We read with interest the article named 'Prevention and treatment of
decompression sickness using training and in-water recompression among
fisherman divers in Vietnam' that was published in Injury Prevention 2016
February issue. We want to share our opinion about some parts of the
article, especially in three subjects.
It was mentioned that, the aim of the study was to investigate the
impact o...
We read with interest the article named 'Prevention and treatment of
decompression sickness using training and in-water recompression among
fisherman divers in Vietnam' that was published in Injury Prevention 2016
February issue. We want to share our opinion about some parts of the
article, especially in three subjects.
It was mentioned that, the aim of the study was to investigate the
impact of training programmes run over a period of 3 years, focusing on
preventing DCS by reducing unsafe diving practices and treating DCS by
means of IWR, in the last sentence of introduction. So we understood that
the main subject of the study is forcing fisherman divers to make safe
dives resulting in decrease in DCS and also to treat urgently with IWR if
disease occurs. Therefore this education only involves lowering DCS and
treating with IWR. But it is remarked as "Since implementing IWR training,
annual mortality and morbidity incidence rates due to neurological DCS
were reduced in our pilot sample" in second sentence of discussion. It was
understood from the article, prior to 2009, annual mortality due to diving
was estimated 4?1 cases per 1000 fisherman divers and annual incidence of
DCS was 8?2 cases. Between 2009 and 2012 fatality rate dropped 1 per 1000
divers and annual incidence of DCS dropped 2?1 per 1000 divers. However we
know it is unlikely to have a mortality rate of four cases in every eight
DCS cases before 2009 and also one fatal case within two cases of DCS
between 2009 and 2012. Many studies was reported before about this issue,
in one of them Xu et al. showed nine deaths of 5278 consecutive DCS cases
with a incidence of 0.17% in a decade (1). It seems suspicious that one in
a two cases DCS mortality rate as mentioned in the article. Probably the
mortality reasons must be other than DCS, e.g. drowning, nitrogen narcosis
and diving related accidents, before 2009 and also between 2009 and 2012
in these dive sites. We found it very challenging; two days 10 subjects
IWR training courses reduced annual mortality rates due to the DCS.
On the other hand, in the treatment of DCS, there appears three main
goals; [1] immediate reduction in bubble size, [2] to increase the washout
of inert gas and [3] to provide oxygen delivery to the tissues to restore
normal functions (2). If we put an order in terms of treatment efficacy;
standart recompression treatment in chamber (oxygen, 45-60 feet), IWR with
oxygen, breathing oxygen at surface, IWR with air at working depth
(fisherman divers' traditional IWR), IWR with air (Clipperton Protocol, 9
m.) had superiority each other, respectively in the treatment of DCS. It
is well known that, in the absence of a hyperbaric chamber treatment, IWR
with oxygen of course superior to breathing oxygen at surface in DCS.
Known risks of IWR are drowning, applying difficulties, hypothermia and
disability to transfer patient to chamber because of being underwater. It
has been shown that IWR with air at 9 meters has no significant benefit in
DCS; also authors mentioned in the article IWR with air is useless which
the fisherman divers used to do traditionally. Nevertheless authors
advised to divers apply IWR with air at nine meters, which is the last
choice in treatment of DCS but they did not mention exactly why divers
should follow this protocol. If it is done with oxygen it should be
helpful but not with air. According to our knowledge IWR with air should
not be performed, if it is to be done deep treatment protocols must be
chosen, not at shallow depth like nine meters (3).
The last point we want to take attention is that only eight of 24 DCS
patients have been treated with oxygen, the rest were treated with air.
Unfortunately the number of divers, which were treated with oxygen, is
very low. However, two of eight of these patients (%25) started with
oxygen but continued with air, because the cases were not able to breathe
from a second stage regulator. In our opinion, if the rate (%25) is really
in high ranges like this, there could be given educations about using
hoses without second stage regulator.
Declaration of conflicting interests:
The authors declared no conflicts of interest with respect to the
authorship and/or publication of this letter.
Funding:
No author or related institution has received any financial benefit for
this letter.
References
1. Xu W1, Liu W, Huang G, Zou Z, Cai Z, Xu W. Decompression illness:
clinical aspects of 5278 consecutive cases treated in a single hyperbaric
unit. PLoS One. 2012;7(11):e50079.
2. Diving and Subaquatic Medicine, Fifth Edition. Carl Edmonds, Michael
Bennett, John Lippmann, Simon Mitchell. 2015. p. 167
3. 6th ed. USA: U.S. Navy Diving Manual, 2008
In responding to my critique of the report,[1] Joan Ozanne-Smith failed
to address my specific comments.[2]
I therefore call upon her and her colleagues to explain more about their
methodology:
a) Why were the Victorian results not compared with those of Western
Australia? Western Australia had draconian, restrictive firearms laws dating back many
years, prior to the Vicorian laws, but they still have...
In responding to my critique of the report,[1] Joan Ozanne-Smith failed
to address my specific comments.[2]
I therefore call upon her and her colleagues to explain more about their
methodology:
a) Why were the Victorian results not compared with those of Western
Australia? Western Australia had draconian, restrictive firearms laws dating back many
years, prior to the Vicorian laws, but they still have one of the highest per
capita murder/suicide rates in Australia.
b) By what criteria was it decided that "suicide by firearm" was more
significant than death by rope, car exhaust or other method. J Ozanne-Smith refers to the "thousand more lives lost to firearms" but that figure
equates to those who suicided by other methods. What was the ranking
system used to decide that "firearms deaths" were of greater importance
that the many other methods used? Are those murdered, or who suicided by
gun, classed as "REALLY DEAD", while those killed by other methods, are
somehow capable of being resurrected? My own personal interest in this
topic is because my wife's cousin had to hand in two of his late father's
guns in the 1996/97 "buy back". So distraught was he, at parting with
those family heirlooms, the only memory he held of his father, that he
took the Government cheque, went and bought a bottle of scotch and some
rope and hanged himself in his back yard. I have heard of several other
similar cases, where the harsh gun laws "caused" deaths.
c) What influence had the Victorian Government on the outcome of the
report? I note that many of the references were from Vic Gov., or Vic
Police reports... Was the funding for this report, conditional on
production of a "favourable" outcome"?
