Increase In Death Rate Research Articles

Association between disability-related budget reductions and increasing drug-related mortality across local authorities in Great Britain

BackgroundDrug-related mortality in the UK rose markedly after 2012. Here we test the hypothesis that cuts to disability-related spending were associated with increased drug-related mortality across local governments in Great Britain. MethodsWe regressed changes in drug-related death rates (years 2010–12 versus 2015–17) on local government disability-related budget reductions, adjusting for a range of regional, demographic, and economic factors. Budget reductions are captured with a combined measure of financial losses due to Incapacity Benefit and Disability Living Allowance reforms, expressed in pounds sterling per capita, per year. 364 local authorities across England, Scotland, and Wales were included in the study. FindingsGreater budget reductions were associated with greater increases in drug-related death rates. In the unadjusted model, each £100 per capita budget reduction was associated with an increase in drug-related death rates of 3.30 per 100 000 population (95% CI: 2.43 to 4.17). The magnitude of the association increased after adjusting for region and demographic factors (b = 4.84; 95% CI: 3.26 to 6.43). The association remained statistically significant after adjusting for a full set of controls, including baseline and trends in unemployment rates, median hourly pay, and gross disposable household income per capita (b = 4.41; 95% CI: 2.57 to 6.24). ConclusionDeeper cuts to local government spending in Great Britain in the 2010s were associated with larger increases in drug-related deaths.

Impact of the COVID-19 pandemic on coronary artery bypass graft surgery in Brazil: A nationwide perspective.

IntroductionThe coronavirus disease 2019 (COVID‐19) pandemic has been a worldwide challenge, and efforts to “flatten the curve,” including restrictions imposed by policymakers and medical societies, have forced a reduction in the number of procedures performed in the Brazilian Health Care System. The aim of this study is to evaluate the outcomes of coronary artery bypass graft (CABG) from 2008 to 2020 in the SUS and to assess the impacts of the COVID‐19 pandemic in the number of procedures and death rate of CABG performed in 2020 through the database DATASUS.MethodsThis study is based on publicly available material obtained from DATASUS, the Brazilian Ministry of Health's data processing system, on numbers of surgical procedures and death rates. Only isolated CABG procedures were included in our study. We used the TabNet software from the DATASUS website to generate reports.ResultsWe identified 281,760 CABG procedures performed from January 2008 to December 2020. The average number of procedures until the end of 2019 was of 22,104. During 2020 there was a 25% reduction CABG procedures, to 16,501. There was an increase in the national death rate caused by a statistical significant increase in death rates in Brazil's Southeast and Central‐west regions.ConclusionThe COVID‐19 pandemic remains a global challenge for Brazil's health care system. During the year of 2020 there was a reduction in access to CABG related to an increase in the number of COVID‐19 cases. There was also an increase in the national CABG death rate.

The impact of the COVID-19 pandemic on paediatric emergency service.

AimsThe aims of this research were to review patients visiting the paediatric emergency department over a 6‐month period 1 year before and during the pandemic, to review paediatric emergency department referral ratios and to determine whether there were any significant decreases in mortality and morbidity.MethodsAll patients from the ages of 0 to 18 years visiting the University of Health Sciences, Ankara Research and Training Hospital, paediatric emergency service from April‐October 2019 to April‐October 2020 with no missing information in their records were involved in this retrospective cross‐sectional study.ResultsThe total number of paediatric emergency service consultations was 74 739; the number of emergency visits from April to October 2019 was 55 678, whereas it was 19 061 from April to October 2020 in the midst of the COVID‐19 pandemic period. There was a 67.7% decrease in consultations during the pandemic period. The mean age of participants from April to October 2019 was 8.11 ± 5.31 years, and 52.4% of cases were male. The mean age from April to October 2020 was 8.58 ± 5.93 years, and 51% of cases were male. COVID‐19‐related symptoms were higher during the pandemic period (P < .05), with fever and gastroenteritis being the most frequently received diagnosis in both periods. During the pandemic period, the newborn consultation ratio was higher (P > .05), there was a decrease in consultation ratios related to suicide attempts (P < .05), and a threefold increase in death rates was observed (P < .05).ConclusionIn Turkey, where emergency consultation rates are quite high, these decreases look fearsome for secondary injuries that can develop in children. For this reason, families should be made aware of the importance of bringing their children to the hospital during emergencies, and that all necessary health precautions are being taken to decrease the spread of infection in hospitals.

