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Background and Purpose: Poisoning with pesticides, drugs, and chemicals is one of the most important health problems in the world, causing a varying mortality rate in different regions. Easy access to a variety of drugs and poisons has caused some people to be hurt by using such things. The aim of this study was to evaluate the poisoning and mortality rate by using poisons, drugs, and chemicals in Meshkinshahr, a city in Ardabil Province. Materials and Methods: This descriptive and analytical cross-sectional study was conducted in Meshkinshahr Hospital from 2017 until the end of 2018. All information of people who were poisoned with pesticides, drugs, and chemicals was extracted from hospital case, and then was analyzed by SPSS 23. Results: Totally, 453 cases were referred to hospital with 173 (38.20 %) male and 280 (61.80 %) female. 73% of the cases were poisoned by using medications and drugs , 18% by using other chemicals and 9% by poisons and pesticides. The mortality rate was 4%, with 70% due to exposure to pesticides and toxics, and 60% pertaining to deliberate suicide. Conclusion: According to the results of this study, most of the poisoning cases occurred as a result of using drugs; however, more than 70% of mortality was due to pesticides which indicated the toxicity of the pesticides. Also, the findings emphasized that the knowledge of target people is low.

Objective (s): The epidemiological transition causes changes and accumulation of diseases and deaths in old age. This study presents information on the leading causes of deaths for elderly (aged 60 and over) in Iran for this group for 2011 to 2017. Methods: This was a secondary analysis and is primarily based on data available in the Census and Civil Registration Organization. Deaths in 17 groups of causes according to the international classification of diseases-10 [ICD-10] were analyzed by sex and age groups. The main causes of deaths identified using YLL index and compared by time, gender and age. Results: During the study period more than 65 percent of all deaths occurred in elderly adults. About half of the deaths of elderly were related to cardiovascular diseases. Deaths due to cancer and tumors, and respiratory diseases were about 10%. The number of YLL for men and women in the year 2016 were 118027 and 1174054, respectively. Conclusion: The epidemiological transition has taken placed and was associated with the spread of chronic diseases and the emergence of deaths attributable to social factors.

Context: The spread of COVID-19 pandemic poses a great challenge to health care organizations and unprecedented need for information. This study aims to identify possible factors causing delay and losing precious time during diagnosis and treatment of COVID-19 at home and health facility level. It also aims to highlight perceptions and experiences of family members of deceased regarding diagnosis and treatment of COVID-19 infection in hospital. Methods: A retrospective study was done to review COVID-19 deaths from 18th March to 5th June 2020 in Punjab, India. A total of 48 laboratory confirmed (RT-PCR) COVID-19 deaths were reported during this period. Socio demographic profile, sequence of events including clinical symptoms, medical aid taken, time of confirmation of diagnosis and treatment before death were noted from the records on a predesigned proforma. Family members of deceased were also interviewed and asked open-ended questions regarding their experiences at various health facilities. Descriptive statistics was presented in percentages, mean, and median. Results: Mean age of subjects was 56.3 ± 18.3 years. Majority (82.2%) had three or more than three comorbidities. Median time from appearance of first symptom to first medical contact and confirmation of diagnosis was 1 and 5 days, respectively. On the basis of interview with deceased's relative, various themes like delay in diagnosis and treatment, dissatisfied with hospital system and lack of communication between relative and patient were generated. Conclusion: Presence of comorbidities was the most important risk factor. Health seeking behavior of patients immediately after appearance of symptoms was found to be satisfactory.

Abstract Background Living alone is increasingly common and has been depicted as an important cause of mortality. We examined the association between living alone and mortality risks among older men and women in northern Sweden, by linking two unique longitudinal datasets. Methods We used the Linnaeus database, which links several population registers on socioeconomic and health. This register-based study included 22,226 men and 23,390 women aged 50 and 60 years in Västerbotten County who had participated in the Västerbotten Intervention Program (VIP) during 1990–2006, with a total of 445,823 person-years of observation. We conducted Cox-proportional hazard regression to assess the risk of living alone on the mortality that was observed between 1990 and 2015, controlling for socio-demographic factors, chronic disease risk factors and access to social capital. Results Older men and women who lived alone with no children at home were at a significantly higher risk of death compared to married/cohabiting couples with children at home (with an adjusted hazard ratio of 1.38, 95% CI of 1.26–1.50 in men and 1.27, 95% CI of 1.13–1.42 in women). Living alone was an even stronger factor than the well-established chronic disease risk factors and a lack of access to social capital. Conclusions A significant association between living alone and mortality among the older adult population in Sweden was observed. Providing good social support for older people is important in preventing the negative health impact of living alone.

Background: Mortality rates for children under five years of age, and stillbirth risks, remain high in parts of sub-Saharan Africa and South Asia. The Child Health and Mortality Prevention Surveillance (CHAMPS) network aims to ascertain causes of child death in high child mortality settings (>50 deaths/1000 live-births). We aimed to develop a “greenfield” site for CHAMPS, based in Harar and Kersa, in Eastern Ethiopia. This very high mortality setting (>100 deaths/1000 live-births in Kersa) had limited previous surveillance capacity, weak infrastructure and political instability. Here we describe site development, from conception in 2015 to the end of the first year of recruitment. Methods: We formed a collaboration between Haramaya University and the London School of Hygiene & Tropical Medicine and engaged community, national and international partners to support a new CHAMPS programme. We developed laboratory infrastructure and recruited and trained staff. We established project specific procedures to implement CHAMPS network protocols including; death notifications, clinical and demographic data collection, post-mortem minimally invasive tissue sampling, microbiology and pathology testing, and verbal autopsy. We convened an expert local panel to determine cause-of-death. In partnership with the Ethiopian Public Health Institute we developed strategies to improve child and maternal health. Results: Despite considerable challenge, with financial support, personal commitment, and effective partnership, we successfully initiated CHAMPS. One year into recruitment (February 2020), we had received 1173 unique death notifications, investigated 59/99 MITS-eligible cases within the demographic surveillance site, and assigned an underlying and immediate cause of death to 53 children. Conclusions: The most valuable data for global health policy are from high-mortality settings, but initiating CHAMPS has required considerable resource. To further leverage this investment, we need strong, sustained, local research leadership, and to broaden the scientific remit. To support this, we have set up a new collaboration, the “Hararghe Health Research Partnership”.

