To explore the extent to which causes and circumstances surrounding fatal drowning data are captured by the studies that use VA instruments, what challenges are faced, and what opportunities lie in improving this instrument.

A scoping review, including publications from January 2012 to September 2023, was conducted using 14 electronic databases, 3 academic search engines and 10 grey literature sources. Data were analysed using frequency counts. Five experts were engaged to corroborate the review findings.

11 457 publications were identified, and 9 were included after eligibility screening. Only one study captured the causes and circumstances of fatal drowning using VA instruments. Challenges regarding the VA instruments were reporting and recall bias, misclassification of cause of death and missing records. Opportunities include: optimising the ‘open narrative’ section, creating a drowning-specific module for VA instruments and complementing the instrument with social autopsy tools and qualitative methods.

Findings indicate a severe gap in evidence, with implications for global organisations which develop VA instruments, to update their VA instruments with questions that can report the circumstances of a drowning death. It is anticipated that this could accelerate the action on global drowning prevention for sustainable development.

Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we systematically searched PubMed/Medline, Web of Science, Scopus, Google Scholar, African Journals Online, EMBASE databases and grey literatures from 10 January to 15 March 2025 using Medical Subject Headings terms and Boolean operators. Studies published since 2020 were screened to ensure the inclusion of the most recent and contextually relevant evidence, and data were extracted independently by two reviewers using a standardised Excel sheet form. Quality was assessed via the Joanna Briggs Institute checklist. Random-effect models were employed due to heterogeneity. Meta-analysis was conducted using STATA V.14.0 software. Subgroup analysis and meta-regression were performed to identify factors and source of heterogeneity. Small study effects and publication bias were examined through funnel plots and Egger’s/Begg’s tests.

12 studies (n=5222) were included. Pooled prevalence of road traffic accidents related death was 33% (95% CI 23% to 48%) and injury 48% (95% CI 28% to 58%). Meta-regression showed no significant effects of publication year, zone, study design or sample size. Key risk factors included driver-related issues (young age, inexperience, speeding, phone use, alcohol/fatigue driving, overloading), poor vehicle/road and environmental conditions.

Road traffic accidents related injuries and death burden remain high in the Amhara region, driven mainly by risky driver’s behaviour, suboptimal infrastructure and environmental conditions. Strengthening safety regulations and sustained behavioural interventions are urgently needed.

CRD 420251003488

This was a retrospective study using the Trauma Quality Improvement Program database in midlife (aged 50–64 years) and older adult (aged 65 years and older) trauma patients from 2012 to 2021. Frailty was assessed using the five-item Modified Frailty Index. The adjusted change of frailty incidence over the study period was evaluated via Poisson regression.

Frailty incidence in midlife trauma patients rose from 2.4% in 2012 to 5.1% in 2021. The adjusted annual incidence rate ratio (IRR) for midlife frailty was 1.08 (95% CI 1.08, 1.09). Among older adult patients, frailty incidence rose from 6.4% to 14.7%, with an adjusted annual frailty IRR of 1.10 (95% CI 1.10, 1.10).

Frailty is rising in both the midlife and older adult populations, indicating that these groups present increasing risk for unintentional falls and further morbidity and mortality. This underscores the necessity of fall screening in both midlife and older adult patients alongside further explorations into methods to delay the onset of frailty.

This mixed-methods study used data from the Bureau du coroner du Québec. Reports with recommendations were analysed by sex, age group, context, mechanism and activity. A four-phase thematic analysis was conducted to emphasise the developed themes and connect them with the existing literature.

Of 1937 coronial reports reviewed, 13.3% (n=258) contained at least one recommendation, totalling 609 recommendations (31 per 100 activity-related deaths). Reports were more likely to contain at least one recommendation for women (20.3%, p=0.0004), paediatric populations (≤5 years: 30.3%, p<0.0001; 6–11 years: 29.3%, p=0.0003; 12–17 years: 27.6%, p<0.0001), and organised events (55.0%, p<0.0001), despite most deaths occurring among men, adults and during unstructured events. All-terrain vehicle and snowmobile activities showed significantly lower rates of reports with recommendations (8.1%, p=0.0008 and 8.6%, p=0.0044, respectively). Most frequently addressed themes were Development, inspection and modification of bicycle infrastructure for cycling and Lake and river safety measures for swimming. Conflict with other types of users was the top theme for land motorsports, while Personal flotation device use was the most common for navigation activities.

