BMJ open
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Review Meta Analysis
Benefits of probiotics in preterm neonates in low-income and medium-income countries: a systematic review of randomised controlled trials.
Although there is an overall reduction in underfive mortality rate, the progress in reducing neonatal mortality rate has been very slow. Over the last 20 years, preterm births have steadily increased in low-income and medium-income countries (LMICs) particularly in sub-Saharan Africa and South Asia. Preterm birth is associated with increased mortality and morbidity, particularly in LMICs. Based on systematic reviews of randomised controlled trials (RCTs), many neonatal units in high-income countries have adopted probiotics as standard of care for preterm neonates. We aimed to systematically review the safety and efficacy of probiotics in reducing mortality and morbidity in preterm neonates in LMICs. ⋯ Probiotics have significant potential to reduce mortality and morbidity (eg, NEC, LOS) in preterm neonates in LMICs.
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Review Meta Analysis
Benefits of probiotics in preterm neonates in low-income and medium-income countries: a systematic review of randomised controlled trials.
Although there is an overall reduction in underfive mortality rate, the progress in reducing neonatal mortality rate has been very slow. Over the last 20 years, preterm births have steadily increased in low-income and medium-income countries (LMICs) particularly in sub-Saharan Africa and South Asia. Preterm birth is associated with increased mortality and morbidity, particularly in LMICs. Based on systematic reviews of randomised controlled trials (RCTs), many neonatal units in high-income countries have adopted probiotics as standard of care for preterm neonates. We aimed to systematically review the safety and efficacy of probiotics in reducing mortality and morbidity in preterm neonates in LMICs. ⋯ Probiotics have significant potential to reduce mortality and morbidity (eg, NEC, LOS) in preterm neonates in LMICs.
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This systematic review out of Berkeley investigated data on death, injury and disability resulting from crowd control projectiles:
- Rubber and plastic bullets
- Beanbag rounds
- Shot pellets
- Baton rounds
The researchers looked at published data from a 27 year period in the US, UK/N Ireland, Israel, Palestine, Switzerland, Turkey, Kashmir and Nepal.
The study was part of a larger effort from Physicians for Human Rights and the International Network of Civil Liberties Organizations.
What did they find?
Analysing 26 articles (mainly cohort studies) including 1,984 injured people, they identified 53 (3%) deaths and 300 (15%) permanently disabled. Half of total deaths and 83% of disabilities were due to head or neck strikes.
More than half (56%) of the deaths were from penetrative injuries, and 27% from chest or abdominal trauma.
The majority of permanent disability was vision loss, or abdominal injuries resulting in splenectomy or colostomy.
71% of survived injuries were severe, mostly to skin or extremities.
"Given their inherent inaccuracy, potential for misuse and associated health consequences of severe injury, disability and death, KIPs do not appear to be appropriate weapons for use in crowd-control settings."
Take-home
Although colloquially called 'non-lethal weapons', it would be more accurate to label kinetic impact projectiles (KIPs) as less-lethal weapons given the high risk of severe injury, permanent disability or even death.
"We identified only two basic contexts in which CCWs should be used in crowd-control settings:
- Arrest of individuals engaged in unlawful behaviour, such as throwing rocks and;
- Crowd dispersal in riot situations that threaten public safety."
Compounding issue...
Several articles highlighted the effect on morbidity of delays in accessing medical care due to police action and civil unrest.
"There is an urgent need to establish international guidelines on the use of CCWs to prevent unnecessary injury, disability and death, particularly in the use of operational models that avoid the use of weapons."
-
This systematic review out of Berkeley investigated data on death, injury and disability resulting from crowd control projectiles:
- Rubber and plastic bullets
- Beanbag rounds
- Shot pellets
- Baton rounds
The researchers looked at published data from a 27 year period in the US, UK/N Ireland, Israel, Palestine, Switzerland, Turkey, Kashmir and Nepal.
The study was part of a larger effort from Physicians for Human Rights and the International Network of Civil Liberties Organizations.
What did they find?
Analysing 26 articles (mainly cohort studies) including 1,984 injured people, they identified 53 (3%) deaths and 300 (15%) permanently disabled. Half of total deaths and 83% of disabilities were due to head or neck strikes.
More than half (56%) of the deaths were from penetrative injuries, and 27% from chest or abdominal trauma.
The majority of permanent disability was vision loss, or abdominal injuries resulting in splenectomy or colostomy.
71% of survived injuries were severe, mostly to skin or extremities.
"Given their inherent inaccuracy, potential for misuse and associated health consequences of severe injury, disability and death, KIPs do not appear to be appropriate weapons for use in crowd-control settings."
Take-home
Although colloquially called 'non-lethal weapons', it would be more accurate to label kinetic impact projectiles (KIPs) as less-lethal weapons given the high risk of severe injury, permanent disability or even death.
"We identified only two basic contexts in which CCWs should be used in crowd-control settings:
- Arrest of individuals engaged in unlawful behaviour, such as throwing rocks and;
- Crowd dispersal in riot situations that threaten public safety."
Compounding issue...
Several articles highlighted the effect on morbidity of delays in accessing medical care due to police action and civil unrest.
"There is an urgent need to establish international guidelines on the use of CCWs to prevent unnecessary injury, disability and death, particularly in the use of operational models that avoid the use of weapons."