Preventable Deaths Research Articles

Psychological therapy for the prevention of suicide in prison: study protocol for a randomised controlled trial

BackgroundSuicide is the leading cause of preventable death in prisons. Deaths from suicide in prison are significantly, and persistently, elevated compared to those living in the community. Psychological therapies have been shown to be a potentially effective means of alleviating suicidal thoughts, plans and behaviours, but patients located in prison often have no access to evidence-based psychological interventions targeting suicide. The objectives of this programme of research are to investigate the clinical and cost effectiveness of a new psychological therapy programme delivered to male prisoners at risk of suicide.MethodsThe PROSPECT trial is a two-armed single blind, pragmatic, randomised controlled trial and will recruit a target sample size of 360 male prisoners, identified as at-risk of suicide, across 4 prisons in the North of England. Participants will be randomised to receive a psychological talking therapy (Cognitive Behavioural Suicide Prevention, CBSP) plus treatment as usual, or treatment as usual alone. Co-primary outcomes (Suicide Ideation and Suicide Behaviours), as well as related secondary outcomes, will be assessed at baseline and at 6-months follow-up. An intention to treat analysis will be conducted with primary stratification based on prison site and lifetime history of suicide attempt (yes/no). A nested qualitative process evaluation will investigate the nature and context in which the intervention is delivered, with specific focus upon the facilitators and barriers to the implementation of the therapy within prisons.DiscussionThe key outputs from this trial will be to determine whether a psychological therapy for suicidal prisoners is clinically and cost effective; and to generate a project implementation platform that identifies how best to implement the new intervention across the broader prison estate.Trial registrationISRCTN (reference ISRCTN14056534 https://www.isrctn.com/ISRCTN14056534; 24th September 2021). Registration confirmed prior to participant recruitment commencing. Modifications to protocol are listed on the study website at ISRCTN.

Available equipment for traumatic haemorrhage management in Austrian prehospital physician response units: a nationwide survey and analysis of guideline adherence

BackgroundTraumatic injuries, particularly those involving massive bleeding, remain a leading cause of preventable deaths in prehospital settings. The availability of appropriate emergency equipment is crucial for effectively managing these injuries, but the variability in equipment across different response units can impact the quality of trauma care. This prospective survey study evaluated the availability of prehospital equipment for managing bleeding trauma patients in Austria.MethodsA nationwide survey was conducted across 139 Austrian Prehospital Physician Response Units (PRUs) to evaluate the presence and adherence to guidelines of bleeding control equipment. The digitally distributed survey included questions on equipment types, such as pelvic binders, tourniquets, haemostatic gauze, and advanced intervention sets. Data were analysed against the most recent recommendations and guidelines to assess conformity and identify gaps.ResultsThe survey achieved a 96% response rate, revealing that essential equipment like pelvic binders and tranexamic acid was available in all units, with tourniquets present in 99% of them. However, few services carried advanced equipment for procedures like REBOA or thoracotomy. While satisfaction with the current equipment was high, with 80% of respondents affirming adequacy, the disparities in the availability of specific advanced tools highlight potential areas for improvement, offering a promising opportunity to enhance trauma care capabilities.ConclusionsWhile essential emergency equipment for haemorrhage control is uniformly available across Austrian PRUs, the variation in advanced tools underscores the need for standardised equipment protocols. The urgency for regular kit updates following prehospital guidelines and training is essential to enhance trauma care capabilities and ensure that all emergency response units are equipped to manage severe injuries effectively. This standardisation could lead to improved patient outcomes nationwide.

Reassessing cardiovascular risk stratification in men with erectile dysfunction.