Reference
1. Whelan P W. Monash Uni Report "junk science" [electronic response to J Ozanne-Smith, K Ashby, S Newstead, V Z Stathakis, A Clapperton.
Firearm related deaths: the impact of regulatory reform] injuryprevention.com 2004 URL direct link to eLetter
2. Ozanne-Smith J, Ashby K, Newstead S, Stathakis V Z, Clapperton A. Authors' reply [electronic response to Whelan P W. Monash Uni Report "junk science"] injuryprevention.com 2004 URL direct link to eLetter
I read with interest this paper by Ozanne-Smith and co-workers.[1] I
congratulate the authors on their meticulous confirmation of the intuitive
expectation that fewer firearms in the community correlates with a
reduction in firearms deaths and injuries. Unfortunately, the authors
confine themselves to the limited objective of studying firearm deaths in
isolation. They do not ask whether the reduction...
I read with interest this paper by Ozanne-Smith and co-workers.[1] I
congratulate the authors on their meticulous confirmation of the intuitive
expectation that fewer firearms in the community correlates with a
reduction in firearms deaths and injuries. Unfortunately, the authors
confine themselves to the limited objective of studying firearm deaths in
isolation. They do not ask whether the reduction in firearm deaths has any
influence on total deaths and injuries. They make only a single comment
that “despite the declines related to homicide, overall suicide and
homicide rates in Victoria did not show a similar decline.” However,
review of the wider literature shows that changes in gun ownership are
unrelated to total suicide and homicide rates.
I am concerned that political activist groups will take this study
beyond its frame of reference and misquote it as proving that “gun bans
work”. Some moral zealots of anti-gun persuasion have had an ongoing
campaign of media advocacy to manipulate public opinion and policy on this
issue, starting some years BEFORE the Port Arthur killings which were the
catalyst for the Australian mass gun confiscations of 1996. This is
mentioned repeatedly in the work by Chapman,[2] one of the references
listed by the authors. Indeed, Chapman suggests such groups form a prior
contingency plan to maximise politically advantageous media coverage of
any dramatic gun crimes which may occur in the future.
Because of this controversy, it is vital that hard facts be obtained
on the specific question of whether mass confiscation of legally owned
guns causes a sustained and significant reduction in TOTAL suicide and
homicide. Besides the AUS$340 million mentioned by Ozanne-Smith and co-
workers, Australian taxpayers have paid another AUS$100 million for the
2003 handgun confiscations from legally licensed owners. This diverts
valuable scarce resources from health, education and law enforcement. There is no point in paying huge sums to get people to hang themselves
instead of shoot themselves and to stab each other instead of shoot each
other.
We must check whether there is a net benefit to public health and
safety. Resources for compensation payments and for enforcement costs must
come from somewhere. If taken from the health sector, such bans may
indirectly end up costing more lives than they might save. For example,
over the relevant time, is there a correlation between declining gun
deaths and lengthening hospital waiting lists or frequency of ambulance
bypass? No-one has attempted such a difficult assessment, apart from Lott
and Mustard, who examined only crime costs.[3] Australia cannot afford
not to get this wrong.
Review of the wider literature shows:
1. The Australian Bureau of Statistics found a steady decline in all
types of gun deaths over 15 years from 1980-1995, before the law
changes.[4]
2. Australian total murder rates were lower prior to 1970, when
there were virtually no long gun controls at all.[5] The long term
homicide rate is fairly stable despite annual fluctuations.[6]
3. Guns now account for only 12% of Australian suicides[7] and only
16% of Australian murders.[8]
4. Ninety percent of Australian gun murders are committed by
criminals who are unlicensed and with guns which are unregistered.[9]
Ozanne-Smith’s hope of achieving “vision zero” through confiscation of
registered guns from licensed owners is therefore naïve at best.
(NOTE: Only legal guns were confiscated. The authors’ findings are
irrelevant to 88% of total suicides, 90% of gun murders and over 98% of
total murders.)
5. The National Injury Surveillance Unit documented that the fall in
gun suicides was accompanied by a rise in total suicide due to
substitution of hanging and car exhaust gas.[10]
6. Britain has suffered massive rises in gun murder and total
murder, about 70% over 1996-2003, despite the total confiscation of all
legal handguns in 1996-7.[11]
7. The USA has had a 50% fall in murder over a similar period,[12] despite increased gun ownership.[13] This is most marked in those states
which allow guns for self defence.[14]
Readers should also be aware that some criminologists have made
scathing criticisms of the quality of research done by medical doctors in
this area, notably Kates et al.[15]
I look forward to further research from Professor Ozanne-Smith and
the Monash group addressing the relationship between gun availability and
total suicide and murder rates and also the cost-effectiveness of mass gun
confiscation in reducing these deaths, both in Australia and other
nations.
References
1. Ozanne-Smith J et al. Firearms related deaths: the impact of
regulatory reform. Injury prevention 2004;10:280-286.
2. Chapman S. Over Our Dead Bodies: Port Arthur and Australia’s fight
for gun control. Pluto Press 1998.
3. Lott JR, Mustard DB. Crime, Deterrence and Right-to Carry
Concealed Handguns. Journal of Legal Studies. 26(1) 1-68 Jan 1997. URL direct link accessed 14 Nov
2004.
4. Firearms Deaths Australia. Australian Bureau of Statistics. Feb
1997. Cat. No. 4397.0
5. Mouzos J. Homicidal Encounters: a Study of Homicide in Australia
1989-1999. Australian Institute of Criminology 2000.
6. Mouzos J, Segrave M. Homicide in Australia 2002-2003 National
Homicide Monitoring Program Annual Report. Australian Institute of
Criminology 2004.
