3,527 research outputs found
Injury by knife crime amongst children is associated with socioeconomic deprivation:an observational study
PURPOSE: Children who live in areas of socioeconomic deprivation may be at higher risk of being victims of violent crime such as knife wounds. The current study investigated whether socioeconomic disparity was associated with higher risk of knife crime. METHODS: An observational study included patients aged ≤ 17 years at a UK Major Trauma Centre injured by knife trauma from 2016 to 2022. Indices of deprivation were recorded according to the zip code of residence and compared with those of all of England. These included Index of Multiple Deprivation (IMD); income; employment; education and skills; health and disability; crime; barriers to housing and services; living environment; and Income Deprivation Affecting Children Index (IDACI). RESULTS: There were 139 patients (96% male) with median age of 16 years. When compared with the whole of England, patients had worse indices of IMD (p = 0.021); income (p < 0.001); employment (p < 0.001); education and skills (p < 0.001); health and disability; and IDACI (p < 0.001). There were no significant differences in indices of crime, barriers to housing and services or living environment. CONCLUSIONS: Paediatric knife injury was associated with poor socioeconomic status in multiple domains. Focussed efforts to address socioeconomic disparities should be a priority as a public health measure for vulnerable children
Anogenital injury following sexual assault and consensual sexual intercourse:a systematic review and meta-analysis
Injuries among children attributed to violence and social funding:a 10-year observational study
BACKGROUND: Mechanisms and patterns of injury in children are changing, with violent mechanisms becoming more prevalent over time. Government funding of services for children and young people has reduced nationally over the last decade. We aimed to investigate the trends in admissions of injured children to a Major Trauma Centre (MTC) and examine the relationship between injuries sustained by violent mechanisms and local authority funding of children and youth services within the same catchment area. METHODS: A 10-year observational study included all patients aged<18 years treated at a regional MTC between April 2012 and April 2022. Number of admissions with violent trauma, mechanism of injury, requirement for operative intervention and mortality were compared with published annual local authority expenditure reports. RESULTS: 1126 children were included; 71.3% were boys, with median age 11 years (IQR 3–16). There were 154/1126 (14%) children who were victims of violent trauma; they were more likely to be boys than children injured by non-violent mechanisms (84% vs 69%). The proportion of injuries attributed to violence increased over the study period at the same time as reductions in local authority funding of services for the early years, families and youth services. However, there were insufficient data to formally assess the interdependency between these factors. CONCLUSIONS: The proportion of injuries attributed to violence has increased over time, and government spending on specific children and young people’s services has decreased over the same time period. Further work is needed to examine the interdependency between spending and violent injuries in children, and public health interventions to target violence-related injuries should take into account youth service funding
Improvements over time for patients following liver trauma: A 17-year observational study
BackgroundCentralisation of trauma care has been shown to be associated with improved patient outcomes. The establishment of Major Trauma Centres (MTC) and networks in England in 2012 allowed for centralisation of trauma services and specialties including hepatobiliary surgery. We aimed to investigate the outcomes for patients with hepatic injury over the last 17 years at a large MTC in England in relation to the MTC status of the centre.MethodsAll patients who sustained liver trauma between 2005 and 2022 were identified using the Trauma Audit and Research Network database for a single MTC in the East Midlands. Mortality and complications were compared between patients before and after establishment of MTC status. Multivariable logistic regression models were used to determine the odds ratio (OR) and 95% confidence interval (95% CI) for complications according to MTC status, accounting for the potentially confounding variables of age, sex, severity of injuries and comorbidities for all patients, and the subgroup with severe liver trauma (AAST Grade IV and V).ResultsThere were 600 patients; the median age was 33 (IQR 22–52) years and 406/600 (68%) were male. There were no significant differences in 90-day mortality or length of stay between the pre- and post-MTC patients. Multivariable logistic regression models showed both lower overall complications [OR 0.24 (95% CI 0.14, 0.39); p < 0.001] and lower liver-specific complications [OR 0.21 (95% CI 0.11, 0.39); p < 0.001] in the post-MTC period. This was also the case in the severe liver injury subgroup (p = 0.008 and p = 0.002 respectively).ConclusionsOutcomes for liver trauma were superior in the post-MTC period even when adjusted for patient and injury characteristics. This was the case even though patients in this period were older with more comorbidities. These data support the centralisation of trauma services for those with liver injuries
Constraints on the Cosmic-Ray Density Gradient beyond the Solar Circle from Fermi gamma-ray Observations of the Third Galactic Quadrant
We report an analysis of the interstellar -ray emission in the third
Galactic quadrant measured by the {Fermi} Large Area Telescope. The window
encompassing the Galactic plane from longitude 210\arcdeg to 250\arcdeg has
kinematically well-defined segments of the Local and the Perseus arms, suitable
to study the cosmic-ray densities across the outer Galaxy. We measure no large
gradient with Galactocentric distance of the -ray emissivities per
interstellar H atom over the regions sampled in this study. The gradient
depends, however, on the optical depth correction applied to derive the \HI\
column densities. No significant variations are found in the interstellar
spectra in the outer Galaxy, indicating similar shapes of the cosmic-ray
spectrum up to the Perseus arm for particles with GeV to tens of GeV energies.