Erectile dysfunction (ED) is an independent and strong marker of cardiovascular disease (CVD) risk. The Princeton Consensus aimed to evaluate and manage cardiovascular risk in men with ED and no known cardiovascular disease, focusing on identifying those requiring additional cardiologic work-up. It has recently been updated to the American population demographics, but European recommendations are needed. It was developed a cross-sectional investigation including erectile dysfunction patients. Data were collected from hospital registries. Two risk stratification models were employed and compared: Princeton Consensus Criteria (PC) and European Society of Cardiology (ESC) CVD Risk Criteria. The objective was to stress the importance of the changes in IV Princeton Consensus recommendations in stratifying CVD risk in men with erectile dysfunction using a model validated in European men. A total of 137 patients with ED, with a mean age of 57.1 years old, were included. According to the PC criteria, 39.7% of the patients were "Low Risk". When using ESC criteria, the proportion of "Low Risk" patients were significantly lower (12%, p < 0.05). Among "Low Risk" patients according to the PC, 52.5% and 20% were classified as High and Very high risk according to ESC criteria, respectively. One myocardial infarction was reported. The patient was classified as "Low Risk" according to the PC, but the ESC criteria categorized him as "high risk". PC is less sensitive than ESC recommendations detecting CVD. It raises concerns that Urologists could be overlooking patients with undiagnosed CVD, consequently missing out on opportunities for prevention of major cardiovascular events (MACEs) and premature deaths.

Evaluating maternal death surveillance and response system in Sunyani Municipality of Bono region in Ghana from 2017-2021

IntroductionMaternal death rates in Ghana have decreased overall but remain high in rural areas. The Maternal Death Surveillance and Response System (MDSR) aims to eliminate preventable maternal deaths effectively. However, its effectiveness is less pronounced at district and subdistrict levels than at national and regional levels. Despite the requirement for periodic evaluation, there is a lack of evidence supporting these assessments. This study focuses on evaluating the MDSR in Sunyani Municipal.MethodsThe evaluation was conducted using a cross-sectional design, using both qualitative and quantitative approaches. Data from the District Health Information Management Systems (DHIMS) and the maternal death line list from January 2017 to December 2021 on maternal deaths were reviewed. Stakeholders, including health professionals, were interviewed. The means, proportions, and other statistical measures were calculated using Epi Info Version 7. Qualitative data underwent content analysis, and the results were visually presented in tables and flowcharts to illustrate the flow of surveillance information.ResultsMost respondents were female, constituting 51.4% (19/37), with midwives comprising the largest group at 32.4% (12/37). Approximately 75.7% (28/37) were able to explain how the surveillance data has been used for public health action. The notification and reporting process was clear to 85% (17/20) of respondents. Although 94.6% (35/37) expressed willingness to notify and participate in audits at facility and community levels, the audits remained facility-based. All facilities consistently reported maternal deaths, but data storage equipment was lacking. Approximately 80% (20/25) of forms were reported within 24 h, and 88% (22/25) were investigated within seven days. Only 68% (17/25) of forms were filled out correctly, with no municipal and facility-level line list. All reported deaths came from healthcare facilities, with no community-reported maternal deaths.ConclusionsThe MDSR system in Sunyani Municipal demonstrates high awareness and willingness to participate among healthcare providers but faces challenges in data accuracy and community engagement. Death audits remain facility-based, and the lack of community-reported maternal deaths and municipal-level line lists indicates gaps in comprehensive reporting and data management. To improve the system, it is recommended that community case searches be enhanced for better reporting and to address data management issues by ensuring proper data quality assessment.

Navigating Hemorrhagic Shock: Biomarkers, Therapies, and Challenges in Clinical Care

Hemorrhagic shock remains a leading cause of preventable death worldwide, with mortality patterns varying significantly based on injury mechanisms and severity. This comprehensive review examines the complex pathophysiology of hemorrhagic shock, focusing on the temporal evolution of inflammatory responses, biomarker utility, and evidence-based therapeutic interventions. The inflammatory cascade progresses through distinct phases, beginning with tissue injury and endothelial activation, followed by a systemic inflammatory response that can transition to devastating immunosuppression. Recent advances have revealed pattern-specific responses between penetrating and blunt trauma, necessitating tailored therapeutic approaches. While damage control resuscitation principles and balanced blood product administration have improved outcomes, many molecular targeted therapies remain investigational. Current evidence supports early hemorrhage control, appropriate blood product ratios, and time-sensitive interventions like tranexamic acid administration. However, challenges persist in biomarker validation, therapeutic timing, and implementation of personalized treatment strategies. Future directions include developing precision medicine approaches, real-time monitoring systems, and novel therapeutic modalities while addressing practical implementation barriers across different healthcare settings. Success in hemorrhagic shock management increasingly depends on integrating multiple interventions across different time points while maintaining focus on patient-centered outcomes.

