New This Week

in the

Resource Library

June 12 - 16, 2000

General/Cross-cutting:

Cummings GE, Voaklander D, Vincenten J, Policicchio C, Borden K. Emergency staff survey on their role in pediatric injury prevention education: A pilot study. The Journal of Emergency Medicine 2000; 18(3): 299-303. (E.47.02 S)

Abstract: A survey was developed to measure the attitudes of emergency department staff members regarding their role in child injury prevention education. The implementation of the survey was preceded by the studied intervention, which included educating all emergency staff members. The results of the survey showed that health care workers do not perceive the ED as an important venue for injury prevention education. The reasons are complex, but center on the fact that ED staff view injury prevention education as another task for an already busy department to provide with little immediately visible return and little financial support. The authors recommend better surveillance and collection of accurate injury data as a way of evaluating trends and formulating strategies for injury control. ED staff members should seize the opportunity to educate children and families on injury prevention at a time when the relevance of such teaching is most obvious.

Farrior KC, Engelke MK, Collins CS, Cox CG. A community pediatric prevention partnership: Linking schools, providers, and tertiary care services. Journal of School Health 2000; 70(3): 79-83. (E.10.14 S)

Abstract: Integrated school health services traditionally have been provided through the local board of education or health department. However, increased competitiveness in the health care arena has challenged providers to find innovative models to deliver health services to school aged children. This article describes a partnership among a hospital, a university, private providers, and a local school system and health department to provide school health services. Noteworthy aspects of the project include the organizational structure and funding of the program, implementation of a case management model, and a focus on documenting outcomes. This program has been successful in building local alliances to provide health care services to school children. Implications for other school systems struggling to fund health services for children are discussed.

Residential:

Stone KE, Lanphear BP, Pomerantz WJ, Khoury J. Childhood injuries and deaths due to falls from windows. Journal of Urban Health: Bulletin of the New York Academy of Medicine 2000; 77(1): 26-33. (E.55.06 S)

Abstract: This study estimates the incidence and identifies the population at risk for falls from windows in Hamilton County, Ohio from January 1, 1991 to December 31, 1997. During the study period, there were 86 falls from windows, with a mortality rate of 4.7%. Children 0-4 years old had a higher rate of falls than children aged 5-14. Males were twice as likely to fall as females, and black children were three times more likely to fall than non-black children. The incidence of falls in the city of Cincinnati was four times that of the non-urban area. The authors discuss legislation and other injury prevention methods.

Yeoh C, Nixon JW, Dickson W, Kemp A, Sibert JR. Patterns of scald injuries. Archives of Disease in Childhood 1994; 71:156-158. (E.55.09 S)

Abstract: This study describes common patterns of bath water scald injuries in children, examines differences between accidental and nonaccidental bath water scalds, and discusses prevention methods.

Occupational:

Runyan CW, Zakocs RC. Epidemiology and prevention of injuries among adolescent workers in the United States. Annual Review of Public Health 2000; 21:247-269. (E.65 S)

Abstract: In the U.S., most adolescents are employed at some time during their teen years. Provisions of the Fair Labor Standards Act, the nation's child labor law, address some of the risks of adolescent employment, however >70 teenage workers are estimated to die from work related injuries each year, with greater risk among males, whites, and older adolescents. Furthermore, the nonfatal work related injuries of the more than 64,000 teens who receive emergency department care each year are believed to significantly undercount actual injuries. Many of these nonfatal injuries are severe, with 15%-45% leading to work restrictions or permanent disabilities. Significant methodological issues limit the ability of existing surveillance systems to monitor youth worker injury. Risk factor and intervention research is very limited, but does suggest the role of some worker characteristics, management practices, and training issues. However, these factors need more careful study. This review considers existing information about occupational injuries among adolescents and identifies needs for research and policy attention.

Findorff-Dennis MJ, McGovern PM, Bull M, Hung J. Work related assaults: The impact on victims. AAOHN Journal 1999; 47(10): 456-465. (E.65.10 S)

Abstract: This pilot project employed a case study design to describe the impact of violence on individuals who incurred a work-related assault in 1992. Randomly selected subjects were interviewed from a population reporting a work-related assault that resulted in a wage loss claim. The study hypothesis, stating the impact of the assault (e.g., pain and suffering, decrease in functioning) years after a work related assault was associated with the severity of the injury was not supported by the data. However, individuals' health and quality of life 4 years after the assault were affected significantly and resulted in job changes, chronic pain, changes in functional status, and depression. The authors discuss the implications of these findings, and recommend employer support and mental health intervention immediately after an assault to decrease mental health sequelae.

