Increased Risk of Suicide Attempts and Unintended Death Among Those Transitioning From Prison to Community in Later Life.

OBJECTIVE: The number of individuals transitioning from correctional facilities to community in later life (age ≥50 ) is increasing. We sought to determine if later-life prison release is a risk factor for suicidal behavior and death by accidental injury, including drug overdose. DESIGN: Retrospective cohort study. SETTING: U.S. Department of Veterans Affairs and Medicare healthcare systems, 2012-2014. PARTICIPANTS: Veterans age ≥50 released from correctional facilities (N = 7,671 re-entry veterans) and those never incarcerated (N = 7,671). METHODS: Dates of suicide attempt and cause-specific mortality defined using the National Suicide Prevention Applications Network and the National Suicide Data Repository, respectively. RESULTS: Later-life prison release was associated with increased risk of suicide attempt (599.7 versus 134.7 per 100,000 per year; adjusted hazard ratio [HR] 3.45; 95% confidence interval [CI] 2.24-5.32; p < 0.001, Wald χ2 = 31.58, degrees of freedom [df] = 1), death by drug overdose (121.7 versus 43.5; adjusted HR 3.45; 95% CI 1.37-8.73; p = 0.009, Wald χ2 = 6.86, df = 1), and other accidental injury (126.0 versus 39.1; adjusted HR 3.13; 95% CI 1.28-7.69; p = 0.013, Wald χ2 = 6.25, df = 1), adjusting for homelessness, traumatic brain injury, medical and psychiatric conditions, and accounting for competing risk of other deaths. Suicide mortality rates were observed as nonsignificant between re-entry veterans and those never incarcerated (30.4 versus 17.4, respectively; adjusted HR 2.40; 95% CI 0.51-11.24; p = 0.266, Wald χ2 = 1.23, df = 1). CONCLUSION: Older re-entry veterans are at considerable risk of attempting suicide and dying by drug overdose or other accidental injury. This study highlights importance of prevention and intervention efforts targeting later-life prison-to-community care transitions.

Does dental trauma in the primary dentition increases the likelihood of trauma in the permanent dentition? A longitudinal study.

OBJECTIVES: The aim of this longitudinal study was to assess the likelihood of children suffering traumatic dental injuries in the permanent dentition subsequent to traumatic dental injuries in their primary dentition. MATERIALS AND METHODS: A longitudinal study was conducted in Pelotas, Brazil. Children were assessed in 2007, when they were aged 2-5 years, and in 2013, at which time, they were aged 8-11 years. Data collection included interviews with parents and clinical oral examination for dental trauma and occlusion. The classification proposed by Andreasen and Andreasen was used, and crown discoloration and fistula were added to this criterion in order to assess pulp involvement. Child/parent report was used to aid in the diagnosis of both treated and untreated injuries. As a limitation, no radiographs were taken. Descriptive, univariate, and multivariate logistic regression analyses were performed. RESULTS: A total of 110 children were included. Dental trauma frequency in the primary dentition was 38.2% and that in the permanent dentition was 30.9%. In the multivariate analyses, children with dental trauma in the primary dentition showed a higher likelihood of suffering dental trauma in the permanent dentition [odds ratio (OR) 2.97, 95% confidence interval (CI) 1.01-8.91, P = 0.05]. CONCLUSIONS: Individuals with previous trauma in the primary dentition are prone to further trauma in the permanent dentition. The history of dental trauma may be used to predict dental trauma in the permanent dentition and to establish preventive measures. CLINICAL RELEVANCE: Behavioral characteristics may be related to the risk of a child suffering injuries. The results suggested that some children are accident-prone.

The attention-deficit/hyperactivity disorder model for traumatic dental injuries: a critical review and update of the last 10 years.