Diarrhea and associated factors among under-five children in open defecation free and open defecation rural households of Degem district, Oromia, Ethiopia

IntroductionDiarrheal diseases are the top cause of preventable death, particularly among children under the age of five in developing countries like Ethiopia. Despite the national level of latrine coverage being 61%, diarrhea is responsible for the deaths of half a million children under 5 years annually. Therefore, this study aimed to assess diarrhea and its associated factors among children in open defecation free (ODF) and open defecation (OD) households of Degem district, Oromia, Ethiopia.MethodsA comparative cross-sectional study was conducted within the community, involving 398 participants (200 from open defecation free [ODF] and 198 from open defecation [ODF] households). The selection of study participants from OD and ODF households was done using a multistage sampling approach. Data input was carried out using Epi Data 3.1, while data analysis would be performed using Statistical Package for Social Sciences (SPSS) version 26 software, employing appropriate testing methods. Statistical significance and the strength of relationships were assessed using odds ratios with a 95% confidence interval.ResultsThe prevalence of diarrhea among children in open defecation free and open defecation households was 26 and 38%, respectively. Factors such as children who were not vaccinated for rotavirus, mothers or caregivers did not have diarrhea, mothers or caregivers did not wash their hands at critical times, and individuals with poor latrine utilization were significantly associated with diarrhea among children in ODF households. On the other hand, children who were not vaccinated for rotavirus, not received vitamin A supplementation, mothers or caregivers did not wash their hands at critical times, children lacking access to latrines and children whose their families practice open field solid waste disposal were significantly associated with diarrhea among children in open defecation free households.ConclusionThe study results indicated that the prevalence of diarrhea among children under five in open defecation areas was notably higher compared to those residing in open defecation free areas. Consequently, it is imperative for all responsible bodies to focus on evidence-based strategies to combat childhood diarrhea and to ensure child health status.

The Invisible Dangers of Electronic Cigarettes and their Cardiovascular Effects

Objective: To investigate the relationship between electronic cigarettes (ECs) and cardiovascular diseases (CVDs), such as acute myocardial infarction (AMI). Theoretical Framework: Cardiovascular diseases are one of the main preventable causes of death globally, requiring sustainable policies to combat diseases such as AMI. The popularization of ECs increases concerns due to their illicit commercialization and lack of regulation. Method: Literature review using PRISMA, selecting 24 articles that met the inclusion criteria. Results and Discussion: Studies have not shown a clear association between daily use of ECs and cardiovascular events such as AMI. Smoking and hypertension were strongly associated with CVD. EC smokers had a lower risk of AMI than tobacco smokers, but a higher risk compared to non-smokers or ex-smokers. The dichotomy in the studies indicates the need for caution when considering ECs as a safe alternative to smoking. Research Implications: The lack of a clear association between the use of ECs and cardiovascular events highlights the need for further studies and careful interpretation of results. Considering the temporality of events is crucial to assess health risks. Originality/Value: This study highlights the importance of considering the chronology of events when evaluating associations between the use of ECs and health risks. It points to the need for future studies to better understand the impacts of ECs on cardiovascular health.