Introduction: Coronavirus diseases-2019 (COVID-19) has emerged as a pandemic with significant mortality risk. The early predictors of mortality in COVID-19 patients are older age, male gender, co-morbidities like uncontrolled diabetes, hypertension, severe asthma, Chronic Obstructive Pulmonary Disease (COPD), Chronic Kidney Disease (CKD), Coronary Artery Disease (CAD), Chronic Liver Disease and malignancy and raised pro-inflammatory markers in most of the studies from China, Western Europe and US. Aim: To determine the various risk factors associated with outcomes of COVID-19 infection among laboratory confirmed COVID-19 patients. Materials and Methods: This descriptive cross-sectional study was conducted among 420 laboratory confirmed COVID-19 patients, aged 18 years and above, who were admitted in a designated COVID-19 hospital in Puducherry, India. Pretested structured questionnaire was used to collect the data through telephonic interview. Descriptive statistics, frequency, mean and standard deviation was estimated for demographic characteristics as appropriate. Chi-square test was used to investigate demographic and health related predictors of COVID-19 outcomes. Results: The mean age of the study participants was 41.38 (±17.552) years. Thirty five (8.3%) patients died during their treatment. The common presenting symptom was fever (142, 33.80%), followed by cold and cough (96, 22.85% each). Factors such as more than 60 years of age, female gender, resident of rural area, patients owning yellow ration card, unemployment, overcrowding, current smoking and alcoholics, attending social gathering, social distancing, hand washing, level of wearing mask were found to be significantly associated with fatal prognosis. Conclusion: Risk factors such as older age, females, rural residence, unemployment, overcrowding, smoking and alcoholism, co-morbidities, social gathering, social distancing, hand washing and mask usage were found to be associated with COVID-19 deaths.

The work makes a comparative analysis on the economic and health impact of the covid19 pandemic in Argentina and the world. Regardless of the indicators used (GDP, confinement, deaths and vaccinations), Argentina was in the worst quadrant along with Panama and Peru, being in the four indicators in the most unfavorable scenarios. Other countries, such as Iraq, Bahamas and Colombia were placed in two, while Spain, Chile and Great Britain were placed in only one category. Argentina has been one of the countries with the worst treatment of the coronavirus crisis in the world according to the variables used.

Introduction: We described how COVID-19 fatality and symptoms varied by dominant variant and vaccination in the US., Methods: Using the Restricted Access Dataset from the US CDC (1/1/2020-10/20/2022), we conducted a cross-sectional study assessing differences in COVID-19 deaths, severity indicators (hospitalization, ICU, pneumonia, abnormal X-ray, acute respiratory distress syndrome, mechanical ventilation) and 12 mild symptoms by dominant variant/vaccination periods using logistic regression after controlling for confounders., Results: We found the highest fatality during the dominant periods of Wild (4.6%) and Delta (3.4%). Most severe symptoms appeared when Delta was dominant (Rate range: 2.0-9.4%). Omicron was associated with higher mild symptoms than other variants. Vaccination showed consistent protection against death and severe symptoms for most variants (Risk Ratio range: 0.41-0.93). Boosters, especially the second, provided additional protection, reducing severe symptoms by over 50%., Discussion: This dataset may serve as a useful tool to monitor temporospatial changes of fatality and symptom for case management and surveillance., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Lin, Liu, Qi, Trees, Gao, Friedman, Xue and Lawrence.)

The aim of this study is to describe the profile, causes of death, and associated complications among women who died with a diagnosis of gynecological cancer during a four-year period in a gynae oncology unit in a tertiary hospital. The study is based on a retrospective review of clinical records of patients. There were 368 gynecological cancer admissions during the study period and 51 gynecological cancer-related deaths (13.8%); however, only 48 (13%) of the 51 files were available for analysis. The mean age of the women who died was 52.7 years (SD ±16.92). Most of the women who died were South African citizens (41, 85%), black (44, 91.7%) and unemployed (37, 77.1%). The most common comorbidities were hypertension and HIV which occurred at similar frequencies (20, 41.7%), followed by diabetes mellitus (7, 14,6%). The three most common cancers were cervical (18, 37.5%), ovarian (13, 27.1%), and endometrial (12, 25,0%). All women who died (48, 100%) had some form of cancer-related complications on admission to the hospital. The most common complication at presentation was obstructive uropathy (16, 31.3%) followed by ascites (11, 21.6%) and pleural effusion (8, 15.8%). Just less than half of the patients (22, 45.8%) received palliative treatment due to advanced-stage disease, and the remainder, (20, 41.6%) and (5, 10.4%) surgical and radiation therapy, respectively. The surgical procedure performed was staging laparotomy for ovarian and endometrial cancer (19, 95%) and radical hysterectomy and lymph node dissection for operatable cervical cancer (01, 5%). Forty-nine complications were recorded among the 20 women who underwent surgical treatment. The most common complications were sepsis and hemorrhage followed by organ injury., Competing Interests: The Authors declared no conflict of interest, (African Journal of Reproductive Health © 2024.)