It has been more than 10 years since the proposal of attention-deficit/hyperactivity disorder (ADHD) model as an explanatory construct for traumatic dental injuries (TDIs) in children. The aim of this review was to address developments in the study of the issue after 2005-2016. A systematic literature search covering the period from 2005 to 2016 was conducted on PubMed, the Cochrane library and Google Scholar using relevant keywords. Fourteen studies exploring the relationship between ADHD and TDIs from 2005 and onward (including the proposal paper) were identified. Of the 12 controlled studies, nine reported confirming findings for a link with ADHD in the occurrence of TDIs. More than one-third of all children with ADHD may suffer from TDIs. In ADHD children, the most common types of injury were uncomplicated/complicated crown fractures and subluxation of maxillary central incisors resulting from falls and collisions. There is also evidence that ADHD represents an independent risk factor other than the well-established risk factor of incisor overjet. Over the last 10 years, convincing evidence has accumulated that ADHD is an important and common risk factor for TDIs. Increased awareness and side-by-side work of medical, dental and mental professionals at both clinical and research settings are necessary.

[Incidence of accident proneness and its influencing factors in rural children].

OBJECTIVE: To investigate the incidence of accident proneness and its influencing factors in rural children. METHODS: By random cluster sampling, 1 560 children were enrolled from one rural area in Hunan Province, China, and were surveyed with self-designed general and injury questionnaires. Unconditional multivariate logistic regression analysis was used to explore the major risk factors for accident-prone children. RESULTS: One hundred and forty-seven accident-prone children were screened out and the incidence of accident proneness was 9.42%. Univariate analysis showed that gender (P<0.01), academic record (P<0.01), left-behind status (P<0.05), family type (P<0.05), family economic status (P<0.01), guardian's gender (P<0.05), guardian's marital status (P<0.05), guardian's occupation (P<0.05), and family educational mode (P<0.05) were influencing factors for accident proneness in rural children. Multivariate logistic regression analysis further revealed that low grade (OR=3.683, 95%CI: 1.028-4.283) and very low grade (OR=2.099, 95% CI: 1.587-8.546) in academic record, poverty in family economic status (OR=2.353, 95% CI: 1.222-4.533), and indulgence or indifference (OR=1.914, 95% CI: 1.029-3.559) and fickleness (OR=4.153, 95% CI: 1.847-9.338) in guardian's educational mode were risk factors for accident proneness in rural children, while female gender (OR=0.539, 95% CI: 0.369-0.788) was a protective factor. CONCLUSIONS: Low academic record, poor family economy, and incorrect family education mode (indulgence or indifference and fickleness) would increase the incidence of accident proneness in rural children, but girls have less accident proneness than boys.

[Sleep disorders and work: guidelines for health surveillance, risk management and prevention]. / I disturbi del sonno in ambito lavorativo: indirizzi di sorveglianza sanitaria, prevenzione e gestione del rischio.

Sleep disorders and related diseases are becoming increasingly relevant for the health and wellbeing of the general and working populations. Sleep disorders affect all aspects of health, showing a bi-directionality with health conditions and comorbidity with several diseases. Consequently, sleep disorders may have severe negative consequences both for the individual and the enterprise, as well as for society on the whole, in terms of health, productivity and social costs. When considering the disturbances of the sleep/wake cycle, it is important to distinguish between those connected with endogenous biological factors from those related to socio-environmental conditions, including work, and those associated with mental and physical diseases, that are often associated and interact with each other. Many sleep disorders are still underestimated and under-valued in clinical practice and, to a much greater extent, in workers' health surveillance. The present paper is aimed at drawing the attention of the occupational health physician to some key issues, particularly regarding excessive daytime sleepiness, obstructive sleep apnea syndrome and shift and night work, as well as their implications in terms of health and occupational consequences. Information on the main aspects of clinical diagnosis and health surveillance, as well as risk management and prevention at the workplace, are provided.

Personality correlates of accident-proneness in auto-rickshaw drivers in India.