The Italian Perinatal Surveillance System SPItOSS: insights from Confidential Enquiries

BackgroundAn effective strategy to reduce perinatal mortality requires an active surveillance system. This includes monitoring cases, organizing multidisciplinary local audits, conducting Confidential Enquiries, identifying avoidable factors, and facilitating changes in the healthcare system. In 2017, the Italian Obstetric Surveillance System launched the SPItOSS pilot Perinatal Surveillance System. The aim of this paper is to describe the results of the SPItOSS Confidential Enquiries on perinatal deaths focusing on the emergent critical aspects in obstetric and neonatal care, as well as on the healthcare facilities organization.MethodsSPItOSS, a population-based surveillance system, collected and analysed incident perinatal deaths from July 2017 to June 2019 in three Regions encompassing 32.3% of Italian births. Cases were defined according to WHO definition as fetuses born dead ≥ 28 weeks of gestation and live newborn died within 7 days from birth. The International Statistical Classification of Diseases and related Health Problem-Perinatal Mortality was adopted for coding causes of death and contributing maternal and placenta-related conditions. Confidential Enquiries, prioritized according to perinatal deaths preventability, were conducted by expert committees at Regional and National level.ResultsA total of 830 incident perinatal deaths were notified, with 58.3% classified as antepartum, 4.3% as intrapartum, and 37.3% as neonatal deaths. According to the SPItOSS protocol, Confidential Enquiries evaluated only the most preventable deaths, including 19 intrapartum and 70 neonatal deaths. Of these, 43.8% were assessed as unavoidable with appropriate care; 29.2% as unavoidable with improvable care, and 15.7% as avoidable due to inappropriate care. Most intrapartum deaths were attributed to intrauterine hypoxia, while neonatal deaths recognized a multifactorial aetiology. Different aspects of inappropriate care were highlighted, such as failure to recognise maternal or fetal problems before labour, delayed or inappropriate neonatal resuscitation, and poor or suboptimal neonatal monitoring.ConclusionsThe SPItOSS Confidential Enquires provided insights for improving maternity and perinatal services. By targeting key areas of obstetric and neonatal care, the surveillance can generate recommendations and actions to prevent avoidable perinatal deaths.

An Autopsy Based Epidemiological Study Of Abdominal Injuries In A South India Population

Trauma to the abdomen is caused by either blunt or penetrative force due to various reasons and is a major cause of mortality in India. Abdominal injury is an important aspect of trauma because of the difficulty in diagnosis and its lethal potential if not properly and immediately treated. The present study was aimed at finding the nature and pattern of injuries in the abdomen region among the trauma cases autopsied at a canter. They were evaluated according to age, sex, manner of causation, status of victims and causes of death. After examination of 134 trauma cases involving abdominal injuries, data was compiled and analysed. The results drawn were as follows: Most of the victims belonged to the age group of 21–40 years (n = 61 and 44%), and males outnumbered females in the ratio of 9:1. Road traffic and railway accidents (RTAs) (n=104, 77%) were the most common cause of abdominal injuries. Among RTA’s, pedestrians (29%) and 2-wheeler riders (34%) were the most affected individuals than occupants of other vehicles. Common external abdominal injuries noted were abrasions (72%) and contusions (44%). Common intra-abdominal organs injured were liver (79%), spleen (39%), intestines (14%), and kidneys (12%). Liver sustained more lacerations (69%) than contusions (11%). The most frequent associated injuries involved the head, chest, limbs, and spine. The most common associated injury was head injury (35%), and the major cause of death was hemorrhagic shock (47%). This study concluded that RTA is the main cause of abdominal trauma and males in the most productive age group (21–50 years) were the most affected. Abrasions and contusions were the most common external injuries while lacerations of the liver and spleen were the common internal types. Most of the injured persons died on the spot and hemorrhagic shock, followed by head injury were the main causes of death. These findings reiterate that efforts should be made to decrease these kinds of preventable deaths by creating awareness among the public about importance of following safety measures, on road and at workplaces.

Assault rifle injuries in civilians: ballistics of wound patterns, assessment and initial management.

