Hospital Accident Research Articles

Bipolar disorder and early childhood trauma

Case Background There is a reported 48.8 million case of bipolar disorder (BD) world- wide. It can also be one of the most challenging disorders to manage clinically as patients often have poor medical compliance and numerous relapses throughout their lifetime. The etiology of this illness is still poorly understood, but it is recognized to compromise both genetic and environmental factors. Regarding the latter, abuse and instability in childhood and adolescence was reported as an important area of consideration in regard to the development and prognosis of bipolar disorder. We report here the case of a female who exemplifies the significance of early childhood experience in this disorder. Case Presentation Isabelle is a 21 year old, female, with a background history of bipolar disorder. She presented to the Cork University Hospital accident and emergency 2 weeks after discharge after a 4 week admission for a depressive episode. Isabelle was referred from the home-based team with an acute episode of mania and was detained involuntarily under the Mental Health Act. Her history is significant for childhood neglect, physical, emotional and sexual abuse, along with multiple foster care placements. She was managed as an inpatient with antipsychotics and a mood stabilizer before being discharged after a lengthy, arduous, admission. Conclusion Childhood trauma is an important consideration in BD. Therefore, practitioner awareness of the role of such trauma with regard to its etiology and prognosis is of great importance. It is also essential to the practice of preventive medicine. Patient Consent Obtained: Yes

A Survey on Safety Accidents in Clinical Practice of Nursing Students

Purpose: The purpose of this survey was to investigate the type of safety accidents experienced by nursing students during clinical practice in hospital and to determine the safety accident experiences according to the general characteristics of nursing students. Methods: The subjects of the study were 340 senior nursing students who experienced clinical practice of 9 nursing colleges in 7 regions of Korea. Data collection was done using the general characteristics and the safety accidents in clinical practice of nursing students tool that the researchers developed and took validity verification. Result: The most common safety accident in clinical practice was physical/psychological burnout, experienced by 111 students (32.6%). The second was psychological violence, experienced by 86(25.3%), and the third was needle stick/sharps Injuries, experienced by 63(18.5%). The fourth were musculoskeletal problems and sexual violence, each experienced by 43(12.6%). The occurrence of physical/ psychological burnout significantly differs depending on gender (χ2=16.40, p<.001), personality trait (χ2=7.03, p=.008), class lesson score (χ2=10.39, p=.006), university affiliated hospital (χ2=9.73, p=.002), health status (χ2=40.06, p<.001), and fatigue level (χ2=11.42, p=.003). The occurrence of traumatic injuries significantly differs depending on health status (χ2=11.89, p=.003). The occurrence of psychological violence significantly differs depending on personality traits (χ2=4.52, p=.033), health status (χ2=10.17, p=.006), and stress level (χ2=9.13, p=.010). Conclusion: In order to prevent and cope with safety accidents in clinical practice, universities and hospitals should have an organic relationship and provide education on accident prevention for nursing students, continuous monitoring of safety accidents, and develop in-hospital safety protocols for nursing students.

How Safety Knowledge and Work Environment Affect Workplace Accidents: Uncovering the Role of Safety Behaviors

Workplace accidents in hospitals can arise from human or environmental factors, highlighting the necessity of implementing Hospital Occupational Safety and Health (HOSH) measures. Preliminary study at X Hospital shows that work-related accidents persist, with the majority leading to physical injuries. This study aims to observe the impact of HOSH knowledge and the work environment on nurse workplace accidents, with safety behaviors serving as a mediating factor. The research utilizes a quantitative survey method with a cross-sectional design. A total of 123 nurses participated in the study. An analysis using Structural Equation Modeling (SEM) was conducted to assess the statistical impact. The findings indicate that improving Occupational Safety and Health (OSH) knowledge and enhancing the work environment can significantly reduce workplace accidents. The mediating role of safety behaviors further amplifies this effect. Both HOSH knowledge and the work environment have a positive significant impact on safety behaviors, while HOSH knowledge, the work environment, and safety behaviors each have a negative significant impact on workplace accidents

An 'alcohol health champions' intervention to reduce alcohol harm in local communities: a mixed-methods evaluation of a natural experiment.