Background: No studies have updated the epidemiologic changes in non-rheumatic degenerative mitral valve disease (DMVD) since 2019, thus this study utilized data from the Global Study of Diseases, Injuries, and Risk Factors 2019 (GBD2019) to assess the burden of DMVD in 204 countries and territories over the period 1990-2019, as well as changes in the prevalence, incidence, deaths and changes in disability-adjusted life years (DALYs)., Methods: Using the results from the GBD2019, analyzing the incidence, prevalence, deaths, and DALYs rates, as well as their age-standardized rates (ASR). Based on the human development index (HDI), the socio-demographic index (SDI), age, and sex., Results: In 2019, there were 24.229 million (95% uncertainty interval (UI) 23.081-25.419 million) existing cases of DMVD worldwide, with 1.064 million (95% UI 1.010-1.122 million) new cases and 0.034 million (95% UI 0.028-0.043 million) deaths, and 0.883 million (95% UI 0.754-1.092 million) disability-adjusted life years. The incidence, prevalence, deaths, and DALYs of DMVD and their ASR showed significant differences across sex, age groups, regions, and countries from 1990 to 2019. It is projected that by 2030, the incidence of DMVD in females will be 0.72 million with an ASR of 15.59 per 100,000 population, 0.51 million in males with an ASR of 11.75 per 100,000 population, and a total incidence of 1.23 million with an ASR of 14.03 per 100,000 population., Conclusions: DMVD remains a significant public health problem that cannot be ignored, despite a decreasing trend in the ASR of global incidence, prevalence, deaths and DALYs from 1990 to 2019. However, we note an adverse development trend in countries with low socio-demographic indexes and seriously aging societies, and sex inequality is particularly prominent. This indicates the need to reposition current prevention and treatment strategies, with some national health administrations developing corresponding strategies for preventing an increase in DMVD based on local health, education, economic conditions, sex differences, and age differences., Competing Interests: The authors declare no conflict of interest., (Copyright: © 2024 The Author(s). Published by IMR Press.)

Objective: Liver cancer is a major health concern globally and in China. This analysis investigated deaths and disability-adjusted life years (DALYs) with respect to etiologies and risk factors for liver cancer in China and worldwide., Methods: Global and China-specific data were collected on liver cancer deaths, DALYs, and age-standardized rates (ASRs) from the Global Burden of Disease Study 2019 database. Liver cancer etiologies were classified into five groups and risk factors were categorized into three levels. Each proportion of liver cancer burden was calculated in different geographic regions. The joinpoint regression model were used to assess the trends from 1990-2019., Results: Liver cancer accounted for 484,577 deaths worldwide in 2019 with an ASR of 5.9 per 100,000 population. China had an elevated liver cancer death ASR in 2019 and males had an ASR 1.7 times the global rate. The global ASR for DALYs peaked at 75-79 years of age but peaked earlier in China. Hepatitis B virus was the prominent etiology globally (39.5%) and in China (62.5%), followed by hepatitis C virus and alcohol consumption. In high sociodemographic index countries, non-alcoholic steatohepatitis has gained an increasing contribution as an etiologic factor. The liver cancer burden due to various etiologies has decreased globally in both genders. However, metabolic risk factors, particularly obesity, have had a growing contribution to the liver cancer burden, especially among males., Conclusions: Despite an overall decreasing trend in the liver cancer burden in China and worldwide, there has been a rising contribution from metabolic risk factors, highlighting the importance of implementing targeted prevention and control strategies that address regional and gender disparities., Competing Interests: No potential conflicts of interest are disclosed., (Copyright © 2024 The Authors.)

Aims: To devise effective preventive measures, a profound understanding of the evolving patterns and trends in atrial fibrillation (AF) and atrial flutter (AFL) burdens is pivotal. Our study was designed to quantify the burden and delineate the risk factors associated with AF and AFL across 204 countries and territories spanning 1990-2021., Methods and Results: Data pertaining to AF and AFL were sourced from the Global Burden of Disease Study 2021. The burden of AF/AFL was evaluated using metrics such as incidence, disability-adjusted life years (DALYs), deaths, and their corresponding age-standardized rates (ASRs), stratified by age, sex, socio-demographic index (SDI), and human development index (HDI). The estimated annual percentage change was employed to quantify changes in ASRs. Population attributable fractions were calculated to determine the proportional contributions of major risk factors to age-standardized AF/AFL deaths. This analysis encompassed the period from 1990 to 2021. Globally, in 2021, there were 4.48 million incident cases [95% uncertainty interval (UI): 3.61-5.70], 8.36 million DALYs (95% UI: 6.97-10.13) and 0.34 million deaths (95% UI: 0.29-0.37) attributed to AF/AFL. The AF/AFL burden in 2021, as well as its trends from 1990 to 2021, displayed substantial variations based on gender, SDI quintiles, and geographical regions. High systolic blood pressure emerged as the leading contributor to age-standardized AF/AFL incidence, prevalence, death, and DALY rate globally among all potential risk factors, followed closely by high body mass index., Conclusion: Our study underscores the enduring significance of AF/AFL as a prominent public health concern worldwide, marked by profound regional and national variations. Despite the substantial potential for prevention and management of AF/AFL, there is a pressing imperative to adopt more cost-effective strategies and interventions to target modifiable risk factors, particularly in areas where the burden of AF/AFL is high or escalating., Competing Interests: Conflict of interest: none declared, (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Jellyfish stings account for numerous deaths in the Philippines. Despite this, there is little scientific information on the identity, distribution, seasonality, and ecology of the box jellyfish species involved. We present initial findings of three months (April–June 2021) of monitoring the abundance of and envenomations by box jellyfishes in eastern and western Luzon. Emergent patterns suggest encounters between box jellyfish and people are more likely to occur in beach areas within a few kilometers from rivers when tidal ranges are large, particularly around the flood phase of high tide. Encounters are also more likely on coasts where the monsoon winds blow onshore during the warmer months, bringing these animals closer to beach areas. They then stay longer in the shallows when the seas are calm. Beachgoers are, thus, advised to plan their destinations and activities carefully and wear protective clothing when venturing into shallow coastal areas. [ABSTRACT FROM AUTHOR]

