Socio-Ecological Nature of Drowning in Low- and Middle-Income Countries: A Review to Inform Health Promotion Approaches

Most deaths by drowning (91%) have occurred in low- and middle-income countries (LMICs), particularly in Southeast Asia (35%) and Africa (20%), in proportion to total drowning deaths worldwide. Poor data collection in LMICs hinders the planning, implementation, and evaluation of prevention strategies. The objective of this study was to review the rates and risk factors of unintentional drowning in LMICs and to identify drowning prevention strategies within a socio-ecological health promotion framework. A systematic search, guided by PRISMA, was conducted on Ovid MEDLINE, CINAHL, Informit health, PsycINFO (ProQuest), Scopus, SafetyLit, Google Scholar, and BioMed Central databases for all relevant studies published between 2012 and 2017. McMaster appraisal guideline was used for critical review. The disparity of available drowning data was observed across selected countries. The highest rates were identified in low-middle income South-east Asian countries. The socio-economic background of the family, overcrowding, and living close to water bodies were important predictors for paediatric drowning in LMICs, while the presence of mother as caregiver was identified as a protective factor. The over-reliance on active injury prevention strategies was identified. Further research focusing on developing relevant upstream drowning prevention and water safety promotion is needed to ensure the sustainability of drowning prevention in LMICs

Physiotherapy Students’ Attitudes Toward Working With People With Dementia: A Cross-Sectional Survey

Aims: To understand personal, educational and clinical experiences and the attitudes of physiotherapy students towards people with dementia. Methods: Online survey questionnaire. Physiotherapy students in the last year of a two-year Masters of Physical Therapy (MPT) entry-to-practice degree program (n = 59) were surveyed. Descriptive statistics were used to analyze the data. Results: Fifty-five students participated (93%). The majority of students (n = 52/55, 77%) had at least one clinical placement working with people with dementia. Overall, 53% (n = 29/55) felt their academic training was sufficient to effectively work with people with dementia. Moreover, 82% (n = 45/55) reported their confidence was greatest working with people who could communicate well verbally. Conclusions: Disease-based knowledge was strong, yet just over half felt their academic training was sufficient to effectively work with people with dementia. The findings support the need for more training, particularly in communication strategies, to support students to effectively work with client with dementia upon graduation

Epidemiology of unintentional fatal drowning among migrants in Australia

Objective: This study aimed to describe the epidemiology and risk factors contributing to drowning among migrants in Australia. Methods: A total population retrospective epidemiological study of unintentional drowning deaths in Australia between 1 July 2009 and 30 June 2019 of people born outside Australia (migrants). Cases were extracted from the National Coronial Information System. Descriptive statistics, chi-square and relative risk were calculated. Crude drowning rates were based on country of birth and population in Australia. Results: There were 572 migrant deaths over the study period, 28.9% of total drowning deaths, 82.9% were male. Twenty-one per cent were aged 25–34 years and 40.8% had lived in Australia for 20+ years. Migrants at highest risk of drowning were from: South Korea (2.63/100,000 95%CI: 0.85–8.25), Taiwan (2.29/100,000 95%CI: 0.27–13.44), and Nepal (2.15/100,000 95%CI: 0.23–11.55). Migrants were more likely to drown when around rocks (p<0.001) compared with Australian-born people, who most frequently drowned in rivers (p<0.001). Conclusions: Migrants are not over-represented in drowning statistics. However, unique trends were found for drowning among migrants based on country of birth and length of time in Australia. Implications for public health: Holistic drowning prevention strategies and policies are required to effectively lower drowning risk among migrant communities

Fatal drowning in Indonesia: understanding knowledge gaps through a scoping review

Little is known about unintentional drowning deaths in Indonesia, the world’s fourth most populous and largest archipelagic country. This study aimed to describe the epidemiology and risk factors of unintentional drowning in Indonesia and explore existing health promotion and drowning prevention approaches in Indonesia within a socio-ecological health promotion framework. A scoping review, guided by PRISMA-ScR, was conducted to locate peer-reviewed studies and government reports/policy documents published until May 2023, in English or Indonesian language, using MEDLINE (Ovid), CINAHL, Informit, PsycINFO (ProQuest), Scopus, SafetyLit, BioMed Central and Google Scholar, Indonesian journal databases (Sinta, Garuda) and government agencies websites around the terms: drown, swim, flood, hurricane, cyclone, disaster, water rescue and maritime/boat safety. This review identified 32 papers. However, a paucity of information on unintentional drowning rates, risk factors and prevention in Indonesia was noted. The unavailability of a coordinated national drowning data collection system in Indonesia, from which national and subnational subcategory data can be collected, underlines the possibility of under-representation of drowning mortality. The association between various exposures and drowning incidents has not been fully investigated. An over-reliance on individual-focused, behaviour-based, preventive measures was observed. These findings highlight the need for improving drowning surveillance to ensure the availability and reliability of drowning data; and strengthening research to understand the risk factors for drowning and delivery of drowning prevention programs. Further policy development and research focusing on health promotion approaches that reflect a socio-ecological approach to drowning prevention in Indonesia is imperative

