Peter Barss - Academia.edu (original) (raw)

Papers by Peter Barss

Papua and New Guinea medical journal, Jun 1, 1989

PubMed, Mar 1, 1985

The maternal death rate is high in grand multiparas giving birth in remote villages in Milne Bay ... more The maternal death rate is high in grand multiparas giving birth in remote villages in Milne Bay Province, Papua New Guinea. Such women are often reluctant to go to hospital for delivery. However, many of them have accepted the idea of going to hospital to await delivery and postpartum tubal ligation. We discuss the results and benefits of this program. 43% of grand multiparas suffered one or more complications during their hospitalization; 77% were sterilized. Considerable morbidity and mortality can be prevented by an active program for hospital management of grand multiparas. Costs of such early referral are at least partially offset by decreasing costs for late emergency transfer of obstetric disasters. 47% of emergency air charters for obstetric complications were for grand multiparas. Numbers of such emergency transfers have decreased as increasing numbers of grand multiparas have been referred early for delivery and tubal ligation.

Injury Prevention, Sep 1, 2016

resolving prior to physician visit, and physician availability. Facilitators of appropriate behav... more resolving prior to physician visit, and physician availability. Facilitators of appropriate behaviour: Team personnel explaining to the parents the importance of physician visits at time of injury and a team protocol that enforces physician-based management. Conclusions Concussion awareness is improving but there are still gaps in hockey parents' and players' understanding of management. Understanding beliefs, barriers and facilitators of proper concussion management behaviour may assist with reducing the consequences that can arise due to mismanagement.

Injury Prevention, Sep 1, 2016

Background Indigenous peoples in Canada live in a mix of rural and urban areas. Open bodies of wa... more Background Indigenous peoples in Canada live in a mix of rural and urban areas. Open bodies of water are often essential for subsistence and recreational transport, fishing, and hunting. Death rates are several times higher than nationally. The goal is preventing immersion deaths by implementing evidence-based interventions for main activities and risk factors in culturally appropriate programs. Methods Annual Red Cross collection of 1991-2010 coroner data by structured questionnaire, including activity, purpose, personal, equipment, environment factors, and trends. Cultural factors pertinent to interventions were assessed by literature reviews, including anthropological surveys. Interventions were developed based upon risk factors for main activities, cultural values, and practical considerations. Logistic regression was used to assess flotation device wearing, controlling for other variables. Results Surveillance identified 1213 immersion and 27 trauma deaths. Boating, including transport, fishing, and hunting, accounted for 37% (n = 444), non-aquatic activities such as walking or playing near water and on ice 21%, aquatic such as swimming or wading 17%, land ice and air transport 17%, bathing 3%, unknown 6%. 52% involved recreation, 34% daily life/ subsistence, occupational 4%, rescue 2%, other 1%, unknown 8%. Main risk groups were males 15 years, 73%, and 1-4year-olds, 9%. Swimming ability was reported for 26% of 5 years, including 23% non-swimmers, 12% weak, 45% average/ intermediate/unspecified, 6% strong. Among 15 year-olds, alcohol was involved for 60% and illegal drugs 10%. Rivers and current were a factor for 35%. For 0-9-year-olds, 73% died without adults. Death rates were similar across Canada, much higher in the North. Boating death rates fell from 4.9 to 1.2/ 100,000/population/year between 1991-1995 and 2006-2010; for other activities, deaths fell during 1991-2000, but not 2001-2010. Main risks for boating included non-wearing of flotation, with only 5% wearing; for 40% none was aboard. Logistic regression showed 68% (p = 0.000) reduced odds of properly wearing flotation, compared with non-indigernous. Among 0-14year-olds, 44% of known ethnicity were indigenous, 0% wearing, others 33% wearing; no indigenous youth wore PFDs, others 13%. Capsizing, falling overboard, and swamping accounted for 75%. Waves, wind, cold water and other cold factors were frequent. For aquatic activities, 15-40-year-old males were main victims, for non-aquatic 1-4-year-olds and 15 males. Rivers were the most frequent body of water. Ice transport victims were predominantly 20-year-old males using snowmobiles, while both males and females 15 were victims of on-road into water deaths. Ice transport deaths mainly occurred in central and Prairie Provinces and northern territories. Most road transport immersions were in the Prairies.

