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September 11 - 15, 2000


  • Polivka BJ, Ryan-Wenger N. Health promotion and injury prevention behaviors of elementary school children. Pediatric Nursing 1999; 25(2):127-34, 148. (E.37.02 S)

    This cross-sectional study examined health and lifestyle behaviors of 302 urban elementary school children. Over half of the children considered themselves very healthy, with asthma and allergies the most commonly reported illnesses. The majority of children reported high levels of injury prevention and health promotion behaviors. Over 75% of the students reported that they did not smoke, drink, use guns or drugs; they looked both ways before crossing a street; took medicine only with parental permission; had a working smoke detector at home; and knew how to safely exit their home during a fire. Boys reported more risk-taking behaviors than did girls; White youth had lower injury- prevention scores than Black youth; and younger children and children with behavior or emotional disorders in specialized classrooms reported fewer health promotion activities related to nutrition, exercise, and dental hygiene. Findings suggest the need for tailoring health education efforts for different subgroups of children

  • Milio N. Priorities and strategies for promoting community-based prevention policies. Journal of Public Health Management and Practice 1998; 4(3):14-28. (E.45.02 S)

    The public health community faces major choices in priorities for its mission in a rapidly changing environment. One option is to place greater emphasis on public health policy development. Policymaking requires a grasp of the interplay among stakeholders, policy makers, the press, and the public. A framework for gathering relevant information and guiding strategic action is a useful tool for participation in community, state, and national arenas in the interests of population health. Organization-targeted approaches can make policy advocacy, community mobilization, and public education about policy issues more effective. This requires investment in public health infrastructure


  • Hudson S, Thompson D, Mack MG. The prevention of playground injuries. Journal of School Nursing 1999; 15(3):30-33. (E.60.02 S)

    Playground accidents are the most common cause of injury to children in school. As the health professional who attends to these injured children, school nurses should be aware of safety practices that can help eliminate the risks that children encounter. The National Program for Playground Safety has identified four areas that can reduce the level of risk on school playgrounds: supervision, age-appropriate design of the play area, fall surfaces under and around playground equipment, and equipment and surface maintenance. The article discusses each of these, and recommends leadership methods and practices that nurses can implement that will eliminate or reduce risk factors. In addition, a comprehensive playground risk model is described, and suggestions for policy areas are outlined. Policy areas include assessment, education, and enforcement in relation to each of the risk factors


  • Stanken BA. Promoting helmet use among children. Journal of Community Health Nursing 2000; 17(2):85-92. (E.51.02.02 S)

    Despite the proven efficacy of bicycle helmets, helmet use among children remains low. Helmet use among children riding bicycles significantly reduces head injuries and death. A variety of promotional programs to increase helmet use in children have demonstrated limited success. This article reviews a variety of approaches to increase helmet use among children. The PRECEDE-PROCEED model is applied and recommendations for community health nurses to promote helmet use among children are provided.

  • Thompson DC, Rivara FP, Thompson R. Helmets for preventing head and facial injuries in bicyclists. The Cochrane Database of Systematic Reviews 2000;(3):CD001855. (E.51.02.02 S)

    Each year, in the United states, approximately 900 persons die from injuries due to bicycle crashes and over 500,000 persons are treated in emergency departments. Head injury is by far the greatest risk posed to bicyclists, comprising one-third of emergency department visits, two-thirds of hospital admissions, and three-fourths of deaths. Facial injuries to cyclists occur at a rate nearly identical to that of head injuries. Although it makes inherent sense that helmets would be protective against head injury, establishing the real-world effectiveness of helmets is important. A number of case-control studies have been conducted demonstrating the effectiveness of bicycle helmets. Because of the magnitude of the problem and the potential effectiveness of bicycle helmets, the objective of this review is to determine whether bicycle helmets reduce head, brain and facial injury for bicyclists of all ages involved in a bicycle crash or fall. The authors searched The Cochrane Controlled Trials Register, MEDLINE, EMBASE, Sport, ERIC, NTIS, Expanded Academic Index, CINAHL, PsycINFO, Occupational Safety and Health, and Dissertations Abstracts. They checked reference lists of past reviews and review articles, studies from government agencies in the United States, Europe and Australia, and contacted colleagues from the International Society for Child and Adolescent Injury Prevention, World Injury Network, CDC funded Injury Control and Research Centers, and staff in injury research agencies around the world. Controlled studies that evaluated the effect of helmet use in a population of bicyclists who had experienced a crash were selected. The authors required that studies have complete outcome ascertainment, accurate exposure measurement, appropriate selection of the comparison group and elimination or control of factors such as selection bias, observation bias and confounding. Five published studies met the selection criteria. Two abstractors using a standard abstraction form independently abstracted data. Odds ratios with 95% CI were calculated for the protective effect of helmet for head and facial injuries. Study results are presented individually. Head and brain injury results were also summarized using meta-analysis techniques. No randomized controlled trials were found. This review identified five well-conducted case control studies, which met the selection criteria. Helmets provide a 63%-88% reduction in the risk of head, brain and severe brain injury for all ages of bicyclists. Helmets provide equal levels of protection for crashes involving motor vehicles (69%) and crashes from all other causes (68%). Injuries to the upper and mid facial areas are reduced 65%. Helmets reduce bicycle-related head and facial injuries for bicyclists of all ages involved in all types of crashes including those involving motor vehicles.