Globally alcohol consumption is a leading risk factor for premature death and disability and is associated with crime, social and economic consequences. Local communities may be able to play a role in addressing alcohol-related issues in their area. To evaluate the effectiveness and cost-benefit of an asset-based community development approach to reducing alcohol-related harm and understand the context and factors that enable or hinder its implementation. A mixed-methods evaluation. Area-level quasi-experimental trial analysed using four different evaluation methods (a stepped-wedge design where each area was a control until it entered the intervention, comparison to matched local/national controls and comparison to synthetic controls), alongside process and economic evaluations. Ten local authorities in Greater Manchester, England. The outcomes evaluation was analysed at an area level. Ninety-three lay persons representing nineareas completed questionnaires, with 12 follow-up interviews in five areas; 20 stakeholders representing ten areas were interviewed at baseline, with 17 follow-up interviews in eight areas and 26 members of the public from two areas attended focus groups. Professionals in a co-ordinator role recruited and supported lay volunteers who were trained to become alcohol health champions. The champion's role was to provide informal, brief alcohol advice to the local population and take action to strengthen restrictions on alcohol availability. Numbers of alcohol-related hospital admissions, accident and emergency attendances, ambulance call-outs, street-level crime and antisocial behaviour in the intervention areas (area size: 1600-5500 residents). Set-up and running costs were collected alongside process evaluation data exploring barriers and facilitators. Routinely collected quantitative data on outcome measures aggregated at the intervention area and matched control and synthetic control areas. Data from policy documents, licensing registers, meeting notes, invoices, time/cost diaries, training registers, questionnaires, interviews, reflective diaries and focus groups. The intervention rolled out in nine out of ten areas, seven of which ran for a full 12 months. Areas with better-established infrastructure at baseline were able to train more champions. In total, 123 alcohol health champions were trained (95 lay volunteers and 28 professionals): lay volunteers self-reported positive impact. Champions engaged in brief advice conversations more readily than taking action on alcohol availability. There were no consistent differences in the health and crime area-level indicators between intervention areas and controls, as confirmed by using three different analysis methods for evaluating natural experiments. The intervention was not found to be cost-beneficial. Although the sequential roll-out order of the intervention was randomised, the selection of the intervention areas was not. Self-reported impact may have been subject to social desirability bias due to the project's high profile. There was no measurable impact on health and crime outcomes. Possible explanations include too few volunteers trained, volunteers being unwilling to get involved in licensing decisions, or that the intervention has no direct impact on the selected outcomes. Future similar interventions should use a coproduced community outcomes framework. Other natural experiment evaluations should use methodological triangulation to strengthen inferences about effectiveness. This trial is registered as ISRCTN81942890. This award was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme (NIHR award ref: 15/129/03) and is published in full in Public Health Research; Vol. 12, No. 9. See the NIHR Funding and Awards website for further award information.

Road traffic crash data in Southwestern Nigeria: a qualitative analysis of sources, contents and management methods

Objective This study qualitatively examined road traffic crash (RTC) data collection and management in southwest Nigeria, with the goal of addressing the tenets of the UN Decade of Action Plan on Road Safety’s call for an effective data system. Methods Data on RTCs data collection in the study area was obtained through key informant interviews with five hospital accident emergency unit directors, three Federal Road Safety Commission (FRSC) Sector commanders, and three Nigeria Police Force (NPF) commissioners. Datasets were transcribed, categorized, and interpreted using content analysis, descriptive statistics, and WHO recommended minimal crash data element requirements. Results The study found disparate systems, a lack of synergy, and discrepancy in the various data sources in the country when compared with WHO recommendations on road traffic data collection systems, with 55% of agencies using non-standardized paper forms. The study also reveals that the minimum crash data elements recommended by WHO are not consistently captured in the NPF, FRSC, and hospital traffic crash data sources. Conclusions The study suggested the use of an upgraded National Road Traffic Crash Data Management System (NRTCDMS) Data Template to unify data gathering and linkage issues, but recommends a digital version of the template.