Wounds from assault rifles and their commercial offspring have been encountered with increasing frequency in civilian practice. Our aim is to summarize wound ballistics related to the main injury patterns that can also affect management strategies. An online search of the PubMed was conducted for research and review articles published after 2000 in English, using the MeSH terms "gunshot wounds", "mass casualty incidents", "war-related injuries", "soft tissue injuries", "vascular system injuries", "colon injuries", "wound infection", "antibiotic prophylaxis", "debridement", "hemorrhage", "penetrating head injuries", "pneumothorax" and additional free-text terms. Other academic databases were also searched for relevant articles and book chapters. Consensus regarding recognition of high energy wounds from assault rifle projectiles is largely based on war experience. Studies of such wounds inflicted by expanding projectiles suggest that their wounding effects significantly increase tissue damage and adverse outcomes following injury, as a result of the temporary cavity and bullet fragmentation. The use of assault rifles in mass shootings has prompted utilization of tourniquet for control of life-threatening hemorrhage, also derived from military experience, while limited evidence indicates that tension pneumothorax rather than extremity wounds is the leading cause of potentially preventable death in these incidents. Wound ballistics provides a system for evaluation of injuries from assault rifles and risk analysis of shooting incidents. Lessons learned from armed conflicts can improve the management of victims, with due consideration given to characteristics of civilian injuries. Further research is required to define the impact on survival by key life-saving procedures in the prehospital setting, in order to prioritize these interventions.

Smoking-Related Interstitial Lung Disease: CT Image-Based Review and Update

Tobacco smoking is the leading cause of preventable deaths in the United States. Beyond the risks of cardiovascular disease and several cancers, smoking contributes to lung inflammation, lung destruction, and smoking-related interstitial lung diseases (SRILD). SRILD describes a broad range of conditions that includes respiratory bronchiolitis, respiratory bronchiolitis-associated interstitial lung disease, desquamative interstitial pneumonia, pulmonary Langerhans cell histiocytosis, acute eosinophilic pneumonia, idiopathic pulmonary fibrosis, combined pulmonary fibrosis and emphysema, interstitial lung abnormality, and smoking-related interstitial fibrosis. Computed tomography (CT) is central to the diagnosis and understanding of clinicopathologic manifestations of smoking-related lung injury. Common features of SRILD on CT include low-attenuation areas, ground-glass opacities, fibrosis, and lung nodules. Although the various SRILDs are often described as distinct entities, they may manifest with nonspecific features or exhibit mixed patterns and may more accurately be described as a continuum of pathology. Understanding the broad range of radiologic features and recognizing the potential coexistence and overlap of disease processes is essential to maintaining an appropriate differential diagnosis. In this article, we review the radiologic findings associated with SRILDs with a focus on diagnostic considerations and challenges when interpreting CT images.

The mortality impacts of greening Italy

Green spaces have been shown to be beneficial to humans, but quantifying these benefits is a challenge for epidemiology. In this health impact assessment study, we exploit satellites to estimate for the whole of Italy the number of deaths that could be prevented in the 49 million adult population by greening residential areas. The exposure was assessed by calculating the normalized difference vegetation index at 10-m resolution within a 300-m distance from homes in 7904 municipalities. In this study we estimate, by achieving nationwide the level of residential greenness currently reached by the 25% of the population, a total of 28,433 (95% confidence interval: 21,400–42,350) preventable deaths and 279,324 (210,247–415,980) preventable years of life lost in Italy in 2022, representing the 5% of the total mortality burden. More green means fewer deaths, thus strong action is needed to increase the amount and accessibility of green spaces in all human settlements.