Patterns from reports with recommendations will be shared with the Bureau du Coroner du Québec to improve coronial practices. Integrating recurrent themes and recommendations with activity-specific risk factors will help identify critical patterns and inform preventive measures holistically.

A cohort analysis from the healthcare system perspective based on data from a double-blinded randomised controlled trial—the Opti-Med trial. The trial participants were 303 people aged ≥65 years. Identification of in-scope data from the trial dataset was achieved using the falls description note and the National Hospital Cost Data Collection diagnostic related group classification system. Data analyses were performed using STATA V.17. All costs were adjusted to 2022 Australian dollars.

On average, the cost of an injurious fall per incident was $2494 (SD=$6199), while the average cost of falls per resident annum was $1798 (SD=$6002). The potential cost of injurious falls per annum in Australia’s RAC system was $325 million. Sex and body mass index (BMI) were identified factors associated with fall injury. There was an inverted U-shaped relationship between BMI and falls risk in RAC.

The healthcare spending on fall injury per resident annum in RAC represents 20% of the 2021–2022 healthcare expenditure per capita. The high cost and inverted U-shaped relationship between BMI and falls risk underscores the need for more effective and RAC-tailored falls prevention strategies in this setting.

Australian New Zealand Clinical Trial Registry (ACTRN12613001204730); WHO Universal Trial (U1111-1148-6094).

Using the National Electronic Injury Surveillance System All Injury Program database, we analyzed SHI cases in the emergency department from 2005 to 2021 and examined demographic characteristics, injury mechanism and anatomic location, emergency department disposition and temporal patterns relative to cases involving assault and intimate partner violence.

Of all injury-related emergency department visits, 1.5% (7 774 900) were due to SHI, 4.8% (24 165 696) due to assault and 0.6% (3 188 790) due to intimate partner violence. SHI peaked in ages 15–19 (18.3%), assault in ages 20–24 (17.3%) and intimate partner violence in ages 25–29 (19.2%). Patients with SHI were 41.0% males, compared with assault (66.3%) and intimate partner violence (19.3%) groups (p<0.0001). Most SHIs involved white patients (75.2%), compared with assaults (46.2%) and intimate partner violence (40.4%) (p<0.0001). Lacerations (20.6%) were the most common injury for SHI, while contusions/abrasions were the most common injuries for both assaults (27.8%) and intimate partner violence (39.1%) (p<0.0001). The upper extremity was the most common injury location in SHI (71.11%), while the head/neck was the most injured area in assaults (58.4%) and intimate partner violence (59.7%). Of adolescents sustaining SHI, 76.7% were women, compared with 59.0% of emerging adults and 53.2% of adults (p<0.0001). Among adolescents, the prevalence of SHI was lowest on weekends and during the summer.

Our findings highlight distinct demographic, injury and temporal patterns observed in patients with SHI.

Data from the Center for Disease Control’s National Vital Statistical System and the Bureau of Alcohol, Tobacco, Firearms and Explosives’ Federal Firearms Listing included 284 cities in 2015–2021. Types, locations and rates of firearms dealers as well as firearm suicide rates were examined. Poisson regression models tested associations between city firearms dealer and firearm suicide rates, controlling for city characteristics. Models were stratified by city size and poverty level, and results were examined for firearms dealers overall and by type.

Firearms dealer rates were highest in cities in the Midwest, South and West; with populations less than 500 000; and with the most veterans or white residents. Firearm suicide rates were 3.4 times higher in cities with the highest firearms dealer rates (9.8 per 100 000 population) than the lowest (2.9). In adjusted regression models, city firearms dealer rates were associated with firearm suicide rates, and results depended on dealer type, city size and poverty level.