Mortality, morbidity and educational outcomes in children of consanguineous parents in the Born in Bradford cohort

Background Children of consanguineous parents have a higher risk of infant and childhood mortality, morbidity and intellectual and developmental disability. Methods Using a prospective UK based longitudinal family cohort study we quantify differences according to the consanguinity status of children from birth to age 10 in mortality, health care usage, two health and three educational outcomes. Results Compared to children whose parents were not related children whose parents were first cousins were more likely to die by the age of 10 years (odds ratio 2.81, 95% CI 1.82-4.35) to have higher rates of primary care appointments (incident rate ratio 1.39, 95% CI 1.34-1.45) and more prescriptions (incident rate ratio 1.61, 95% CI 1.50-1.73). Rates of hospital accident and emergency attendance (incident rate ratio 1.21,95% CI 1.12-1.30) and hospital outpatients’ appointments (incident rate ratio 2.21,95% CI 1.90-2.56) are higher. Children whose parents are first cousins have higher rates of speech/ language development difficulties (odds ratio 1.63, 95% CI 1.36-1.96) and learning difficulties (odds ratio 1.89, 95% CI 1.28-2.81). When they begin school children whose parents are first cousins are less likely to reach phonics standards (odds ratio 0.73, 95% CI 0.63-0.84) and less likely to show a good level of development (odds ratio 0.61, 95% CI 0.54-0.68). At age 10 there are higher numbers with special educational needs who are from first cousin unions when compared to all children whose parents are not blood relations (odds ratio 1.38, 95% CI 1.20-1.58). Effect sizes for consanguinity status are similar in univariable and multivariable models where a range of control variables including deprivation are added. Conclusions There is higher childhood mortality and greater use of health care as well as higher rates of learning difficulties, speech and language development challenges and substantive differences in education outcomes in children whose parents are first cousins

Post-Pandemic Evolution of Suicide Risk in Children and Adolescents Attending a General Hospital Accident and Emergency Department.

Lockdowns and other health protective measures, such as social distancing, imposed during the COVID-19 pandemic nurtured unprecedented levels of stress and social isolation around the world. This scenario triggered an increase in suicide thoughts and self-harm behaviours among children and young people. However, the longer-term impact of the pandemic on children's and adolescents' mental health, especially with regard to self-harm, is still to be fully discovered. We carried out a retrospective study where we collected data related to suicide ideation and self-harm behaviours in all patients aged under 18 that required on-call psychiatric services at the General Hospital Accident and Emergency (A&E) department in Salamanca, Spain, during 2019 (pre-pandemic) and in both 2021 and 2022 to capture possible variation at different time points during the post-pandemic period. A total of 316 patients aged under 18 were seen by on-call psychiatric services at the A&E department during the three time periods: 78 in 2019, 98 in 2021 and 140 in 2022. The mean age was 15.12 (SD 2.25) and females represented more than twice the number of males each year. More than half of all patients assessed during 2022 disclosed suicide thoughts, whilst in 2019, it was near 25%. This increase in suicide ideation rates was more marked among females (X2 = 15.127; p = 0.001), those aged over 15 (X2 = 16.437; p < 0.001) and/or those with a previous history of mental health problems (X2 = 17.823; p < 0.001). We identified an increase in the proportion of males with suicide ideas, especially between 2021 and 2022 (X2 = 8.396; p = 0.015). Our study suggests that children's and adolescents' demand for urgent mental healthcare and their clinical presentations in A&E departments with suicide thoughts and/or self-injuries do not seem to be declining after the pandemic but increasing over time. More research is warranted to understand possible factors involved in this sustained upward trend.

Solar Lights for Highways with Zone-Wise Speed Control System for Vehicle

The challenge of providing adequate lighting along highways, particularly at critical points such as sharp turns and speed breakers, poses significant safety concerns. Traditional energy sources often fail to meet the demands of continuous lighting, especially in remote areas. To tackle this challenge, we present an automatic lighting system aimed at selectively activating lights during nighttime while also reducing vehicle speed near or at danger zones. Entire system is designed as automatic, human involvement is not required; lights are controlled automatically by sensing the vehicles. Whenever the vehicle enters into the danger zone, lights will be energized and they remain in ON state until the vehicle leaves that area. The system will be activated automatically during dark. In this method precious energy acquired from the solar panel can be saved. During the day time the battery will be charged and this stored energy is utilized in the nights[10]. It is a novel approach to vehicle navigation and safety implementation, and also aimed at automatically sensing the areas/zones like Schools, Hospital Accident, etc and automatically reducing the speed of the vehicle for safety purposes.