  • Anderson CL, Agran PF, Winn DG, Greenland S. Fatalities to occupants of cargo areas of pickup trucks. Accident Analysis and Prevention 2000; 32(4):533-540. (E.52.08 S)

    This study sought to describe the fatalities to occupants of pickup truck cargo areas and to compare the mortality of cargo area occupants to passengers in the cab. From the Fatality Analysis Reporting System (FARS) files for 1987-1996, the authors identified occupants of pickup trucks with at least one fatality and at least one passenger in the cargo area. Outcomes of cargo area occupants and passengers in the cab were compared using estimating equations conditional on the crash and vehicle. Thirty-four percent of deaths to cargo occupants were in noncrash events without vehicle deformation. Fifty-five percent of those who died were age 15-29 years and 79% were male. The fatality risk ratio (FRR) comparing cargo area occupants to front seat occupants was 3.0 (95% Confidence Interval [CI] = 2.7-3.4). The risk was 7.9 (95% CI = 6.2-10.1) times that of restrained front seat occupants. The FRR ranged from 92 (95% CI = 47-179) in noncrash events to 1.7 (95% CI = 1.5-1.9) in crashes with severe vehicle deformation. The FRR was 1.8 (95% CI = 1.4-2.3) for occupants of enclosed cargo areas and 3.5 (95% CI = 3.1-4.0) for occupants of open cargo areas. The authors conclude that passengers in cargo areas of pickup trucks have a higher risk of death than front seat occupants, especially in noncrash events, and that camper shells offer only limited protection for cargo area occupants.

  • Ulmer RG, Preusser DF, Williams AF, Ferguson SA, Farmer CM. Effect of Florida's graduated licensing program on the crash rate of teenage drivers. Accident Analysis and Prevention 2000; 32(4):527-532. (E.52.04.04 S)

    On 1 July 1996, Florida instituted a graduated licensing program for drivers younger than age 18. For the first 3 months, holders of learner's licenses are not allowed to drive at all between 19:00 and 06:00 h; thereafter, they may drive until 22:00 h. Learner's licenses must be held for 6 months prior to eligibility for the intermediate license. Sixteen-year-old intermediate license holders are not permitted to drive unsupervised from 23:00 to 06:00 h, 17 year-olds from 01:00 to 06:00 h. All drivers younger than 18 have strict limits on the number of traffic violations they can accumulate and, effective 1 January 1997, all drivers younger than 21 are subject to a zero tolerance law for drinking and driving. Florida crash data for 1995- 1997 were obtained and compared with similar data from Alabama, a state that borders Florida but does not have graduated licensing. For 15, 16, and 17 year-olds combined, there was a 9% reduction in the fatal and injury crash involvement rate in Florida during 1997, the first full year of graduated licensing, compared with 1995. On a percentage basis, crashes declined most among 15 year-olds, followed by 16 year-olds and then 17 year-olds. Reductions were not seen among Alabama teenagers nor among 18 year-olds in Florida.


  • Calvert WJ. Integrated literature review on effects of exposure to violence upon adolescents. The ABNF Journal 1999; 10(4):84-96. (E.80.06 S)

    Violence has reached epidemic proportions in the Unites States. The past decade has seen professionals in public health, law enforcement, social sciences, and health care commit more attention to this area. Research and anecdotal articles read by the researcher indicated adolescents exposed to chronic community violence may experience a myriad of problems including: academic failure, the tendency to engage in violent behavior, depression, and a nihilistic, fatalistic orientation to the future, which often leads to increased risk-taking behaviors. The purpose of this integrative literature review is to discover what is known about exposure to violence among adolescents. While the review did find various negative effects of being exposed to violence, a cross-sectional design was often used, with self-reported data. Instruments with established validity and reliability were used to gather the data were often appropriate to the population. Aspects of the methodologies used by the researchers should be replicated in order to add to the knowledge of this topic

  • Milne JS, Hargarten SW. Handgun safety features: a review for physicians. The Journal of Trauma: Injury, Infection, and Critical Care 1999; 47(1):145-150. (E.96 S)

