The pH and volume of gastric aspirate were measured immediately after the induction of anaesthesia in 224 healthy children to determine the effects of decreasing the period of fasting and of giving oral premedicants before anaesthesia. Fasting for less than 4 h was found to increase the volume of gastric aspirate and the risk of developing pulmonary aspiration syndrome. Trimeprazine syrup was found to increase the pH of the gastric contents, and decrease the likelihood of the pulmonary aspiration syndrome. There was a significant increase in gastric volume in patients premedicated with temazepam elixir which did not occur in patients given temazepam capsules. These results support the custom of fasting patients for at least 4 h before anaesthesia and indicate that oral premedicants and their vehicles can have significant effects on the stomach.
Purpose: Rates of suicide are increasing rapidly among youth. Social media messages and online games promoting suicide are a concern for parents and clinicians. We examined the timing and location of social media posts about one alleged youth suicide game to better understand the degree to which social media data can provide earlier public health awareness. Methods: We conducted a search of all public social media posts and news articles on the Blue Whale Challenge (BWC), an alleged suicide game, from January 1, 2013, through June 30, 2017. Data were retrieved through multiple keyword search; sources included social media platforms Twitter, YouTube, Reddit, Tumblr, as well as blogs, forums, and news articles. Posts were classified into three categories: individual "pro"-BWC posts (support for game), individual "anti"-BWC posts (opposition to game), and media reports. Timing and location of posts were assessed. Results: Overall, 95,555 social media posts and articles about the BWC were collected. In total, over one-quarter (28.3%) were "pro"-BWC. The first U.S. news article related to the BWC was published approximately 4 months after the first English language U.S. social media post about the BWC and 9 months after the first U.S. social media post in any language. By the close of the study period, "pro"-BWC posts had spread to 127 countries. Conclusions: Novel online risks to mental health, such as prosuicide games or messages, can spread rapidly and globally. Better understanding social media and Web data may allow for detection of such threats earlier than is currently possible.
Among rampage shooting massacres, the Sandy Hook Elementary School shooting on December 14, 2012 galvanized public attention. In this Commentary we examine the features of this episode of gun violence that has sparked strong reactions and energized discourse that may ultimately lead toward constructive solutions to diminish high rates of firearm deaths and injuries in the United States.
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