| Date | Comment |
|---|---|
| Sun Jul 4 15:26:55 1999 | Note: 3 reviewers and one consultant have been assigned to this paper. The editors do not plan to comment until the reviews have been received.
Deadline for first round of reviews: 5 July 1999 Index of discussion 1. Comments by Fish 4.7.99 2. Review by DJ 5.7.99 3. Author's response to comments by Fish - Ian Mackie 6.7.99 4. Author's note regarding comments by DJ - Ian Mackie 25.7.99 5. Follow-up by DJ 28.7.99 6. Review by JN 20.8.99 7. Editorial comment and advice for revision by Ruth Armstrong 15.9.99 OVERALL I found the focus of the article somewhat diffuse. Was the aim of the study to "review patterns of drowning" or "to review patterns of drowning and discuss implications for preventive strategies". If the second then the preventive strategies are not provided enough emphasis or referencing to enable their value to be seen. ABSTRACT INTRODUCTION The point of para 20 - 22 is not apparent. If the idea is to provide credence to par 23 then it fails as the evidence presented is that "drowning has been a not uncommon cause of death" but not that "drowning has been a common cause of death". Para 26. Line 2. "a frequent place for death" Line 4. "remarkable fact" These again over state the frequency of drowning as a cause of death. METHODS Para 38 appears redundant as this is evident from the results section. RESULTS This is the longest section of the paper and with the 17 figures could benefit from condensation. Repetition of facts obvious from the tables adds to the length but does not increase the clarity. Particularly if the aim is to highlight areas needing further preventive action (as stated in para 26). Para 40. Recommend moving Fig 17 to here with a comment on the decreasing incidence rate. This graph provides incentive to read on as it places the overall context of drowning trends in Australia. NON BOATING DROWNING The repeated use of raw numbers (with male female breakdown) and incidence graphs adds to the total number of graphs. Beyond figs 1, 8 and 16 the male female comparisons appear to add little. Combining figs 3-6 and 9-12 into one fig with removal of male-female data would enable a clearer picture of at risk age groups and sites. As a non-expert in drowning I want to know who is most at risk and which are the most risky sites for swimming. Suggest a major rewrite of paras 44- 49 and 51-57 highlighting who is most at risk (age, M/F) and which are the most dangerous sites. Having made the point that alcohol or other drugs is significant in para 42 it appears unnecessary to repeat this in paras 44, 45, 47, 46 and 50. Fig 7 representing an isolated state by state comparison is hard to interpret as no population comparisons are provided and is not provided for other data. I am unsure what the point of including this fig is. Bathtub drowning appears to warrant separate mention because of different M/F and age incidences. Linking of comments between para 50 and 59-69 would appear appropriate. There is again a lot of text on drug and alcohol and the intended message is unclear. TODDLER DROWNING Paras 61-67 and 69 would be clearer presented as a fig. OLDER AGE GROUP Suggest delete paras 72-86 and at para 87 "… in the pool (M:F=11:22) and bathtub (M:F=4:18)." ABORIGINAL POPULATION Paras 90-102 add little, as these sites are similar to that for the overall population. Similarly paras 104-116 provides no new information of value to preventive programs. Para 117 could be rewritten to shorten it to " … in six years, with ages from 6-60. All were male." OVERSEAS TOURISTS Para 121 suggest delete after Germany. Paras 122-146 could be more succinctly combined " … 61% of deaths (n=30) occurred at surf beaches or elsewhere in ocean (18% of all surf/ocean drowning) …" DISCUSSION Detailled comments to follow. Overall I felt it would benefit from a greater focus on preventive strategies other than education. FISH |
| Mon Jul 5 18:41:34 1999 | In validating the data used for this article, I have discovered a number of figures that need further clarification. With the editor's permission, I contacted Dr Mackie who has provided me with a copy of his source data which I am currently reviewing.
Some areas that need clarification - Para 37 The ABS has used a national consistent set of drowning flags since 1992. These flags provide additional information on locality and activity and form the basis of specialised drowning tables. Coverage - The review relates to drownings that occurred from 1992 to 1997. To this end, drownings that occurred in 1997 but were not registered until 1998 or later have been excluded. - Indigenous Data - Deaths data for indigenous persons is underennumerated. While indigenous status is a question on death forms, ABS only regards data for South Australia, Western Australia and Northern Territory as being of a publishable standard. DJ |
| Tue Jul 6 13:06:16 1999 | Response to comments by "Fish"
Many thanks for the valuable advice. I have made a start on your suggested alterations and will submit version 2 to the Editor as soon as possible. My friends from the ABS are yet to check on a few details and some of the rewrite may have to wait on them. Thanks again. Ian Mackie |
| Sun Jul 25 22:47:18 1999 | David Jayne from the ABS has nearly completed the check of my figures. These should be completed within ten days and he will then communicate via this page to give his go ahead. Several of his suggestions will need to be incorporated into the text which I have been advised to keep on hold. These mostly concern privacy considerations. Ian Mackie |
| Wed Jul 28 17:02:44 1999 | Have finalised validating data used by Dr Mackie and am happy for him to use the agreed figures in his rewrite. We also recommended a number of changes in relation to classifications and clarity in presentation of data. Dr Mackie has made all the appropriate changes and from a statistical viewpoint, we are happy with the article. DJ |
| Fri Aug 20 14:20:43 1999 | This paper provides a comprehensive review of drowning in Australia in recent years. It is topical as there have been record numbers of drownings in the waters surrounding Australia during the past two years. Childhood drownings continue to fluctuate.