7. Year Book Australia 2002. Health Special Article-Suicide.
Australian Bureau of Statistics. URL direct link accessed 29 Oct 2004.
8. Mouzos J., Segrave M. Homicide in Australia 2002-2003 National Homicide
Monitoring Program Annual Report. p42. Australian Institute of
Criminology 2004.
9. Mouzos J. Licensing and Registration Status of Firearms used in
Homicide. Trends and Issues Paper 151. May 2000. Australian Institute of
Criminology. URL direct link accessed 14 Nov 2004.
10. Harrison JE., Steenkamp M. Suicide in Australia: Trends and data
for 1998. Australian Injury Prevention Bulletin Issue 23 2000. URL direct link accessed 14 Nov 2004.
11. Povey D. Ed. Crime in England and Wales 2002/2003: Homicide and
Gun Crime. January 2004. Home Office –United Kingdom. URL direct link accessed 14 Nov 2004.
12. Homicide Trends in the US. Long term trends and patterns. US
Department of Justice 2003. URL direct link accessed 14 Nov 2004.
13. Kleck G. Targeting Guns: Firearms and their Control. Table 3.1
pp 96-7. Aldine de Gruyter 1997.
14. Lott JR, Mustard DB. ibid.
15. Kates DB. Et al. Chapter 5, Bad medicine: Doctors and Guns. in
“Guns: Who should have them?” Ed. Kopel DB. Prometheus 1995.
The 1996 national gun law reforms in Australia saw 660 959 semi-automatic and pump action shotguns removed from the Australian community.
The impressive fall in the Victorian and Australian gun death rate and the
falls in reported gun ownership in Melbourne homes reported by Ozanne-Smith et al plainly have much to do with this.[1] However the impact of the
gun law reforms on mass killings is even mo...
The 1996 national gun law reforms in Australia saw 660 959 semi-automatic and pump action shotguns removed from the Australian community.
The impressive fall in the Victorian and Australian gun death rate and the
falls in reported gun ownership in Melbourne homes reported by Ozanne-Smith et al plainly have much to do with this.[1] However the impact of the
gun law reforms on mass killings is even more impressive.
Eighty percent of gun deaths in Australia are suicides. Semi-automatic and pump action shotguns (the only guns subject to the buyback)
are irrelevant in suicides -- with only one squeeze of the trigger
required, any of the bolt or lever action guns still available to licensed
shooters can be used. The same applies to guns used in domestic
slayings of the sort where angry or depressed men shoot their partners and
children. As suicides and domestic killings together constitute the
largest proportion of gun deaths, removing only semi-automatics from the
community should not make any difference. But it certainly seems to have
done so.
The ban on semi-automatic rifles with their potential to kill many
people quickly was introduced as a specific response to the horror of the
Port Arthur killings. What all Australians can be thankful for is
that, in the 103 months since Port Arthur, there have been no mass
shooting incidents in Australia where four or more people were shot, let
alone killed. Yet in the nine years before Port Arthur, there were 10 such
incidents such as Strathfield (NSW),
Hoddle and Queen Streets (Victoria), with 66 people being killed.
Peter Whelan [2] fails to support his hypothesis with any data nor
even one reference demonstrating that improvements in surgical techniques
since 1996 and the proliferation of mobile phones (that might get
ambulances to firearm injured persons more quickly) may explain the
improved firearm death rates. As author of the main study that has
examined the use of mobile phones in emergency situations [3] I can assure
him that many hours of investigation to see if mobile phone use has
indeed shortened the "golden hour" has failed to provide any evidence
that this intuitive and appealing hypothesis is in fact the case.
References
1. J Ozanne-Smith, K Ashby, S Newstead, V Z Stathakis, and A
Clapperton Firearm related deaths: the impact of regulatory reform. Inj
Prev 2004; 10: 280-286.
2. Whelan P W. Monash Uni Report "junk science" [electronic response to Ozanne-Smith J, Ashby K, Newstead S, Stathakis V Z, Clapperton A. Firearm
related deaths: the impact of regulatory reform] injuryprevention.com 2004 URL diredt link to eLetter
3. Chapman S, Schofield W. Lifesavers and Samaritans: emergency use of
cellular (mobile) phones in Australia.
Accid Anal Prev. 1998;30(6):815-9.
I read the response from Chapman with interest.[1] In referring to the number of guns handed in during the 1996/97 buy back, Chapman fails to disclose that those firearms, legally owned by
farmers and sporting shooters, had never been a problem in society. I
refer to the submission by Australian Institute of Criminology to the
publication "Evaluating Gun Policy: Effects on Crime and Violence"
published...
I read the response from Chapman with interest.[1] In referring to the number of guns handed in during the 1996/97 buy back, Chapman fails to disclose that those firearms, legally owned by
farmers and sporting shooters, had never been a problem in society. I
refer to the submission by Australian Institute of Criminology to the
publication "Evaluating Gun Policy: Effects on Crime and Violence"
published by Brookings Institute Wash. USA, in which the topic of
Australia's gun laws was covered under the heading of "A massive Buy Back
of Low Risk Guns"!! Murder by firearm has always been a relatively rare
occurence in Australia.
Since the harsh gun laws of 1996/97, contrary to Chapman's claims, there
have been several mass murders; the Childers (QLD) Fire Massacre, in which
15 young backpackers were murdered, and the Snow Town (S.A.) "bodies in
the barrels" case, in which 12 people were murdered (by piano wire!) as
well as several cases where parents murdered their children (and sometimes
themselves) by knife, bathwater, pillows and car exhaust. (ref. A.I.C.
Research Report no 46).
The tragic mass murders, where a firearm was selected as the weapon,
should have been treated as problems of mental health, not of firearms
ownership! As long as mental health is ignored in our community, murders
and suicides will continue to be a problem. Those in the medical
profession, who choose to place the blame for such occurrences, on legally
owned firearms, are simply diverting attention from the real issues.
