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• Russian-American partners for prevention. Adaptation of a school-based parent-child programme for alcohol use prevention.

  Williams CL, Grechanaia1 T, Romanova O, Komro KA, CL Perry CL, Farbakhsh K. European J Public Health 2001; 11(3): 314-321.
  
  Correspondence: C.L. Williams, Division of Epidemiology, School of Public Health, University of Minnesota, 1300 S 2nd St., Minneapolis, MN 55454, USA (e-mail: williams_c@epi.umn.edu).

  BACKGROUND: The Russian-American Partners for Prevention was an adaptation and evaluation of the Slick Tracy Home Team Program which was developed in Minnesota in order to delay the onset of drinking. The Slick Tracy Home Team Program was the first intervention of Project Northland, a large 3 year community trial of the efficacy of a public health intervention for under age drinking.
  
  OBJECTIVES: To evaluate a program designed to delay the onset of alcohol drinking.
  
  METHODS: The programme was administered through schools, but involved parents using engaging and fun homework activities. The Russian version was implemented in fifth-grade classrooms in 20 Moscow schools with 1,212 students surveyed at baseline. Students were surveyed again after programme implementation (n=1,182), or whom 980 were present at baseline. Parents of 1,078 students were surveyed by telephone after programme implementation.
  
  RESULTS: The results demonstrated the successful recruitment and retention of 20 Moscow schools in a research project, acceptability of programme materials in Russia, high participation rates, changes in students' knowledge about problems associated with under age drinking and some evidence about increases in parent-child communication about alcohol use. As in the USA, no changes in students' alcohol use rates were observed at the end of the first year of the 3 year programme.
  
  CONCLUSIONS: Russian youth, as compared to Americans, began drinking at earlier ages, received fewer prevention messages from their parents, and had fewer prevention programs in school. The results suggested that carefully implemented and evaluated replications of the US Project Northland interventions might provide effective and appropriate school-based programs for Russia.

• Drowning-related deaths in New Zealand, 1980-94.

  Langley JD, Warner M, Smith GS, Wright C. Aust N Z J Public Health 2001; 25(5): 451-457.
  
  Correspondence: John D. Langley, Injury Prevention Research Unit, Dunedin School of Medicine, University of Otago, PO Box 913, Dunedin, NEW ZEALAND (e-mail: john.langley@ipru.otago.ac.nz).

  BACKGROUND: Drowning is an important cause of injury death in New Zealand and in most of the rest of the world.
  
  OBJECTIVES: To describe the epidemiology of drowning in New Zealand for the period 1980-94.
  
  METHODS: Drowning-related incidents were identified by linking New Zealand Health Information Service and Water Safety New Zealand databases.
  
  RESULTS: 2,606 drowning-related incidents were identified. In three-quarters of the incidents, drowning was listed as the immediate cause of death. The majority of drownings were unintentional (85%), involved males (76%), and 0-4 and 15-24 year age groups had the highest rates. Boating was the leading cause of unintentional drowning (28%) followed by swimming and other water sports (19%), motor vehicle drownings (13%) and falls or slips (12%).
  
  CONCLUSIONS: Although there has been a significant decline in drownings, New Zealand compares poorly internationally. In particular, our unintentional drowning rate is twice that of Australia. For New Zealand to continue to make substantial progress in addressing its overall drowning rate, we need to continue and strengthen our efforts in priority areas, in particular those due to motor vehicle crashes and boating and among pre-schoolers, adolescents and young adults. Motor vehicle traffic crashes warrant closer attention than has been the case to date.

• Injury risks and socioeconomic groups in different settings. Differences in morbidity between men and between women at working ages.

  Laflamme L, Eilert-Petersson E. European J Public Health 2001; 11(3): 309-313.
  
  Correspondence: Lucy Laflamme, Karolinska Institutet, Department of Public Health Sciences, Division of Social Medicine, SE-171 76 Stockholm, SWEDEN, (e-mail: lucie.laflamme@phs.ki.se).

  BACKGROUND: It is unclear whether greater injury risk in lower socioeconomic groups at working ages is attributable to differences in work conditions or a reflection of a wider overall pattern of risk.
  
  OBJECTIVES: To investigate socioeconomic differences in non-fatal injury risks in a variety of settings.
  
  METHODS: Data were taken from a community-based injury register built up over one year (November 1989 to October 1990) in a semi-urban Swedish municipality (256,510 inhabitants), and then linked by record to Sweden's National Population Register (based on the census of 1990). Injuries among the age group 20-64 were considered. Age-standardized odds ratios were computed by gender for five injury settings and four socioeconomic groups, using salaried employees as the reference group.
  
  RESULTS: Compared with salaried employees, male manual workers and from the unspecified population (long-term unemployed, students, etc.) show an excess risk of injury in all settings except sports. Males from all socioeconomic groups show significantly higher morbidity in production/education; those from the unspecified population, in home settings, transport areas, and 'other areas'.
  