Treatment of the lung injury of drowning: a systematic review

Background: Drowning is a cause of significant global mortality. The mechanism of injury involves inhalation of water, lung injury and hypoxia. This systematic review addressed the following question: In drowning patients with lung injury, what is the evidence from primary studies regarding treatment strategies and subsequent patient outcomes? Methods: The search strategy utilised PRISMA guidelines. Databases searched were MEDLINE, EMBASE, CINAHL, Web of Science and SCOPUS. There were no restrictions on publication date or age of participants. Quality of evidence was evaluated using GRADE methodology. Results: Forty-one papers were included. The quality of evidence was very low. Seventeen papers addressed the lung injury of drowning in their research question and 24 had less specific research questions, however included relevant outcome data. There were 21 studies regarding extra-corporeal life support, 14 papers covering the theme of ventilation strategies, 14 addressed antibiotic use, seven papers addressed steroid use and five studies investigating diuretic use. There were no clinical trials. One retrospective comparison of therapeutic strategies was found. There was insufficient evidence to make recommendations as to best practice when supplemental oxygen alone is insufficient. Mechanical ventilation is associated with barotrauma in drowning patients, but the evidence predates the practice of lung protective ventilation. There was insufficient evidence to make recommendations regarding adjuvant therapies. Conclusions: Treating the lung injury of drowning has a limited evidentiary basis. There is an urgent need for comparative studies of therapeutic strategies in drowning

UAS Literary & Arts Journal

Proof copy provided by Tidal Echoes.Featuring the work of students, faculty, and staff of the University of Alaska Southeast and members of the community.A Note from Loren, Sometimes Known as Senior Editor -- A Letter from Josh, Affectionately Known as “Sugah” (say it with a southern accent) -- A Note from Emily Wall -- On the Move -- Dangly Jangly Things -- Taco Surf -- Midwestern Trash -- On the Distaff Side -- Christmas Joy -- The Three Little McCormicks -- Trollin’ Ray’s Brain: An Interview with Ray Troll -- His Long Coat Turning -- First Autumn -- Pinta Cove Birthday Gifts -- September Wings -- When in Rome -- Early Morning Conspiracy Theory -- Flesh Wound -- Two Ravens, Five Ways -- Shades of Brown: The Question -- Hayfield-Clarke Psychiatric Center -- Hardscrabble -- Smoked Meat Sandwiches -- Slime Squishing Through Gold: An Interview with Nora Marks Dauenhauer -- Berries -- Buds -- Grandpa Jakwteen in Eclipse -- Cross Talk -- Voices -- Trouble -- Flying Home -- Snorkeling at Hanauma Bay -- Genocide -- Raven, Saving It for Later -- Mama Abel’s -- Settling In -- Blue -- Dad at 27 -- Dad photographs mother -- Backyard theatre & Oz -- Love-in, Easter Day, 1968 -- Topanga Corral -- Swallowing Senora -- Keeping Time on the Kee Nax Trail -- Ode to Ching -- Beneath the Surface (chapter title) -- A Visit from the Wild -- Teacher’s Pets -- Centennial -- See Spot Rot -- With Salsa -- Moonbaby -- The Fine Art of Raising a Tarpaulin -- Prologue -- Epiphany 2008 -- View of Auke Lake -- Shark Fins -- Translating Pasternak -- Raven Boys -- Institutional Back Door -- Uneasy Disguise -- Christmas Wind -- The Life and Times of the Orlando Bloom Fan Club -- Writer & Artist Biographie

Cervical spine immobilisation is only required in drowning patients at high risk of axial loading of the spine

Objectives: Wave forced impacts are known to result in cervical spine injuries (CSI) and approximately 20% of drownings in Australia occur at the beach. The most common mechanism of injury in studies examining the frequency of CSI in drowning patients is shallow water diving. The aim of the present study was to determine what proportion of CSIs occurring in bodies of water experienced a concomitant drowning injury in a location where wave forced impacts are likely to be an additional risk factor. Methods Electronic medical records at the Sunshine Coast Hospital and Health Service EDs, Queensland Ambulance Service case records and Surf Life Saving Queensland data between 1 January 2015 and 21 April 2021 were manually linked. Outcomes recorded included victim demographics, scene information, hospital course and patient disposition. Results Ninety-one of 574 (15.9%) CSIs occurred in a body of water with risk of drowning. However, only 4 (4.3%) had a simultaneous drowning injury, representing 0.8% (4/483) of drowning presentations. Ten (10.9%) patients reported loss of consciousness, including the four with drowning. The principal mechanism of CSI was a wave forced impact (71/91, 78%). Most injuries occurred at the beach (79/91, 86.8%). Delayed presentation was common (28/91, 31%). A history of axial loading was 100% sensitive when indicating imaging. Conclusions The combination of CSI and drowning is uncommon. Cervical spine precautions are only required in drowning patients with signs or a history, or at high risk of, axial loading of the spine. This paper supports the move away from routine cervical spine precautions even in a high-risk population