Changes in the epidemiology of under-5 mortality in China from 2016 to 2022: an observational analysis of population-based surveillance data

Sustainable Development Goal (SDG) 3.2 aims to end preventable deaths of newborns and children younger than 5 years. China's progress towards SDG 3.2 has not been evaluated on multiple dimensions. We aimed to assess mortality rates in children younger than 5 years (hereafter referred to as under-5 mortality) and to quantify preventable child mortality and geospatial and temporal trends in child mortality in China from 2016 to 2022. In this observational analysis, we used data from the Chinese National Maternal and Child Health Surveillance System (MCHSS) for the period Jan 1, 2016, to Dec 31, 2022 and conducted all-cause mortality and cause-specific mortality analyses for different age groups (age 0-6 days, 7-27 days, 0-27 days, 1-5 months, 6-11 months, 12-23 months, 24-59 months, and birth to 59 months) separately at the national, residential (rural vs urban), and regional (eastern vs central vs western China) levels. All mortality rates were adjusted by age group, type of residency, region, and region-residency strata using a 3-year moving average of the under-reporting rates. National deaths were estimated using the number of livebirths from 2016 to 2022 from the Health Statistics Yearbook of China. Estimated national-level and regional-level mortality rates were weighted by the proportion of the population living in urban and rural areas from the 2010 national census. Optimal survival metrics for neonates and children younger than 5 years were calculated by cause of death in 2020-22 (termed the national optimum), on the basis of the lowest mortality observed among the six region-residency strata. In 2022, approximately 65 700 (95% CI 62 700-68 800) children younger than 5 years died in China, with 45·1% (42·7-47·4) of these deaths occurring in the neonatal period (age <28 days). China's under-5 mortality rate decreased from 10·2 deaths (9·9-10·5) per 1000 livebirths in 2016 to 6·8 deaths (6·5-7·2) per 1000 livebirths in 2022; the neonatal mortality rate decreased from 4·9 deaths (4·7-5·1) per 1000 livebirths in 2016 to 3·1 deaths (2·9-3·3) per 1000 livebirths in 2022. The relative risk of death in children younger than 5 years in rural areas compared with urban areas decreased from 2·4 (2·2-2·6) in 2016 to 1·9 (1·7-2·1) in 2022, and in the western region compared with the eastern region decreased from 3·4 (3·0-3·9) in 2016 to 2·3 (1·9-2·8) in 2022. The leading causes of under-5 mortality in 2022 were injuries (23·1% [21·1-25·1] of all-cause deaths), congenital malformations (14·8% [13·1-16·4]), preterm birth complications (14·1% [12·5-15·7]), intrapartum-related events (10·1% [8·7-11·5]), and acute respiratory infections (9·5% [8·2-10·9]). The leading cause of death in the neonatal period was preterm birth complications (12·8% [11·4-14·2] of deaths in children younger than 5 years). Under-5 mortality in China declined between 2016 and 2022. Disparities across regions and in urban versus rural areas narrowed over time, but they still exist. Therefore, efforts should be made to further reduce child mortality in China, including consistent investments and implementing of policies, programmes, and interventions, especially for the western rural areas. None. For the Chinese translation of the abstract see Supplementary Materials section.

India’s Consensus Statement Tobacco Control Priorities: Review of Current Strategies and the Way Forward

IntroductionTobacco consumption remains a significant global public health challenge, causing over 8 million preventable deaths annually, with India bearing a substantial burden as second largest producer and consumer of tobacco products. Despite some advanced tobacco control policies, there are certain gaps, which requires effective implementation. To address these challenges, a national consultation was organized, bringing together experts to identify priorities in tobacco control in India and formulate an action plan. Design/MethodsA national consultation on ‘tobacco control priorities in India- challenges and way forward’ was organised where a total of 40 experts from the government, developmental organizations, and academia participated to formulate Short, Intermediate and Long-term priorities for tobacco control in India. Preceding the consultation, an extensive literature review and policy analysis were conducted to establish initial priorities. Subsequently, a consensus statement was developed to assist policymakers in identifying tobacco control priorities in India with agoal to achieve SDG 3a, aiming to strengthen the implementation of the WHO FCTC. ResultsThe proposed short-term priorities focused on promoting anti-tobacco curricula in health educational institutions, expanding cessation services, creating a national task force for Tobacco Control, training, monitoring and evaluation, and strengthening Tobacco Control Act. The intermediate priorities focused on advancing tobacco taxation, creating Tobacco-Free environments, adopting and implementing FCTC Article 5.3, building the capacity of National Tobacco Testing Laboratories and implementating Tobacco Vendor Licensing. The development of a comprehensive, multi-sectoral strategy to address the policy gaps and maintain resources to support the sustainability of tobacco control efforts to reach the goal of tobacco-free India were long-term priorities. ConclusionsNational policies and legislation play a crucial role in strengthening the comprehensive tobacco control framework. The collaborative formulation of short, intermediate, and long-term priorities for tobacco control in India is essential for their phased implementation toward achieving a Tobacco-Free Generation, emphasizing a holistic approach for addressing challenges and leading the way ahead.