PubMed, Sep 1, 1983

Light aircraft can be valuable for transfer of emergency patients from remote island health centr... more Light aircraft can be valuable for transfer of emergency patients from remote island health centres to a central hospital. A two-year experience of 92 such flights in Milne Bay Province, Papua New Guinea was reviewed. 50% of air charter evacuations were for obstetric or gynaecological patients, 35% for surgical, and 15% for medical cases. 63 of the patients might have died and another nine might have been left with a serious disability without the emergency air transfer. The average cost per life saved was approximately Kina 461 (360 pounds; US$520) and the average cost of providing the emergency service per head of population per year was about Kina 0.10 (0.08 pounds; US$0.12).

PubMed, Sep 1, 1983

Milne Bay Province, Papua New Guinea, with a scattered population of 130,000 suffers from irregul... more Milne Bay Province, Papua New Guinea, with a scattered population of 130,000 suffers from irregular health patrols in remote areas, and often inadequate supplies of contraceptive agents. A total of 694 tubal ligations were performed by hospital staff under local anaesthesia between 1978 and 1982 in the province, the number increasing each year. Detailed analysis of 324 operations from 1979 to 1981 showed an average age of 34, average parity of 7 (84% of women had five or more children) and the presence of one or more high risk factors other than multiparity in half the women operated upon. Tubal ligation decreases maternal mortality, and has proven to be a useful method of family planning for multiparous women living in remote villages in Milne Bay Province.

Injury Prevention, Sep 1, 2016

The study supports the usage of multiple intervention strategies within a holistic approach that ... more The study supports the usage of multiple intervention strategies within a holistic approach that acknowledge these factors to prevent any future home injuries.

The Lancet, Jun 1, 1983

April 30, p 984) of unexpected deaths in pulmonary tuberculosis prompted us to review our case-re... more April 30, p 984) of unexpected deaths in pulmonary tuberculosis prompted us to review our case-records for 1977-82. Pulmonary tuberculosis was a certified cause of death in 32 patients with disease substantiated by sputum culture. Deaths appeared to cluster into an early, a mid, and a late phase from starting chemotherapy. The 8 late deaths (61-234 days) were not unexpected and were usually the result of coexistent disease rather than tuberculosis, although 2 patients had organisms resistant to standard chemotherapy. 9 of the 16 early deaths (1-17 days) could be attributed to overwhelming tuberculosis. However, in 3 of these and 3 others the final event before death was "collapse" with no certain diagnosis, even after necropsy in 1 patient. 8 patients died 28-39 days after

PubMed, Feb 1, 1990

The University National Oceanographic System operates a fleet of vessels to carry out its scienti... more The University National Oceanographic System operates a fleet of vessels to carry out its scientific projects. Illnesses and injuries at sea are handled by first responders aboard the vessels in consultation with land-based physicians at a telecommunications response center in the United States. During the period 1985 to 1987, 122 cases among regular and scientific crew required medical consultation by telecommunications. Of these, 31% were injuries, 34% were medical cases (infected), 12% were sexually transmitted diseases, and 23% were medical cases (noninfected). Evacuation from the vessel, vessel diversion, or repatriation of the patient was required for 20% of all cases; of these, 48% were for injuries, 36% for noninfected medical illnesses, and 16% for infected medical cases. Rates of illness and injury were calculated using the crew days at sea as a denominator.