Cortical Neurons Require Otx1 for the Refinement of Exuberant Axonal Projections to Subcortical Targets

AbstractInformation processing in the nervous system depends on the creation of specific synaptic connections between neurons and targets during development. The homeodomain transcription factor Otx1 is expressed in early-generated neurons of the developing cerebral cortex. Within layer 5, Otx1 is expressed by neurons with subcortical axonal projections to the midbrain and spinal cord. Otx1 is also expressed in the precursors of these neurons, but is localized to the cytoplasm. Nuclear translocation of Otx1 occurs when layer 5 neurons enter a period of axonal refinement and eliminate a subset of their long-distance projections. Otx1 mutant mice are defective in the refinement of these exuberant projections, suggesting that Otx1 is required for the development of normal axonal connectivity and the generation of coordinated motor behavior

Learning in a pandemic : primary school children’s emotional engagement with remote schooling during the Spring 2020 Covid-19 lockdown in Ireland

Open Access funding provided by the IReL Consortium. This study was funded by UK Research and Innovation-Economic and Social Research Council and the Irish Research Council under the ‘ESRC-IRC UK/Ireland Networking Grants’. The Children’s School Lives study, on which this analysis is based, is conducted by University College Dublin and funded by the National Council for Curriculum and Assessment through a grant awarded to Dympna Devine, Jennifer Symonds, Senaeen Sloan, and Gabriela Martinez Sainz.The COVID-19 pandemic resulted in the greatest disruption to children’s schooling in generations. This study analyses primary school children’s emotional engagement with remote schooling during the Spring 2020 lockdown in the Republic of Ireland, which involved one of the longest school closures among rich countries at the time. It investigates whether children’s engagement with their remote schooling varied by personal and family characteristics, using data from the Children’s School Lives (CSL) surveys. CSL is a nationally representative study of primary schools in Ireland, which collected information from children aged 8–9 years in May – August 2019 and in May – July 2020. Linear regression estimates with school fixed effects are based on the analytic sample of nearly 400 children (from across 71 schools) who took part in both waves and have complete data on all the key variables. Emotional engagement with schooling is measured using child-reported items on satisfaction with schooling. Everything else being equal, children who reported higher engagement with schooling before the pandemic were more engaged with remote schooling during the lockdown. Although there were no significant differences by family affluence, children with greater resources for home schooling reported higher levels of engagement. This includes having a computer or a laptop for schoolwork, having someone to help with schoolwork if the child is worried about falling behind, and having schoolwork checked by a teacher. This points to the paramount importance of adequate digital technologies in the home as well as the availability of help during periods of remote schooling.Publisher PDFPeer reviewe

Building the capacity of rural allied health generalists through online postgraduate education: a qualitative evaluation

Introduction: Workforce development is a key strategy for building the capacity and capability of a workforce. Accordingly, rural and remote practising allied health professionals require relevant and accessible continuing professional development to enhance their knowledge and skills and improve consumer health outcomes. This study explored the impact of an online postgraduate allied health rural generalist education program, from the perspective of allied health professionals participating in the program and their supervisors and managers. Methods: A qualitative, exploratory descriptive study design was employed using semistructured interviews. This study formed the qualitative component of a larger convergent mixed-methods evaluation study aimed at evaluating the reach, quality and impact of an online rural generalist education program for allied health professionals in Australia. Allied health professionals from seven professions enrolled in an online postgraduate rural generalist education program, the rural generalist program (RGP). Their designated work-based supervisors and their managers who were responsible for the operational management of the study sites were invited to participate in the study. All participants were employed in rural and remote health services in 10 sites across four Australian states. Study participants’ experience and perceptions of the impact of the RGP on themselves, the healthcare service and the broader community were explored using semistructured interviews. Data were thematically analysed site by site, then across sites using Braun and Clarke’s (2012) systematic six-phase approach. Provisional codes were generated and iteratively compared, contrasted and collapsed into secondary, more advanced codes until final themes and subthemes were developed. Results: Semistructured interviews were conducted with 23 allied health professionals enrolled in the RGP and their 27 work-based supervisors and managers across the 10 study sites. Three final themes were identified that describe the impact of the RGP: building capability as rural generalist allied health professionals; recruiting and building a rural workforce; enhancing healthcare services and consumer outcomes. Conclusion: Allied health professionals working in rural and remote locations valued the RGP because it provided accessible postgraduate education that aligned with their professional and clinical needs. Integrated into a supportive, well-structured development pathway, the experience potentiated learning and facilitated safe clinical practice that met the needs of consumers and organisations. The findings demonstrate that effective work-integrated learning strategies can enhance the development of essential capabilities for rural practice and support early-career allied health professionals’ transition to rural and remote practice. These experiences can engage allied health professionals in a way that engenders a desire to remain working in rural and remote contexts