The cross-country relationship of coronavirus disease 2019 (COVID-19) case and death rates with previously measured income inequality and poverty in the pandemic's first wave is studied, controlling for other underlying factors, in a worldwide sample of countries. If the estimated associations are interpreted as causal, the Gini coefficient for income has a significant positive effect on both cases and deaths per capita in regressions using the full sample and for cases but not for deaths when Organisation for Economic Co-operation and Development (OECD) and non-OECD sub-samples are treated separately. The Gini coefficient for wealth has a significant positive effect on cases, but not on deaths, in both sub-samples and in the full sample. Poverty generally has weak positive effects in the full and non-OECD samples, but a relative poverty measure has a strong positive effect on cases in the OECD sample. Analysis of the gap between COVID-19 first-wave cases and deaths per capita in Canada and the higher rates in the United States indicates that 37 percent of the cases gap and 28 percent of the deaths gap could be attributed to the higher-income Gini in the United States according to the full-sample regressions. [ABSTRACT FROM AUTHOR]

The research in this article sheds light on issues related to the evolution of the national situation of the natural movement of the population from January 2019 to May 2021, given the registrations made at the civil registry services in Romania on births, deaths, marriages and divorces, aiming to make a comparison between the period before the pandemic and the period after its onset in our country, in March 2020. We want to see if the number of the four life events mentioned above was really influenced by the pandemic and thus increased or decreased significantly. Also, the study of the natural movement of the population in Romania, under the spectrum of the current health crisis is of major importance, given that the pandemic has visible effects on the acceleration of deaths in people with various comorbidities. [ABSTRACT FROM AUTHOR]

There is no denying the fact that road transport is the backbone of society and have telling impact on the economy also. As a result of massive growth of both road network and vehicles there in, the problem of road accident injury and fatalities to road users have also gone up and road accident has become most common and fatal disaster of present time. This study, therefore, aims to analyse the trend and the regional variation of concentration of road accident in the Punjab state of India. The present study is entirely based on the secondary data, collected from statistical abstracts published by Punjab Government. The study reveals that during the period of 2006-2016, the number of total road accidents in Punjab increased from 5099 to 6952 recording a growth rate of 36.34. District with highest number of total road accidents is Ludhiana followed by district Patiala. While, S.A.S. Nagar with 2.10 and 2.02 concentration index values in 2006 and 2016 respectively has been the leading district in both years of study. Number of road accidents in the study area is positively correlated with size of population, population density, number of registered vehicles and road length. [ABSTRACT FROM AUTHOR]

Background: Ketamine is a phencyclidine derivative with dissociative anaesthetic properties. Increasing numbers of individuals in England take ketamine recreationally. Information on deaths arising from such use in England is presented. Methods: Cases were extracted on 31 January 2020 from the National Programme on Substance Abuse Deaths database, based on text searches of the cause of death, coroner's verdict and positive toxicology results for the terms 'ketamine' or 'norketamine'. Findings: During 1997–2005, there were <5 deaths p.a. in which ketamine was implicated. Numbers increased until 2009 (21), plateauing until 2016; thereafter, deaths have risen to about 30 p.a. Decedents' characteristics (N = 283): male 84.1%, mean age 31.2 (SD 10.0) years, employed 56.5%, drug use history 79.6% and living with others 60.3%. Ketamine was detected with other substances in most cases. Main (74.6%) underlying cause of death was accidental poisoning. Ketamine may have impaired judgement in other cases. Conclusions: Although controlled, recreational ketamine use and related fatalities continue to increase. Consumers need to be more aware of the potentially fatal risks they face. [ABSTRACT FROM AUTHOR]

OBJECTIVE: In our study, the effects of the COVID-19 pandemic in Malatya province, other than confirmed case deaths, were investigated. MATERIAL AND METHODS: The records of those who died between 2016 and 2020 were reviewed on the official website of the Malatya Metropolitan Municipality, and the numbers of deaths in those 5 years were recorded on a weekly basis. The arithmetic mean of the deaths between 2016 and 2019 was calculated, and it was investigated whether the number of deaths in 2020 was more than expected. RESULTS: In 2020, 1743 (61%) excess deaths were detected. While the mean number of deaths reported 4 years before 2020 was 2860, it was determined that the number of deaths in 2020 was 4603, and there were 1743 (61%) excess deaths. CONCLUSION: The deaths occurred in Malatya during the COVID-19 pandemic were more than expected. It has been supposed that some deaths were of polymerase chain reaction negative and hence unrecorded COVID-19 patients' deaths, and some deaths were caused by other indirect effects of the pandemic. [ABSTRACT FROM AUTHOR]

COVID-19 has taken over the world as the largest viral outbreak in the past 100 years. With over 13 million confirmed cases and 0.5 million-plus people dead, it has affected the life around us. With Pakistan being amongst the top 15 countries affected by it, the government of Pakistan has started vaccination, issued SOPs on daily life and smart lockdown continues in the country, but a part of this activity developing countries are still facing even greater difficulties in handling this crisis. This paper was designed to evaluate the status of scientific literature available on Covid-19 pandemic and to relate this situation from Pakistan perspective. A detailed review of published literature was conducted from March 2020 to August 2020. Covid-19, pandemic, Pakistan, healthcare setup, psychological impact, educational activities and challenges SOPs were utilized as key vocabulary. Miscellaneous searching tools including, Science Direct, Embase, PubMed, Google Scholar and Covid-19 portal from Government of Pakistan were visited for relevant information. A total of 30 research commentaries, articles, opinions and editorial letters were selected based on the required information. This article discusses the effects of COVID-19 on society and focus on SOPs introduced and their effects on the physical and mental health of the general public. [ABSTRACT FROM AUTHOR]

COVID-19 exposed and tested many dimensions of the support system for vulnerable groups and communities. The convergence of racial, political, and economic upheaval amplified and complicated the effects of the pandemic. Social science demonstrated impressive responses in data collection, real-time analyses, and policy guidance. Articles in this volume demonstrate many of these innovations in data and methods. Despite their diversity, these articles also demonstrate consistent themes in the geographical and population targeting of the pandemic, the underlying social vulnerability of particular groups and communities, and the residual population consequences that will occupy researchers and policy-makers for the foreseeable future. Long-term social and economic impacts, from the mental health consequences of death and tragedy to the setbacks in education, job mobility, household financial security, and health, need to become the focus of an ongoing program of research and policy development. [ABSTRACT FROM AUTHOR]