Interobserver variability in preclinical assessment of collision variables following traffic accidents

PurposeTraffic accidents persist as a leading cause of death. European law mandates the integration of automatic emergency call systems (eCall). Our project focuses on an automated injury prediction device for car accidents, correlating technical and epidemiological input data, such as age, gender, seating position, impact on the passenger compartment, seatbelt usage, impact direction, EES, vehicle class, and airbag deployment. This study aims to explore interobserver variability in data collection quality in real accident scenarios. The assessment will evaluate the impact of user training and measure the time needed for data collection to inform user recommendations for the prehospital assessment.Insights from this study can aid in evaluating the ability of different professional groups to identify potential accident-independent parameters at accident scenes. This includes, among other things, relaying information to dispatchers at rescue control centers, also within the context of telemedicine approaches.MethodsDuring group sessions, real accident scenarios were presented both before and after a training presentation. Participants, including laypersons, accident research staff, emergency services, hospital physicians, and emergency physicians, visually assessed injury prediction parameters within a time limit. Training involved defining and explaining parameters using accident images. The study analyzed participant demographics, prediction accuracy, and time required, comparing assessment quality between professional groups and before and after training.ResultsIn summary, the study demonstrates that training had a significantly positive impact on the quality of assessment for technical accident parameters. The processing time decreased significantly after training. A notable training effect was observed, particularly for the parameters of rigid collision object, affected passenger compartment, energy equivalent speed (EES), and front and side airbags. It was recommended that individuals without prior knowledge should receive training on assessing EES. Overall, it was evident that technical parameters following a traffic accident can be well assessed through training, irrespective of the professional group.ConclusionSignificant differences in the assessment quality of technical accident parameters were observed based on technical and medical expertise. After user training, interdisciplinary differences were reconciled, and all professional groups yielded comparable results, indicating that training can enhance the assessment abilities of all participants in the rescue chain, while the time required for assessing accident parameters was significantly reduced with training.

Effects of Benzodiazepine Exposure on Real-World Clinical Outcomes in Individuals at Clinical High Risk for Psychosis.

Animal models indicate GABAergic dysfunction in the development of psychosis, and that benzodiazepine (BDZ) exposure can prevent the emergence of psychosis-relevant phenotypes. However, whether BDZ exposure influences real-world clinical outcomes in individuals at clinical high risk for psychosis (CHR-P) is unknown. This observational cohort study used electronic health record data from CHR-P individuals to investigate whether BDZ exposure (including hypnotics, eg, zopiclone) reduces the risk of developing psychosis and adverse clinical outcomes. Cox proportional-hazards models were employed in both the whole-unmatched sample, and a propensity score matched (PSM) subsample. 567 CHR-P individuals (306 male, mean[±SD] age = 22.3[±4.9] years) were included after data cleaning. The BDZ-exposed (n = 105) and BDZ-unexposed (n = 462) groups differed on several demographic and clinical characteristics, including psychotic symptom severity. In the whole-unmatched sample, BDZ exposure was associated with increased risk of transition to psychosis (HR = 1.61; 95% CI: 1.03-2.52; P = .037), psychiatric hospital admission (HR = 1.93; 95% CI: 1.13-3.29; P = .017), home visit (HR = 1.64; 95% CI: 1.18-2.28; P = .004), and Accident and Emergency department attendance (HR = 1.88; 95% CI: 1.31-2.72; P < .001). However, after controlling for confounding-by-indication through PSM, BDZ exposure did not modulate the risk of any outcomes (all P > .05). In an analysis restricted to antipsychotic-naïve individuals, BDZ exposure reduced the risk of transition to psychosis numerically, although this was not statistically significant (HR = 0.59; 95% CI: 0.32-1.08; P = .089). BDZ exposure in CHR-P individuals was not associated with a reduction in the risk of psychosis transition or adverse clinical outcomes. Results in the whole-unmatched sample suggest BDZ prescription may be more likely in CHR-P individuals with higher symptom severity.

Impaled trans-palatal crochet needle impacted at skull base; a multidisciplinary management challenge.

Pediatric oro-pharyngeal trauma is a common observation in hospital accidents &amp; emergencies reception. Immense responsibility rests with specialized health care providers to instantly diagnose and manage a rather small proportion of life-threatening complication associated with such injuries. Postero-lateral oropharyngeal trauma carries a significant risk of major neurovascular insult. More-over such patients are exposed to high radiation exposure to face, head &amp; neck regions. A multi-disciplinary approach involving high dependency nursing, neuro-observation, meticulous imaging, prompt surgical exploration where indicated and a cautious follow-up must be considered as neurovascular manifestation may become apparent after some days of initial injury.