Trends of diagnostic adverse events in hospital deaths: longitudinal analyses of four retrospective record review studies.

To investigate longitudinal trends in the incidence, preventability, and causes of DAEs (diagnostic adverse events) between 2008 and 2019 and compare DAEs to other AE (adverse event) types. This study investigated longitudinal trends of DAEs using combined data from four large Dutch AE record review studies. The original four AE studies included 100-150 randomly selected records of deceased patients from around 20 hospitals in each study, resulting in a total of 10,943 patient records. Nurse reviewers indicated cases with potential AEs using a list of triggers. Subsequently, experienced physician reviewers systematically judged the occurrence of AEs, the clinical process in which these AEs occurred, and the preventability and causes. The incidences of DAEs, potentially preventable DAEs and potentially preventable DAE-related deaths initially declined between 2008 and 2012 (2.3 vs. 1.2; OR=0.52, 95 % CI: 0.32 to 0.83), after which they stabilized up to 2019. These trends were largely the same for other AE types, although compared to DAEs, the incidence of other AE types increased between 2016 (DAE: 1.0, other AE types: 8.5) and 2019 (DAE: 0.8, other AE types: 13.0; rate ratio=1.88, 95 % CI: 1.12 to 2.13). Furthermore, DAEs were more preventable (p<0.001) and were associated with more potentially preventable deaths (p=0.016) than other AE types. In addition, DAEs had more and different underlying causes than other AE types (p<0.001). The DAE causes remained stable over time, except for patient-related factors, which increased between 2016 and 2019 (29.5 and 58.6 % respectively, OR=3.40, 95 % CI: 1.20 to 9.66). After initial improvements of DAE incidences in 2012, no further improvement was observed in Dutch hospitals in the last decade. Similar trends were observed for other AEs. The high rate of preventability of DAEs suggest a high potential for improvement, that should be further investigated.

Educational Disparities in Preventable Deaths: Do They Explain the Longevity Gap Between Mexico and Spain?

Determine how preventable causes of death contribute to the life expectancy gap between Mexico and Spain. We used a linear integral decomposition to analyze the impact of preventable mortality on life expectancy between ages 30-75 (temporary life expectancy) between Mexico and Spain in 2018. Additionally, we computed cause-deleted life tables to estimate potential gains in temporary life expectancy. Analyses were stratified by educational attainment, sex, and age. Low-educated Mexicans showed the largest gains in temporary life expectancy from removing preventable deaths (3.4 years for males, 1.6 for females), partially explaining the gap with Spain. Removing these deaths would close the gap almost entirely due to a higher relative decrease for middle- and high-educated individuals. While access to adequate healthcare is crucial for improving population health, appropriate non-medical public policies can significantly reduce mortality disparities between Mexico and Spain, especially for individuals from higher educational backgrounds.

Battlefield mechanical ventilation and extracorporeal membrane oxygenation: A scoping review.

