• Media
• alcohol/drugs
• database
• suicide
• terminology
• concussion
• behaviour change
• public health
• pedestrian
• implementation/translation
• fall
• suicide/self-harm
• community research

Traumatic brain injury (TBI) is no laughing matter, but sometimes, taking a whimsical view can get the reader's attention in ways that nothing else can. I was delighted to find an article analysing 704 TBI cases as portrayed in 34 Asterix comic books. The Asterix series (written by Rene Goscinny) has been popular throughout Europe since it first appeared in 1959, and the books have been translated into more than 100 languages. Not surprisingly, the hapless Romans suffered the most injuries, primarily at the hands of the heroic Gauls. No deaths or permanent deficits seemed to result from the TBIs. An accompanying commentary wonders how these results would compare with, say, the Pink Panther and then reminds us to wear our helmets appropriately. If you enjoyed Asterix and Obelix, you will appreciate this retrospective analysis.

▶ Kamp MA, Slotty P, Sarikaya-Seiwert S, et al. Traumatic brain injuries in illustrated literature: experience from a series of over 700 head injuries in the Asterix comic books. Acta Neurochir 2011;153:1351–5.

Unlike many World Health Organization member nations where suicide dominates as the leading cause of injury mortality, in Brazil, the bulk of injury deaths are due to traffic and homicide. This article analyses the epidemiology, risk factors and determinants associated with these deaths and examines regional differences throughout the nation. Alcohol, illegal drugs and firearms are closely associated with high rates of homicide and other forms of violence. Brazil lacks sufficient public transportation and is “poorly equipped to deal with the infringement of traffic rules.” The authors describe recent advancements in policy and call for continued progress. This article is the fifth in a series of six that addresses health in Brazil.

▶ Reichenheim ME, de Souza ER, Moraes CL, et al. Violence and injuries in Brazil: the effect, progress made, and challenges ahead. Lancet 2011;377:1962–75.

Falls are common among older adults but are not inevitable. A range of interventions can reduce the risk and severity of falls, but many primary care physicians do not screen adequately for falls or the risk factors that precede them. A local health department surveyed primary care doctors about their practices and their perceived barriers to screening. Most respondent a screened for falls only if their patients raised it as a concern. Only 8% used clinical guidelines as the basis for their recommendations. The physicians were constrained by time and by more pressing health issues among their patients. The authors describe how health departments can help provide information and training to improve the frequency with which providers give educational materials to their patients.

▶ Jones TS, Ghosh TS, Horn K, et al. Primary care physicians perceptions and practices regarding fall prevention in adults 65 years and over. Accid Anal Prev 2011;43:1605–9.

Issue 3 of the current volume of the Western Journal of Emergency Medicine contains a number of articles of interest to our readers, including on using policy to strengthen injury prevention efforts, systems thinking for informing state and local policies, brief reports on the effects of media coverage on a particular form of poisoning, a new trend in suicide by means of hydrogen sulphide (first in Japan and now in the USA), family violence in Mozambique, 2 articles on intimate partner violence among men who have sex with men and a case study on bullying.

▶ Western J Emerg Med 2011;12. http://escholarship.org/uc/uciem_westjem.

Smoke detectors and fire extinguishers are great, but to prevent house fires, we need to reduce smoking in the home. A programme to create smoke-free homes was launched in a community with high levels of smoking and smoking-related illness; the evaluation showed that about three-quarters became smoke-free after signing up for the initiative. Many of the homes that signed up turned out to have already been smoke-free; it seems that they wanted to support antismoking campaigns. Other households had set rules to limit smoking to only one room. Although participants were motivated primarily by health benefits and secondarily by fire safety, the primary benefit that they noted 4 months later was a cleaner, better smelling home. Barriers to implementation included uncooperative family members, both as residents and as visitors.

▶ Allmark P, Tod AM, McDonnell A, et al. Evaluation of the impact of a smoke-free home initiative in Rotherham, a deprived district in Northern England. Eur J Public Health. Published Online First: 15 Jun 2011. doi:10.1093/eurpub/ckr072.

Non-suicidal self-injury is an area that is not yet well understood. Researchers engaged in a telephone survey of more than 12 000 Australians, aged 10 years and older; interviews were conducted in 6 languages. Self-injury included cutting, scratching, striking, biting and burning oneself. Existing mental illnesses were documented (15% with anxiety disorders, 19% with mood disorders), and questions were asked about self-injury in the prior 4 weeks (1.1% of participants), 6 months (1.8%) and lifetime (8.1%). Recent self-injurers said that they did so primarily to manage their emotions or to punish themselves. Of the recent self-injurers, 48.1% had also experienced suicidal ideation during the same period. Almost three-quarters of self-injurers had told at least one other person about their behaviour, but only about a third of them had asked for help. Very few sought medical treatment for their injuries. This study gives greater insight into the characteristics of self-injurers, a first step towards designing prevention or intervention programmes.

▶ Martin G, Swannell SV, Hazell PL, et al. Self-injury in Australia: a community survey. Med J Aust 2010;193:506–10.

Have you read—or authored—an interesting article recently? Please send the citation, and copy if possible, to the editor of Splinters & Fragments: Anara Guard; email anara{at}anaraguard.com