Association between continuity of care and attendance of post-discharge follow-up after psychiatric emergency presentation

The number of accident and emergency (A&E) hospital attendances by young people aged 18 or under with a recorded diagnosis of a psychiatric condition more than tripled between 2010 and 2022. After discharge from the hospital, attendance at follow-up appointments in the community is critical to ensure the safety of young people and optimise the use of clinical resources. A retrospective cohort study was conducted to evaluate the association between follow-up attendance and the continuity of clinicians and clinical teams, using electronic clinical record data from East London NHS Foundation Trust (ELFT), between April 2019 and March 2022. Multi-level mixed effects logistic regression was performed to model the follow-up attendance odds based on whether the same or different clinician and clinical team offered the initial A&E and the community follow-up appointment or whether a crisis team was involved. 3134 A&E presentations by 2368 young people were identified within the study period. Following these presentations, 2091 follow-up appointments in the community were offered. The attendance rate increased by more than three times if the follow-up appointment was offered by the same clinician who saw the young person in A&E (odds ratio (OR) = 3.66; 95% CI 1.65–8.13). Whether the same clinical team provided the community follow-up appointment, or whether a crisis team was involved before discharge made no difference to the likelihood of follow-up attendance. The findings support the importance of the continuity of clinicians in the care of young people in crisis.

Clinicodemographic Pattern of Death in Road Traffic Accidents at Tangail Medical College.

Background: Rapid motorization bought a boon along with the curse of road traffic accidents toll. Injuries and death due to RTA are one of the major public health problems across the globe, especially in developing countries, due to lack of comprehensive legislative measures. RTA are responsible for the greatest number of injuries and fatalities worldwide by killing around 1.2 million people each year and injuring another 50 million. It will have an immeasurable impact on the families affected by RTA. Objective: To evaluate the situation of RTA in Tangail and to find out the pattern of injuries present in the dead bodies in RTA.Materials and Methods: This is a retrospective study based on autopsy reports conducted to find out the pattern of death due to road traffic accidents in Sheikh Hasina Medical College and Hospital, Tangail during the period from 1st January 2020 to 31st December 2020. After reviewing all postmortem reports 53 cases were found due to RTA, including railway accidents during this study period.Results: A total of 391 postmortem were conducted during the study period from January 2020 to December 2020 and out of which 53 cases were RTA. Female deaths were only 12( 22.64%) and the majority of the deaths were male 41( 77.36%). The highest percentage of deaths were found in the age group 21-30 year 21( 39.62%), followed by 31-40 (18.87%), 41-50 years( 16.98%). According to the types of vehicles, buses and lorries were responsible for the deaths. Regarding the types of victim distribution, pedestrians 28 (52.83(%) were the highest percentage and vehicle occupants were 15(28.30%). Among total cases, head injury (41.51%) was the highest percentage responsible for deaths, followed by fracture of the skull bone ( 41.51%), fracture of the long bone ( 16.98%), chest injuries( 22.64%) and pelvis fracture (5.66%.)Conclusion: Strict enforcement of traffic law, using seatbelts, maintaining the fitness of vehicles, driving licenses, improving public awareness, etc., can reduce this economic burden and protect vulnerable groups of people in our country. KYAMC Journal Volume: 14, No: 03, October 2023: 158-160.

Health risk assessment and occupational safety at hospitals in Southwest of Iran

Background/objectives: Risk assessment is very important to reduce the occurrence and spread of preventable accidents in hospitals because they have huge resources of funds related to the health of society, human, financial, physical, and equipment capital. This study was done in order to assess the occupational health and safety risks at Mehr and Razi Hospital in Ahvaz. MethodsIn this descriptive-cross-sectional study, the HOSHRA method was used at Mehr Private and Razi University of Education Hospital in Ahvaz during 2022. Then, descriptive statistics were used to analyze the results. ResultsBased on result of this study in Razi Hospital, the final score of risk is in order from the highest to the lowest related to biological risks > physical risks > chemical risks > ergonomic risks > psychological risks, and in Mehr Hospital, in order from the highest to the lowest related to biological risks > ergonomic risks > psychological risks > risks Physical and chemical hazards were obtained. The findings of the total HOSHRA index for different risks in the two selected hospitals showed that close to each other, but it was slightly higher in Razi Hospital in Ahvaz than in Mehr Hospital. ConclusionAccording to the findings study the chemical, ergonomic, psychological, physical, and biological risk assessment results showed that the risk level at Razi Educational and Mehr Private Hospitals is unacceptable and requires fundamental and urgent changes.