PubMed, Jun 1, 1985

Fractured hips are increasingly common in elderly citizens of many developed countries. Such frac... more Fractured hips are increasingly common in elderly citizens of many developed countries. Such fractures seem to be rare in less affluent people of some developing countries, even amongst the elderly. A four year review was done of all trauma patients admitted to a provincial hospital in hospital in Papua New Guinea which serves 135.000 people living mainly in remote hamlets. Only three fractures of the proximal femur were noted. One of these was in a bedridden plantation owner. Not a single fracture of the femoral neck was noted in the Melanesian population. Colles fractures of the distal radius were also rarely seen. Other fractures were common. Elderly Melanesian villagers are physically active, and it appears that this is an important factor in preventing bone weakness and associated fractures of the hip and distal radius. Modern cities and urban lifestyles need radical change to keep elderly people more physically active.

Injury Epidemiology, Jul 12, 2016

Background: Baby walkers (BWs) are frequent causes of infant injuries. Little research is reporte... more Background: Baby walkers (BWs) are frequent causes of infant injuries. Little research is reported from the Middle East and few population-based studies anywhere. Methods: Using multistage random sampling in a city of the United Arab Emirates, 4 of 8 female Arab government high schools and 3 final-year classes each from science and arts tracks were selected. Structured self-administered questionnaires assessed prevalence, frequency, severity, and external causes of BW incidents and injuries, and residential hazards. Results: Response was 100 %, 696 students, 55 % (n = 385) Emirati citizens. 87 % (n = 605) of families used/had used BWs. Among 646 injuries were 118 ER (emergency) visits, 42 hospitalizations, 11 disabilities, and 3 deaths. Average risk was 1 incident/user, 1 injury/4 users, 1 ER visit/20, 1 hospitalization/55, 1 disability/200, 1 death/1000. Odds ratios for >1:1 floor levels were 2.3 (95 % confidence interval: 1.2, 4.3) for hospitalization, 16.8 (95 % CI: 2.1, 132.5) disability. Incidents included hitting objects 48 % (n = 1322), overturning 23 % (n = 632), accessing hazardous objects 17 % (n = 473), and falling down stairs 11 % (n = 300); 1 % (n = 32) fell into swimming pools. In 49 % (n = 297/605) of user families, ≥1 child had been injured. Conclusions: Despite causing many injuries including disabilities and fatalities, BWs were used by nearly all families. Governments should consider Canada's lead in prohibiting importation, sales, and advertising of BWs.

Papua and New Guinea medical journal, Jun 1, 1989

PubMed, Mar 1, 1985

The maternal death rate is high in grand multiparas giving birth in remote villages in Milne Bay ... more The maternal death rate is high in grand multiparas giving birth in remote villages in Milne Bay Province, Papua New Guinea. Such women are often reluctant to go to hospital for delivery. However, many of them have accepted the idea of going to hospital to await delivery and postpartum tubal ligation. We discuss the results and benefits of this program. 43% of grand multiparas suffered one or more complications during their hospitalization; 77% were sterilized. Considerable morbidity and mortality can be prevented by an active program for hospital management of grand multiparas. Costs of such early referral are at least partially offset by decreasing costs for late emergency transfer of obstetric disasters. 47% of emergency air charters for obstetric complications were for grand multiparas. Numbers of such emergency transfers have decreased as increasing numbers of grand multiparas have been referred early for delivery and tubal ligation.

Injury Prevention, Sep 1, 2016

resolving prior to physician visit, and physician availability. Facilitators of appropriate behav... more resolving prior to physician visit, and physician availability. Facilitators of appropriate behaviour: Team personnel explaining to the parents the importance of physician visits at time of injury and a team protocol that enforces physician-based management. Conclusions Concussion awareness is improving but there are still gaps in hockey parents' and players' understanding of management. Understanding beliefs, barriers and facilitators of proper concussion management behaviour may assist with reducing the consequences that can arise due to mismanagement.