Clinical Characteristics and Survival Analysis in Frequent Alcohol Consumers With COVID-19.

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection can generate a systemic disease named coronavirus disease–2019 (COVID-19). Currently, the COVID-19 pandemic has killed millions worldwide, presenting huge health and economic challenges worldwide. Several risk factors, such as age, co-infections, metabolic syndrome, and smoking have been associated with poor disease progression and outcomes. Alcohol drinking is a common social practice among adults, but frequent and/or excessive consumption can mitigate the anti-viral and anti-bacterial immune responses. Therefore, we investigated if patients with self-reported daily alcohol consumption (DAC) presented alteration in the immune response to SARS-CoV-2. We investigated 122 patients with COVID-19 (101 male and 46 females), in which 23 were patients with DAC (18 men and 5 women) and 99 were non-DAC patients (58 men and 41 women), without other infections, neoplasia, or immunodeficiencies. Although with no difference in age, patients with DAC presented an increase in severity-associated COVID-19 markers such as C-reactive protein (CRP), neutrophil count, and neutrophil-to-lymphocyte ratio. In addition, patients with DAC presented a reduction in the lymphocytes and monocytes counts. Importantly, the DAC group presented an increase in death rate in comparison with the non-DAC group. Our results demonstrated that, in our cohort, DAC enhanced COVID-19-associated inflammation, and increased the number of deaths due to COVID-19.

"Know your epidemic, know your response": Epidemiological assessment of the substance use disorder crisis in the United States.

The United States (U.S.) is currently experiencing a substance use disorders (SUD) crisis with an unprecedented magnitude. The objective of this study was to recognize and characterize the most vulnerable populations at high risk of SUD mortality in the U.S., and to identify the locations where these vulnerable population are located. We obtained the most recent available mortality data for the U.S. population aged 15-84 (2005-2017) from the Centers for Diseases and Prevention (CDC). Our analysis focused on the unintentional substance poisoning to estimate SUD mortality. We computed health-related comorbidities and socioeconomic association with the SUD distribution. We identified the most affected populations and conducted a geographical clustering analysis to identify places with increased concentration of SUD related deaths. From 2005-2017, 463,717 SUD-related deaths occurred in the United States. White population was identified with the highest SUD death proportions. However, there was a surge of the SUD epidemic in the Black male population, with a sharp increase in the SUD-related death rate since 2014. We also found that an additional average day of mental distress might increase the relative risk of SUD-related mortality by 39%. The geographical distribution of the epidemic showed clustering in the West and Mid-west regions of the U.S. In conclusion, we found that the SUD epidemic in the U.S. is characterized by the emergence of several micro-epidemics of different intensities across demographic groups and locations within the country. The comprehensive description of the epidemic presented in this study could assist in the design and implementation of targeted policy interventions for addiction mitigation campaigns.

Improved the detection and classification of breast cancer using hyper parameter tuning

The early diagnosis of any disease can be curable with a small amount of human effort. Most people will not be able to detect their illness before it becomes chronic. Breast cancer has been one of the diseases that can be treated until it spreads to all parts of the body when the disease is diagnosed at an earlier stage.Breast cancer is causing an increase in death rates all over the world. The medical practitioner can diagnose diseases incorrectly due to misinterpretation. In both developed and emerging countries, breast cancer is one of the leading causes of death for women. Breast cancer can be detected and classified early on in its progression, allowing patients to get adequate treatment. For detecting and classifying breast cancer in breast cytology videos, deep learning frameworks are suggested. The suggested architecture uses the Convolutional layer and the pooling layer to remove features. The data would be classified using the dense layer.The Convolutional Neural Network and DenseNet are used to extract image features that are then fed into a fully connected layer for the classification of malignant and benign cellsFor image classification of breast cancer, the models are trained, validated, and tested.The distinction is based on CNN and DenseNet's different batch sizes and learning rates. To see how well the proposed CNN and DenseNet programs work, they are compared. In terms of accuracy, the suggested system will outperform CNN and DenseNet in the diagnosis and classification of breast tumors from histological photographs. Hyper parameter tuning is used to measure the efficiency of CNN and DenseNet.