On the topic of mobile telephones, I do not need to offer any supporting
data, as reference was made to mobile telephone ownership, as an example
of the many variables that should have been taken into account, in
analysing what had happened since 1978. I might well have highlighted the
increasing use of CCTV surveillance of shopping centres and railway
stations, or of the dramatic increase in private security guards, armed
with handguns, who now patrol our streets. All of the above, and many
other factors, may have had an effect on "gun deaths" , but the original
paper by Monash Uni Accident Prevention Unit, failed to take any of those
factors into account.
Further study should also be made of the useage of firearms for self-
defence. It can be assumed that if just one person at Port Arthur in 1996,
had been carrying a firearm, the number of deaths might have been as low
as 2 or 3, rather than 35.
References
1. Chapman S. No mass shootings in Australia since gun law reform [electronic response to Ozanne-Smith J, Ashby K, Newstead S, Stathakis V Z, Clapperton A. Firearm related deaths: the impact of regulatory reform] injuryprevention.com 2004 URL direct link to eLetter
We read the article by Hendrie et al with interest.[1] Compared to the salaries of their North American and European counterparts, the average Japanese family income is higher. The majority of parents
tend to believe that the cost of child restraint seats (CRS) is comparatively higher than other countries. CRS in Japan are much more expensive - around US$ 250-400. Government subsidiary would
be nece...
We read the article by Hendrie et al with interest.[1] Compared to the salaries of their North American and European counterparts, the average Japanese family income is higher. The majority of parents
tend to believe that the cost of child restraint seats (CRS) is comparatively higher than other countries. CRS in Japan are much more expensive - around US$ 250-400. Government subsidiary would
be necessary to reduce this price and motivate parents to use this highly
effective safety device. This would be expensive, but when
viewed against the huge public health and traffic safety benefits in the long-term, this would be cost effective.[2] As many surveys have found, CRS use in Japan is lower; this strategy would help improve CRS use. Arguably, a moral obligation exists to offer
subsidies that give all children a fair chance of surviving to
adulthood.[1] In 1982-84 the Swedish government introduced a routine
childhood car-seat lending scheme. Sixty-seven % of children used
car seats on short trips and 73% on long trips, which subsequently led to
a decrease in childhood injuries.[3]
References
1. Hendrie D, Miller T R, Orlando M, Spicer RS, Taft C,
Consunji R, Zaloshnja E. Child and family safety device affordability
by country income level: an 18 country comparison. Injury Prevention
10:338-343;2004.
2. Desapriya E B R, Iwase N, Brussoni M, Papsdorf M. Child
motor vehicle occupant casualties before and after enactment of Child
Restraint Seats (CRS) legislation in Japan. Injury Prevention and Safety
Control (In press).
3. Svanstrom L, Schelp L, Ekman R. Sweden, 10 years after,
still a safe community? International J Consumer Safety 1996;3(1):1-7;1996.
I note with interest Chapman's contribution to the discussion[1] on the paper by Ozanne-Smith et al. on firearm law reform in
Australia.[2] Chapman's claims are not incorrect, as far as they go.
However, like Ozanne-Smith et al, it is what Chapman has left out that
may confuse readers.
There have been several mass murders (defined as four or more deaths in
one incident) in A...
I note with interest Chapman's contribution to the discussion[1] on the paper by Ozanne-Smith et al. on firearm law reform in
Australia.[2] Chapman's claims are not incorrect, as far as they go.
However, like Ozanne-Smith et al, it is what Chapman has left out that
may confuse readers.
There have been several mass murders (defined as four or more deaths in
one incident) in Australia since 1996, although none with guns. The worst
was the arson attack in Childers, where 15 people were murdered. Others
have involved knives and parents gassing themselves and their children in
their cars.
The effectiveness of the 1996 Australian gun confiscations ("buy-
back" is a Government euphemism) in reducing suicide and violent crime has
been examined in detail by Reuter and Mouzos.[3]
They find, inter alia, that:
1. Mass murders account for only 3% of all Australian homicides.[4] Of the 13 such killings 1989-90 to 1996-7, only six involved guns.[5] (Chapman's comments are simply irrelevant to over 98% of Australian
murders).
2. "Observed declines in ... homicide continued a long term trend
rather than the effects of the Port Arthur incident."[6]
3. On mass murder, as raised specifically by Chapman, they state "there
has been a modest reduction in severity and frequency ... none have
involved firearms, although the frequency of these events is so low that
not much can be inferred".[7]
4. The lowest Australian gun homicide rate was in 1950,[8] (when there
were no virtually long gun controls at all).
5. "Suicide rates did not fall ... homicides continued a modest
decline."[9]
6. There was a marked rise in total armed and unarmed robbery,
particularly with knives.[10]
7. UK gun bans did not reduce violent crime.[11]
8. "All this is generally consistent with substitution."[12]
The most enthusiastic endorsement Reuter and Mouzos can scrape
together is "There may have been a modest effect on homicides. The number
declined continuing a pre-existing trend ... one could not reject the
hypothesis that it had reduced homicides by 10%."[13] (As the homicide
rate before the 1996 confiscations fluctuated by up to 15% each year,[14] this is not significant). While Reuter and Mouzos do not say so, their
findings suggest that the 1996 confiscations have wasted over half a
billion dollars of Australian taxpayers' money.
Chapman attributes the passage of the 1996 Australian
confiscation laws NOT to hard facts, or any plausible theory, but to years
of prior media advocacy extending over several years BEFORE the Port
Arthur killings.[15] He further urges that such tragedies be "anticipated
and planned for" by such activists to "exploit to advantage" the interest
generated.[16]
Chapman is well known for his enthusiastic use of media advocacy to
bring about changes in the law and teaches tertiary courses on this
subject.[17]
Details of technique are provided in his outstanding text,[18] which
is essential reading for political activists of all persuasions. Despite
the reference to public health in the title, the book is about media
manipulation, with minimal reference to public health principles. There is
nothing on relative risk, cost-benefit analysis, correlation versus
causation or outcome evaluation. There is no matching insistence on
checking actual outcome of the law changes. In particular, Chapman insists
the activist must " frame the debate".[19] In our current context, this
means insisting that we are concerned only with gun murders, not total
murders.