OBJECTIVE: We examined the personality correlates of accident-proneness of auto-rickshaw drivers in the Indian city of Ranchi. METHODS: This was a cross-sectional study in which 50 male drivers aged 18-50 years, selected randomly from a list of licensed auto-rickshaw drivers in Ranchi, were assessed with a Hindi version of Cattell's 16 Personality Factors (16-PF) Questionnaire. RESULTS: There was a significantly higher frequency of breaking rules, crossing speed limits, substance use and a trend towards a higher frequency of carrying extra persons (i.e., more than recommended) in accident-prone drivers. There was significant negative correlation of accident-proneness with 16-PF factors such as reasoning, rule consciousness, apprehension and emotional stability. CONCLUSION: Personality characteristics with lower scores of reasoning, rule consciousness, apprehension and emotional stability are common in commercial auto-rickshaw drivers with high accident-proneness.

Exploring safety culture research in the construction industry.

BACKGROUND: Despite numerous regulatory initiatives to improve health and safety in the construction industry, it still ranks as one of the most accident-prone industries worldwide. A dedicated focus on safety culture has been suggested as a complement to laws, regulations and management systems. OBJECTIVE: This article explores safety culture research conducted in the construction industry, with the aim to provide insight into the specific themes that tend to be in focus as well as what theoretical and methodological approaches that tend to be favored. METHODS: Searches in scientific databases were conducted twice. In a first attempt, searches resulted in 54 hits but only two articles fit the scope of the study. A revision of the search phrase resulted in 124 hits. Ultimately, 17 articles fit the scope of the study and were included. The content of the articles was analyzed and sorted thematically. RESULTS: The results show that four themes are prevalent in the existing literature: 1) unique challenges entail a need for situated applications, 2) models developed to operationalize safety culture, 3) measuring safety culture, and 4) safety management and leadership as key factors. CONCLUSION: Although research focusing on the construction industry has come to favor certain study designs and definitions of safety culture, further research may be enriched by broadening the theoretical and methodological perspectives. Specifically, researchers should conduct more in-depth qualitative studies that take the complexity of the industry into account, including the interpersonal relations between the actors involved.

Accident proneness, laterality, and time estimation.

Cerebral laterality has been linked to accident proneness and time perception, but the possible role of time estimation abilities has received little attention. Accordingly, the present study focused on this under-explored question while also aiming to replicate past work examining the relationship between measures of laterality and injury proneness. Participants reported on the number of accidents they have had in their lifetime requiring medical care and the number of minor accidents they had in the past month as outcome variables. They also completed the Waterloo Handedness Questionnaire, a left bias visual task (Greyscales task), a right bias auditory verbal task (Fused Dichotic Words Task), and an objective measure of time perception. Extensive examination of statistical model fit showed that a model assuming a Poisson distribution provided the best fit for minor injuries and an additional negative binomial provided the best fit to the lifetime accidents. Results showed a negative relation between the degree of verbal laterality (absolute right bias) and injuries requiring medical care. Furthermore, the number of accidents requiring medical care was positively related to the precision of time estimation and the direction of verbal laterality on response time (raw right bias). Interpretations of these findings emphasize their implications for interhemispheric communication and motor control in the context of time estimation and auditory verbal laterality. These aspects seem to provide promising avenues for future research.

Personal and family perfectionism of Taiwanese college students: relationships with depression, self-esteem, achievement motivation, and academic grades.