Injury Prevention, Sep 1, 2016

Background Indigenous peoples in Canada live in a mix of rural and urban areas. Open bodies of wa... more Background Indigenous peoples in Canada live in a mix of rural and urban areas. Open bodies of water are often essential for subsistence and recreational transport, fishing, and hunting. Death rates are several times higher than nationally. The goal is preventing immersion deaths by implementing evidence-based interventions for main activities and risk factors in culturally appropriate programs. Methods Annual Red Cross collection of 1991-2010 coroner data by structured questionnaire, including activity, purpose, personal, equipment, environment factors, and trends. Cultural factors pertinent to interventions were assessed by literature reviews, including anthropological surveys. Interventions were developed based upon risk factors for main activities, cultural values, and practical considerations. Logistic regression was used to assess flotation device wearing, controlling for other variables. Results Surveillance identified 1213 immersion and 27 trauma deaths. Boating, including transport, fishing, and hunting, accounted for 37% (n = 444), non-aquatic activities such as walking or playing near water and on ice 21%, aquatic such as swimming or wading 17%, land ice and air transport 17%, bathing 3%, unknown 6%. 52% involved recreation, 34% daily life/ subsistence, occupational 4%, rescue 2%, other 1%, unknown 8%. Main risk groups were males 15 years, 73%, and 1-4year-olds, 9%. Swimming ability was reported for 26% of 5 years, including 23% non-swimmers, 12% weak, 45% average/ intermediate/unspecified, 6% strong. Among 15 year-olds, alcohol was involved for 60% and illegal drugs 10%. Rivers and current were a factor for 35%. For 0-9-year-olds, 73% died without adults. Death rates were similar across Canada, much higher in the North. Boating death rates fell from 4.9 to 1.2/ 100,000/population/year between 1991-1995 and 2006-2010; for other activities, deaths fell during 1991-2000, but not 2001-2010. Main risks for boating included non-wearing of flotation, with only 5% wearing; for 40% none was aboard. Logistic regression showed 68% (p = 0.000) reduced odds of properly wearing flotation, compared with non-indigernous. Among 0-14year-olds, 44% of known ethnicity were indigenous, 0% wearing, others 33% wearing; no indigenous youth wore PFDs, others 13%. Capsizing, falling overboard, and swamping accounted for 75%. Waves, wind, cold water and other cold factors were frequent. For aquatic activities, 15-40-year-old males were main victims, for non-aquatic 1-4-year-olds and 15 males. Rivers were the most frequent body of water. Ice transport victims were predominantly 20-year-old males using snowmobiles, while both males and females 15 were victims of on-road into water deaths. Ice transport deaths mainly occurred in central and Prairie Provinces and northern territories. Most road transport immersions were in the Prairies.

PubMed, Sep 1, 1983

Light aircraft can be valuable for transfer of emergency patients from remote island health centr... more Light aircraft can be valuable for transfer of emergency patients from remote island health centres to a central hospital. A two-year experience of 92 such flights in Milne Bay Province, Papua New Guinea was reviewed. 50% of air charter evacuations were for obstetric or gynaecological patients, 35% for surgical, and 15% for medical cases. 63 of the patients might have died and another nine might have been left with a serious disability without the emergency air transfer. The average cost per life saved was approximately Kina 461 (360 pounds; US$520) and the average cost of providing the emergency service per head of population per year was about Kina 0.10 (0.08 pounds; US$0.12).

PubMed, Sep 1, 1983

Milne Bay Province, Papua New Guinea, with a scattered population of 130,000 suffers from irregul... more Milne Bay Province, Papua New Guinea, with a scattered population of 130,000 suffers from irregular health patrols in remote areas, and often inadequate supplies of contraceptive agents. A total of 694 tubal ligations were performed by hospital staff under local anaesthesia between 1978 and 1982 in the province, the number increasing each year. Detailed analysis of 324 operations from 1979 to 1981 showed an average age of 34, average parity of 7 (84% of women had five or more children) and the presence of one or more high risk factors other than multiparity in half the women operated upon. Tubal ligation decreases maternal mortality, and has proven to be a useful method of family planning for multiparous women living in remote villages in Milne Bay Province.

Injury Prevention, Sep 1, 2016

The study supports the usage of multiple intervention strategies within a holistic approach that ... more The study supports the usage of multiple intervention strategies within a holistic approach that acknowledge these factors to prevent any future home injuries.