City firearms dealers play an important role in access to lethal means, especially in small cities and through pawnshops. These findings hold implications for how cities can engage firearms dealers as suicide prevention partners.

Using the 2019 National Emergency Medical Services (EMS) Information System data set, we identified 1 854 909 patients injured from falls requiring an EMS response and determined the fall location (eg, indoors or on street/sidewalk). We analysed data on the EMS clinician’s notation of alcohol or drug involvement and Glasgow Coma Scale.

Overall, for 7.4% of injurious falls, there was a notation of substance use: 6.5% for alcohol alone, 0.6% for drugs and 0.3% for alcohol and drugs. 21.2% of falls that occurred on a street or sidewalk had a notation of substance use. Substance use prevalence was highest, at 30.3%, in the age group 21–64 years, for falls occurring on streets and sidewalks, without syncope or heat illness as contributing factors. Reported substance use involvement was more frequent for men compared with women for each location type. Glasgow Coma Scale scores indicative of moderate or severe trauma were more prevalent among falls involving alcohol and/or drugs.

Overall, one in five injurious falls on streets and sidewalks and requiring EMS attention involved substance use, and these numbers likely underestimate the true burden. As cities seek to expand nightlife districts, design strategies to protect pedestrians from falls should be enacted.

Retrospective cross-sectional population-based analysis of all lower limb amputations performed in the Brazilian public health system between 2008 and 2021 in children up to 14. Using a public database, all types of amputations were selected, defining the number of procedures, their main aetiologies, trends over the years, patient demographics and regional distribution.

19 439 lower limb amputations were performed in the Brazilian public health system between 2008 and 2021, mainly at the toe level (85%). Amputations occurred predominantly in males (64%) and children aged 0–4 (47%). The global trend is a non-significant decrease in the total number of amputations over the period (p=0.427), but we observe a significant decrease (p<0.001) in amputations in older children (aged 10–14). Amputations are more concentrated in the most populated regions, while the highest mortality is found in the least densely populated areas. Trauma is the main aetiology associated with lower limb amputations in Brazilian children (60%).

The epidemiology of amputations in Brazil differs from the rest of the world. Trauma is the main aetiology.

We performed Poisson interrupted time-series analyses using daily traffic fatality and injury data from 2015 to 2022, to assess the change in rate expressed per 10 000 population. A Québec COVID-19 NPIs Index was applied, incorporating 58 interventions enacted from March 2020 to March 2022 in these cities. We accounted for weather conditions and seasonal patterns and divided the pandemic period into four semesters to better understand changes over time.

The analysis revealed a nuanced interaction between NPIs and road safety. Alcohol-related injuries decreased during stringent NPIs, particularly in Montréal, Québec city and Longueuil. In contrast, the effects on speed-related incidents were mixed, with Montréal and Laval, showing increases and the other three cities displaying no meaningful changes across the four semesters.

These findings highlight the necessity for ad hoc road safety strategies that address specific patterns of alcohol consumption and speeding risks during future pandemic-related disruptions.

In this repeated cross-sectional study, registry data were extracted from legal medicine organisations during 2005–2022. The mortality rate per 1 million population was calculated by gender and province. The joinpoint regression model was fitted to estimate average annual percentage changes and an annual percentage change in the drowning mortality rate. We used spatial scan statistics to detect high-risk clusters of drowning deaths at the provincial level.

Over 17 years 19 547 people died due to unintentional drowning. The highest yearly drowning rate was 15.58 per 1 000 000, and men had the highest rates of death (25.91) compared with women (4.98) in 2019. The overall mortality rate has decreased from 18.69 in 2005 to 12.87 in 2022. In the spatio-temporal analysis, four statistically significant high-risk clusters were detected in the north, southeast and centre of Iran.

The overall mortality rate in 2022 decreased compared with the 17-year period. In the spatial analysis, several high-risk clusters were identified in different locations, which highlights the importance of targeted and more comprehensive interventions. It seems that the prevention of drowning requires the effective participation of all responsible organisations and risk reduction plans in the field of environmental and individual risk factors.