He also recommends the use of "creative epidemiology" in advocacy work, ie reworking the data into "interesting and arresting forms."[20] He actually
does this in his electronic letter where he compares 103 months with 9
years. Chapman describes how to facilitate misrepresentation of extremist
opposing views as being typical of moderate mainstream opposing views.[21]
Many will doubt whether such a simplistic "sound bite"[22] approach
is likely to improve public safety. Browning, in particular, claims that
political activists dress their agendas in public health clothes so as to
claim respectability, moral superiority and sometimes government
funds.[23] In addition, the mass media may well be part of the problem.
Criminologists have repeatedly pointed out the media practice of
concentrating on rare sensational events, thus misleading the public about
crime risks in the real world.[24-26]
It would be very helpful if Chapman and Ozanne-Smith could EITHER
publicly clarify why they believe gun deaths are of much greater
importance than non-gun suicides and murders OR confirm that the real
issue is how to reduce TOTAL deaths, not just deaths from a particular
instrument. We must decide whether the aim is to reduce deaths ONLY from
GUN murders and suicides or deaths from total murders and suicides. Given
limited resources, what is the best way to use them?
Conclusions: 1) The 1996 mass gun confiscations were not nearly as effective as Chapman
implies, if they were effective at all; 2) all political activists should study Chapman's book on media advocacy; and 3) the subtle distinction between "media advocacy" and propaganda, if any,
is unclear and readers may wish to ponder for this for themselves.
I have previously detailed the failure of mass gun confiscation in
both Australia and the United Kingdom to bring about any significant
change in total homicide rates.[27]
References
1. Chapman S. No mass shootings in Australia since gun law reform [electronic response to Ozanne-Smith J, Ashby K, Newstead S, Stathakis V Z, Clapperton A. Firearm related deaths: the impact of regulatory reform] injuryprevention.com 2004 URL direct link to eLetter .
2. Ozanne-Smith J et al. Firearms related deaths: the impact of
regulatory reform. Injury prevention 2004;10:280-286.
3. Reuter P, Mouzos J. "Australia: a Massive Buyback of Low-Risk
Guns".Chapter 4. In: "Evaluating Gun Policy- Effects on crime and
violence". Eds. Ludwig J, Cook P J. Brookings Institute Press, 2003.
4. ibid. p127
5. ibid. p127
6. ibid. p134
7. ibid. p122
8. ibid. p126
9. ibid. p121
10. ibid. p138
11. ibid. p122
12. ibid. p140
13. ibid. p140
14. Mukherjee S, Carcach C. "Violent Deaths & firearms in Australia:
data and Trends". Australian Institute of Criminology 1996. Derived from
Table 3.1, p18.
15. Chapman S. "Over Our Dead Bodies-Port Arthur and Australia's fight for
gun control". Pluto Press 1998. Preface vii, pp 5,8,9. NOTE: This book
may be out of print. Contact Pluto Press Australia (not Pluto UK)
pluto@plutoaustralia.com
16. Chapman S. Over our dead Bodies. ibid. pp 6,7.
18. Chapman S, Lupton D. "The Fight for Public Health-Principles and
practice of media advocacy". BMJ Publishing Group 1994.
19. Chapman & Lupton. Ibid. p12
20. ibid. p160-163
21. ibid pp158-9.
22. Chapman S. Over Our Dead Bodies op. cit. p90.
23. Browning RW. "Exploiting Health-Activists and Government v the
people". Canonbury Press 1992. Pp 3,4,13.
24. Mouzos J., Segrave M. "Homicide in Australia. 2002-2003 National
Homicide monitoring program Annual Report". Australian institute of
criminology 2004. p3.
25. Weatherburn D. "Law and Order in Australia-Rhetoric and reality". The
Federation Press 2004. pp 2,3,48
26. Grabowsy P., Wilson P. "Journalism and Justice-How crime is reported".
Pluto Press Sydney. 1989. Especially chapters 2,8,9.
27. Lawson J B. Re: Firearm related deaths: the impact of regulatory reform. [electronic response to Ozanne-Smith J, Ashby K, Newstead S, Stathakis V Z, Clapperton A. Firearm related deaths: the impact of regulatory reform] injuryprevention.com 2004 URL direct link to eLetter
Despite James Lawson’s best efforts to suggest otherwise [1],
ordinary people – and thankfully nearly all politicians on all sides of
Australian politics -- understand that 10 mass shootings involving 66
deaths in 10 years, followed by 103 months with no such incidents is a
positive development. Opinion polls before and after the 1996 Port Arthur
massacre repeatedly showed overwhelming proportions of A...
Despite James Lawson’s best efforts to suggest otherwise [1],
ordinary people – and thankfully nearly all politicians on all sides of
Australian politics -- understand that 10 mass shootings involving 66
deaths in 10 years, followed by 103 months with no such incidents is a
positive development. Opinion polls before and after the 1996 Port Arthur
massacre repeatedly showed overwhelming proportions of Australians
surveyed believed there was no place in a civilized society for virtually
unrestricted civilian ownership of semi-automatic and pump action weapons
capable of rapidly killing many people [2]. These were the guns that were
banned in Australia in 1996 after the massacre.
People like James Lawson mourn the loss of the ability to own such
weapons and trivialize mass killings (“only 3% of all Australian
homicides”) and gun deaths (“only 12% of Australian suicides and only 16%
of Australian murders.”). The nub of their argument is that people intent
on killing or suiciding will find other means to do so and therefore
policies designed to reduce the ease with which people can kill many
others quickly are ill-conceived.