Evaluation of emergency hospital admissions for inflammatory bowel disease as a possible marker of quality of care of British IBD inflammatory bowel disease units

BackgroundKey performance indicators (KPIs) are required to facilitate quality improvement for inflammatory bowel disease (IBD). Emergency admissions for IBD may represent a possible KPI.MethodsIBD emergency admissions for 2018–2019 from Hospital...

Mortality, morbidity and educational outcomes in children of consanguineous parents in the Born in Bradford cohort.

Children of consanguineous parents have a higher risk of infant and childhood mortality, morbidity and intellectual and developmental disability. Using a UK based longitudinal cohort study we quantify differences according to the consanguinity status of children from birth to 10 in mortality, health care usage, two health and three educational outcomes. The cohort comprises 13727 children; 35.7% White British, 43.7% Pakistani heritage, and 20.8% are from other ethnic groups. Compared to children whose parents were not related children whose parents were first cousins were more likely to die by age 10 (odds ratio 2.81, 95% CI 1.82-4.35) to have higher rates of primary care appointments (incident rate ratio 1.39, 95% CI 1.34-1.45) and more prescriptions (incident rate ratio 1.61, 95% CI 1.50-1.73). Rates of hospital accident and emergency attendance (incident rate ratio 1.21,95% CI 1.12-1.30) and hospital outpatients' appointments (incident rate ratio 2.21,95% CI 1.90-2.56) are higher. Children of first cousins have higher rates of speech/ language development difficulties (odds ratio 1.63, 95% CI 1.36-1.96) and learning difficulties (odds ratio 1.89, 95% CI 1.28-2.81). When they begin school they are less likely to reach phonics standards (odds ratio 0.73, 95% CI 0.63-0.84) and less likely to show a good level of development (odds ratio 0.61, 95% CI 0.54-0.68). At age 10 there are higher numbers with special educational needs from first cousin unions compared to all children whose parents are not blood relations (odds ratio 1.38, 95% CI 1.20-1.58). Effect sizes for consanguinity status are similar in univariable and multivariable models where a range of control variables are added. There is higher childhood mortality and greater use of health care as well as higher rates of learning difficulties, speech and language development challenges and substantive differences in education outcomes in children whose parents are first cousins.

RELATIONSHIP ATTITUDE AND NURSE KNOWLEDGE ABOUT THE COMPLIANCE OF THE USE OF PERSONAL PROTECTIVE EQUIPMENT (PPE) IN OUTPATIENT INSTALLATION AT TANGERANG SELATAN HOSPITAL

Results from the National Safety Council report show that the incidence of workplace accidents in hospitals is 41% higher compared to other industrial workers. Frequent cases are needle needles, scratches, and infectious diseases. The implementation of K3RS is of course determined by policy by the hospital by applicable laws and regulations. The purpose of this study was to see that there is a relationship between knowledge and attitudes with adherence to PPE use. This study used quantitative analysis methods with a cross-sectional study design. This study was conducted in November-January at South Tangerang Hospital. The population of this research source is all South Tangerang Hospital Workers, the target population is nurses at South Tangerang Hospital. The sample size of this study was 100 samples. Take samples using random sampling techniques. Analysis of research data using chi-square. Based on the analysis, it was found that all independent variables are related to dependent variables. Including, knowledge p-value 0.000 and attitude with p-value 0.000. It is estimated that the hospital will conduct routine socialization of the use of PPE for nurses. Nurses should be more compliant with the use of PPE.

Meta-analysis of clinical risk factors for suicide among people presenting to emergency departments and general hospitals with suicidal thoughts and behaviours.