A cross-sectional study was employed using records from the 2017/2018 Canadian Health Behaviour in School-aged Children study (n=21 745). Indicators of poor sleep (insufficient sleep on school and non-school days, impaired sleep, daytime sleepiness) and annual reports of medically treated injuries (any, serious) were obtained. Descriptive and hierarchical modified Poisson regression analyses were performed to explore these relationships, while controlling for potential confounders.

Insufficient sleep, impaired sleep and daytime sleepiness were reported by 11.3–35.3% of adolescents; variations in these estimates were observed by gender. Sleep indicators were modestly but consistently associated with risks for the occurrence of ‘any injury’, whereas impaired sleep and daytime sleepiness were the only meaningful and significant risk factors for ‘serious injuries’ in adjusted models (prevalence ratio range: 1.18–1.30). The analysis of interactions revealed boys with insufficient sleep on non-school days as well as impaired sleep to have higher injury risks compared with girls.

Impaired sleep and its effects have emerged as a quiet epidemic, affecting up to one-third of Canadian adolescents and being associated with risks for injury. Sleep hygiene may therefore act as a plausible focus for clinical and public health initiatives to mitigate injury risks.

To develop and validate an ML model that predicts 90-day ED returns after orthopaedic trauma surgery using input data readily available in the electronic health record.

This is a retrospective model development and validation study. The study used data from a registry that includes information on all orthopaedic surgeries conducted at a level 1 academic medical centre. Patients who underwent orthopaedic trauma between 1 January 2017 and 1 March 2023 were identified using common procedural terminology code. The model used demographic, comorbid and perioperative variables. Return to the ED was captured as a binary outcome. Model performance was evaluated using the area under the receiver operator curve (AUROC).

A total of 12 069 patients met the inclusion criteria. Patients were predominantly female (53%) and white (70%), with a median age of 55. The 90-day ED return rate was 14% (table 1). The random forest model identified body mass index, distance from the patient’s residence to the hospital, age, length of hospital stay and complexity of procedure (work relative value unit) as significant predictors of ED return, each accounting for greater than 10% of the total importance across all features in the model (table 2). Further, the model displayed strong discrimination of patients returning to the ED (AUROC=0.74) (figure 1).

The random forest model demonstrated predictive discrimination of 90-day ED returns. Critical predictors such as patient distance from the hospital suggest considering geographical and socioeconomic factors in postdischarge care planning. Operational factors such as length of stay or complexity of the procedure also predicted return to the ED. The study lays the groundwork for future predictive models in clinical decision-making and healthcare resource utilisation.

Level III, retrospective model development and validation study.

This study uses 2020–2023 data from the National Electronic Injury Surveillance System to analyse injuries from various powered vehicles, incorporating diagnostic, event-related and demographic factors. In addition, the study evaluates non-poweredskateboard-related injuries, which provided a comparable baseline for motorised vehicle injuries.

Our analysis included 3721 head and neck injuries: 1359 from scooters, 1743 from skateboards and 619 from hoverboards. Males sustained most injuries, accounting for 64% of scooter accidents, 74% of skateboard accidents and 58% of hoverboard accidents. Hospitalisation was required in 10% of scooter accidents, 9.2% of skateboard accidents and 6.9% of hoverboard accidents. Males, alcohol use and drug use were associated with increased risk of hospitalisation (p=0.00002, p=0.00004 and p<0.00001, respectively). Internal injury (37%) and lacerations (24%) were the most common types of injury. In cases, wear helmets were worn involving helmets, there were no significant differences in hospitalisation rates.

These findings underscore the need for improved injury prevention strategies, including more effective helmet designs and infrastructure enhancements, to reduce the growing burden of micromobility vehicle-related head and neck injuries.

The rising incidence of head and neck injuries associated with personal mobility vehicles highlights the need for injury management and prevention strategies. Helmets may mitigate head and neck injuries associated with motorised scooters, skateboards and hoverboards.