Temporal Trends in Hypertension Death Rate in Mississippi, 2000-2018.

In Mississippi, hypertension as a leading cause of death moved from 15th in 2000 to 11th in 2018, but research on temporal trends is limited. We examined temporal trends in hypertension-related mortality among Mississippi adults by age, sex, and race. We extracted data on the number of deaths due to hypertension among adults aged 45 or older annually from 2000 to 2018 from Mississippi Vital Statistics. We used underlying cause-of-death codes from the International Classification of Diseases, Tenth Revision to identify hypertension deaths. We calculated the annual percentage change (trend segment) and average annual percentage change (AAPC) in age-adjusted hypertension death rates from 2000 to 2018 and examined differences in the AAPC by age, sex, and race. From 2000 through 2018, the age-adjusted hypertension death rate increased annually by 3.0% (AAPC 3.0%, 95% confidence interval, 1.9%-4.0%) with 3 distinct time periods. There was an average annual increase in age-adjusted hypertension death rates for all subgroups, i.e., men, women, Blacks, Whites, White females, Black males, and White males. The highest magnitude of increase was among those aged 45-64 years (AAPC 6.0%), men (AAPC 4.5%), Whites (AAPC 3.5%), and White men (AAPC 6.2%) compared with other age groups, women, Blacks, and Black men, respectively. For nearly 2 decades, there was an increase in age-adjusted hypertension death rates among Mississippi adults aged 45 years or older. Blood pressure lowering interventions that target hypertensive adults are needed.

Community Characteristics and COVID-19 Outcomes: A Study of 159 Counties in Georgia, United States.

The COVID-19 pandemic affects population groups differently, worsening existing social, economic, and health inequities. This study examined 159 counties within Georgia to identify community characteristics associated with county-level COVID-19 case, hospitalization, and death rates. Data from the 2020 County Health Rankings, the 2010 US Census, and the Georgia Department of Public Health COVID-19 Daily Status Report were linked using county Federal Information Processing Standard codes and evaluated through multivariable linear regression models. The percentages of children in poverty, severe housing problems, and people not proficient in the English language were significant predictors associated with increases in case, hospitalization, and death rates. Diabetic prevalence was significantly associated with increases in the hospitalization and death rates; in contrast, the percentages of people with excessive drinking and female were inversely associated with hospitalization and death rates. Other independent variables showing an association with death rate included the percentages of people reporting fair or poor health and American Indian/Alaska Native. Local authorities' proper allocation of resources and plans to address community social determinants of health are essential to mitigate disease transmission and reduce hospitalizations and deaths associated with COVID-19, especially among vulnerable groups.

Permanently Repealing the Global Gag Rule Will Internationally Advance Reproductive and Sexual Health

The Global Gag Rule bans foreign nongovernmental organizations (NGOs) that receive U.S. global health assistance funding from providing abortion services and referrals, advocating for abortion rights, or funding other organizations that provide abortion-related services. The rule presents a double bind: if NGOs elect to continue providing abortion-related care, they must forgo U.S. funding, requiring them to roll back services across the board. This reduces access to contraceptives, family planning resources, and maternal and child healthcare. The alternate option is to shut down abortion-related care to retain U.S. funding. Thus, the rule is ineffective in its purpose as it creates barriers to comprehensive sexual and reproductive healthcare, leading to increases in unintended pregnancies, abortions, and newborn and maternal death rates. In addition, restricted funding has negative implications for HIV/AIDS and reproductive cancer screening and treatment. The rule is currently implemented and repealed by each incoming president using executive orders. The United States Congress should pass the Global Health, Empowerment, and Rights Act and repeal the Helms Amendment. This will permanently revoke the Global Gag Rule and reduce unintended pregnancies, abortions, and child and maternal mortality rates across the world.

Genome-Wide Identification and Analysis of Chitinase-Like Gene Family in Bemisia tabaci (Hemiptera: Aleyrodidae).