Sports/Playgrounds:

Morrongiello BA, Dawber T. Mothers' responses to sons and daughters engaging in injury risk behaviors on a playground: Implications for sex differences in injury rates. Journal of Experimental Child Psychology 2000; 76:89-103. (E.60.08 S)

Abstract: Videotapes of children engaging in injury risk activities on a playground were shown to mothers, who were asked to intervene by stopping the tape and saying whatever they would to their child in the situation shown. Results revealed that mothers of daughters were more likely to judge behaviors as posing some degree of injury risk, and they intervened more frequently and quickly than mothers of sons. Mothers' speed to intervene positively correlated with both children’s' injury history and their risk taking behaviors, indicating that mothers of children who were previously injured and who often engaged in injury risk behaviors had a higher degree of tolerance for children's risk taking than mothers of children who experienced fewer injuries and less frequently engaged in injury risk behaviors. Mothers' verbalizations to children's risk taking revealed that daughters received more cautions and statements communicating vulnerability for injury, whereas sons received more statements encouraging risk taking behavior.

Kingma J, Ten Duis H-J. Injuries due to school sports accidents in 4 to 13 year old children. Perceptual and Motor Skills 2000; 90:319-325. (E.61 S)

Abstract: This study investigated the incidence of school sports injuries in kindergarten and primary school children from 1990-1997 in the Netherlands. Results showed that injuries due to school sports activities comprised 26% of all sports injuries in 4-13 year old patients. A significant increase was observed in the incidence of school sports injuries from the 4-5 year olds to the 12-13 year olds. This study showed no sex differences in school sports injuries for the 4-13 year old age range. Falls were the major cause of school sports injuries. The authors found, however, that injuries due to falls decreased across the age range studied for injuries due to ball sports (soccer, basketball, handball), but increased for older ages. The majority of school sports injuries involved the upper extremities. The authors discuss possible reasons for these findings, and recommend increased efforts at injury prevention in school sports programs.

Transportation:

Kohn M, Chausmer K, Flood MH. Anticipatory guidance about child safety seat misuse: Lessons from safety seat "checkups". Archives of Pediatrics and Adolescent Medicine 2000; 154:606-609. (E.52.02.06 S)

Abstract: In this article, the authors describe what they found during a series of child safety seat checkups sponsored by the Louisiana Safe Kids Coalition in southeastern Louisiana in 1998. Of the 266 forward- and rear-facing seats checked, 250 (96%) were installed incorrectly. The 3 most frequently found problems were seat not belted into vehicle tightly (88% of forward-facing seats and 81% of rear-facing seats), safety seat harness straps not snug (43% of forward-facing and 47% of rear-facing seats), and harness retainer clip not at armpit level (34% of forward-facing and 37% of rear-facing seats). The authors recommend that, as part of the routine anticipatory guidance offered during well-child visits, health care providers should counsel parents specifically about these 3 errors in child safety seat use.

Drugs/Alcohol:

Friedman AS, Glassman K. Family risk factors versus peer risk factors for drug abuse: A longitudinal study of an African American urban community sample. Journal of Substance Abuse Treatment 2000; 18(2000): 267-275. (E.40.02 S)

Abstract: This study compared the influence of family problems with influence of deviant and delinquent social behavior and peer relationships up to the time of the 16th birthday as risk factors for substance use, for lifetime up to age 26. Control variables for the analysis were available from the National Collaborative project's longitudinal data file, collected from time of birth, on the African American community study sample. A key finding was that the social behavior and peer relationship problems accounted for 18.8% of the additional variance in later degree of substance use, whereas the family problems accounted for only 5.1% of the additional variance in later degree of substance use. These findings may have implications for the development of drug abuse interventions for African American adolescents.