The emissivity as a function of Galactocentric radius does not show a large
enhancement in the spiral arms with respect to the interarm region. The
measured emissivity gradient is flatter than expectations based on a cosmic-ray
propagation model using the radial distribution of supernova remnants and
uniform diffusion properties. In this context, observations require a larger
halo size and/or a flatter CR source distribution than usually assumed. The
molecular mass calibrating ratio, , is
found to be
in the Local-arm clouds and is not significantly sensitive to the choice of
\HI\ spin temperature. No significant variations are found for clouds in the
interarm region.Comment: Corresponding authors: I. A. Grenier ([email protected]); T.
Mizuno ([email protected]); L. Tibaldo
([email protected]) accepted for publication in Ap
Forward pi^0 Production and Associated Transverse Energy Flow in Deep-Inelastic Scattering at HERA
Deep-inelastic positron-proton interactions at low values of Bjorken-x down
to x \approx 4.10^-5 which give rise to high transverse momentum pi^0 mesons
are studied with the H1 experiment at HERA. The inclusive cross section for
pi^0 mesons produced at small angles with respect to the proton remnant (the
forward region) is presented as a function of the transverse momentum and
energy of the pi^0 and of the four-momentum transfer Q^2 and Bjorken-x.
Measurements are also presented of the transverse energy flow in events
containing a forward pi^0 meson. Hadronic final state calculations based on QCD
models implementing different parton evolution schemes are confronted with the
data.Comment: 27 pages, 8 figures and 3 table
Deep-Inelastic Inclusive ep Scattering at Low x and a Determination of alpha_s
A precise measurement of the inclusive deep-inelastic e^+p scattering cross
section is reported in the kinematic range 1.5<= Q^2 <=150 GeV^2 and
3*10^(-5)<= x <=0.2. The data were recorded with the H1 detector at HERA in
1996 and 1997, and correspond to an integrated luminosity of 20 pb^(-1). The
double differential cross section, from which the proton structure function
F_2(x,Q^2) and the longitudinal structure function F_L(x,Q^2) are extracted, is
measured with typically 1% statistical and 3% systematic uncertainties. The
measured partial derivative (dF_2(x,Q^2)/dln Q^2)_x is observed to rise
continuously towards small x for fixed Q^2. The cross section data are combined
with published H1 measurements at high Q^2 for a next-to-leading order DGLAP
QCD analysis.The H1 data determine the gluon momentum distribution in the range
3*10^(-4)<= x <=0.1 to within an experimental accuracy of about 3% for Q^2 =20
GeV^2. A fit of the H1 measurements and the mu p data of the BCDMS
collaboration allows the strong coupling constant alpha_s and the gluon
distribution to be simultaneously determined. A value of alpha
_s(M_Z^2)=0.1150+-0.0017 (exp) +0.0009-0.0005 (model) is obtained in NLO, with
an additional theoretical uncertainty of about +-0.005, mainly due to the
uncertainty of the renormalisation scale.Comment: 68 pages, 24 figures and 18 table
Searches at HERA for Squarks in R-Parity Violating Supersymmetry
A search for squarks in R-parity violating supersymmetry is performed in e^+p
collisions at HERA at a centre of mass energy of 300 GeV, using H1 data
corresponding to an integrated luminosity of 37 pb^(-1). The direct production
of single squarks of any generation in positron-quark fusion via a Yukawa
coupling lambda' is considered, taking into account R-parity violating and
conserving decays of the squarks. No significant deviation from the Standard
Model expectation is found. The results are interpreted in terms of constraints
within the Minimal Supersymmetric Standard Model (MSSM), the constrained MSSM
and the minimal Supergravity model, and their sensitivity to the model
parameters is studied in detail. For a Yukawa coupling of electromagnetic
strength, squark masses below 260 GeV are excluded at 95% confidence level in a
large part of the parameter space. For a 100 times smaller coupling strength
masses up to 182 GeV are excluded.Comment: 32 pages, 14 figures, 3 table
Measurements of Transverse Energy Flow in Deep-Inelastic Scattering at HERA
Measurements of transverse energy flow are presented for neutral current
deep-inelastic scattering events produced in positron-proton collisions at
HERA. The kinematic range covers squared momentum transfers Q^2 from 3.2 to
2,200 GeV^2, the Bjorken scaling variable x from 8.10^{-5} to 0.11 and the
hadronic mass W from 66 to 233 GeV. The transverse energy flow is measured in
the hadronic centre of mass frame and is studied as a function of Q^2, x, W and
pseudorapidity. A comparison is made with QCD based models. The behaviour of
the mean transverse energy in the central pseudorapidity region and an interval
corresponding to the photon fragmentation region are analysed as a function of
Q^2 and W.Comment: 26 pages, 8 figures, submitted to Eur. Phys.
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