An increasing number of perfectionism studies have been conducted across different countries outside of the Western framework. Using an international egalitarian approach that adopts indigenous frameworks and concepts from the cultural context of the population studied is imperative. This study examines different groups of perfectionists with a sample of 348 Taiwanese college students, emphasizing the collectivistic culture. In particular, this is a follow-up study to further explore characteristics of a group with low standards/high discrepancy--a feeling that they are not good enough despite having low standards--found in a previous study with Taiwanese students. More specifically, this study investigates whether the source of the high discrepancy scores among this group is related to having higher perfectionistic standards from their family. Perfectionism was examined not only from a personal/individualistic perspective, but also from a familistic dimension to reflect Taiwanese collectivistic cultural values. Results partially supported the hypotheses--this group reported having higher family discrepancy, but not family standards, than nonperfectionists. However, this group of participants reported lower academic grades, which implies the possibility of their discrepancy being associated with poorer performance. Four cluster groups--adaptive perfectionists, maladaptive perfectionists, nonperfectionists, and those with low standards/high discrepancy--were compared on their levels of depression, self-esteem, achievement motivation, and academic grades. Maladaptive perfectionists reported the highest depression level, while adaptive perfectionists reported the highest self-esteem. Results also show that aspects of personal perfectionism and family perfectionism related to self-esteem differently among this sample. Findings and implications are discussed with consideration of the collectivistic cultural context in Taiwan.

The long-term psychological effect of fatal accidents at sea on survivors: a cross-sectional study of North-Atlantic seamen.

OBJECTIVE: This study aimed to ascertain whether disasters at sea had an enduring traumatic effect on psychological functioning, accident proneness, and on their interest to continue working at sea. METHOD: Crew members of selected sea-disasters were contacted. The chosen disasters were of differing severity and in some cases fatalities had occurred. The disasters had taken place on average 8 years previously. Those who agreed to participate were interviewed in a semi-structured interview. They also answered the CIDI; DIS; GHQ-30; IES, and PTSS-10. One hundred-and-twelve seamen who had been in disasters were compared with a comparison group consisting of 59 peers who had not been in a disaster. RESULTS: Survivors of fatal disasters experienced more long-lasting negative effects than did others where lives were not lost. They had more frequently unpleasant intrusive thoughts on the IES (p < 0.01) compared with their peers. On the DIS, they also more frequently experienced heightened arousal (p < 0.001), sleep problems (p < 0.01), and nightmares (p < 0.01). The duration of PTSD symptoms from the time of the disaster was on average 18 months. Over 33% of the disaster group had experienced some PTSD symptoms within the past 12 months. Disaster survivors had not quit seamanship as frequently as non-disaster seamen. CONCLUSION: The most severe and long-lasting symptoms were found among those who had been in disasters where one or more crew members had perished. Loss of life in disasters therefore seems significant in the process of creating or extending the endurance of symptoms of psychological vulnerability.

Pilot age and geographic region of commuter and air taxi crashes: a case-control study.

BACKGROUND: Previous studies of major airline and general aviation crashes have identified a host of risk factors. We examined risk factors related to crashes involving commuter air carrier and air taxi flights. METHODS: A matched case-control design was applied to assess the association of pilot age, total flight time, and geographic region with commuter air carrier and air taxi crashes (14 CFR Part 135) from 1983-2002 in the United States. A total of 2033 commuter air carrier or air taxi crashes from the National Transportation Safety Board aviation crash database were identified as eligible cases. Controls were randomly selected incidents from the Federal Aviation Administration's (FAA) aviation incident database coded under Part 135 operation. RESULTS: Relative to controls, commuter air carrier and air taxi crashes were less likely to occur in pilots under 30 yr of age (adjusted odds ratio 0.68, 95% confidence interval 0.54-0.88) after adjusting for geographic region and total flight time. With adjustment for pilot age and total flight time, the commuter air carrier and air taxi crashes with pilot error were nearly 13 times as likely to be in Alaska as their matched controls (adjusted odds ratio 12.84, 95% confidence interval 5.24-31.45). CONCLUSIONS: These results suggest that pilot age may be associated with risk of crash involvement in Part 135 operations. The excess crash risk in Alaska with or without pilot error underscores the importance of environmental hazards in flight safety.

The effects of psychological risk factors at work on cognitive failures through the accident proneness.

