Reduction in drug related suicide in Scotland 1990-1996: an artefactual explanation.
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Drug Overdose↗
Biomedical subjects
T Squires
Publications and source records attributed to T Squires.
Sir Henry Duncan Littlejohn - a dynamic figure in forensic medicine and public health in the nineteenth century.
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Forensic Medicine↗
Deaths related to methadone have doubled in Lothian.
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Death, Sudden↗
Alcohol and house fire fatalities in Scotland, 1980-1990.
The association between house fire fatalities and high blood-alcohol concentrations has been recognized as a particular problem in Scotland. Alcohol intoxication increases the risk of the outbreak of fire and decreases the intoxicated individual's ability to effect an escape. This survey investigates the reported blood-alcohol concentrations from all Scottish fire fatalities during the 11-year period 1980-90 and analyses the data by age, sex, year and geographical location. Alcohol intoxication in fires is shown both to be a national problem and one relevant to females as well as males. Fire prevention campaigns must continue to emphasize the risk of consuming excessive quantities of alcohol in the home whilst parallel efforts to reduce the objective risk should be encouraged.
Accidents↗
Lothian inter-agency child protection guidelines: impact on a children's NHS trust.
OBJECTIVE: To evaluate the process involved in cases of suspected child abuse within a children's NHS Trust, 6 months after implementation of new inter-agency Child Protection guidelines. DESIGN: Prospective evaluation of case records. SETTING: Four departments within a combined child health trust in Edinburgh. MAIN MEASURES: Review of practice within each department, according to the Inter-Agency guidelines. RESULTS: No standard procedure existed for the child protection process prior to the guidelines. In the first 6 months following implementation of the guidelines, a substantial increase in workload was experienced by community paediatricians. Medical examinations were better co-ordinated, with fewer children receiving repeated, intrusive examinations. However, note keeping was deficient, as 3% of referrals did not appear to be recorded in the case notes. Cross-referencing between departments was variable, with 81% of cases referred to Community Child Health not recorded in hospital case notes. CONCLUSIONS: The Inter-Agency guidelines have resulted in better coordination of the early referral stages. Deficiencies highlighted in this audit are due to record keeping and lack of liaison between departments within a combined children's trust.
Child Abuse↗
Fire fatalities in elderly people.
Fatal dwelling-house fires account for 10% of all accidental deaths in the United Kingdom with one-quarter of the deaths being of elderly people. No study had described the characteristics of elderly individuals who die in fires. We report results from a retrospective review of all fatal dwelling-house fires in Scotland from 1980 to 1990. Of 1096 people dying in fires, 243 (23%) were aged over 75. When compared with patients under the age of 75, older patients were significantly less likely to be smokers. Significantly more fires killing elderly people were caused by faulty or misused electrical items in the house, particularly electric blankets. These differences between elderly and younger individuals dying in dwelling-house fires may suggest that preventive strategies for the elderly population require a different emphasis from those for younger people.
Accidents, Home↗
Can child fatalities in house fires be prevented?
OBJECTIVES: To analyse all child deaths in house fires in Scotland between 1980 and 1990. METHODS: Retrospective study of all child house fire fatalities based on the 'sudden death' investigation instigated by the procurator fiscal in whose jurisdiction the death occurred. The necropsy, toxicology, police, and fire brigade reports were examined in each case. RESULTS: There were 168 child deaths occurring in 118 house fires. In the 0-5 years age group 40% of deaths occurred in fires started as a direct result of the actions of children. The careless disposal of smoking materials was the most frequent cause of fatal fires killing older children. Upholstery and bedding were common materials of first ignition, accounting for over half the incidents. The majority of children were dead before the arrival of the emergency services and most died as a result of the inhalation of smoke. CONCLUSIONS: This survey emphasises the importance of 'self escape' which, particularly in the case of young children, requires the assistance of adult carers. The number of fires started as a result of children playing with sources of ignition raises important questions of supervision and the provision of a safe environment. There is, we contend, a need to highlight the importance of individual behaviour and responsibility while recognising the need to develop measures that are relevant to, and effective in, a particular socioeconomic context.
Adult↗
Suicide by young men in Lothian 1993 and 1994.
OBJECTIVES: To examine the circumstances surrounding the suicides during 1993 and 1994 of young men aged 20-29 from the Lothian region. METHODS AND MATERIALS: The list of suicides for Lothian residents in this group was obtained from the General Registry Office and information relating to these people abstracted from records held in General Practice and at the Forensic Medicine Unit at the University of Edinburgh. RESULTS: Thirty-nine men met the selection criteria which gave a suicide rate of 28.7/100,000. Twenty-five had zero blood alcohol recorded post mortem and ten had blood alcohol concentrations above the legal driving limit of 80 mg/100 ml. Ten (26%) had seen their General Practitioner (GP) in the week and 13 (33%) in the month before suicide. Previous suicide attempts (seven within a year of death) were recorded in 19 men. Ten men left suicide notes. CONCLUSION: Using an overall rate to describe suicide hides the complexity of the issues involved: the inclusion or not of undetermined deaths in numerical targets also causes confusion. Targets should be interpreted carefully and suicide rates should not be considered as a proxy for the mental health status of a population. Prevention cannot be the domain of only the GP. Assessment of suicide risk should be integrated as part of improved mental health training for all health service staff.
Adult↗
Child fatalities in Scottish house fires 1980-1990: a case of child neglect?
This paper considers 168 child (< 17 years) fatalities killed in house fires in Scotland. Data were obtained from the records retained by the procurators fiscal, as part of a survey into all Scottish fire fatalities during the period 1980 to 1990. Although these fires were generally perceived as being tragic "accidents," we conclude that they were largely a direct result of the activities of adults in the home. We analyze this in terms of contemporaneous supervision and the child-care environment. The role of alcohol in domestic fires is particularly important. Behavioral patterns of parents and caregivers are seen to be placing children in a very high risk category and fatality rate could be significantly reduced if behavior was modified to reduce the risk. Whether these considerations imply "neglect" is partly a question of definition. It is important to recognize that the fire safety message could usefully be integrated within a more general child care or family welfare scheme. Front line professionals in these fields are ideally placed to convey this message and to make a contribution towards reducing the risk of children being killed or injured in fire.
Adolescent↗