The paper is long and could be reduced in size without reducing the basic message. The introduction (par 1-26) includes interesting work about drowning from history and literature however it does not provide a clear rationale for the review in 1999. The statement of the purpose of the paper could be stated more clearly. The method (Par 27-par 38) needs the inclusion of clear statement of the source and the extent of the data used, how the data were manipulated to arrive at the results and details of the baseline data used to make calculations. Par 28 tells what ABS codes include, what is needed is a statement of what codes were included in the data base used for this paper. Par 35 needs a statement of how the "flags" were used in this current study. The information about 1920 is not relevant to this study unless those data were used in the study. Par 40. I don't see the relevance of this par to the review Par 42 is the first mention that this is a review of six years of drowning data. This information with the particular years should be included in the Method section. Also in Par 42 reference to the population figures used to calculate the drowning rate. The rate itself is a result however it should state whether it is for the whole of Australia. The paper does not require both text descriptions and figures for all of the drowning sites. Figure 2 an overview rates of drowning for various age groups, Figures 3, 4, 5, 8, 11and 17 are the main figures which show the patterns of drowning. The other figures can be dealt with in the text. The age distribution is similar for ocean and surfing beach and the vulnerable groups could be described. The authour may want to argue for a different emphasis. Par. 48 line 4. The state by state comparison lists population tourism climate local culture and accessibility to the surf as factors in surf beach drownings. No evidence has been put to implicate any of these but it certainly mirrors population distribution. Par 51 needs a heading to be consistent with other sections of the paper. Par 53 and 54 would be better placed following on par 46. Pools could be dealt with as private, public and other. Percentages should be shown to be consistent with other parts of the presentation and to mane comparisons. The tables under the headings toddler drownings, the older age group, Aboriginal population and overseas tourists could be shown in one table showing the various sites where drownings occurred. This would allow easier comparisons to be made. Par 161 line 8. This line indicates that the film shows several people drowning while the next line refers to the plight of a single victim. Par 163 line 7. The words "and their nature poorly understood by at least 95% of the population " are speculative and should be removed. Par 164 Line 7 References for the list of causes associated with bathtub drownings should be shown. The Nixon reference is out of place in the context as it does not indicate a cause. (The Nixon reference does not describe drowning in Japan but reports someone else who did describe it) Par 165. No evidence or reference for the claims in this paragraph have been supplied. The paragraph should be deleted Par 166. The evidence for swimming ability as a protection against drowning especially in children is controversial. Evidence for the statement in lines 2 and 3 should be included. Par 171 line 3. Policing should be replaced with enforcement. Par 172, 174, 175and 178 could be deleted as they do not add to the issues already discussed. This paper provides an over view of drowning in Australia. Such an overview is necessary in view of the recently publicised surf drownings and continued toddler drownings in domestic pools. The paper could be shortened without losing its impact. It raises issues of suicide homicide and drownings reported in official statistics in other categories (MVA) which have not been discussed in the australian context before. I think with suitable revision it is a suitable paper for inclusion in the Journal. JN |
| Tue Sep 14 19:33:54 1999 | Editorial comment and advice re "Patterns of drowning", being reviewed by the MJA on the internet.
Thank-you to the author for submitting his manuscript and to those reviewers and consultant panellists who participated. We are missing the comments of one reviewer but feel we should proceed on the excellent advice of the three people who did participate. The manuscript has been considered by the Editorial Committee in the light of the reviewers' comments. Although the reviewers have noted some problems with the paper, we feel it provides a good overview of the subject and look forward, pending a satisfactory revision, to publishing it in our 1999 Christmas issue as well as on this site. From an editorial point of view, our main concern is that the current manuscript is too long (it would currently occupy about eight journal pages, and our limit is 4-5). However the reviewers have provided some excellent suggestions which should also sharpen the focus of the paper. In accordance with/addition to their comments we suggest the following changes: Please semi-structure your ABSTRACT into Objective, Methods, Results and conclusions. The INTRODUCTION is interesting but a bit confusing (are you saying drowning is a big or a small problem?). It may be better just to provide a brief rationale as to why you think it's important to present THIS data in AUSTRALIA, NOW. It may be useful to refer to Figure 17 in this section as it does not seem to be directly derived from your described method. Please reference where your source for this. The METHODS should report which six years were studied early on. They need to be clarified as per JN (what codes you included, how you extracted the data etc. Paragraph 36 could be removed for brevity. RESULTS. Paragraph 40 could also be removed. In "Non-boating drownings" the results could be reported much more briefly as per Fish. We very much like the idea of combining the figures as he suggests and also believe that repeating the alcohol data is a bit repetitive. We also think JN's suggestion of combining toddler, Aboriginal, elderly and tourist drownings into one table for comparison (leaving out age groups but including location) is a good one. The DISCUSSION is unfortunately going to need some cutting. You should start by recapping on your main findings, talk about how these add to what we already know and believe, and suggest avenues for intervention as suggested by your findings. If you are willing to revise the manuscript to address these concerns, we will be keen to pursue publication in the Christmas issue. We would like to receive the revised version by Friday October 15 1999. If you are unable to meet this deadline, please contact us as soon as possible Please outline in an accompanying letter how you have responded to the referee's main points and highlight on the manuscript (using underlining or a bold font) where alterations have been made. Ensure that you include a word count and that you do not exceed our limit of 2500 words. Please include raw data for any figures. Your revised manuscript and covering letter should be e-mailed to medjaust at ampco dotcom dotau or you can send a disk if you find this convenient. We look forward to receiving the revised manuscript. Thanks again everyone Dr Ruth Armstrong, Assistant Editor, MJA |