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December 15, 2000



Residential

  • Murray JA, Chen D, Velmahos GC, Alo K, Belzberg H, Asensio JA et al. Pediatric falls: is height a predictor of injury and outcome? American Surgeon 2000; 66(9):863-865. (E.55.06 S)

    Abstract:
    Falls account for a significant proportion of pediatric injuries and deaths. A retrospective review of pediatric patients (age 0-14 years) was performed to determine whether patterns of injuries and outcomes could be predicted on the basis of the height of the fall. In addition, the authors evaluated the triage criterion "fall greater than 15 feet" for transport of patients to a trauma center. Patients were stratified by the height of the fall: greater than or less than 15 feet. The end points for analysis were the associated injuries and survival. Patients who fell less than 15 feet had a higher incidence of intracranial injuries (and fewer extremity fractures than patients who fell more than 15 feet). Skull fractures were the most frequent injury and were associated with an increase in intracranial injuries in both subgroups. In conclusion low-level falls are associated with significant intracranial injuries.


  • Ahrens M. The U.S. fire problem overview report: Leading causes and other patterns and trends. 2000. Quincy, MA: National Fire Protection Association. (E.55.08 S)
    Abstract:
    This report discusses residential and non-residential structure fires in the US. Fires and associated losses hit a record low in 1998. Home fires, the most deadly type of fire, still dominate the structure fire problem, but vehicle fires are becoming a significant source of fire deaths. This report contains charts and tables presenting data on fire department activities and the overall picture of fires in the US; residential structure fires, by cause, time, and type of structure; and non-residential structure fires, by type of establishment. The appendices include a discussion of how national estimates are calculated; general comments on fire causes in structure fires; and smoke alarm and automatic sprinkler system statistics.


  • Hall JR. Patterns of fire casualties in home fires by age and sex. 2000. Quincy, MA: National Fire Protection Association. (E.55.08 S)

    Abstract:
    Most civilian fire deaths and injuries occur in homes (one and two family dwellings, including manufactured homes and apartments). During 1993-1997, 81% of all civilian deaths and 73% of all injuries occurred in homes. This report examines civilian casualties in homes for patterns by age and sex of victim, relative to various circumstances surrounding the casualty, such as the cause of the fire and activity of the victim at the time of the injury. Young children and older adults were found to be at higher risk from dying in home fires than any other age groups. Preschool children had a death rate more than twice the national average. Older adults ages 65 and over had a death rate roughly twice the national average, and the older the group, the higher the risk. The rate for those ages 85 and over was four and a half times the national death rate. Fires due to children playing with ignition sources victimized the very young most often. Fires that involved smoking materials and heating equipment victimized older adults most often. Despite the fact that over 90% of US homes had smoke alarms in the years studied, roughly 3/5 of fire fatalities occurred in homes not equipped with alarms. Various education and legislative interventions are discussed to target these high-risk groups.

Child care:

  • Dorfman L, Woodruff K. Child care coverage in U.S. newspapers. 1999. Berkeley, CA: Berkeley Media Studies Group. (E.71 S)

    Abstract:
    For many families, current economic reality requires that both parents work outside the home; consequently, most Americans accept childcare as a fact of life. Yet 60% of Americans believe that childcare is a private problem to be resolved by the individual family rather than be addressed by society as a whole. News coverage can have a strong influence on how the public and policy makers interpret and respond to social issues. To advocate effectively for high quality, adequately supported childcare and early childhood education, advocates must be able to articulate a clear message that resonates with specific audiences. They have to make their case well, and make it publicly. Similarly, if journalists are going to tell the story of child care as it is debated by different stakeholders, they should know what parts of the discussion are being emphasized and which, if any, are being neglected. This report examines how news coverage and editorial content on childcare has been discussed in the nation's major newspapers over the last five years. The authors first present their methods for sampling the coverage, then what they found in the analysis, and finally, their recommendations based on those findings for childcare advocates and for journalists covering the issue.

Transportation:

  • Burden D. Streets and sidewalks, people and cars: The citizens' guide to traffic calming. Davis D, Lamming J, Zykofsky P, editors. 2000. Sacramento, CA: Local Government Commission Center for Livable Communities. (E.50 S)

    Abstract:
    This workbook is intended to help the reader better understand the dynamics of vehicle and pedestrian movement, identify traffic calming opportunities, and recommend improvements to streets throughout the community. Each of the guide's four chapters has been organized to help the reader understand traffic calming and apply it to his/her streets. Chapter 1 describes how streets are part of a region-wide transportation system, discusses the relationship between transportation and land use, and defines the parts of a street. It includes a description of the relationship between street design and speeding. Chapter 2 explains the background on traffic calming and demonstrates the links between well designed streets and high quality neighborhoods. The process of doing a traffic calming program in a neighborhood is explained in detail, including how to evaluate streets, define the problems, select tools or treatments to help solve the problems, get the treatments built, and evaluate the success of the treatments. Chapter 3 describes 20 traffic-calming tools. Each tool is described and illustrated with sketches and photographs. Also included in this chapter are other design elements that can improve the overall safety, walkability, and vitality of streets. Chapter 4 includes the inventory forms and tools needed to survey and evaluate streets. The evaluation of patients sustaining low-level falls should not be limited on the basis of the height of the fall. Using falls of greater than 15 feet as a triage criterion for transport to a trauma center needs to be prospectively evaluated to ensure that critically injured patients are triaged appropriately.