Berman M, Hull T, May P. Alcohol control and injury death in Alaska Native communities: Wet, damp, and dry under Alaska's local option law. Journal of Studies on Alcohol 2000; 61:311-319. (E.40.02 S)

Abstract: Since 1981, Alaska state law has given local residents broad powers to control the way alcohol enters the community, via a local option referendum. This article evaluates the effect of the local option on injury deaths, most of which are alcohol related. The study compares population and community specific death rates under different levels of alcohol control for the 97 communities that passed restrictions between 1980 and 1993 with the death rates in the same communities during periods when no restrictions were in place. Results showed that injury death rates were generally lower during periods when alcohol sales, importation, or possession were restricted than when no restrictions were in place (wet). More restrictive controls (dry) significantly reduced homicides; less restrictive control options (damp) reduced suicides. A control group of communities that did not change control status under the law showed no significant changes over time in accident or homicide death rates.

Perry CL, Komro KA, Veblen-Mortenson S, Bosma L, Munson K, Stigler M et al. The Minnesota DARE PLUS Project: Creating community partnerships to prevent drug use and violence. Journal of School Health 2000; 70(3): 84-88. (E.40.02 S)

Abstract: The research community has criticized Drug Abuse Resistance Education (D.A.R.E.) because the extant literature indicates a lack of evidence that the elementary school program prevents drug use. Yet DARE continues to be the most widely implemented drug use prevention program in the U.S. and has considerable community support. To date, the junior high DARE program has not been evaluated. The Minnesota DARE PLUS Project is a randomized trial of 24 schools and communities. During 1999-2001, students in 8 schools will receive the junior high DARE curriculum in 7th grade; 8 schools will also receive the curriculum as well as additional parent involvement, peer leadership, and community components in the 7th and 8th grades; and 8 schools will serve as controls. This article describes the background and conceptualization, the curriculum, and additional intervention components, and the evaluation methods of the DARE PLUS Project.

Family Violence:

Knight RA, Remington PL. Training internal medicine residents to screen for domestic violence. Journal of Women's Health and Gender Based Medicine 2000; 9(2): 167-174. (E.82.02 S)

Abstract: The authors conducted an evaluation of the effectiveness of an educational intervention intended to increase screening of patients for domestic violence by internal medicine resident physicians and to identify characteristics associated with increased screening. Prior to the intervention, only 0.8% of patients reported being asked about domestic violence. After the intervention, the percentage rose to 17%. Patients who were younger than 50 years were more likely to be asked. Caucasian physicians were more likely to ask. The authors found evidence that moderately intense training and focusing on results can increase resident physician screening rates for domestic violence. They recommend a training session similar to the one described and continued monitoring of outcome in the clinical setting.

Dubowitz H, Giardino A, Gustavson E. Child neglect: Guidance for pediatricians. Pediatrics in Review 2000; 21(4): 111-116. (E.80.02.08 S)

Abstract : This article provides practical information for the brief assessment and initial management of different types of neglect. The authors offer general principles for assessing and managing all types of neglect, followed by a brief description of each form of neglect, adding specific issues pertaining to its assessment and management. Systematic screening is recommended during child health supervision visits to help prevent neglect or to detect problems that may or may not be apparent.

Krueger PM, Schafer S. Physician awareness of domestic violence: Does continuing medical education have an impact? Journal of the American Osteopathic Association 2000; 100(3): 145-148. (E.82.02 S)

Abstract : One hundred currently practicing physicians were surveyed regarding screening and management of domestic violence to determine whether mandatory continuing medical education (CME) is likely to increase awareness of and response to domestic violence. Results indicate that Florida's mandatory CME law does not appear to have made an impact on the management of domestic violence. Even though practices with a female physician were four times more likely to screen for domestic violence than practices with all male physicians, less than half (47%) of such offices did so. Besides ignorance of the scope of domestic violence, the survey showed that physicians frequently believe that domestic violence is more common in nonwhite or poorer communities, and may perceive victims as "deserving" the abuse.

Margolin G, Gordis EB. The effects of family and community violence on children. Annual Review of Psychology 2000; 51:445-479. (E.78 S)

Abstract: This review examines theoretical and empirical literature on children's reactions to three types of violence - child maltreatment, community violence, and interparental violence. In addition to describing internalizing and externalizing problems associated with exposure to violence, this review identifies ways that violence can disrupt typical developmental trajectories through psychobiological effects, posttraumatic stress disorder (PTSD), cognitive consequences, and peer problems. Methodological challenges in this literature include high rates of co-occurrence among types of violence exposure, co-occurrence of violence with other serious life adversities, heterogeneity in the frequency, severity, age of onset, and chronicity of exposure, and difficulties in making causal inferences. A developmental psychopathology perspective focuses attention on how violence may have different effects at different ages and may compromise children's abilities to face normal developmental challenges. Emphasis is placed on the variability of children's reactions to violence, on outcomes that go beyond diagnosable disorders, and on variables that mediate and moderate children's reactions to violence.