Aims: To describe the adverse events (AEs) of recreational cannabis use in France between 2012 and 2017. Methods: AEs related to recreational cannabis use, alone or in combination with alcohol and/or tobacco reported to the French Addictovigilance Network were analysed (excluding cannabidiol and synthetic cannabinoids). Results: Reporting of AEs tripled between 2012 (n = 179, 6.3%, 95% confidence interval [CI] = 5.4–7.2) and 2017 (n = 562, 10.1%, 95% CI = 9.3–10.9), reaching 2217 cases. They concerned mainly men (76.4%) and users aged between 18 and 34 years (18–25: 30.9%; 26–34: 26.3%, range: 12–84 years). Cannabis was mainly inhaled (71.6%) and exposure was most often chronic (64.2%). Many types of AEs were reported: psychiatric (51.2%), neurological (15.6%), cardiac (7.8%) and gastrointestinal (7.7%), including unexpected AEs (n = 34, 1.1%). The most common effect was dependence, ranging from 10.1% (95% CI = 7.9–12.3) to 20.3% (95% CI = 17.3–23.2) over the study period. Cannabinoid hyperemesis syndrome (n = 87, 2.8%) emerged from 2015. Deaths accounted for 0.2% of all AEs (4 men and 3 women aged on average 35 years). A chronic pattern of cannabis use was reported in 4 of them (intracranial hypertension in the context of lung cancer, suicide, cerebral haematoma, neonatal death with concomitant chronic alcohol use), while in the other cases the toxicological analysis identified cannabis use (ruptured aneurysm and unknown aetiology). Conclusion: This study showed a multitude of AEs related to recreational cannabis use, including unexpected AEs and deaths. It highlights the problem of dependence and the emergence of cannabinoid hyperemesis syndrome. [ABSTRACT FROM AUTHOR]

Hospital-acquired infections are emerging major concurrent conditions during the coronavirus disease (COVID-19) pandemic. We conducted a retrospective review of hospitalizations during March‒October 2020 of adults tested by reverse transcription PCR for severe acute respiratory syndrome coronavirus 2. We evaluated associations of COVID-19 diagnosis with risk for laboratory-confirmed bloodstream infections (LCBIs, primary outcome), time to LCBI, and risk for death by using logistic and competing risks regression with adjustment for relevant covariates. A total of 10,848 patients were included in the analysis: 918 (8.5%) were given a diagnosis of COVID-19, and 232 (2.1%) had LCBIs during their hospitalization. Of these patients, 58 (25%) were classified as having central line‒associated bloodstream infections. After adjusting for covariates, COVID-19‒positive status was associated with higher risk for LCBI and death. Reinforcement of infection control practices should be implemented in COVID-19 wards, and review of superiority and inferiority ranking methods by National Healthcare Safety Network criteria might be needed. [ABSTRACT FROM AUTHOR]

BackgroundThere is increasing recognition of stroke as an important contributor to childhood morbidity and mortality. Current estimates of global childhood stroke burden and its temporal trends are sparse. Accurate and up-to-date estimates of childhood stroke burden are important for planning research and the resulting evidence-based strategies for stroke prevention and management.ObjectivesTo estimate the prevalence, mortality and disability-adjusted life years (DALYs) for ischemic stroke (IS), hemorrhagic stroke (HS) and all stroke types combined globally from 1990 to 2013.MethodologyStroke prevalence, mortality and DALYs were estimated using the Global Burden of Disease 2013 methods. All available data on stroke-related incidence, prevalence, excess mortality and deaths were collected. Statistical models and country-level covariates were employed to produce comprehensive and consistent estimates of prevalence and mortality. Stroke-specific disability weights were used to estimate years lived with disability and DALYs. Means and 95% uncertainty intervals (UIs) were calculated for prevalence, mortality and DALYs. The median of the percent change and 95% UI were determined for the period from 1990 to 2013.ResultsIn 2013, there were 97,792 (95% UI 90,564-106,016) prevalent cases of childhood IS and 67,621 (95% UI 62,899-72,214) prevalent cases of childhood HS, reflecting an increase of approximately 35% in the absolute numbers of prevalent childhood strokes since 1990. There were 33,069 (95% UI 28,627-38,998) deaths and 2,615,118 (95% UI 2,265,801-3,090,822) DALYs due to childhood stroke in 2013 globally, reflecting an approximately 200% decrease in the absolute numbers of death and DALYs in childhood stroke since 1990. Between 1990 and 2013, there were significant increases in the global prevalence rates of childhood IS, as well as significant decreases in the global death rate and DALYs rate of all strokes in those of age 0-19 years. While prevalence rates for childhood IS and HS decreased significantly in developed countries, a decline was seen only in HS, with no change in prevalence rates of IS, in developing countries. The childhood stroke DALY rates in 2013 were 13.3 (95% UI 10.6-17.1) for IS and 92.7 (95% UI 80.5-109.7) for HS per 100,000. While the prevalence of childhood IS compared to childhood HS was similar globally, the death rate and DALY rate of HS was 6- to 7-fold higher than that of IS. In 2013, the prevalence rate of both childhood IS and HS was significantly higher in developed countries than in developing countries. Conversely, both death and DALY rates for all stroke types were significantly lower in developed countries than in developing countries in 2013. Men showed a trend toward higher childhood stroke death rates (1.5 (1.3-1.8) per 100,000) than women (1.1 (0.9-1.5) per 100,000) and higher childhood stroke DALY rates (120.1 (100.8-143.4) per 100,000) than women (90.9 (74.6-122.4) per 100,000) globally in 2013.ConclusionsGlobally, between 1990 and 2013, there was a significant increase in the absolute number of prevalent childhood strokes, while absolute numbers and rates of both deaths and DALYs declined significantly. The gap in childhood stroke burden between developed and developing countries is closing; however, in 2013, childhood stroke burden in terms of absolute numbers of prevalent strokes, deaths and DALYs remained much higher in developing countries. There is an urgent need to address these disparities with both global and country-level initiatives targeting prevention as well as improved access to acute and chronic stroke care.