A retrospective cohort study was conducted among 6 128 921 veterans (399 125 homeless and 5 729 796 non-homeless) who received VA healthcare between 2017 and 2020 and were followed until 2021 using linked data from VA’s Corporate Data Warehouse, Homeless Operations Management System and the VA/Department of Defense Joint Mortality Data Repository. Injury death rates were estimated by homelessness status with 95% CIs using the exact Poisson method. Multivariable Cox regression models were applied to estimate HRs with 95% CI for homelessness as a predictor of injury deaths, controlling for demographic, clinical, substance use and mental health characteristics.

The injury-specific mortality rate (per 100 000 person-years) was estimated at 254.4 (95% CI 252.5 to 256.4) and was higher among homeless (453.3 (95% CI 443.3 to 463.5)) versus non-homeless (239.9 (95% CI 237.9 to 241.9)) veterans. There were disparities in anatomical sites and injury type by homelessness status. Injury-related risk of death was twice as high among veterans with versus without a homelessness experience (adjusted HR 1.93, 95% CI 1.88 to 1.98).

Homeless veterans may be at high risk for specific patterns of injury death. Injury prevention efforts should target exposures that distinguish this vulnerable population from other veterans seeking VA healthcare services.

Safe-ride programs in four cities were examined (Montreal, Quebec, Sherbrooke and Trois-Rivières) using an ecological approach. The data set was structured as a balanced cross-sectional time series. Random-effects negative binomial regression modelled the relationship between the number of rides provided by the safe-ride program and night-time alcohol-related crashes involving serious injuries and fatalities, with individual city population as an offset variable.

The median number of night-time alcohol-related crashes for the months of December for the 2000–2019 period was 3.0 (IQR=1.5–4.5). The median number of rides offered was 16 894 (IQR=15 586–18 391). The association between the number of rides provided by the safe-ride program and night-time alcohol-related crashes (IRR=1.0002; 95% CI 0.9999, 1.0005) was not significant.

The role of the number of rides provided by the safe-ride program in reducing night-time alcohol-related crashes was inconclusive. Specific program features may influence the findings. Future research is needed to understand the specific characteristics of safe-ride programs that could influence their putative benefits.

We conducted a cross-sectional survey through purposive sampling to identify child fatal and non-fatal drownings among a total of 18 004 households, comprising 71 185 people, in 2 unions in Northern Bangladesh. Interviews were conducted between January and March 2024 with the households that experienced child drownings in the region. We employed a mixed-methods approach to data collection, using quantitative analysis to examine socioeconomic, demographic and environmental factors, alongside qualitative analysis to explore situational factors associated with drownings in the region.

Through household visits, a total of 117 households were identified that faced child drowning incidents, comprising 84 fatal (71.8 %) and 33 non-fatal (28.2 %) drownings between 2018 and 2023. The households that faced drownings were comparatively of lower income groups, had lower rates of education and were mostly engaged in agriculture and other domestic work. In 2023, the number of drowning incidents was 34. Out of 117 drownings, 95% occurred between 9:00 and 15:00 hours, and more than 82% occurred between June and October. Out of 117 drowning incidents, approximately 97% of children did not know how to swim prior to the incident. Out of 117 respondents, 73.5% stated that they did not teach their child how to swim. Of those who taught their child to swim, the average age for learning to swim was 8.33 years. Out of 84 child drowning deaths, 75% were male and 25% were female, and the average age was 3.9 years. Out of the 84 fatal drowning deaths, 72.6% occurred in ponds.

Identification of socioeconomic, demographic and environmental factors associated with child drownings will help to develop feasible prevention strategies and interventions in the region.

We execute a cross-sectional examination of pooled firearm incidents (2018–2023) and the relationship of neighbourhood-level SDOHs across the state of South Carolina using negative binomial count regression models.

Findings indicate that neighbourhood disadvantage, residential mobility, per cent black, the percentage of older housing units, lack of technology access and lack of insurance access were all positively associated with an increased risk of firearm victimisation and death. The relationship between neighbourhoods with longer drive times of firearm incidents to trauma hospitals and firearm-related death was significantly moderated by the per cent black of residents within census tracts.