Simple SummaryFor the sake of growth and development, old exuviums of Bemisia tabaci nymphs should be periodically substituted by new ones until a final emergence turns them into adults. During ecdysis, chitinases are of great importance in chitin degradation and turnover of cuticles, which provides us potential targets for RNA interference-based B. tabaci management. Therefore, we annotated 14 chitinase and chitinase-like genes in B. tabaci based on data of genome and transcriptomes. With the help of a nanomaterial-promoted RNAi method, we found that silencing of BtCht10, BtCht5, and BtCht7 resulted in significant increase of death rate on B. tabaci nymphs and the developmental duration was noticeably postponed for BtCht2-silenced nymphs.Chitinases are of great importance in chitin degradation and remodeling in insects. However, the genome-wide distribution of chitinase-like gene family in Bemsia tabaci, a destructive pest worldwide, is still elusive. With the help of bioinformatics, we annotated 14 genes that encode putative chitinase-like proteins, including ten chitinases (Cht), three imaginal disk growth factors (IDGF), and one endo-β-N-acetylglucosaminidase (ENGase) in the genome of the whitefly, B. tabaci. These genes were phylogenetically grouped into eight clades, among which 13 genes were classified in the glycoside hydrolase family 18 groups and one in the ENGase group. Afterwards, developmental expression analysis suggested that BtCht10, BtCht5, and BtCht7 were highly expressed in nymphal stages and exhibit similar expression patterns, implying their underlying role in nymph ecdysis. Notably, nymphs exhibited a lower rate of survival when challenged by dsRNA targeting these three genes via a nanomaterial-promoted RNAi method. In addition, silencing of BtCht10 significantly resulted in a longer duration of development compared to control nymphs. These results indicate a key role of BtCht10, BtCht5, and BtCht7 in B. tabaci nymph molting. Our research depicts the differences of chitinase-like family genes in structure and function and identified potential targets for RNAi-based whitefly management.

Interleukin 1 beta-induced chloride currents are important in osteoarthritis onset: an in vitro study

Persistent hypotonic and inflammatory conditions in the joint cavity can lead to the loss of cartilage matrix and cell death, which are the important mechanisms of osteoarthritis (OA) onset. Previous studies have confirmed that the existence of a hypotonic environment is a red flag for inflammation, as hypotonic environment induces the opening of the chloride channel of the cell and promotes chloride ion efflux, which prompts the cell volume to increase. Chloride channels play an important role in the regulation of mineralization and chondrocyte death. Here, we reported that OA chondrocytes showed a significant increase of cell death rate and the imbalance of cartilage matrix catabolism. We found that the distribution of skeleton protein F-actin was disordered. In addition, the volume-sensitive chloride current of OA chondrocytes decreased significantly with the increase of the expression levels of inflammation-related proteins caspase-1, caspase-3, and NLRP3. Moreover, interleukin-1β (IL-1β) showed a potential to activate the chloride current of normal chondrocytes. These results indicate that IL-1β-induced chloride channel opening in chondrocytes may be closely related to the occurrence of OA. This chloride channel opening process may therefore be a potential target for the treatment of OA.

Toxicity and environmental impact of multi-walled carbon nanotubes to nitrogen-fixing bacterium Azotobacter chroococcum

With the large-scale production and wide applications of carbon nanotubes (CNTs), they are inevitably entering the environment and bringing unknown threats to environmental organisms. Nitrogen-fixing bacteria dominate 80% of the nitrogen fixation in nitrogen cycle. Herein, we investigated the toxicity and environmental impact of multi-walled CNTs (MWCNTs) to nitrogen-fixing bacterium Azotobacter chroococcum. MWCNTs slightly inhibited the growth of A. chroococcum and induced small increase of death rate at high concentrations. MWCNTs did not penetrate the cell walls of A. chroococcum and no cytoplasm loss was observed. MWCNTs were only observed surrounding the A. chroococcum cells. According to oxidative stress assays, MWCNTs induced meaningful oxidative damage at 0.5 mg/mL after 6 d exposure, but the oxidative damage diminished at 14 d. MWCNTs did not affect the nitrogen fixation activity of A. chroococcum and the soil nitrogen contents. Our findings provided the fundamental data for the environmental safety of CNTs to nitrogen-fixing bacteria.

