Hispanic Ethnicity, Male Gender and Age Predict Restraint Use and Hospital Resource Utilization in Pediatric Trauma

Child restraint reduces the severity of injuries in motor vehicle crashes. Racial/ethnic groups appear to have differing restraint use rates. The objective of this study was to identify restraint use differences between ethnic and other demographic subgroups of pediatric trauma patients. Prospective data were analyzed for 1072 consecutive pediatric patients aged 19 or less who were involved in motor vehicle crashes and brought to our Trauma Center over a 42 month period. The demographic breakdown of this study cohort was 55.3% male, 21.4% Hispanic, 9.7% African American, 64.5% Caucasian, 2.2% Asian and 2.2% other. The highest rates of restraint use (56.1%) were reported for children ages 0 to 3 years, and the lowest for those 12-15 years (p=.0001). Restraint use rates were lower among males than females (OR=0.72; 95% CI = 0.55, 0.93), and lower among Hispanic than non-Hispanic pediatric patients (OR=0.52; 95% CI = 0.37, 073). Restrained patients were more likely than unrestrained patients to be discharged to home. Restrained patients were less severely injured than unrestrained patients as measured by Revised Trauma Score, the Glasgow Coma Score, Injury Severity Score, ICU days and length of hospital stay. Low restraint use is associated with Hispanic ethnicity, male gender and the age group 12-15 years. Measures of injury severity consistently indicate more severe injuries among unrestrained than restrained patients

Understanding Suicide Attempts Among American Indian Adolescents in New Mexico: Modifiable Factors Related to Risk and Resiliency

OBJECTIVE: To examine correlates of suicide attempts among American Indian adolescents living on reservations in New Mexico. DESIGN: Cross-sectional PARTICIPANTS: American Indian adolescents attending school in New Mexico, grades 6 to 12. MAIN OUTCOME MEASURES: Data from the Search Institute Profiles of Student Life Attitudes and Behaviors survey related to suicide attempts and student assets and risk behaviors. Hypothesized predictor variables derived from 39 survey questions were tested against one outcome variable relating to prior suicide attempts. RESULTS: Of 690 American Indian students included in the study, 24.2% indicated having attempted suicide one or more times in their lives. Salient assets included having neighbors who cared about them, adults who made them feel important, and having friends who did well in school. Notable risk factors were feeling depressed, drug and alcohol use, and having been the victim of violence. CONCLUSIONS: Adolescent suicide continues to be a major concern for American Indians. A focus on strengthening parent-child relationships and community support for families may increase resiliency among youth at risk

Suicidality: Clusters, Contagion, and Pacts

Suicide clusters are generally defined as groups of suicides, suicide attempts, or both that are closer in time and space than normally expected in a given location. Suicide contagion is a related concept whereby susceptible persons are thought to be influenced toward suicidal behavior as a result of knowledge of another person\u27s suicidal act. Suicide pacts describe the suicides of two or more individuals with an agreed-upon plan to die together or separately and closely timed. This entry discusses each of these concepts

Suicidality: Nomenclature

Each year since 2001, over 30,000 people have died by suicide in the United States. At least 650,000 persons each year receive emergency treatment after attempting suicide. Over a million die by suicide worldwide. Suicide, the taking of one\u27s own life, is the 13th leading cause of death worldwide and 11th in the United States. In the United States, suicide kills nearly twice as many people each year as homicide. Although suicide is an individual act that occurs in what can appear to be unique circumstances, examining patterns of suicide deaths indicates many risk and protective factors at different levels-demographic, community, familial, and individual. Demographically, suicide completion and attempt patterns vary by age, gender, race-ethnicity, occupation, geography, income, and other factors

Suicidality: Prevention

Suicide prevention is complex and necessary at many levels. One obvious suicide prevention strategy includes supporting healthy childhood environments in which child maltreatment, intimate partner violence, and substance abuse are absent. Suicide prevention demands individual-level prevention and broader public health strategies that reduce the likelihood of suicide before individuals become vulnerable or before vulnerable individuals engage in suicidal behaviors. Current knowledge suggests reaching individuals early when developmental patterns leading to problematic behaviors in youth and psychiatric symptoms can be prevented or changed. Suicide prevention includes surveillance of suicidal acts to determine patterns and intervention points. The best suicide prevention incorporates multiple interventions at different levels because of overlapping of risk and protective factors across many domains of influence

Suicidality: Demographic Risk and Protective Factors

Each year since 2001, over 30,000 people have died by suicide in the United States. At least 650,000 persons each year receive emergency treatment after attempting suicide. Over a million die by suicide worldwide. Suicide, the taking of one\u27s own life, is the 13th leading cause of death worldwide and 11th in the United States

Familial Factors in Suicidal Behaviors

Familial factors related to suicide can be categorized as environmental, heritable (genetic), and interactions of the two. Many familial risk and protective factors in suicide are interrelated, and it is difficult to determine whether a trait is directly associated with suicide and what proportion of that trait is heritable. Research in this area is ongoing, and knowledge is evolving rapidly

Suicide, Risk and Protective Factors: Individual Level

Risk and protective factors related to suicide can be grouped in several ways, one of which is to separate them into individual, interpersonal, and environmental factors. Such distinctions are somewhat artificial, as individual characteristics can be fully understood only as they exist and are expressed in a person\u27s social and physical environment. However, categorizing risk and protective factors this way is useful in identifying potential solutions to the complex causes of suicidal behavior