Suicidal thoughts and behaviours (STB) are a common reason for presentation to emergency departments and general hospitals. A meta-analysis of the strength of clinical risk factors for subsequent suicide might aid understanding of suicidal behaviour and help suicide prevention. We conducted a meta-analysis of cohort and controlled studies on clinical risk factors and later suicide among people presenting to emergency departments and general hospitals with STB. Data were extracted from papers meeting inclusion criteria, published in Medline, PsycINFO, and Embase between 1 January 1960 and 10 October 2022 using papers located with the search terms ((suicide*).m_titl AND (emergency* OR accident and emergency OR casualty OR general hospital OR toxicology service).mp) or were indexed in PubMed and had titles located with the search terms (suicide* OR self-harm OR self-harm OR self-injury OR self-injury OR self-poisoning OR self-poisoning OR overdose OR para-suicide OR parasuicide [title/abstract]) AND (Emergency department OR emergency room OR Casualty OR general hospital OR toxicology OR accident and emergency [all fields]). Data about the association between clinical risk factors and suicide extracted from three or more studies were included in a random-effects meta-analysis of the odds of later death by suicide. The study was registered in PROSPERO and conducted according to MOOSE and PRISMA guidelines. Seventy-five studies reported on 741,624 people, of which 19,649 died by suicide (2.65%). Male sex (odds ratio (OR) = 1.99) and age (OR = 2.01) were the most consistently reported risk factors. The strongest associations with subsequent death by suicide related to violent self-harm methods at the hospital presentation, including: unspecified violent method (OR = 4.97), any violent method (OR = 4.57) and the specific violent methods of drowning (OR = 4.32), hanging (OR = 4.26), and use of firearms (OR = 10.08). Patients categorised as higher risk using suicide prediction scales or any other method that combined risk factors had moderately increased odds of suicide (OR = 2.58). Younger age, Black and Hispanic ethnicity, overdose, a diagnosis of adjustment disorder, and the absence of any psychiatric diagnosis were protective against suicide. Most risk factors for suicide among people who have presented with STB are not strongly associated with later suicide. The strongest risk factors relate to self-harm methods. In the absence of clear indicators of future suicide, all people presenting with suicidality warrant a thorough assessment of their needs, and further research is needed before we can meaningfully categorise people with STB according to suicide risk.

Influence of meteorological variables on the frequency of visits and hospital admission for epistaxis in a city with a cold semi-arid climate (Lorca, Spain).

Epistaxis is a common emergency for otorhinolaryngologists. Although the aetiological factors have been widely studied, they remain subject to debate. The role of meteorological variables has been discussed in recent years, but results have been inconsistent. Given a lack of prior data, the aim of our study was to identify the meteorological variables that influence the frequency of visits and hospital admission for epistaxis in a city with a cold semi-arid climate in Spain. Case-control study. patients who attended the accident and emergency department of a secondary level hospital for epistaxis over a 9-year period (2011-2019). Controls were established by simple random sampling among emergency rooms visits in general (patients who attended the same centre over the same period of time). Sociodemographic, clinical and meteorological variables were all taken into account. 2749 patients in the epistaxis group and 2764 in the control group. There were significant differences in the epistaxis group, with a higher proportion of male (62.85%) and older patients. Univariate and multivariate analysis revealed that the daily minimum temperature and maximum wind speed were factors significantly associated with the onset of epistaxis. In addition, logistic regression analysis showed that decreases in minimum temperature and increases in maximum wind speed were associated with an increase in epistaxis (p < 0.01). No association was found between hospital admission and the weather conditions. Our findings suggest that low minimum temperatures and high wind speeds are associated with the number of visits to hospital accident and emergency departments for epistaxis, but not with hospital admission.

Acil servise başvuran hastane çalışanlarının iş kazası bildirimlerinin analizi

ABSTRACT&#x0D; Aim: The purpose of this study is to analyze the occupational accidents experienced by all employees working in a university hospital in Turkey, according to their demographic data, as well as their title, ocuupations, accident type and location of accident in hospital, accident days and time periods, Types of occupational accidents. reasons that cause work accidents.&#x0D; Materials and Methods: The data of this research, which is planned to be descriptive, is collected from all staff (both healthcare workers and non-healthcare workers) of the University Hospital, which provides tertiary healthcare services, who applied to the Emergency Department due to a occupatinal accident, were registered between 15 August 2022 and 15 August 2023. &#x0D; Results: The number of work accidents is equal to the number of hospital employees exposed to a occupational accident. The frequency of singles according to marital status was 57%, the most common days spent on occupatianal accidents are friday with 22.8% (n=26), 64.9% (n=74) most frequently in the working hours between 08:00-16:00, according to the units where employees work; Internal medicines first with 32.5% (n=37), occupatianal accidents injury incident types are examined; needlestick and sharp injuries comes first with 59.6% (n=68). No fatal accident was detected in this retrospective study.&#x0D; Conclusion: As a university hospital with a large campus, it is aimed to shed light on occupational health and safety studies within the framework of Health Quality Standards in the hospital by analyzing the work accidents of hospital employees who apply to our department of emergency medicine and also we aimed to contribute to the literature.