Casualties of military conflicts suffer a multitude of injuries, and recent research has documented a significant number develop acute respiratory distress syndrome (ARDS). The present study undertakes a scoping review of research on the treatment of ARDS in combat casualties near the battlefield. We review the extent of the current ARDS care, from intubation and mechanical ventilation (MV) to the use of extracorporeal membrane oxygenation (ECMO), and how the respective echelons of care across the Military Health System (MHS) are involved in the care of these patients. Online databases were used to identify article published 1988-2022, from which we selected 112 publications from various countries including the USA, UK, Germany, Italy, and India that used military relevant keywords (i.e., battlefield, combat, deployed, military trauma), in the titles or abstract in conjunction with the MeSH descriptors for battlefield respiratory failure, and MV or ECMO. Mechanical ventilation and ECMO have clearly moved forward with progressions in technologies and now are routinely used and are well documented in the prehospital setting and during aeromedical transport. Overview of the MHS and descriptive analysis of battlefield casualties are well represented in the literature. There are multiple publications on airway management on the battlefield and innumerable regarding the somewhat comparable civilian prehospital trauma airway management. While there is an abundance of publications on MV in the prehospital and combat environments, there are few case examples of the use of ECMO on the battlefield. Although MV may be required for many combat casualties, airway management failure remains the second leading cause of preventable death on the battlefield.

Smoking status and interventions among children and adolescents in China

Abstract. Tobacco use is the leading cause of preventable death globally. China is the Worlds large tobacco-producing and consuming country, and the burden of death and disease caused by tobacco use will continue to increase .The "Healthy China 2030" Planning Outline proposes to reduce the smoking rate of the population over the age of 15 to 20% by 2030. Taxation and price measures are recognized as the single most effective tobacco control policy measures. A variety of interventions are needed for adolescents, including China can carry out tobacco control according to the comprehensive tobacco control policy of WHO MPOWER (monitor,protect,offer,warm,enforce,raise),smoking ban in public places, cigarette sales to minors, prohibiting advertising promotion, raising the tobacco tax, adding health warnings to the cigarette packaging, use new media to expand coverage.

Alcohol-attributable deaths in Thai people from 2015 to 2021 using the comparative risk assessment approach.

The alcohol-attributable mortality rate is an important health indicator for surveillance of health-related impacts of alcohol consumption. This study aimed to estimate the annual number and rate of alcohol-attributable deaths among the Thai population aged 15 years and over during 2015-2021. Mortality data were drawn from the National Death Registry based on ICD-10. We used the standard methodology of comparative risk assessments for alcohol within the general framework of the Global Burden of Disease Studies and used alcohol-attributable fractions, derived from exposure, and relative risk compared to lifetime abstainers as the counterfactual. Age-standardization was used to adjust mortality rates which were calculated by cause, age group, and sex. The estimated annual number of alcohol-attributable deaths was 20,039 (men: 17,726 [6.50% of total annual deaths of the Thai population] and women: 2312 [1.11%]). The age-standardized alcohol-attributable mortality rates continuously increased from 33.8 to 37.5 deaths per 100,000 population from 2015 to 2019 and slightly decreased to 34.5 and 35.3 in 2020 and 2021, respectively. The three leading causes of death attributed to alcohol consumption were road injuries, cirrhosis and other liver diseases, and other unintentional injuries. Alcohol remains an important preventable cause of death among Thais. The alcohol-attributable mortality rate increased from 2015 to 2019 but declined in 2020 and 2021, possibly due to the coronavirus pandemic and lockdown measures. Culturally appropriate, cost-effective interventions should be used to control alcohol accessibility, particularly among young people who frequently sustain injuries from external causes and have high mortality rates.

Telehealth to Address Preventable Maternal Deaths: A Call to Action.

Over 80% of maternal deaths are preventable. Telehealth approaches can help address disparities by increasing access to quality maternal health care. In this position statement, we advocate for the utility of telehealth to address maternal mortality disparities, focusing specifically on the postpartum period, where most maternal deaths occur. Specifically, we describe how telehealth visits, mobile health applications, and wearable devices for remote patient monitoring can be used to promote the uptake of postpartum care and adherence to evidence-based treatment for the most common causes of maternal death (i.e., cardiovascular conditions and mental health-related conditions). We discuss challenges that must be overcome to ensure the broad and equitable reach of telehealth and identify specific action steps to address this pressing public health issue.