Covid-19 prevalence and empty college seats

ABSTRACT Using the National Association for College Admission Counselling’s annual list of colleges with open seats and Covid-19 cases and deaths at the county level, this paper provides a first look at how Covid-19 has altered enrolment at four-year colleges. I find that a one standard deviation increase in deaths per 100,000 is associated with a 61% increase in the probability that a school reports available seats, housing, and aid for first-year students. For a one standard deviation increase in cases per 100,000, schools are 53% more likely to report openings. For a one standard deviation increase in the growth rate of deaths and cases, schools are 45 and 56%, respectively, more likely to report openings. These openings are not driven by the fact that many Covid-19 hot spots in March and April of 2020 are also home to schools with higher tuition and fees, a high share of out-of-state or international students, and more progressive political leanings.

Trends and Geographic Patterns in Drug and Synthetic Opioid Overdose Deaths - United States, 2013-2019.

Deaths involving synthetic opioids other than methadone (synthetic opioids), which largely consist of illicitly manufactured fentanyl; psychostimulants with abuse potential (e.g., methamphetamine); and cocaine have increased in recent years, particularly since 2013 (1,2). In 2019, a total of 70,630 drug overdose deaths occurred, corresponding to an age-adjusted rate of 21.6 per 100,000 population and a 4.3% increase from the 2018 rate (20.7) (3). CDC analyzed trends in age-adjusted overdose death rates involving synthetic opioids, psychostimulants, cocaine, heroin, and prescription opioids during 2013-2019, as well as geographic patterns in synthetic opioid- and psychostimulant-involved deaths during 2018-2019. From 2013 to 2019, the synthetic opioid-involved death rate increased 1,040%, from 1.0 to 11.4 per 100,000 age-adjusted (3,105 to 36,359). The psychostimulant-involved death rate increased 317%, from 1.2 (3,627) in 2013 to 5.0 (16,167) in 2019. In the presence of synthetic opioid coinvolvement, death rates for prescription opioids, heroin, psychostimulants, and cocaine increased. In the absence of synthetic opioid coinvolvement, death rates increased only for psychostimulants and cocaine. From 2018 to 2019, the largest relative increase in the synthetic opioid-involved death rate occurred in the West (67.9%), and the largest relative increase in the psychostimulant-involved death rate occurred in the Northeast (43.8%); these increases represent important changes in the geographic distribution of drug overdose deaths. Evidence-based prevention and response strategies including substance use disorder treatment and overdose prevention and response efforts focused on polysubstance use must be adapted to address the evolving drug overdose epidemic.

Changing Spatiotemporal Trends in County-Level Heart Failure Death Rates in the United States, 1999 to 2018.

BackgroundAmid recently rising heart failure (HF) death rates in the United States, we describe county‐level trends in HF mortality from 1999 to 2018 by racial/ethnic group and sex for ages 35 to 64 years and 65 years and older.Methods and ResultsApplying a hierarchical Bayesian model to National Vital Statistics data representing all US deaths, ages 35 years and older, we estimated annual age‐standardized county‐level HF death rates and percent change by age group, racial/ethnic group, and sex from 1999 through 2018. During 1999 to 2011, ~30% of counties experienced increasing HF death rates among adults ages 35 to 64 years. However, during 2011 to 2018, 86.9% (95% CI, 85.2–88.2) of counties experienced increasing mortality. Likewise, for ages 65 years and older, during 1999 to 2005 and 2005 to 2011, 27.8% (95% CI, 25.8–29.8) and 12.6% (95% CI, 11.2–13.9) of counties, respectively, experienced increasing mortality. However, during 2011 to 2018, most counties (67.4% [95% CI, 65.4–69.5]) experienced increasing mortality. These temporal patterns by age group held across racial/ethnic group and sex.ConclusionsThese results provide local context to previously documented recent national increases in HF death rates. Although county‐level declines were most common before 2011, some counties and demographic groups experienced increasing HF death rates during this period of national declines. However, recent county‐level increases were pervasive, occurring across counties, racial/ethnic group, and sex, particularly among ages 35 to 64 years. These spatiotemporal patterns highlight the need to identify and address underlying clinical risk factors and social determinants of health contributing to these increasing trends.