  • Roesler JS, Kinde MR. Air bags. An imperfect and incomplete solution. Minnesota Medicine 2000; 83(8):57-60. (E.52.02 S)

    Abstract:
    This article discusses some of the benefits and risks of air bags, particularly among children. Minnesota laws regarding passenger safety and general rules for child passenger safety are discussed. The authors' recommendations include the following immediate actions steps: infants should never ride in the front seat of a vehicle with an activated passenger air bag; children aged 12 and under should always be properly restrained in a child safety seat or safety belt and ride in the back seat; and safety belts, both lap and shoulder, should be worn at all times, regardless of the air bag status of the vehicle. Intermediate action steps are: physicians should be able to recognize and respond to the new spectrum of injuries associated with air bags; for any MVC victim, emergency medical staff should document in the medical record air bag deployment; and physicians and hospitals should participate in research and public health surveillance activities concerning air bags. Longer-term action steps are: the next generation of air bag technologies should be provided in all cars, including side-impact and adaptive air bags to cushion and protect occupants of different sizes; research and injury surveillance data must be increasingly analyzed and promptly disseminated to guide practice and policy regarding air bags; and physicians should routinely ask questions about air bag and seat belt use in their preventive care discussions with patients.


  • Children's Safety Network National Children's Center for Rural and Agricultural Health and Safety. Youth riding in pickup truck cargo areas. Rural Youth Injury Highlight. 2000. Marshfield, WI: National Farm Medicine Center. (E.52.08 S)

    Abstract:
    Youth represent a disproportionate share of pickup truck cargo area occupant deaths. Raising awareness about cargo area safety is critical given the increasing popularity of pickup trucks for personal use. This fact sheet presents data on deaths and injuries to children and adolescents while riding in pickup truck cargo areas. Risk factors and prevention recommendations are discussed, and educational, legislative, and data tools are presented.


  • Langlois JA, Keyl PM, Guralnik JM, Foley DJ, Marottoli RA, Wallace RB. Characteristics of older pedestrians who have difficulty crossing the street. American Journal of Public Health 1997; 87(3):393-397. (E.51.04 S)

    Abstract:
    This study examined the sociodemographic and health characteristics and problems of older pedestrians. Interviews and assessments were conducted with 1249 enrollees aged 72 or older from the New Haven, Conn, community of the Established Populations for Epidemiologic Studies of the Elderly who agreed to participate in a seventh follow-up. Approximately 11% of the New Haven residents reported difficulty crossing the street. Older pedestrians needing help in one or more activities of daily living were more than 10 times as likely as others, and those with the slowest walking speeds were nearly 3 times as likely as others, to report difficulty crossing the street. Fewer than 1% of these pedestrians aged 72 or older had a normal walking speed sufficient to cross the street in the time typically allotted at signalized intersections (1.22 m/sec). Crossing times at signalized intersections in areas with large populations of elders should be extended, and the recommended walking speed for timing signalized crossings should be modified to reflect the range of abilities among older pedestrians

Suicide:

  • Education Development Center Inc., Children's Safety Network Injury DataTechnical Assistance Center. Northeast Injury Prevention Network Suicide Databook. 2000. Newton, MA: Education Development Center, Inc. (E.90.02 S)

    Abstract:
    Across the nation, suicide is the 8th leading reported cause of death for all ages. Despite the large number of deaths, suicide is known to be underreported. Problems with coding injuries and deaths, the social stigma of suicide attempts, and the absence of national standards for identifying suicide attempts in medical records can all lead to misclassification of both attempts and completions. This databook represents a cooperative effort by state health departments in Public Health Service Regions I and II to describe the extent of suicide in the Northeast. The suicide data were prepared by each state in Regions I and II using a modification of the Injury Mortality Matrix for Intentional and Unintentional Injury - 2nd Edition. Each state reported their mortality and hospital discharge data into provided spreadsheets by method of suicide, age, gender, and if reliable data were available, by race. The Matrix automatically calculates rates once frequency and population data are entered. The source of completed suicide data was the vital statistics death records for each state. Each state provided 5 year averages of completed suicides from 1992-1996. Data on hospitalizations for self-inflicted injuries were obtained from each state's Uniform Hospital Discharge Data files, which include discharges from acute care hospitals.


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