Data from the Istituto Superiore di Sanità (ISS) emphasized by the media indicate that COVID-19 vaccination reduces related infections, hospitalizations and deaths. However, a comparison showed significantly more hospitalizations and intensive care unit accesses in the corresponding months and days in 2021 versus 2020 and no significant differences in deaths. The combination of non-alternative hypotheses may help explain the discrepancy between the results in the entire population and the vaccination’s success claimed by the ISS in reducing infections, serious cases and deaths: a bias: counting as unvaccinated also 'those vaccinated with 1 dose in the two weeks following the inoculation', and as incompletely vaccinated also 'those vaccinated with 2 doses within two weeks of the 2nd inoculation'. a systematic error: counting as unvaccinated also 'vaccinated with 1 dose in the two weeks following the inoculation', and as incompletely vaccinated also 'vaccinated with 2 doses within two weeks of the 2nd inoculation'. Many reports show an increase in COVID-19 cases in these time-windows, and related data should be separated levels of protective effectiveness in vaccinated people, often considered stable, actually show signs of progressive reduction over time, which could contribute to reducing the overall population result unvaccinated people show more severe disease than in 2020, supporting also in humans the theory of imperfect vaccines, which offer less resistance to the entry of germs than the resistance later encountered inside the human body. This favors the selection of more resistant and virulent mutants, that can be spread by vaccinated people. This damages first the unvaccinated people, but ultimately the whole community. An open scientific debate is needed to discuss these hypotheses, following the available evidence (as well as to discuss the inconsistent theory of unvaccinated young people as reservoirs of viruses/mutants), to assess the long-term and community impact of different vaccination strategies.

Introduction: The outbreak of COVID-19 as changed patterns of mortality in different setups. The rate of suicide has increased in some countries during the pandemic while the overall death rates have decreased. The study was conducted with objective to find out the prevalence of unnatural deaths among the autopsy cases brought at tertiary care hospital during COVID-19 pandemic period. Methods: This is a descriptive cross-sectional study using the records of the medico legal autopsies conducted from 24th March 2020 to 23rd August 2020 during the COVID-19 pandemic in Pokhara Academy of Health Sciences. Ethical approval was taken from Institutional Review Committee of Pokhara Academy of Health Sciences (Reference number 28.2077/78). Whole sampling method was used. Records which were available were included in the study whereas those cases whose complete records were not available were excluded. Point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data. Results: Out of 188 deaths studied at the autopsy during the COVID-19 pandemic period, the prevalence of unnatural deaths was 147 (78.19%) (71.04-85.33 at 95% Confidence Interval). Among these deaths, 109 (74.14%) were males and 38 (25.85%) were females. Suicide was the most common manner attributing to 78 (53.06%) of the unnatural deaths. Conclusions: The prevalence of suicide was more than those demonstrated by earlier observations in similar settings before the pandemic period. Suicidal deaths were more common during the COVID 19 pandemic. This is an indicator of frustration of the people and necessary steps have to be taken to decrease such deaths in similar conditions to come.

Background: Climate change, poverty, and violence increasingly drive migration to the United States. United States Immigration and Customs Enforcement (ICE) detain some individuals while awaiting determination of immigration status or potential deportation. Over the last two decades, more than 200 individuals died in ICE detention. In this study, we aim to identify systemic issues related to deaths of individuals in ICE detention to potentially mitigate further harm. Methods: The ICE Office of Detention Oversight conducts investigations after each death in detention, producing a report called a “Detainee Death Review”. To identify systemic issues in these deaths, we used thematic analysis to review 55 Detainee Death Reviews available between 2011 and 2018. Findings: We identified 3 major themes of pervasive issues—Detainee Not Patient, System Over Patient, and Grossly Substandard Care— and 11 subthemes. Subthemes of culture of shortcuts, delays in care, and poor care delivered were present in the vast majority of cases. Subthemes bias and discrimination, language injustice, falsification of and inconsistencies between records and reports, willful indifference, security over health, communication breakdown, inadequate resources, failure of protective mechanisms, missing/ignoring red flags, and failure of emergency response were also prominent. Interpretation: This study identified underlying systems issues within the medical care provided in ICE detention. While there are issues with language services, discrimination, and inadequate response to medical emergencies, the greatest issue is the lack of independent, external review. Greater transparency is required, so that adherence to basic standards of care for individuals in ICE detention can be better evaluated. Funding: Haas Jr. Fund and the University of Southern California’s Equity Research Institute.

In February 2020, Italy has been the first country in Europe fighting against COVID-19. In March 2020, Italian government declared national lockdown. Until May 4th, people stayed in home confinement and only the so-called “essential works and activities” were continued. Like in other countries, both for the disease severity and for the risk of death, the higher the age of people the higher the risk. In the first months of 2020, Italy saw a very high number of deaths related to COVID-19, with a huge age effect, and there is an agreement on the view that there had been also an excess of mortality and on the role of mortality as a correct way to reflect the dynamics of the virus’s spread. In this paper we briefly discuss the trends of mortality during the first 4 months of 2020 according to the data by the Italian National Institute of Statistics.

