Janne Pearson

Pattern of injury mortality by age-group in children aged 0-14 years in Scotland, 2002-2006, and its implications for prevention.

BackgroundKnowledge of the epidemiology of injuries in children is essential for the planning, implementation and evaluation of preventive measures but recent epidemiological information on injuries in children both in general and by age-group in Scotland is scarce. This study examines the recent pattern of childhood mortality from injury by age-group in Scotland and considers its implications for prevention.MethodsRoutine mortality data for the period 2002–2006 were obtained from the General Register Office for Scotland and were analysed in terms of number of deaths, mean annual mortality rates per 100,000 population, leading causes of death, and causes of injury death. Mid-year population estimates were used as the denominator. Chi-square tests were used to determine statistical significance.Results186 children aged 0–14 died from an injury in Scotland during 2002–06 (MR 4.3 per 100,000). Injuries were the leading cause of death in 1–14, 5–9 and 10–14 year-olds (causing 25%, 29% and 32% of all deaths respectively). The leading individual causes of injury death (0–14 years) were pedestrian and non-pedestrian road-traffic injuries and assault/homicide but there was variation by age-group. Assault/homicide, fire and suffocation caused most injury deaths in young children; road-traffic injuries in older ones. Collectively, intentional injuries were a bigger threat to the lives of under-15s than any single cause of unintentional injury. The mortality rate from assault/homicide was highest in infants (<1 year) and decreased with increasing age. Children aged 5–9 were significantly less likely to die from an injury than 0–4 or 10–14 year-olds (p < 0.05). Suicide was an important cause of injury mortality in 10–14 year-olds.ConclusionInjuries continue to be a leading cause of death in childhood in Scotland. Variation in causes of injury death by age-group is important when targeting preventive efforts. In particular, the threats of assault/homicide in infants, fire in 1–4 year-olds, pedestrian injury in 5–14 year-olds, and suicide in 10–14 year-olds need urgent consideration for preventive action.

Does writing a list help cancer patients ask relevant questions

We examined the use of written lists to give patients an opportunity to have their questions answered. Patients undergoing radical radiotherapy for cancer were given a sheet of paper with the simple prompt to write questions and give to the hospital doctor at their appointment 3 weeks later. At 3 months, patients were asked about their use and opinions of the written list. About half of the 478 patients attended with a written list. Fewer patients living in deprived areas used the list compared to more affluent areas. Doctors thought that 34% of patients would not otherwise have asked those questions and 91% of prompted discussions were a worthwhile use of time.

Varying gender pattern of childhood injury mortality over time in Scotland

Objective: This article explores gender in relation to Scottish child injury mortality over time. Design: Injury mortality data for children aged 0–14 years in Scotland were obtained from the General Register Office for Scotland. The study period was 1982–2006 inclusive. Data were analysed in terms of age, gender, year of death and cause of death. Age-adjusted injury mortality rates, male:female (m:f) ratios and temporal trends were calculated. Setting: Scotland, UK. Subjects: Children, aged 0–14 years, resident in Scotland, who died from injury during the study period. Results: There was an overall significant male excess (m:f ratio 1.70). Boys were significantly more likely to die from injuries in all age groups except infancy (m:f ratio 1.20, 1.32, 2.09, 2.09 in age groups <1, 1–4, 5–9 and 10–14 years). For childhood as a whole, the most gender-related fatal injury causes were poisoning (m:f ratio 3.21), falls (m:f ratio 2.75), suicide (m:f ratio 2.19), drowning and suffocation (m:f ratio 2.09), pedestrian (m:f ratio 1.72) and road traffic injuries (m:f ratio 1.65). The only cause that did not show a significant m:f ratio was fire. The male excess declined markedly over time. Conclusion: The gender pattern of child injury mortality in Scotland is highly variable and changing over time to the point where the previous male excess has almost disappeared in some age and cause categories. The overall male excess in child injury mortality has, however, remained consistent over time although the trend is downwards and converging. These findings are largely unexplained.