Impact of impaired ambulatory capacity on the outcomes of peripheral vascular interventions among patients with chronic limb-threating ischemia

ObjectiveDespite prior literature recommending against limb salvage in patients with poor functional status such as nonambulatory patients with chronic limb-threatening ischemia (CLTI), peripheral endovascular interventions continue to be carried out in this group of patients. Clinical outcomes following these interventions are, however, not well-characterized. MethodsA retrospective review was conducted on all patients treated for CLTI in the Vascular Quality Initiative from September 2016 to December 2019. Logistic regression, Kaplan-Meier survival estimates, log-rank tests, and Cox regression analyses were used as appropriate to study outcomes. The primary outcomes were 30-day mortality and 1-year amputation-free survival. The secondary outcomes were in-hospital death, postoperative complications, 1-year freedom from major amputation, and 2-year survival. ResultsOf the 49,807 patients studied, 28,469 (57.2%) were ambulatory, 15,148 (31.0%) were ambulatory with assistance, 5395 (10.8%) were wheelchair bound, and 525 (1.1%) were bedridden. There was a 2-fold increase in the odds of 30-day death in patients who were ambulatory with assistance (odds ratio [OR], 2.03; 95% confidence interval [CI], 1.77-2.34; P < .001) and wheelchair-bound patients (OR, 2.09; 95% CI, 1.74-2.51; P < .001), and a more than 6-fold increase in bedridden patients (OR, 6.28; 95% CI, 4.55-8.65; P < .001) compared with ambulatory patients. There was a significantly higher odds of postoperative complications in patients who were ambulatory with assistance or bedridden, but no difference with wheelchair-bound patients. Among ambulatory patients, the risks of major amputation and death within 1 year were only 10% and 12%, respectively, whereas that of bedridden patients were as high as 30% and 38%, respectively. A stepwise decrease in amputation-free survival from 81% with full ambulatory capacity to less than 50% (47.7%) in bedridden patients was observed. The risk of major amputation or death within 1 year was 35% higher for ambulatory with assistance (hazard ratio [HR], 1.35; 95% CI, 1.26-1.44; P < .001), 65% higher for wheelchair-bound (HR, 1.65; 95% CI, 1.51-1.79; P < .001) and 2.6-fold higher for bedridden (HR, 2.64; 95% CI, 2.17-3.21; P < .001) compared with ambulatory. A similar association was seen for 1-year freedom from major amputation and 2-year survival. ConclusionsAmbulatory impairment in patients with CLTI is associated with a significant increase in 30-day mortality and significant decrease in amputation-free survival after peripheral endovascular intervention. Bedridden patients had a 6-fold increase in the 30-day death rate, whereas their amputation-free survival dropped to less than 50% at 1 year. These risks should be considered during shared decision-making regarding management options for nonambulatory patients with CLTI.

It's all in the details: A call for administering the COVID-19 vaccine in Lebanon through a transparent and un-politicized collaborative approach.

It's all in the details: A call for administering the COVID-19 vaccine in Lebanon through a transparent and un-politicized collaborative approach.

Structural Racism and COVID-19 in the USA: a County-Level Empirical Analysis.

Substantial health disparities exist across race/ethnicity in the USA, with Black Americans often most affected. The current COVID-19 pandemic is no different. While there have been ample studies describing racial disparities in COVID-19 outcomes, relatively few have established an empirical link between these disparities and structural racism. Such empirical analyses are critically important to help defuse “victim-blaming” narratives about why minority communities have been badly hit by COVID-19. In this paper, we explore the empirical link between structural racism and disparities in county-level COVID-19 outcomes by county racial composition. Using negative binomial regression models, we examine how five measures of county-level residential segregation and racial disparities in socioeconomic outcomes as well as incarceration rates are associated with county-level COVID-19 outcomes. We find significant associations between higher levels of measured structural racism and higher rates of COVID-19 cases and deaths, even after adjusting for county-level population sociodemographic characteristics, measures of population health, access to healthcare, population density, and duration of the COVID-19 outbreak. One percentage point more Black residents predicted a 1.1% increase in county case rate. This association decreased to 0.4% when structural racism indicators were included in our model. Similarly, one percentage point more Black residents predicted a 1.8% increase in county death rates, which became non-significant after adjustment for structural racism. Our findings lend empirical support to the hypothesis that structural racism is an important driver of racial disparities in COVID-19 outcomes, and reinforce existing calls for action to address structural racism as a fundamental cause of health disparities.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40615-020-00948-8.