The Lancet, Jun 1, 1983

April 30, p 984) of unexpected deaths in pulmonary tuberculosis prompted us to review our case-re... more April 30, p 984) of unexpected deaths in pulmonary tuberculosis prompted us to review our case-records for 1977-82. Pulmonary tuberculosis was a certified cause of death in 32 patients with disease substantiated by sputum culture. Deaths appeared to cluster into an early, a mid, and a late phase from starting chemotherapy. The 8 late deaths (61-234 days) were not unexpected and were usually the result of coexistent disease rather than tuberculosis, although 2 patients had organisms resistant to standard chemotherapy. 9 of the 16 early deaths (1-17 days) could be attributed to overwhelming tuberculosis. However, in 3 of these and 3 others the final event before death was "collapse" with no certain diagnosis, even after necropsy in 1 patient. 8 patients died 28-39 days after

PubMed, Feb 1, 1990

The University National Oceanographic System operates a fleet of vessels to carry out its scienti... more The University National Oceanographic System operates a fleet of vessels to carry out its scientific projects. Illnesses and injuries at sea are handled by first responders aboard the vessels in consultation with land-based physicians at a telecommunications response center in the United States. During the period 1985 to 1987, 122 cases among regular and scientific crew required medical consultation by telecommunications. Of these, 31% were injuries, 34% were medical cases (infected), 12% were sexually transmitted diseases, and 23% were medical cases (noninfected). Evacuation from the vessel, vessel diversion, or repatriation of the patient was required for 20% of all cases; of these, 48% were for injuries, 36% for noninfected medical illnesses, and 16% for infected medical cases. Rates of illness and injury were calculated using the crew days at sea as a denominator.

PubMed, Jun 1, 1985

Fractured hips are increasingly common in elderly citizens of many developed countries. Such frac... more Fractured hips are increasingly common in elderly citizens of many developed countries. Such fractures seem to be rare in less affluent people of some developing countries, even amongst the elderly. A four year review was done of all trauma patients admitted to a provincial hospital in hospital in Papua New Guinea which serves 135.000 people living mainly in remote hamlets. Only three fractures of the proximal femur were noted. One of these was in a bedridden plantation owner. Not a single fracture of the femoral neck was noted in the Melanesian population. Colles fractures of the distal radius were also rarely seen. Other fractures were common. Elderly Melanesian villagers are physically active, and it appears that this is an important factor in preventing bone weakness and associated fractures of the hip and distal radius. Modern cities and urban lifestyles need radical change to keep elderly people more physically active.

Injury Epidemiology, Jul 12, 2016

Background: Baby walkers (BWs) are frequent causes of infant injuries. Little research is reporte... more Background: Baby walkers (BWs) are frequent causes of infant injuries. Little research is reported from the Middle East and few population-based studies anywhere. Methods: Using multistage random sampling in a city of the United Arab Emirates, 4 of 8 female Arab government high schools and 3 final-year classes each from science and arts tracks were selected. Structured self-administered questionnaires assessed prevalence, frequency, severity, and external causes of BW incidents and injuries, and residential hazards. Results: Response was 100 %, 696 students, 55 % (n = 385) Emirati citizens. 87 % (n = 605) of families used/had used BWs. Among 646 injuries were 118 ER (emergency) visits, 42 hospitalizations, 11 disabilities, and 3 deaths. Average risk was 1 incident/user, 1 injury/4 users, 1 ER visit/20, 1 hospitalization/55, 1 disability/200, 1 death/1000. Odds ratios for >1:1 floor levels were 2.3 (95 % confidence interval: 1.2, 4.3) for hospitalization, 16.8 (95 % CI: 2.1, 132.5) disability. Incidents included hitting objects 48 % (n = 1322), overturning 23 % (n = 632), accessing hazardous objects 17 % (n = 473), and falling down stairs 11 % (n = 300); 1 % (n = 32) fell into swimming pools. In 49 % (n = 297/605) of user families, ≥1 child had been injured. Conclusions: Despite causing many injuries including disabilities and fatalities, BWs were used by nearly all families. Governments should consider Canada's lead in prohibiting importation, sales, and advertising of BWs.