BACKGROUND: Various agents such as psychosocial items and accident proneness can affect cognitive failures through different paths. The probable paths are the direct effects of workplace psychosocial items on cognitive failures and their indirect effects on cognitive failures through the mediator variable of accident proneness, which has not yet been studied by others. Thus, the present study aimed to investigate these paths. METHODS: This cross-sectional study was conducted on 164 male employees of Karoon Sugar Company in 2018. The participants were asked to complete a background and demographic questionnaire, Broadbent cognitive failures scale, accident proneness questionnaire, and Copenhagen psychosocial questionnaire. Obtained data were analyzed and modeled using the statistical descriptive method, ANOVA, independent t-test, Pearson correlation test, and path analysis in the SPSS and AMOS software. RESULTS: The results of the path analysis showed that, not only, some psychosocial risk items had a significant direct effect on cognitive failures, but also, they could affect cognitive failures through the accident proneness, indirectly. Work-family conflict and social support from supervisors by coefficients of 0.188 and - 0.187 had the highest direct effects, respectively. The highest indirect effects belonged to justice and respect, and work-family conflict by coefficients of - 0.220 and 0.199, respectively. The highest total effects were also related to the work-family conflict and justice and respect by coefficients of 0.387 and - 0.381, respectively. CONCLUSIONS: In total, our results showed that some psychological items could, directly and indirectly, increase cognitive failure through accident proneness.

Configural approaches to temperament assessment: implications for predicting risk of unintentional injury in children.

This study used two configural approaches to understand how temperament factors (surgency/extraversion, negative affect, and effortful control) might predict child injury risk. In the first approach, clustering procedures were applied to trait dimensions to identify discrete personality prototypes. In the second approach, two- and three-way trait interactions were considered dimensionally in regression models predicting injury outcomes. Injury risk was assessed through four measures: lifetime prevalence of injuries requiring professional medical attention, scores on the Injury Behavior Checklist, and frequency and severity of injuries reported in a 2-week injury diary. In the prototype analysis, three temperament clusters were obtained, which resembled resilient, overcontrolled, and undercontrolled types found in previous research. Undercontrolled children had greater risk of injury than children in the other groups. In the dimensional interaction analyses, an interaction between surgency/extraversion and negative affect tended to predict injury, especially when children lacked capacity for effortful control.

Differences by sex and handedness in right and left femur bone mineral densities.

Left-handedness was reported to be a risk factor for accident-related injuries, head injuries, traumatic brain injuries, sport-related injuries, and bone breaks and fractures. As decreased bone mineral density is a good marker of bone fractures, the femoral bone mineral densities of normal left-handed university students were compared with those of right-handed students. Hand preference of 66 men and 47 women was assessed using the Edinburgh Handedness Inventory. Measures of bone mineral density with a Hologic QDR-4500W (S/N 48403) densitometer showed bone mineral densities of both right and left proximal femur regions were higher in right-handed than in left-handed students. These results are consistent with the claim that left-handed participants had higher trauma and injury risk. Also, these results may explain the sex-related differences by handedness for susceptibility in accident-related injuries such as bone fractures.

In hospital falls of a large hospital.

OBJECTIVES: The present database contains information on patient falls in the hospital setting. Data were collected in January 2018 with of describing in-hospital falls reported from 1st January 2012 to 31 December 2017 in a large hospital in the South of Brazil. Learning about the characteristics of these events and establishing a profile may contribute to the design of adequate prevention and improvement strategies that are effective to reduce the risk of falls. DATA DESCRIPTION: This data set encompasses 1.071 in-patients falls characterized by the follow variables: year, date, patient birth, weekday, shift, department/location of the incident, location, severity, presence of companion, age, sex, risk level, medication associated with fall risk, implemented fall prevention protocol, type of injury, reason, restraint prescription, physical therapy prescription.

Dynamic stability differences in fall-prone and healthy adults.

