Annette MacKay Rossignol

Landmarks in burn prevention

The objective of this paper is to highlight landmarks in burn prevention. Novel strategies in the areas of law and regulation, environmental and consumer product design, and educational programs are identified and discussed. Notwithstanding marked reductions in burn morbidity and mortality, especially in economically developed countries, burn injuries remain an important public health concern throughout the world. More, and more effective, burn prevention programs coupled with renewed efforts to reduce the social and environmental correlates of burn injuries (poverty, overcrowding, family stress, and educational deficits) are needed to further reduce burn incidence and its long-term sequelae.

Pediatric burn injuries in Tehran, Iran

The objective of this study was to identify the epidemiologic features of pediatric burn injuries in western Tehran. Study subjects included all children up to the age of 15 years who were treated as inpatients at the Tohid Burn Center in Tehran between April 1995 and March 1998. Among the 3341 burns admitted to the Center over the 3-year study period, 1454 (43.5%) occurred in children less than 16 years of age. The overall case fatality rate for children was 16%, while the annual burn incidence rates ranged from 22.7 to 17.8 burns per 100000 child-years. The overall gender ratio (boys/girls) was 2.6. Children less than 2 years of age had the highest burn incidence and burn mortality rates. These findings will be used as a basis for developing targeted preventive programs to protect Iranian children from burns.

Epidemiology of childhood burn injuries in Fars province, Iran.

Childhood burn injuries are a major environmental agent responsible for significant morbidity and mortality in Iran. Thus, the objective of this study was to analyze the epidemiology and current causative factors of hospitalized burn injuries among the approximately 1.6 million children between the ages of birth through 15 years residing in the Fars province of Iran. These data will be used as a basis for developing a targeted preventive program to protect children from burns. Epidemiologic data for 760 children, aged 0 to 15 years, admitted to the two burn centers of Shiraz University of Medical Sciences, over a 4-year period, 1994 to 1998, were collected and analyzed. The overall hospitalization rate was 11.8 per 100,000 person-years (PY). The sex ratio (boys/girls) was 1.38. About 60% were children aged 7 years or younger. Children aged 2 years had the highest burn incidence rate (36.9/100,000 PY). A total of 77.4% of the children had body surface area burns less than 40%. Scalds accounted for 46.2% of the burns, whereas 42.9% were caused by flame. Most of the burn injuries occurred at home (93%). There were 31 burns from suicide attempts among children aged 11 to 15 years (1.4/100,000 PY), showing a major public health problem for these children in our society. During the period of the study, 131 children died of the consequences of burns (2/100,000 PY). The epidemiology of childhood burn injuries in the Fars province is similar to that reported in other economically developing countries. It is suggested that a public health education campaign on this issue would help to reduce the incidence of childhood burn injuries in this region.

Paediatric burn injuries in New England, USA.

The authors analysed a subset of data from the New England Regional Burn Program (NERBP) to describe the epidemiology of burn injuries for children aged from birth to 19 years in the six-state New England area of the USA. The subset of the NERBP data analysed pertained to residents of the six New England states who were admitted to hospital for the treatment of a burn injury sustained between 1 July 1978 and 30 June 1979. Analysis of the data revealed that 1128 (41 per cent) of the 2742 hospitalized burns identified occurred to persons between the ages of birth and 19 years, yielding an overall burn incidence rate of 30.7 burns per 100,000 person-years. Children aged from birth to 2 years sustained a higher burn rate, 96.7 burns per 100,000 child-years, than did children in any other age category. The burn rate for males was higher than the rate for females in each age category, as were the rates for black children compared to white children. Children in Massachusetts experienced the highest overall burn rate among the six New England states; the lowest rate occurred in New Hampshire. Overall, 63 per cent of the burns occurred in a residential setting. The most common activities related to burn injury were food preparation and food consumption, which accounted for 471 (42 per cent) of the burn injuries.

Suicidal behavior by burns among adolescents in Kurdistan, Iran: a social tragedy

The aim of this study was to identify the epidemiologic features and current etiological factors of suicidal behavior by burns among adolescents in Kurdistan, Iran. A prospective population-based study was carried out on patients with suicidal behaviors by burns requiring hospitalization among adolescents during 2000-2001 in Kurdistan, Iran. Sociodemographic and etiological factors were obtained through interviews with each patient or with family, relatives, or friends of the patient. Of 54 hospitalized burn patients aged 13-19 years, 40 (74.1%) patients were hospitalized because of suicidal behaviors by burns (6 males and 34 females). The incidence rate of these behaviors was 18.1 per 100,000 person-years (P-Y) and varied by gender (the incidence rates for females and males were 31.6 and 5.3 per 100,000 P-Y, respectively, p(2) = .000004). Most of the patients (60%) were single, 70% were homemakers, and 60% were either illiterate or had a low level of education. The most common precipitating factors for suicidal behaviors by burns were a quarrel with a family member or relative (47.5%) and marital conflict (17.5%). Most of the patients who were able to communicate regretted their suicidal behaviors (85.7%). Adolescents in Kurdistan are at higher risk of suicidal behaviors by burns compared to adolescents in other areas of Iran. Factors likely to be associated with suicidal behaviors by burns include lower socioeconomic status and family problems. These factors should be investigated further to better elucidate the etiology of these events. It also is necessary to implement prevention programs and strategies known to be effective to reduce the incidence of suicide in this region.