Public health neighbourhood risk factors that are detrimental to individuals’ physical health are also associated with increased risk of firearm victimisation. Longer drive times from trauma hospitals increase the risk of death and this relationship disproportionately affects black Americans. The built environment of neighbourhoods and extended drive times to trauma centres ‘doubly disadvantages’ historically disadvantaged populations.

Examine the data by age group, sex and mechanism of injury.

All fall-related hospitalisations in Ontario among children and youth aged 0–19 years from 2010 to 2019 were analysed. International Classification of Diseases, 10th Revision diagnostic codes defined serious and non-serious paediatric fall injuries. Rates per 100 000 population were calculated. We report serious fall injuries by age group, sex and mechanism of injury.

Falls accounted for 22 948 non-serious fall hospitalisations (rate=761.1/100 000; 95% CI 751.3 to 770.9) and 3652 serious fall-related hospitalisations (rate=120.9/100 000; 95% CI 117.0 to 124.8) in Ontario from 2010 to 2019. The highest rate of serious falls among females was observed in the 0–4 age group (150.3/100 000; 95% CI 137.2 to 163.3), while for males, the highest rate was in the 15–19 age group (206.9/100 000; 95% CI 193.0 to 220.7). Overall, males (rate=152.7, 95% CI 146.6 to 158.9) reported higher rates of serious fall injuries compared with females (rate=87.5, 95% CI 82.7 to 92.3).

A significant number of preventable serious fall hospitalisations occurred in Ontario from 2010 to 2019 with the highest rate in older males, followed by younger females. The serious fall indicator identifies important information such as target populations and mechanisms that can be used to prioritise prevention efforts to reduce the burden of fall injury in the paediatric population.

We interviewed 10 allied health and nursing staff who received CRS training to find out the barriers and facilitators they perceived and experienced when engaging parents of newborns with CRS education prior to hospital discharge. Interviews were audio-recorded and transcribed verbatim. Inductive analysis sensitised by Billett’s workplace-based learning theory was conducted using Braun and Clarke’s thematic analysis.

We constructed three themes. At the personal agency level, how participants viewed themselves and directed their cognition to the task affected their involvement in CRS education. At the social agency level, institutional and ward safety culture including the presence of ward CRS champions were powerful motivators for CRS education. Parental receptivity to CRS education was also important. Lastly, at the situational level, barriers to implementing a CRS discharge programme included factors such as competing duties at neonatal discharge.

Using a workplace learning theory, our study highlights that healthcare providers’ commitment and delivery of CRS education at neonatal discharge is a complex interplay of personal agency, social agency and situational factors. Future efforts must address these factors to optimise the effectiveness of a neonatal CRS discharge programme.

Time-series analysis of police data on road collisions in local authorities (LAs) in Great Britain, 2015–2023. Random-effects Poisson regression time-series models compared collision rates in LA districts with an e-scooter trial (n=41) versus matched control districts (n=41). Primary outcomes were all road collisions and bicycle collisions. Models adjusted for time; seasonality; baseline collision rate; COVID-19 period; and preintervention/postintervention period (proxied by intervention group/COVID-19 period interaction).

The rate of bicycle collisions reduced following the introduction of the schemes, compared with control districts (incidence rate ratio (IRR) 0.78, 95% CI 0.68 to 0.89 during peak COVID-19; IRR 0.87, 95% CI 0.77 to 0.99 in the post-COVID-19 period). This effect was specific to bicycle collisions and strongest in the subgroup of serious/fatal collisions.

Findings suggest that the increase of a new and sustainable mode of transport, e-scooters, may have reduced bicycle collisions. This could have far-reaching benefits including reduced injuries, safer environments, and public health and environmental benefits if more people choose bicycles and micromobility over car transport. Findings should be verified in further work.

This is a mixed-method, descriptive study. Data included the content of relevant state statutes and sentencing information from the 19 states with UBC laws in 2019, prosecutions and convictions for private party firearm transfer violations from 5 states and New York City, firearm transfer education and promotion efforts, and key informant interviews.