The reductio ad absurdum of the right to own rapid-fire weapons is
presumably that civilians such as The Coalition of Law Abiding Sporting
Shooters, in the name of freedom to play “sport” with such weapons,
should be allowed to own flame throwers, rocket launchers, grenades,
dynamite, and tanks. People who might one day be dangerous or develop
terrorist proclivities should be identified, they’d argue, so that law
abiding people could play with their rocket launchers, machine guns etc at
will. With the world desperate to pre-identify terrorists, the profound
naivety of this should be obvious to all. If this is not their position
and that they believe the prohibitions on these things are sensible, we
would all appreciate learning where they draw the line.
By the same logic, Dr Lawson would presumably oppose effective
suicide prevention measures that have been associated with reduction in
overall suicide rates such as the strict control of barbiturates[3], the
detoxification of domestic gas supply[4,5], and the construction of access
barriers on high buildings.
Do I believe gun deaths are more important than murders and suicides
not involving guns, and whether it would not be more sensible to try and
reduce all such deaths? The sub-text of the question here is “instead of
going after guns, why don’t you go after larger fish?” This is a bit like
saying “if you can’t fix all health problems, how dare you try to fix any”
or suggesting that diabetes prevention specialists should abandon their
efforts because cancer kills more people.
Public health measures to reduce death and injury always consider the
practicalities and cost-benefits of proposed strategies. The Childers back
-packer murderer Lawson refers to, set fire to a hostel. It would be sheer
folly to ban matches and petrol. Parents who kill their families use a
variety of means such as suffocation, knives and car exhausts, where
similar cost-benefit problems exist in proposals to ban the means.
Plainly, none of these means can be controlled via legislation whereas gun
access can be significantly reduced with the only cost being the loss of
the “freedom” to not be able own one of these ultra-lethal weapons that
the Australian community has repeatedly urged should be banned [2].
Finally, I thank Dr Lawson for his generous comments on my book. He
may be disconcerted to know that I donate royalties to causes such as gun
control.
2. Chapman S. Over our dead bodies. Port Arthur and Australia’s fight for
gun control. Pluto Press 1998. Table 3.1.
3. Schapira K, Linsley KR, Linsley A, Kelly TP, Kay DW. Relationship of
suicide rates to social factors and availability of lethal methods:
comparison of suicide in Newcastle upon Tyne 1961-1965 and 1985-1994. Br J
Psychiatry. 2001 May;178:458-64.
4. Lester D. The effect of restricting access to lethal methods for
suicide: a study of suicide by domestic gas in Japan. Acta Psychiatr
Scand. 1989;80:180-2.
5. Lester D. The effect of the detoxification of domestic gas in
Switzerland on the suicide rate. Acta Psychiatr Scand. 1990;82:383-4.
An open letter to the Insurance Institute for Highway Safety (IIHS).
Please, don’t train and evaluate my surgeon, airline pilot or
electrician as well as we prepare our nation’s youthful drivers.
Studies showing little or no “crash reduction” benefit from
traditional driver education programs have concluded that they have little
or no benefit, or the disbenefit of getting these students on the road
sooner. But aren’t the programs themselves ineffective at achieving crash
reduction? Can we expect a demonstration of improvement in the short time
and attention allotted to those programs? Didn’t the DeKalb study show
that a students who took a “little better” program fare a little better
for a little while? What results could we expect through a “lot better”
program.
We have no evidence that it wouldn’t work.
Why would the insurance industry condemn the motivation to improve?
As evidence, didn’t “every driver that ever crashed”, pass their DMV
driver’s test? We haven’t seen any scrutiny on the ineffectiveness of DMV
standardized testing based on the gruesome evidence of GES data.
From the tragic statistics, the recent tsunami, the 911 terrorism and
the serial mid-eastern wars pale in comparison to the perpetuated human
tragedy of car crashes. Small mistakes make for big consequences with a
moving automobile even if, through engineering, the car is made to be more
crash protective. The forensics show that the victims suffer from some
mistake, their own or someone else’s. We’re all accountable.
Six million crashes and 40,000+ U.S. fatalities per year? After ten
years or forty years? The totals are staggering.
What is to be done? How can we reduce the error rate? However,
unintentional or inadvertent, most crashes aren’t accidents.
Failure is when your best isn’t good enough.
Please don’t believe that violence of this proportion is inevitable
or has to be the price of our free, independent mobility.
I contributed on an advisory committee for the National Highway
Traffic Safety Administration (NHTSA) several years ago. The committee
made recommendations on graduated licensing for the states’ legislatures
to ponder. Most states adopted graduated licensing plans that shelved the
more expensive provisions of training and evaluation, in favor of the less
expensive restrictions and required parental involvement. Oh yes, and
enforcement.
The restrictions and supervision are, gratefully, pointed out as
immediate successes and work primarily because of reduced total youthful
driving exposure, under more controlled conditions and circumstances.
Any parent could have instituted these restrictions at any time prior
to the legislation. Those parents would have had to enforce it themselves
(an unpleasant task in some families).
The international figures show that eight industrialized countries
fare better than the U.S. on their crash and fatality rates. Each of
these countries have more rigorous training (albeit more expensive) for
initial licensing and periodic updates.
Other studies show that few American drivers feel the need to improve
their own driving (“self certified”, “I’m OK”) fewer still have crash
avoidance competency. Forensic crash investigations show that in more than
one third of all crashes, there is no evidence that driver made an attempt
at avoidance. If you hit what is in your way, you probably failed to miss
it. Fatal inability.
All educators know that the most difficult personal factors to
improve are; decision making, judgment and maturity. Twelve years of
English classes most frequently produces readers. How much training
effort does a violinist or quarterback put in? Even the IIHS “Northport”
study stated that emergency procedures training “showed promise” for crash
rate reduction, “when coupled with motivational influences”.
The first time you took a ride in a car (?), and the last time you
will? We’re in cars practically from “womb to tomb”, a lifetime of
potentially hazardous, kinetic mobility.