Effects of passive smoking on respiratory illness from birth to age eighteen months, in Shanghai, People's Republic of China.

The objective of this study was to evaluate the effects of exposure to nonmaternal, passive household cigarette smoke on the incidence of respiratory illness (bronchitis and pneumonia) among children from birth through age 18 months in the Lu-Wan District, Shanghai City, Peoples Republic of China. A secondary objective was to evaluate the effects of other environmental factors, such as the fuel used for cooking and whether the child was breast fed, on the incidence of respiratory illness. The total daily cigarette consumption of family members was used to estimate exposure to passive smoke. The relative risks of exposure to passive cigarette smoke on the incidence of respiratory illness were 1.3, 1.7, and 2.0 for children living in households with members who smoked 1 to 9, 10 to 19, and 20 to 39 cigarettes per day, respectively, compared with the risks for children living in nonsmoking households (p for trend = 0.0002). These effects did not change materially when potential confounding factors were controlled. Children who were not fed human milk had a 1.8-fold increased risk of respiratory disease at each level of exposure to passive cigarette smoke evaluated, in comparison with children who were fed human milk for at least 1 month.

Unintentional injuries among children and adolescents in Aboriginal and non-Aboriginal communities, newfoundland and labrador, Canada

Objectives. To compare epidemiologic characteristics of unintentional injuries among children and adolescents in Aboriginal and non-Aboriginal communities in the Province of Newfoundland and Labrador (NL), Canada. Study design. A comparative population-based study of unintentional injuries among individuals 0–19 years was conducted among Aboriginal and non-Aboriginal communities in NL. Methods. The provincial hospital discharge and mortality data were analyzed for a 6-year period, April 1995 to March 2001. Rates and rate ratios related to hospital discharge and mortality due to unintentional injuries were calculated to assess variation of rates. The 2-independent sample binomial proportion test was used to compare rates between Aboriginal and non-Aboriginal communities. Results. The overall hospital discharge rates of unintentional injury in Aboriginal and non-Aboriginal communities were 1,132.0 and 614 .2 per 100,000 population, respectively (p(2)&0.001). For both Aboriginal and non-Aboriginal communities, the rate among males was higher than that of females (p(2)&0.001). The mortality rate was found to be higher in Aboriginal communities than non-Aboriginal communities (84.3 vs. 10.2 per 100,000 population) (p(2)&0.001). Conclusions. The rate of unintentional injury among children and adolescents in Aboriginal communities is higher than non-Aboriginal communities. Sex (male) and place of residence (Aboriginal communities) were strong predictors of unintentional injury in NL.

SO2 and fine aerosol dispersion from the Kilauea plume, Kau district, Hawaii, USA

Proximal ground-level assessment of sulfur dioxide gas and fine aerosol in the volcanic gas plume downwind from Kilauea volcano indicates high levels of both species. Fine aerosol and SO 2 data were collected in the Kau district, 37-74 km downwind from the eruption, and at a nonexposed control site in Hawi, Hawaii. Typical trade winds and effusive eruption occurred during sampling in August-September 2003. Ambient SO 2 concentrations, measured with diffusion tubes, ranged from 6 to 34 ppbv and correlated negatively with altitude. In contrast, fine aerosol (≤0.3 μm size) concentrations, measured with a cascade impactor, ranged from 0.61 to 11.82 μg/m 3 and correlated positively with altitude. We attribute decrease of SO 2 with altitude to rapid oxidation as diurnal wind patterns blow the plume from oceanic terrain landward to more abundant oxidation sources. Aerosol increase with altitude likely reflects emission of H 2 SO 4 from Kilauea, supplemented by oxidation of SO 2 in atmospheric hydrosols. Kau residents are exposed to volcanogenic pollutants at concentrations that warrant concern for adverse health effects.

Chronic neck pain and whiplash: a case-control study of the relationship between acute whiplash injuries and chronic neck pain.

The authors undertook a case-control study of chronic neck pain and whiplash injuries in nine states in the United States to determine whether whiplash injuries contributed significantly to the population of individuals with chronic neck and other spine pain. Four hundred nineteen patients and 246 controls were randomly enrolled. Patients were defined as individuals with chronic neck pain, and controls as those with chronic back pain. The two groups were surveyed for cause of chronic pain as well as demographic information. The two groups were compared using an exposure-odds ratio. Forty-five per cent of the patients attributed their pain to a motor vehicle accident. An OR of 4.0 and 2.1 was calculated for men and women, respectively. Based on the results of the present study, it reasonable to infer that a significant proportion of individuals with chronic neck pain in the general population were originally injured in a motor vehicle accident.

ON THE VARIANCE OF EIGENVALUES OF THE COMMUNITY MATRIX: DERIVATION AND APPRAISAL

Eigenvalues, the solutions to the characteristic polynomial, are important measures of community behavior. Their range and practical measurement present difficult challenges in ecology. We therefore present the derivation of variance of eigenvalues of the community matrix, var(λ) = var (aii) + (n − 1)aijaji, as well as a novel related formula, namely, the expectancy of pairwise eigenvalues (EPV), var(λpairwise) = var(aii−pairwise) + aijaji. We propose that the two formulae may be useful in evaluating the relative contributions of inter- and intraspecific effects on the behavior of large systems. EPV allows estimating eigenvalue distribution of systems of unknown size.