Messaging Affects the Behavior of African American Parents with Regards to Soft Bedding in the Infant Sleep Environment: A Randomized Controlled Trial.

OBJECTIVE: To evaluate the impact of specific health messages on the decisions of African American parents regarding soft bedding use, specifically related to the high degree of self-efficacy that African American parents have with regards to preventing infant suffocation vs low self-efficacy with regards to sudden infant death syndrome (SIDS) risk reduction. STUDY DESIGN: We conducted a randomized, controlled clinical trial of African American mothers of infants. The control group received standard messaging emphasizing safe sleep practices recommended by the American Academy of Pediatrics for the purposes of SIDS risk reduction. The intervention group received enhanced messaging emphasizing safe sleep practices for both SIDS risk reduction and suffocation prevention. Participants completed interviews at 2-3 weeks, 2-3 months, and 5-6 months after the infant's birth. RESULTS: Of 1194 mothers enrolled, 637 completed all interviews. The use of soft bedding both in the past week and last night declined with age (P < .001). Infants in the enhanced group had a lower rate of use of soft bedding in the past week (P = .006) and last night (P = .013). Mothers who received the enhanced message were more likely to state that they avoided soft bedding to protect their infant from suffocation. CONCLUSIONS: African American mothers who receive an enhanced message about SIDS risk reduction and suffocation prevention are less likely to use soft bedding in their infant's sleep environment. TRIAL REGISTRATION: ClinicalTrials.gov: NCT01361880.

The recent fall in postperinatal mortality in New Zealand and the Safe Sleep programme.

AIM: Postneonatal mortality rates changed very little from 2000 until recently. There has been a decrease in mortality in New Zealand from 2009 to 2015. This study describes an infant Safe Sleep programme and postulates it is the cause for the recent decrease in deaths. METHODS: The Safe Sleep programme involved as follows: a focus on preventing accidental suffocation, a 'blitz' approach to SUDI education, the targeted provision of portable infant Safe Sleep devices (ISSD) and the development of Safe Sleep policy across all district health boards (DHBs). RESULTS: Participation in the education 'blitz' by health professionals exceeded one in 23 live births, distribution of Safe Sleep leaflets exceeded two for every live birth, and over 16 500 ISSDs have been distributed to vulnerable infants. Postperinatal mortality fell 29% from 2009 to 2015 (2.8 to 2.0/1000 live births). The fall has been greatest for Maori and in regions with the most intensive programmes. CONCLUSION: The recent fall in postperinatal mortality has not happened by chance. It is likely that the components of end-stage prevention strategy, a focus on preventing accidental suffocation, the education 'blitz', the targeted supply of ISSDs and strengthened health policy, have all contributed to varying degrees.

Hospitalizations for unintentional injuries among Canadian adults in areas with a high percentage of Aboriginal-identity residents.

INTRODUCTION: Injuries are a leading cause of death and morbidity. While individual Aboriginal identifiers are not routinely available on national administrative databases, this study examines unintentional injury hospitalization, by cause, in areas with a high percentage of Aboriginal-identity residents. METHODS: Age-standardized hospitalization rates (ASHRs) and rate ratios were calculated based on 2004/2005-2009/2010 data from the Discharge Abstract Database. RESULTS: Falls were the most frequent cause of injury. For both sexes, ASHRs were highest in high-percentage First Nations-identity areas; high-percentage Métis-identity areas presented the highest overall ASHR among men aged 20-29 years, and high-percentage Inuit-identity areas presented the lowest ASHRs among men of all age groups. Some causes, such as falls, presented a high ASHR but a rate ratio similar to that for all causes combined; other causes, such as firearm injuries among men in high-percentage First Nations-identity areas, presented a relatively low ASHR but a high rate ratio. Residents of high-percentage Aboriginal-identity areas have a higher ASHR for hospitalization for injuries than residents of low-percentage Aboriginal-identity areas. CONCLUSION: Residents of high-percentage Aboriginal-identity areas also live in areas of lower socio-economic conditions, suggesting that the causes for rate differences among areas require further investigation.

TITRE: Hospitalisations pour blessures non intentionnelles chez les adultes au Canada, dans les régions ayant un fort pourcentage de résidents d'identité autochtone. INTRODUCTION: Les blessures constituent une cause importante de décès et de morbidité. Bien qu'aucun indicateur d'identité autochtone ne soit directement disponible dans les bases de données administratives nationales, cette étude porte sur les hospitalisations pour blessure non intentionnelle, selon la cause, dans les régions ayant un fort pourcentage de résidents d'identité autochtone. MÉTHODOLOGIE: Nous avons calculé les taux d'hospitalisation normalisés selon l'âge (THNA) et les rapports de taux pour 2004-2005 à 2009-2010, à partir de la Base de données sur les congés des patients. RÉSULTATS: Les chutes étaient la cause principale de blessure. Les THNA étaient plus élevés pour les hommes comme pour les femmes dans les régions ayant un fort pourcentage de membres des Premières nations; dans les régions ayant un fort pourcentage de Métis, c'est chez les hommes de 20 à 29 ans que le THNA global était le plus élevé, tandis qu'il était le plus bas chez les hommes de tous les groupes d'âge dans les régions à fort pourcentage d'Inuits. Certaines causes, telles que les chutes, étaient associées à un THNA élevé mais avec un rapport de taux semblable à celui observé pour toutes causes confondues; d'autres causes, comme les blessures par arme à feu chez les hommes dans les régions à fort pourcentage de membres des Premières nations, présentaient un THNA relativement faible mais un rapport de taux élevé. Les résidents des régions à fort pourcentage d'Autochtones présentaient un THNA pour blessure plus élevé que ceux des régions à faible pourcentage d'Autochtones. CONCLUSION: Les résidents des régions à fort pourcentage d'Autochtones vivent dans des régions dont le statut socioéconomique était faible, ce qui invite à une recherche plus approfondie à propos des différences de taux entre régions.

Impulsive but fatal self-poisoning with pesticides among South Asians in Nickerie, Suriname.

BACKGROUND: Intentional self-poisoning with pesticides is a serious problem in many developing countries. It is a commonly used method among South Asians all over the world. AIMS: To describe the circumstances and characteristics of suicides in Nickerie, e, in order to gain insight into why South Asians commonly use self-poisoning. METHODS: An exploratory psychological autopsy study was conducted among 19 survivors of 13 suicides in the Nickerie district in Suriname. RESULTS: Impulsivity plays an important role in self-poisonings, as well as aggression and easy accessibility of pesticides. CONCLUSIONS: Possible answers to the question why South Asians often use self-poisoning as a method for suicide may be found in culture, upbringing, styles of communication and genetics. However, more research is needed to further explore these hypotheses.