Increasing Rate of Unintentional Firearm Deaths in Youngest Americans: Firearm Prevalence and Covid-19 Pandemic Implication

BackgroundThe United States has had, by far, the world's greatest civilian ownership of firearms. An even greater ownership occurred during the Covd-19 pandemic, mostly of handguns and including many new owners. The U.S. has also had the least progress of the 41 highest sociodemographic countries ranked by the Institute for Health Metrics and Evaluation in reducing the unintentional firearm mortality rate in young children. This study characterized the unintentional firearm mortality trends in American 1-4 year-olds by sex and race/ethnicity and evaluated the trends in the context of firearm prevalence in the U.S. MethodsMortality data for 1999–2018 were obtained from the U.S. Centers for Disease Control and Prevention and the Institute for Health Metrics and Evaluation, firearm injury and mortality data for 2016–2020 from Everytown for Gun Safety #NotAnAccident database, firearm background check data for 1999–2020 from the National Instant Criminal Background Check System, and civilian firearm prevalence for 2017 from the Small Arms Survey. ResultsIn American 1-4 year-olds, the rate of unintentional firearm deaths during 1999–2018 increased exponentially at an average annual percent rate of 4.9 (p < 0.001) and was greatest in non-Hispanic black children. Unintentional firearm deaths had the most rapid increase of all evaluable causes of death in the age group. The unintentional firearm death rate increase was correlated with the concurrent rate of firearm background checks and handgun permits issued (each p < 0.001) and in non-Hispanic white children with handgun prevalence in their families (p = 0.03). Globally, the unintentional firearm death rate was also correlated with firearm prevalence (p = 0.02). ConclusionsAn increase in fatal firearm accidents in the United States death rate among 1-4 year-olds is directly associated with the steadily increasing prevalence of firearms. The acceleration of firearm deaths and injuries among young Americans, especially among non-Hispanic black children, requires urgent solutions to address firearm prevalence and access. The problem is expected to become even more urgent as a result of the record high firearm sales that occurred in the United States during the 2020 coronavirus pandemic

Knowledge, Attitudes and Practices of Populations Towards Barrier and Preventive Measures Against COVID-19 in Two Cities in Cameroon

Coronavirus Disease 2019 (COVID-19) is a contagious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Since the first reported case in sub Saharan Africa, countries have struggled to respond to the pandemic despite all the barrier measures and preventions strategies put in place; amongst them, Cameroon is characterized by a large amount of contamination and an increase in death rates. The purpose of this study was to assess the knowledge, attitudes and practices (KAPs) of the Cameroonian population on barrier and preventive measures against COVID-19; the first undertaken in the cities of Douala and Bangangte since the beginning of the COVID-19 pandemic. A cross-sectional study was carried out on 777 residents in the Littoral (Douala) and in the West (Bangante) regions of Cameroon from a structured, pre-tested and self-administered questionnaire (according to WHO guidelines). Data were collected and analyzed using SPSS version 18.0 software. For p=0.05, the difference was statistically significant. Out of 777 participants, 67.7% (n=526) were from Douala and 32.3% (n=251) from Bangangte. Seventy percent (70%) of our participants were aware of the main preventive measures against COVID-19 taken by the Cameroonian government. The most used preventive method was the practice of hand hygiene (88.9%); followed by social distancing (87.2%), respiratory hygiene (75.8%), and self-confinement (85.3%). The majority of our participants had a positive attitude towards hand hygiene (81.6%) and wearing a face mask (84.7%). About 52.9% wore a face mask occasionally, 66.67% always washed their hands, 53.1% always used a hand sanitizer to disinfect their hands and 65,4% regularly self-confined themselves homes. Improving behaviors / attitudes and practices remain a major challenge for our populations. It is important to integrate the community in decision-making and increase awareness among our populations. Further studies are required to assess the impact of strategies undertaken by the decision makers, to roll out the COVID-19 pandemic in Cameroon.