The effects of gender on adolescent suicide in ontario, Canada.

OBJECTIVE: Identify patterns of suicide amongst male and female adolescents aged 11-18 years in Ontario. METHOD: All 370 adolescent suicides in Ontario between January 2000 and November 2006 were analyzed. Previous attempts, history of psychiatric treatment, location committed and method of suicide were assessed. Data was analyzed using 2-tailed t-tests and chi-square without Yates' correction. RESULTS: Male adolescent suicide was twice as common as female suicide. Males were more likely to use violent methods (p=0.0352) and females were more likely to have a history of a previous suicide attempt (p=0.0001). CONCLUSIONS: While most of the data agree with previous studies in adult populations, the ratio of male to female suicides was much lower in our adolescent population.

Are infants exposed to methadone in utero at an increased risk for mortality?

BACKGROUND: The prevalence of opioid abuse is increasing in North America. Opioid abuse during pregnancy can cause medical, obstetric and psychosocial complications. Neonates exposed to opioids in utero often develop the neonatal abstinence syndrome. Methadone maintenance therapy is the treatment of choice for maternal opioid dependency. There have been unsupported concerns that infants cared for by mothers treated with methadone have higher mortality rates during the first year of life than in the general population. OBJECTIVES: To compare the mortality rates of infants exposed to methadone in utero to those of general population in Ontario, Canada. METHODS: We utilized several provincial and national databases including those of the Office of the Chief Coroner of Ontario, the Canadian Institute for Health Information, and the Ontario Infant Mortality Rate Report. Reference organ weights were obtained from the peer reviewed literature. RESULTS: The Office of the Chief Coroner of Ontario has reported 8 deaths in children under one associated with in utero methadone exposure between January 1, 2006 and December 31, 2010. Over the same period there have been a total of 1103 cases of neonatal abstinence syndrome recorded in the province. The mean infant mortality rate in Ontario for children under the age of 1year over the same period was 5.2 per 1000 live births. The odds ratio for mortality among children with neonatal abstinence syndrome was not different from that in the general population [OR 1.45 (95% confidence interval 0.471-4.459)] (p=0.56). CONCLUSION: The available data do not support the concerns that children under the age of one year, born to mothers on methadone maintenance therapy (MMT) are at an increased risk for mortality.

Pediatric fire deaths in Ontario: retrospective study of behavioural, social, and environmental risk factors.

OBJECTIVE: To identify the predictors of residential fire deaths in the Ontario pediatric population using systematically collected data from the Office of the Chief Coroner. DESIGN: Retrospective cohort study. SETTING: Ontario. PARTICIPANTS: Children younger than 16 years of age who died in accidental residential fires in Ontario between January 1, 2001, and December 31, 2006. MAIN OUTCOME MEASURES: The study retrospectively reviewed the coroner's case files for 60 subjects who qualified according to the selection criteria. Reviewed documents included the coroner's investigation statements, autopsy reports, toxicology reports, fire marshal's reports, police reports, and Children's Aid Society (CAS) reports. Information on a range of demographic, behavioural, social, and environmental factors was collected. Statistical tests, including relative risk, relative risk confidence intervals, and χ(2) tests were performed to determine the correlation between factors of interest and to establish their significance. RESULTS: Thirty-nine fire events resulting in 60 deaths occurred between 2001 and 2006. Fire play and electrical failures were the top 2 causes of residential fires. More fires occurred during the night (midnight to 9 AM) than during the day (9 AM to midnight). Nighttime fires were most commonly due to electrical failures or unattended candles, whereas daytime fires were primarily caused by unsupervised fire play and stove fires. Smoke alarms were present at 32 of 39 fire events (82%), but overall alarm functionality was only 54%. Children from families with a history of CAS involvement were approximately 32 times more likely to die in fires. CONCLUSION: Risk factors for pediatric fire death in Ontario include smoke alarm functionality, fire play, fire escape behaviour, and CAS involvement. Efforts to prevent residential fire deaths should target these populations and risk factors, and primary care physicians should consider education around these issues as a primary preventive strategy for families with young children.