I hope that your efforts would be to never give up on helping the
individual behave with deliberate effort to be their own best driver . . .
. and endorse whatever (public policy) improvements to driver training and
education that can reduce the accumulation of cost, pain and the fatal
price we’re all subject to.
Why do some research professionals continue to hold positions that
result in avoiding a serious overhaul of, and investment into, educating
new drivers? Education-testing young drivers warrants as much attention
and investment as crash-testing new vehicles! Exploring how to teach and
motivate teen drivers will result in knowledge that is likely more
valuable to society and traffic safety than expl...
Why do some research professionals continue to hold positions that
result in avoiding a serious overhaul of, and investment into, educating
new drivers? Education-testing young drivers warrants as much attention
and investment as crash-testing new vehicles! Exploring how to teach and
motivate teen drivers will result in knowledge that is likely more
valuable to society and traffic safety than exploring the crush of a new
vehicle!
Researchers Allan Williams and Susan Ferguson of the Insurance
Institute for Highway Safety (IIHS) have weighed in once again on their
position regarding driver education. Although they title their article
“Driver’s Education Renaissance?”, their comments reflect an old position
that does not promote education; it promotes delaying and avoiding
education. The premise of this position is kids who don’t drive won’t
crash, and educating someone on how to do something will result in them
doing it. Their commentary is posted at the Injury Prevention Online Web
site [2]. This article is a rebuttal to the position they put forward.
This author found no positive suggestions for improving driver
education in the Williams and Ferguson commentary, yet research abounds on
how people learn, [3] and the body of knowledge on how it applies to driver
education, although still largely ignored, continues to grow [4]. Their
specific, useful positive suggestions are limited to the agreed benefits
of various elements of graduated driver experience models. But, because
driver education results in kids driving, they also recommend that access
to driver education be made less convenient by removing it from high
schools.
Those who would define the agenda on teen driver education should be
able to offer something more positive than to make driver education less
convenient to the general public. This suggestion leads this author to
believe they are at a loss on how to improve driver education, or as to
what role it can provide in improving the learning experiences of young
drivers.
Their commentary continues their public message that scarce public
dollars will be wasted if spent on driver education. They disclose that a
good driver education program results in more skilled drivers, but the
context and underlying message is “skilled drivers are not necessarily
safe drivers.” [5]. Even so, the article also conveys the fact that efforts
over the past couple decades to convince the public that education
measures are useless has failed, and with that admission the article
appears to divulge a concern that efforts to keep public dollars from
being invested into driver education are at risk.
The Williams and Ferguson article appears to be part of a strategy,
perhaps well intended, to counter the ongoing struggle to adequately fund
and improve driver education—a counter stimulated by renewed interest of
the public and Congress in driver education. The struggle that exists
between some researchers and those who directly work with teens is a
challenging conundrum. Most parents and teachers believe education is
important to help teens learn safe driving behaviours, but some of those
who review literature and research at arms length from young, aspiring
drivers believe teens should not be taught to do something that might
result in their harm.
Would Williams or Ferguson consider delaying young minds from being
taught the basics of the scientific method? Any teacher can tell you that
young minds will err in their methods, analysis and conclusions until they
learn, through experience, to master the skill. Yet, society knows that
young minds should be taught. Teachers, therefore, work patiently, over
time, to establish a foundation of knowledge in the scientific method and
provide expanding experience, helping students overcome errors and produce
more accurate conclusions in more complex scientific inquiries. Society
demands this be done because society understands the value of the
educational process.
The facts cited by Williams and Ferguson overlook new emerging
reports coming out of Washington and Oregon that indicate teens whose
learning experience includes a standards-based, state-approved driver
education program are safer drivers than those who do not take a state-
approved driver education program [6]. In addition, what is known by
research is not the only useful body of knowledge relating to teen
drivers. The writers report “86 percent” of the public “considered
driver education courses ‘very important’ in training new drivers to drive
safely.” Those who are closer to the real world have ways of understanding
things that frustrate the analytical and necessarily myopic world of
research and empiricism. We must respect what is unscientifically
"known" by the public. In fact, intuitive knowledge and hunches are an
important seedbed of hypotheses that eventually become scientific
knowledge.
Champions and guardians of empirical knowledge are invaluable
contributors to public discussion and policy development. However, I
learned years ago that while the advice of accountants and researches is
very important, unless those analyzing the data understand the heartbeat
of the business, their advice may not result in the hoped for outcome.
Why is that? It is because the world of science is a discovery process
and what has been empirically explored and documented represents only the
tiniest piece of the universe of knowledge awaiting exploration. Despite
our great and wonderful advances, what is unknown is far greater than what
is known, and what is thought to be known is often, at best, only
partially known.
It is not unusual for researchers to warn that a particular effort
represents a focus for which there is no scientifically proven value, only
to find through additional research that there is evidence of its value.
Examples of this abound [7].
Delaying license may reduce crashes for the younger teens, but what
does it do for the older teens who have yet to learn to drive, and how
does that help rural states that insist on young teens being able to
drive. At some point the would-be driver must learn to drive and begin
the path of acquiring experience. Society has invested too little effort
and resources into improving methods of initial instruction. The public
intuitively knows that education has to play a part as certainly as the
staff at the IIHS know that young minds must be taught the scientific
method.
Perhaps the driver education agenda should be defined by experts in
education, learning development and human behaviour who have explored the
nuances of the human mind and know the heartbeat of the education and
training process. Perhaps its time to expand the dialogue to folks who
have suggestions other than Williams’ and Ferguson’s suggestion to avoid
or delay the task, and who are willing to forge ahead and improve a driver
education system that has yet to embrace present education and training
knowledge and technologies. Perhaps experts at crashing cars and
calculating the costs of crashes for insurance companies are not the
experts that can best advance solutions to the driver education
challenges.