Information on conducting safe and legal private-party firearm transfers was widely available, but persuasive language encouraging background checks was rare. The median maximum prison time for violating UBC laws was 12 months and the median of the maximum fines was US$5000. However, the chances of being prosecuted in our sample states were extremely low. Finally, public support for UBC policies is high, but among some firearm owners, the perceived utility of such laws is very low.

Available data suggest that enforcement of UBC requirements for private party transfers is rare. Additionally, advocacy efforts to encourage private gun sellers to make sales contingent on buyers passing background checks are few. People may choose to avoid the additional burden of undergoing a background check when they feel neither social nor legal pressure to comply. The results of this research can be used to identify potential avenues for enhancing enforcement of and compliance with private party firearm background check laws.

A retrospective descriptive analysis of rip current drowning deaths between 1 July 2004 and 30 June 2023 was conducted, and rip current involvement was determined using data triangulation methods (incident narrative, beach imagery and expert opinion). Temporal trends were examined using Joinpoint regression, while Australian population and coastal participation data were used to calculate mortality rates.

407 rip current drowning deaths were identified (21 deaths/year); an exposure-based mortality rate of 0.11/1 million coastal visits. Incidents predominantly involved males (85%), 20–34 years (38%), occurred in regional/remote areas (59%) and in the presence of others (80%). For every rip current drowning death, an estimated 2449 people were rescued by someone else and 8171 individuals self-rescued.

Despite small reductions in the rate of rip current drowning among males, little overall progress has been seen in attempts to decrease the mortality burden. Future efforts will require an expanded approach, beyond traditional means.

Rip currents remain a significant public health threat and the number one coastal hazard contributing to preventable mortality along Australia’s coastline.

Implications for public health: Improved rip current education approaches, development and evaluation are needed to direct effective messaging to at-risk groups.

ED visits involving youth violence, suspected child abuse and neglect, and sexual violence among children and youth during January 2022–April 2025 from the AVERT program were examined by individual-level and county-level characteristics.

During the study period, among the violence-related ED visits examined, visit rates were highest for youth violence (860 per 100 000 visits among adolescents aged 10–17 years), followed by suspected child abuse and neglect (401 per 100 000 visits among persons aged 0–17 years) and sexual violence (221 per 100 000 visits among persons aged 0–17 years). Seasonally, youth violence visit rates typically increased during spring and fall; suspected child abuse and neglect and sexual violence visit rates peaked in summer. Child abuse and neglect and sexual violence visit rates were higher among adolescents aged 10–17 years compared with children aged 0–9 years, and highest among females, whereas youth violence rates were highest among males. Across all forms of violence, visit rates were higher among non-Hispanic Black or American Indian/Alaska Native persons compared with Asian persons, and among those living in urban versus rural counties.

Understanding the types of violence-related injuries that children and youth experience, when violence is most likely to occur, and who is at greatest risk is critical for informing prevention.

This was a cross-sectional study of persons of all ages who unintentionally drowned in metropolitan Houston, Texas between 2016 and 2022. Drowning incident data were obtained from media reports (NexisUni using keywords ‘drown’ and ‘submersion’ to access online media archives in print blog, video and audio record formats) and from redacted police reports. Temporal, demographic and incident narratives were obtained manually. Information on swimming ability, supervision, alcohol use and life jacket use was extracted from report narratives using OpenAI’s GPT-4o models which converted unstructured narratives into analysable structured data. Extracted data were validated against manually reviewed ground truth data in 20% of the cases. NLP was assessed for accuracy, precision, recall and F1 score.

There were 190 reports of drowning (142 (74.7%) fatal and 48 (25.3%) non-fatal) between 2016 and 2022. The median age was 16 years (IQR: 5–41). Children aged 0–17 years constituted 45.8% of the cohort; 125 (65.8%) were males. Most drownings occurred in natural water (65.8%); the rest were in confined water (30.5%). The NLP metrics were recall (0.6–1.0), precision (0.7–1.00), F1-score (0.6–1.0) and accuracy (0.9–1.00).

NLP is a novel method of extracting information on drowning risk and protective factors from media report narratives. This can be used to study the epidemiology of drowning.