    Handguns are a ubiquitous consumer product in the United States, which annually cause significant morbidity and mortality. Handgun safety devices are often proposed as potential solutions to this problem. Their effectiveness at reducing handgun injuries and deaths is intensely debated. However, to effectively analyze the potential utility of handgun safety devices, physicians need to be aware of the safety devices available in the consumer market and how they operate. A wide variety of safety devices are available in the consumer market, which vary in terms of their ease of operation, cost, and the types of injuries they may prevent. The authors reviewed several types of handgun safety devices, including loaded chamber indicators, manual thumb safeties, grip safeties, magazine disconnectors, drop safeties, built-in locks, trigger locks, lockboxes, and personalized handguns. Each device is described within the context of reducing unintended discharge and unauthorized use. This review is not exhaustive. There are other types of safety devices that limit access to handguns. Many of these devices, such as barrel locks and chamber locks, work in a similar manner as trigger locks and have the same limitations. The user of any type of safety device should think about the types of injuries the device is designed to prevent and be aware of its limitations. Physicians have the potential to reduce the risk of firearm injuries with their patients and communities. Providing accurate information on firearm safety devices and their limitations is important, just as it is for other aspects of health care advice. Armed with accurate information, physicians can hopefully be effective in firearm injury prevention

  • Pratt HD, Greydanus DE. Adolescent violence: concepts for a new millennium. Adolescent Medicine: State of the Art Reviews 2000; 11(1):103-125. (E.80.06 S)

    Violence is a form of aggressive behavior that has a debilitating effect on the optimal growth and development of our youth. Violence pervades the lives of a significant proportion of all adolescents in the U.S., but has a particularly devastating impact on males and minority youth. Adolescent males are more likely to be victimizers and victims of violence and aggression, except in cases of sexual victimization and suicide attempts. For all adolescents, exposure to violence at home, school, or in the community is associated with aggression later in life, the development of supportive attitudes toward aggression and violence, psychological distress, school absenteeism, academic dysfunction, and subsequent injury. Violence has historical, cultural, and societal roots in our world. Until and unless we begin to understand where violence fits on the continuum of aggressive behavior and until we address the politics of violence, we will remain conflicted and paralyzed by the dangers our youth face. By understanding the social, political, and developmental aspects of violence and understanding the nature and characteristics of resilient children, we can better prepare our youth for life. We may not be able to protect our adolescents from exposure to violence, but we most certainly can help them develop the necessary skills to survive such exposure and work to enhance and strengthen their access to protective factors so that they can experience a healthy transition from adolescence to adulthood in this new millennium.

  • Rodriguez MA, Gorovitz E. The politics and prevention of gun violence. Western Journal of Medicine 1999; 171(5-6):296-297. (E.96 S) Abstract: For years, gun violence has been a major public health concern in which physicians and other health care providers have played important roles. Only recently, however, has the prevention of gun violence become a priority for policymakers. Preventing gun violence requires the use of a variety of strategies including lawsuits. But the gun industry, and the politicians who protect it, have launched a nationwide campaign to block the lawsuits that could promote prevention. This paper discusses how physicians and other health care professionals concerned with preventing gun violence can help defeat this campaign.


  • SideLines. V9(4); Summer 2000. Boston, MA: National Youth Sports Safety Foundation, Inc. Cover story: Team physician consensus statement.
  • SafetyBeltSafe News. V.21(4); Jul 2000. Altadena, CA: SafetyBeltSafe U.S.A. Cover stories: Safety campaign; Who is behind the wheel?
  • EMSC News. V.13(2); Jul/Aug 2000. Washington, DC: EMSC National Resource Center. Cover story: Will fear of vaccines increase the need for emergency care? This issue also contains: Collegiate injury prevention program shows signs of success for Native Americans.


  • The NIJ Research Review. V.1(2); May 2000. Washington, DC: U.S. Department of Justice, National Institutes of Justice. This issue contains selected summaries of significant research findings from recently completed NIJ funded projects.
  • Rennison, CM; Welchans, S. Intimate partner violence. Bureau of Justice Statistics Special Report. May 2000 (NCJ 178247)
  • Howell, JC; Lynch, JP. Youth gangs in schools. OJJDP Juvenile Justice Bulletin. Aug 2000.
  • Curtin, SC; Martin, JA. Births: Preliminary data for 1999. National Vital Statistics Reports. V.48(14); Aug 8, 2000.
  • National Center for Health Statistics. Births, marriages, divorces, and deaths: Provisional data for October 1999. National Vital Statistics Reports. V.48(15); Sep 6, 2000.
  • Hall, MJ; Owings, MF. Hospitalizations for injury: United States, 1996. Advance Data. No. 318; Aug 9, 2000.

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