The purpose of the study is to evaluate county-wide health systems using the data set of the first wave of the COVID-19 pandemic. The overall design of study comprises a literature review, secondary data, and a mathematical analysis. It is a cross-sectional quantitative study following a deductive approach. It uses the data of the first wave of the COVID-19 pandemic taken from the website of Worldometer as of April 8, 2020. The study uses a gray incidence analysis model (commonly known as Gray Relational Analysis, i.e., GRA) as its research methodology. On the basis of the results of GRA, a classification has been made under a predetermined scheme of ensigns: much better, better, somewhat better, fair, poor, somewhat worse, and worse health systems. There are a total 211 countries that have been divided into the seven aforementioned categories. Findings of the study show that Southern Africa Development Community (SADC) countries fall predominantly under the much better ensign, whereas Organization for Economic Co-operation and Development (OECD), Schengen Area (SA), and/or European Union (EU) countries fall under the worse ensign. Pakistan falls under the ensign of poor. It is an original attempt to evaluate the response of health systems based on real data using a scientific methodology. The study provides valuable information about the health systems of the countries for forming an informed opinion about the health systems herein. The study provides useful new information for stakeholders and a new framework for future research.

This work aims to analyze flood-related deaths in northwestern Algeria for the period 1966–2019. Devastating and unpredictable floods resulted in more than a thousand deaths in the last two centuries in this area. Despite the severity of the floods in this territory, official databases and studies on flood fatalities are not available. To address this gap, we compile a database consisting of 324 deaths caused by 52 flood events using referenced sources. The data is assessed according to the type of flood event responsible for each death, the temporal and spatial distribution of deaths, and the analysis of victim's characteristics and incident's circumstances. The results show that flash floods caused most deaths. There has been a downward trend in the number of flood deaths over the years. A coincidence of high daily rainfall values with high mortality events, as well as increased mortality rates in autumn and during daylight hours. Spatially, flood deaths occurred mainly in sites crossed by rivers and in plain zones with high population density. Analysis indicates that males are more vulnerable to deadly floods than females are; moreover, young children and the elderly are the most exposed age groups. Drowning is the leading fatality cause type, and the fatal incidents occur mostly outdoor among individuals on foot. These results contributed to fill the gaps on flood deaths that reflect the vulnerability of the study area and could help the decision makers to improve the strategy against flood risks. [ABSTRACT FROM AUTHOR]

• Physical activity potentially has a buffering effect against COVID-19 related outcomes. • Analysis of data at the county level in the United States. • Physical activity associated with decreased COVID-19 cases and deaths. • Relationship between COVID-19 cases and deaths lower when physical activity is high. The study was to examine county-level associations of physical activity with coronavirus disease 2019 (COVID-19) cases and deaths, per 100,000 county residents. Data were collected from publicly available data sources for 3142 counties and equivalents, including the District of Columbia. Subjective health ratings, percentage uninsured, percentage unemployed, median household income, percentage female residents, percentage White residents, percentage of residents 65 years of age or older, and rural designation served as controls. The two-level random intercept regression showed that physical activity rates at the county level were statistically and negatively associated with COVID-19 cases and deaths. Additional analyses showed that physical activity rates moderated the relationship between cases and deaths, such that the relationship was strongest when physical activity rates were low. The results presented here offer empirical evidence of the benefits of county-level physical activity during a pandemic. Implications for public health and physical activity provision are discussed. [Display omitted] [ABSTRACT FROM AUTHOR]

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Purpose: The purpose of this study is to understand the factors that contribute to the number of reported coronavirus (COVID-19) deaths among low-income and high-income countries, and to understand the sources of differences between these two groups of countries. Design/methodology/approach: Multiple linear regression models evaluate the socio-economic factors that determine COVID-19 deaths in the two groups of countries. The Oaxaca–Blinder decomposition is used to examine sources of differences between these two groups. Findings: Low-income countries report a significantly lower average number of COVID-19 deaths compared to high-income countries. Community mobility and the easiness of carrying the virus from one place to another are significant factors affecting the number of deaths, while life expectancy is only significant in high-income countries. Higher health expenditure is associated with more reported deaths in both high- and low-income countries. Factors such as the transport infrastructure system, life expectancy and the percent of expenditure on health lead to the differences in the number of deaths between high- and low-income countries. Social implications: Our study shows that mobility measures taken by individuals to limit the spread of the virus are important to prevent deaths in both high- and low-income countries. Additionally, our results suggest that countries with weak health institutions underestimate the number of deaths from COVID-19, especially low-income countries. The underestimation of COVID-19 deaths could be affecting a great number of people in poverty in low-income economies. Originality/value: This paper contributes to the emerging literature on COVID-19 and its relation to socio-economic factors by examining the differences in reported between deaths between rates in low-income and high-income countries. [ABSTRACT FROM AUTHOR]

Multisectoral investments over the past decade have accelerated the growth of Maternal Mortality Review Committee (MMRC) programs across the United States. The U.S. Centers for Disease Control and Prevention (CDC) launched the Enhancing Reviews and Surveillance to Eliminate Maternal Mortality (ERASE MM) Initiative in 2019. Under ERASE MM, CDC directly funds 24 U.S. jurisdictions supporting MMRCs in 25 states. With increased investment in programs nationally, the CDC has designed a performance management framework to identify areas for improvement or sustained achievement and standardize measurement of key process benchmarks across programs. This article presents a report on the baseline measures collected through this performance management approach and suggests key partnerships required to continue to accelerate progress toward the elimination of preventable maternal mortality in the United States. [ABSTRACT FROM AUTHOR]