Glaser, D. Child abuse and neglect and the brain: A review. Journal of Child Psychology and Psychiatry 2000; 41(1): 97-116. (E.80.02 S)

Abstract: This review explores the effects of child abuse and neglect on the brain, excluding nonaccidental injury that causes gross physical trauma to the brain. It begins with a background summary of the nature, context, and some deleterious effects of child maltreatment. There then follows a section on environmental influences on brain development, demonstrating the dependence of the orderly process of neurodevelopment on the child's environment. The next section is concerned with bridging the mind and the brain. Neurobiological processes, including cellular, biochemical, and neurophysiological processes, are examined alongside their behavioral, cognitive, and emotional equivalents. The stress response is discussed in some detail. Evidence is outlined for the buffering effects of a secure attachment on the stress response. The section dealing with actual effects on the brain of child abuse and neglect discusses manifestations of the stress response. Recent evidence about reduction in brain volume following child abuse and neglect is also outlined. The importance of early intervention and attention to the timing of environmental adversity are stressed.

Jogerst GJ, Dawson JD, Hartz AJ, Ely JW, Schweitzer LA. Community characteristics associated with elder abuse. Journal of the American Geriatric Society 2000; 48:513-518. (E.84.04 S)

Abstract: The purpose of this study was to help define the relationship between elder mistreatment and Iowa counties' demographics, health care resources, and social service characteristics. County level data were analyzed between 1984 and 1993. The rates of substantiated elder abuse were correlated with population density and child poverty. The strongest risk factor for reported elder abuse was reported child abuse. The significance of these findings, as well as other demographic characteristics associated with elder abuse, are discussed in detail.

Homicide/Suicide:

Blumstein A, Rivara FP, Rosenfeld R. The rise and decline of homicide - and why. Annual Review of Public Health 2000; 21:505-541. (E.75.04 S)

Abstract: A dramatic rise in homicide in the latter half of the 1980s peaked during the 1990s and then declined at an equally dramatic rate. The increase primarily involved young males, especially young black males, occurred first in the big cities, and was related to the sudden appearance of crack cocaine in the drug markets of the big cities around 1985. This development led to an increased need for and use of guns and was accompanied by a general diffusion of guns into the larger community. The decline in homicide since the early 1990s has been caused by changes in the drug markets, police response to gun carrying by young males, especially those under 18 years old, economic expansion, and efforts to decrease general access to guns, as well as an increase in the prison population and a continued decline in homicide among those over age 24. The lessons learned from the recent homicide trends and the facts associated with them have important implications for public health and the criminal justice system.

Ho T-P, Leung PW-L, Hung S-F, Lee C-C, Tang C-P. The mental health of the peers of suicide completers and attempters. Journal of Child Psychology and Psychiatry 2000; 41(3): 301-308. (E.90 S)

Abstract: This study examined the prevalence and risk of psychiatric disturbances and suicidal behaviors among the peers of suicide attempters and completers. The subjects were selected from high schools with and without history of student suicides in the past 3 years. About 1/4 of the peers of suicide completers and attempters were probable psychiatric cases and 15%-21% of them reported suicidal acts. The increased risk of psychiatric disturbances and suicidal behaviors were still evident after controlling for age, sex, and potential risk factors. The presence of psychiatric disturbances could not wholly account for the increased odds of suicidal behaviors. Peers of suicide attempters carried a higher risk than peers of suicide completers. The close friends of suicide completers were particularly at risk of internalizing problems, whereas the close friends of suicide attempters were at high risk of externalizing problems. The peers of suicide attempters and completers represent a high-risk group for psychiatric disturbances and suicidal behavior. The specific association of different types of psychiatric disturbances in the peers of suicide completers and attempters suggests that different risk mechanisms might be in operation within these peer groups.

Back to "New This Week" Menu