The bottom line is that experience without skilled and knowledgeable
instruction will lead to reinforcement and establishment of poor and
illegal driving behaviours and habits. Society can’t expect the teen
driver to drive safely if they do not know how. A quality driver
education and training experience is the foundation for safe driving
behaviour. That foundation needs to be true and sound so that subsequent
safe-driver initiatives can build upon that foundation of knowledge and
skill, including public policies that encourage improved driving norms for
all drivers [8].
In the words of Russell W. Davenport [9], “Progress in every age
results only from the fact that there are some men and women who refuse to
believe that what they know to be right cannot be done.”
For more on the suggestions of this author (David Huff) and other
experts who believe something positive can be done, visit the Driver
Education Forum sponsored by the National Transportation Safety Board at
http://www.ntsb.gov/Events/symp_driver_ed/symp_driver_ed.htm.
David C. Huff 1
References
1. David C. Huff is the director of traffic education for the state
of Montana through the Montana Office of Public Instruction. He has a
master of science in education--learning development with an emphasis on
traffic education.
3. One such resource: National Research Council. (2000). How people
learn: Brain, mind, experience, and school. Washington, D.C.: National
Academy Press.
4. The National Institute for Driver Behavior is one organization
that applies brain-based research on how teens learn to driver education
curriculum and technologies. http://www.NIDB.org.
6. National Highway Traffic Safety Administration research report on
Oregon at 2005 Lifesavers Conference, and research reports on Washington
driver education programs delivered at 2003 and 2004 American Driver and
Traffic Safety Education annual conference by Nickolas Lovrich and Steve
Ellwanger, Washington State University.
7. In the 1960s some members of the medical community warned there
was no evidence of vitamins C and E’s value as a preventative treatment
for various ailments. Today, however, they are valued as an important
part of a healthy diet, as anti-oxidants that fight free radicals and
among other things, recognized as potentially beneficial in preventing
cancer (http://www.cancer.gov/newscenter/pressreleases/antioxidants). A
similar campaign by some scientists resisted alternate theories on the
causes of ulcers. We now know that some forms of ulcers are caused by
bacteria, are easily cured, and not just the symptoms of too much stomach
acid (http://www.cdc.gov/ulcer/).
8. This author recognizes that even the best driver education efforts
will have less positive long-term benefit than desired if the driving
norms of society are poorer than the desired behaviours taught to the new
driver. The teens will soon drive like the parents and neighbors who
perpetuate the norms. Solutions must also be pursued for improving the
norms of all drivers. See the author’s recommendations at the National
Transportation Safety Board Web site listed in the closing paragraph
above, and comments by: Evans, L (2004) Traffic Safety, Chapters 13 and
16. http://scienceservingsociety.com
Sir,
We read with interest the article named 'Prevention and treatment of decompression sickness using training and in-water recompression among fisherman divers in Vietnam' that was published in Injury Prevention 2016 February issue. We want to share our opinion about some parts of the article, especially in three subjects.
It was mentioned that, the aim of the study was to investigate the impact o...
Dear Editor
In responding to my critique of the report,[1] Joan Ozanne-Smith failed to address my specific comments.[2] I therefore call upon her and her colleagues to explain more about their methodology: a) Why were the Victorian results not compared with those of Western Australia? Western Australia had draconian, restrictive firearms laws dating back many years, prior to the Vicorian laws, but they still have...
Dear Editor
I read with interest this paper by Ozanne-Smith and co-workers.[1] I congratulate the authors on their meticulous confirmation of the intuitive expectation that fewer firearms in the community correlates with a reduction in firearms deaths and injuries. Unfortunately, the authors confine themselves to the limited objective of studying firearm deaths in isolation. They do not ask whether the reduction...
Dear Editor
The 1996 national gun law reforms in Australia saw 660 959 semi-automatic and pump action shotguns removed from the Australian community. The impressive fall in the Victorian and Australian gun death rate and the falls in reported gun ownership in Melbourne homes reported by Ozanne-Smith et al plainly have much to do with this.[1] However the impact of the gun law reforms on mass killings is even mo...
Dear Editor
I read the response from Chapman with interest.[1] In referring to the number of guns handed in during the 1996/97 buy back, Chapman fails to disclose that those firearms, legally owned by farmers and sporting shooters, had never been a problem in society. I refer to the submission by Australian Institute of Criminology to the publication "Evaluating Gun Policy: Effects on Crime and Violence" published...
Dear Editor
We read the article by Hendrie et al with interest.[1] Compared to the salaries of their North American and European counterparts, the average Japanese family income is higher. The majority of parents tend to believe that the cost of child restraint seats (CRS) is comparatively higher than other countries. CRS in Japan are much more expensive - around US$ 250-400. Government subsidiary would be nece...
Dear Editor
I note with interest Chapman's contribution to the discussion[1] on the paper by Ozanne-Smith et al. on firearm law reform in Australia.[2] Chapman's claims are not incorrect, as far as they go. However, like Ozanne-Smith et al, it is what Chapman has left out that may confuse readers.
There have been several mass murders (defined as four or more deaths in one incident) in A...
Dear Editor
Despite James Lawson’s best efforts to suggest otherwise [1], ordinary people – and thankfully nearly all politicians on all sides of Australian politics -- understand that 10 mass shootings involving 66 deaths in 10 years, followed by 103 months with no such incidents is a positive development. Opinion polls before and after the 1996 Port Arthur massacre repeatedly showed overwhelming proportions of A...
Dear Editor,
survivethedrive.org “Your Best Behind the Wheel”
An open letter to the Insurance Institute for Highway Safety (IIHS).
Please, don’t train and evaluate my surgeon, airline pilot or electrician as well as we prepare our nation’s youthful drivers.
Studies showing little or no “crash reduction” b...
Dear Editor,
Why do some research professionals continue to hold positions that result in avoiding a serious overhaul of, and investment into, educating new drivers? Education-testing young drivers warrants as much attention and investment as crash-testing new vehicles! Exploring how to teach and motivate teen drivers will result in knowledge that is likely more valuable to society and traffic safety than expl...
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