16 years or older. Being a male (AOR=1.07; 95%CI [1.06, 1.09]), lonely (AOR=1.24; 95%CI [1.22, 1.26]), worried (AOR=1.12; 95%CI [1.11, 1.14]), consuming alcohol (AOR=2.59; 95%CI [2.55, 2.64]), missing classes (AOR=1.30; 95%CI [1.28, 1.32]), and considering attempting suicide (AOR=1.20; 95%CI [1.18, 1.22]) were significantly associated with bullying victimization.
    Conclusions
    Victimization from bullying is prevalent among in-school adolescents in grades 7 to 10 in Zambia, and interventions to curtail it should consider the factors that have been identified in this study.
  • Ali Tavakoli Kashani, Afshin Shariat Mohaymany, Andishe Ranjbari Page 36
    Background
    Iran is a country with one of the highest rates of traffic crash fatality and injury, and seventy percent of these fatalities happen on rural roads. The objective of this study is to identify the significant factors influencing injury severity among drivers involved in crashes on two kinds of major rural roads in Iran: two-lane, two-way roads and freeways.
    Methods
    According to the dataset, 213569 drivers were involved in rural road crashes in Iran, over the 3 years from 2006 to 2008. The Classification And Regression Tree method (CART) was applied for 13 independent variables, and one target variable of injury severity with 3 classes of no-injury, injury and fatality. Some of the independent variables were cause of crash, collision type, weather conditions, road surface conditions, driver's age and gender and seat belt usage. The CART model was trained by 70% of these data, and tested with the rest.
    Results
    It was indicated that seat belt use is the most important safety factor for two-lane, two-way rural roads, but on freeways, the importance of this variable is less. Cause of crash, also turned out to be the next most important variable. The results showed that for two-lane, two-way rural roads, "improper overtaking" and "speeding", and for rural freeways, "inattention to traffic ahead", "vehicle defect", and "movement of pedestrians, livestock and unauthorized vehicles on freeways" are the most serious causes of increasing injury severity.
    Conclusions
    The analysis results revealed seat belt use, cause of crash and collision type as the most important variables influencing the injury severity of traffic crashes. To deal with these problems, intensifying police enforcement by means of mobile patrol vehicles, constructing overtaking lanes where necessary, and prohibiting the crossing of pedestrians and livestock and the driving of unauthorized vehicles on freeways are necessary. Moreover, creating a rumble strip on the two edges of roads, and paying attention to the design consistency of roads can be a helpful factor in order to prevent events such as "overturning" and improve the overall safety of freeways.
  • Lawal Khalid, Adamu Ahmed Page 42
    A 23 year old man presented with intestinal evisceration from stab injury to the left side of the abdomen with a hand-held cow horn at a local night party. He complained of severe abdominal pain and bleeding at the site of injury. He was hemodynamically stable. At emergency exploration, the eviscerated bowel was viable with no adjacent mesenteric tear. Other intra abdominal organs were normal. The eviscerated bowel was lavaged and reduced into the abdomen through the 7cm anterior abdominal wall laceration. The laceration was repaired and abdomen closed in layers. Post operative recovery was uneventful. The hand-held cow horn can easily be concealed and may pass through security checks undetected. It should be added to the ever increasing list of weapons of small scale terror.
  • Samara Mcphedran, Jeanine Baker Page 44