title: Violence-related ambulance call-outs in the North West of England: a cross-sectional analysis of nature, extent and relationships to temporal, celebratory and sporting events.
abstract: OBJECTIVE
  The aim of this study was to explore the potential of ambulance call-out data in understanding violence to inform about prevention activity.
  
  
  METHODS
  This cross-sectional (2013-2015) study examined the nature, extent and characteristics of violence-related ambulance call-outs (n=15 687) across North West England and relationships with temporal, celebratory and sporting events.
  
  
  RESULTS
  The majority of call-outs were for men, with a mean age of 33 years. Most call-outs were to deprived (64.4%) and urban (65.4%) areas and occurred at night (18:00-5:59; 75.2%). Three-quarters (77.3%) were recorded as assault/sexual assault and 22.7% stab/gunshot/penetrating trauma. Significant differences in call-out characteristics were identified between the two violence types. Generalised linear modelling found that call-outs significantly increased on weekends, New Year's Eve and weekday bank holiday eves (except for stab/gunshot/penetrating trauma). No significant associations between all violence call-outs, the two violence categories and sporting or celebration events were identified. Two-thirds (66.1%) of the call-outs were transferred to another health service for further assessment and/or treatment. The odds of being transferred were significantly higher among men (adjusted OR (AOR) 1.5, 95%CI 1.4 to 1.6), those aged 13-24 years (AOR 1.2, 95%CI 1.0 to 1.4), call-outs for stab/gunshot/penetrating trauma (AOR 1.4, 95%CI 1.3 to 1.5) and call-outs on Fridays/Saturdays (AOR 1.1, 95%CI 1.0 to 1.2) and lower for call-outs on New Year's Eve (AOR 0.6, 95%CI 0.4 to 0.9).
  
  
  CONCLUSIONS
  Ambulance call-out data can provide a wealth of information to understand violence and subsequently inform about violence prevention and response activity. Ambulance services and staff could play a key role in preventing violence through sharing data and identifying and supporting victims.
authors.affiliation: Public Health Institute, Liverpool John Moores University, Liverpool, UK.
authors.forename: Zara
authors.initials: Z
authors.lastname: Quigg
authors.affiliation: Public Health Institute, Liverpool John Moores University, Liverpool, UK.
authors.forename: Ciara
authors.initials: C
authors.lastname: McGee
authors.affiliation: Public Health Wales, Cardiff, UK.
authors.forename: Karen
authors.initials: K
authors.lastname: Hughes
authors.affiliation: Public Health Institute, Liverpool John Moores University, Liverpool, UK.
authors.forename: Simon
authors.initials: S
authors.lastname: Russell
authors.affiliation: Public Health Wales, Cardiff, UK.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Bellis
mesh_terms: D000293:Adolescent; D000328:Adult; D000552:Ambulances / Q000706:statistics & numerical data*; D000846:Anniversaries and Special Events; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011204:Poverty Areas; D015995:Prevalence; D012742:Sex Offenses / Q000706:statistics & numerical data; D013177:Sports / Q000706:statistics & numerical data; D014754:Violence / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000453:epidemiology*
keywords: data; health; paramedics; prevention; violence