Background: Poisoning is a major problem in India. However, there is little systematic information on the key poisons responsible for most deaths by geographical area and over time. We aimed to review the literature to identify the poison classes causing the greatest number of deaths in India over the last 20 years.Methods: We performed a systematic literature review in Medline, Embase and Google Scholar (1999-2018), and Indian online medical journals, to find papers that reported deaths from all forms of poisoning in India, with last search 20 April 2020. We included epidemiological studies, observational studies, randomised trials, interventional studies, and case series published from 1999 to 2018 that showed the number of deaths and autopsy studies indicating the specific poisons or poison classes. Studies providing the case fatality for specific poisons or classes, which enabled calculation of the number of deaths, were also included. We excluded deaths due to animal bites and stings, ethanol or methanol poisoning, and gas inhalation as well as papers reporting a single death (case study of single patient). We grouped the papers into 5-year intervals and identified the two most common poison classes in each paper. We used descriptive statistics to summarise the findings over time based on the causative poison and the location of the study.Results: We identified 186 papers reporting 16,659 poisoning deaths between 1999 and 2018. The number of publications per 5-year interval showed no clear trend over the period (48, 38, 67, and 36 for consecutive periods). Half of the deaths (n = 8338, 50.0%) were reported during the first 5 years of the study (1999-2003), the number of deaths declining thereafter (to n = 1714 in 2014-2018). Deaths due to pesticide poisoning (94.5%) were dominant across the study period compared to other classes of poison [hair dye paraphenylenediamine poisoning (2.6%), medicine overdose (1.4%) or plant poisoning (1.0%)]. Among the pesticides, aluminium phosphide was the most important lethal poison during the first 10 years before declining markedly; organophosphorus insecticides were important throughout the period, becoming dominant in the last decade as aluminium phosphide cases declined. Unfortunately, few papers identified the specific organophosphorus insecticide responsible for deaths.Conclusion: Use of the published literature to better understand the epidemiology of lethal poisoning in India has clear limitations, including secular variation in publishing practices and interest in poisoning. Unfortunately, there are no long-term detailed, combination hospital and community studies from India to provide this information. In their absence, our review indicates that pesticides are the most important poison in India, with organophosphorus insecticides replacing aluminium phosphide as the key lethal poison after government regulatory changes in 2001 reduced the latter's lethality. Plant and hair dye poisoning and medicines overdose caused few deaths. Aluminium phosphide deaths mostly occurred in northern Indian states, whereas deaths from organophosphorus insecticide poisoning occurred throughout India. Paraquat poisoning has become a clinical problem in the last 10 years. Lethal pesticide poisoning remains alarmingly common, emphasising the need for additional regulatory interventions to curtail the burden of pesticide poisoning deaths in India. More detailed reporting about the specific pesticide involved in lethal poisoning will be helpful to guide regulatory decisions. [ABSTRACT FROM AUTHOR]

Background: People with intellectual disability die younger than their non‐disabled peers. In recent years, greater attention has been paid to closing the gap. However, evidence that this is being achieved is limited by the dearth of longitudinal, national data. Method: Over 4,000 decedents identified in the Irish National Intellectual Disability Database from 2001 to 2016 were compared to deaths in the general population based on age and gender profiles using death rates and standardised mortality ratios. A binary logistic regression analysis also identified the characteristics of persons who had a higher risk of dying. Results: Irish people with intellectual disability die younger and have a higher rate of death than their non‐disabled peers. Nor has the gap between their mortality and that of the general population closed in recent years. Conclusions: More concentrated effort is needed in Ireland on promoting equitable access to health services for people with intellectual disability. [ABSTRACT FROM AUTHOR]

Introduction: Systemic lupus erythematosus (SLE) is a multisystemic autoimmune disease, in which genetic and environmental factors are involved, that constitutes an important cause of morbidity and mortality in the population. For all of the above, and added to the fact that the epidemiology of SLE is poorly described in Chile, it is necessary to describe the deaths and mortality from this pathology in our country. General objective: To describe deaths from systemic lupus erythematosus according to sex, age group and region in Chile during the period 2016-2020. Materials and methods: Cross-sectional descriptive observational study. Deaths from SLE were studied as the basic cause of death (n = 388), according to sex, age group and region, during the period 2016-2020 in Chile. Data were obtained from the Department of Health Statistics and Information (DEIS). For the statistical analysis, the Microsoft Excel program was used. Due to the nature of the data, this study did not require a review by an ethics committee. Results: 388 deaths from SLE were studied and a mortality rate of 0,42 per 100.000 inhabitants was obtained throughout the period. Of all deads, 87,62% corresponded to women. The age group between 61 and 70 years was the one with the highest number of deaths (n = 106). The region with the highest mortality rate was Arica and Parinacota. Conclusions: SLE is a prevalent and complex pathology that determines an important morbidity and mortality in the general population. It was observed that deaths and the mortality rate from this pathology vary notably according to sex, age group and regions. [ABSTRACT FROM AUTHOR]

SARS-CoV-2 caused by beta-coronavirus RNA spread from the Chinese city of Wuhan in December 2019 and it had been a global pandemic. Today, more than sixty-six million cases of infection are registered in the world, moreover above one and half million people die. For today's situation, 137 000 individuals are infected and approximately 2 000 people die in Kazakhstan. To investigate the independent risk factors associated with Coronavirus-2 Severe Acute Respiratory Syndrome and mortality rate in Almaty (Kazakhstan). A retrospective study was provided according to the participants' medical records with the COVID- 19 and who were in the hospital in the period from June till August of 2020 in city hospital of Almaty, Kazakhstan. Among all 278 patients which were included to our issue 76 of them were unsurvived, and the rest were survived. The survey has been conducted in a retrospective design of the medical records of those people with COVID-19 and patients who have been registered in Almaty city hospital, Kazakhstan in the period of June to August of 2020. Among all 278 participants who attached to our release, 76 of them were dead. The correlation indirectly out of the seriousness of hepatocytes' cytolysis and the development in deceased patients severe type lymphopenia cause of the liver damage is a direct cytopathic effect on hepatocytes SARSCov2, since an absolute decrease in lymphocytes caused by virus-induced apoptosis correlated with the severity of viral load and is a significant and independent predictor of death. [ABSTRACT FROM AUTHOR]

Kyasanur Forest disease (KFD) is a tickborne hemorrhagic disease affecting primates along the Western Ghats mountain range in India. Our retrospective study indicated that >3,314 monkey deaths attributed to KFD were reported in KFD-endemic states in India during 1957-2020. These data can help guide surveillance to protect animal and human health. [ABSTRACT FROM AUTHOR]