Typical stability assessments characterize performance in standing balance despite the fact that most falls occur during dynamic activities such as walking. The objective of this study was to identify dynamic stability differences between fall-prone elderly individuals, healthy age-matched adults, and young adults. Three-dimensional video-motion analysis kinematic data were recorded for 35 contiguous steps while subjects walked on a treadmill at three speeds. From this data, we estimated the vector from the center-of-mass to the center of pressure at each foot-strike. Dynamic stability of walking was computed by methods of Poincare analyses of these vectors. Results revealed that the fall-prone group demonstrated poorer dynamic stability than the healthy elderly and young adult groups. Stability was not influenced by walking velocity, indicating that group differences in walking speed could not fully explain the differences in stability. This pilot study supports the need for future investigations using larger population samples to study fall-prone individuals using nonlinear dynamic analyses of movement kinematics.

Traumatic dental injuries in twins: is there a genetic risk for dental injuries?

Traumatic dental injuries are a major cause of morbidity among children. Investigation of risk factors of dental trauma is important to take preventive measures in patients at high risk for tooth accidents. The aim of this work was to conduct a pilot study in twins, assessing concordance of suffered traumatic dental and facial injuries. Comparison of concordances between monozygotic and dizygotic twin pairs was performed in order to investigate possible genetically determined accident-proneness. Standardized interviews were conducted focusing on the frequency of orofacial accidents and their circumstances. In addition, the front teeth of all participating twins were clinically examined. A total of 104 twins (52 twin pairs) were surveyed: 31 of the 52 twin pairs were DZ and 21 pairs were MZ. 36 (34.6%) of the 104 interviewees had already suffered from a tooth injury, whereas 53 (51%) of the participants had experienced a facial injury. Investigation of concordances of suffered traumatic dental injuries revealed that 66.7% of the MZ twin pairs and 58.1% of the DZ pairs were concordant. With respect to facial traumata, 52.4% of the MZ pairs compared to 58.1% of the DZ pairs were concordant. Differences between zygosity were not statistically significant (P >/= 0.05). With the present pilot study, no statistical evidence of genetic risk for dental and facial injuries could be displayed. On the contrary, environmental factors seem to dominate in determining an individual's risk for orofacial traumata.

The syndrome of accident proneness (Unfallneigung): why psychiatrists did not adopt and medicalize it.

In the World War I period, psychologists in Britain and Germany independently and simultaneously originated the idea of accident proneness (Unfallneigung). This distinctive syndrome of suffering a series of accidents was logically attractive for psychiatrists and psychoanalysts, especially as a pattern of unconsciously motivated deviant and self-destructive behaviour. Yet except for some mid-twentieth-century interest by psychosomatics specialists, psychiatrists did not systematically embrace the syndrome except occasionally as a symptom of other psychiatric conditions, thus showing that there were limits to the extent to which twentieth-century psychiatrists would medicalize patterns of behaviour.

[Keys to preventing accidents in children in the school context]. / Claves infantiles para prevenir la siniestralidad en el contexto escolar.

OBJECTIVE: To learn about children's perception of the causes and prevention strategies involved in school accidents. METHOD: The sample included 584 school children aged 8-9 years from Navarra. A mixed design was chosen by questionnaire with three open-response questions and one multiple-choice assessment. Analysis was performed in two phases: 1) qualitative development of categories and dimensions of the responses of narrative content, and 2) quantitative variables for recoding correlational analysis. RESULTS: 22 categories emerged, which make up three perceptual dimensions: 1) attribution of causality (5), 2) identification of mechanisms of avoidance (11), and 3) development of coping strategies (6). The correlation intra-variables portray varying degrees: on the one hand, moderate positive numbers (r>0.5) in allocating and identifying causality avoidance mechanisms and, on the other hand, high positive correlation values (r>0.7) referred to developing coping strategies. DISCUSSION: Children are able to identify accidents as a health problem. They question the multiplicity of elements involved and relate the origin and kind of accident to prevention and support mechanisms.