  CONCLUSIONS: Higher morbidity in lower socioeconomic groups results not only from work-related differences, where 25% of the injuries analyzed were incurred, but also from the differential impacts of other living environments, e.g. home and transport areas. Differences between socioeconomic groups in care seeking, injury lethality, injury susceptibility, and risk exposure may influence the social patterning of injury morbidity.

• The impact of structural factors on the injury rate in different European countries.

  Melinder KA, Andersson R. European J Public Health 2001; 11(3): 301-308.
  
  Correspondence: Karin A. Melinder, Karolinska Institutet, Department of Public Health Sciences, Division of Social Medicine, Norrbacka, SE-171 76 Stockholm, SWEDEN (e-mail karin.melinder@fhinst.se).

  BACKGROUND: A previous study pointed to there being two kinds of injuries - those with a mainly social genesis and those with a mainly environmental genesis.
  
  OBJECTIVES: The aim of this study was to analyse how socioeconomic factors - such as level of economic development, alcohol consumption and unemployment and more cultural factors - such as education and religion - relate to kinds of injury.
  
  METHODS: Motor vehicle traffic accidents were chosen to represent injuries with a predominantly environmental genesis and suicides those with a mainly social genesis. Qualitative comparative analysis (QCA) complemented by Pearson correlation was employed. The data come from 12 European countries.
  
  RESULTS: Four groups of countries emerged from the analysis. Group 1 was high on both kinds of injuries and was also high on all the independent variables considered. Group 2 was low on social injuries and high on environmental injuries; it had a low level of economic development, high alcohol consumption and a high proportion of Roman Catholics. Group 3 was high on social injuries and low on environmental injuries; it had a high level of economic development, low alcohol consumption and few Roman Catholics. Group 4 was low on both kinds of injuries; the independent variables formed a similar pattern to those of group 3.
  
  CONCLUSIONS: The pattern for traffic fatalities differs from that of suicides. There is also patterning with regard to structural factors; economic level, education and religion seem to be more important with regard to injury rate differentials than alcohol consumption or unemployment.

• Suicide attempts in an adolescent female twin sample.

  Glowinski AL, Bucholz KK, Nelson EC, Fu Q, Madden PA, Reich W, Heath AC. J Am Acad Child Adolesc Psychiatry 2001; 40(11):1300-1307.
  
  Correspondence: Anne L. Glowinski, Missouri Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63108, USA. (e-mail: Glowinsa@matlock.wustl.edu).

  BACKGROUND: Suicide is the third leading cause of death in children and adolescents aged 10 to 19 years. It is estimated that one-third to one-half of youth suicide completers have a known previous suicide attempt history. OBJECTIVES: To examine suicide attempts in an epidemiologically and genetically informative youth sample.
  
  METHODS: 3,416 Missouri female adolescent twins (85% participation rate) were interviewed from 1995 to 2000 with a telephone version of the Child Semi-Structured Assessment for the Genetics of Alcoholism, which includes a detailed suicidal behavior section. Mean age was 15.5 years at assessment.
  
  RESULTS: At least one suicide attempt was reported by 4.2% of the subjects. First suicide attempts were all made before age 18 (and at a mean age of 13.6). Major depressive disorder, alcohol dependence, childhood physical abuse, social phobia, conduct disorder, and African-American ethnicity were the factors most associated with a suicide attempt history. Suicide attempt liability was familial, with genetic and shared environmental influences together accounting for 35% to 75% of the variance in risk. The twin/cotwin suicide attempt odds ratio was 5.6 (95% confidence interval [CI] 1.75-17.8) for monozygotic twins and 4.0 (95% CI 1.1 -14.7) for dizygotic twins after controlling for other psychiatric risk factors.
  
  CONCLUSIONS: In women, the predisposition to attempt suicide seems usually to manifest itself first during adolescence. The data show that youth suicide attempts are familial and possibly influenced by genetic factors, even when controlling for other psychopathology.

• The priming function of road signs.

  Crundall D, Underwood G. Transportation Res Traffic Psychol Behav 2001, 4F(3): 187-200.
  
  Correspondence: David Crundall, School of Psychology, University of Nottingham, University Park, Nottingham NG7 2RD, UK (e-mail: david.crundall@nottingham.ac.uk).

  BACKGROUND: The role of the traffic warning sign is to prepare the driver for a subsequent behavior necessitated by the road configuration ahead. Without advanced notice of road conditions the driver would have to initiate the appropriate behavior when the hazard is first perceived.
  
  OBJECTIVES: To examine the nature of the relationship between road signs and the transmission of information.
  
  METHODS: Twenty-six volunteers aged between 17 and 24 years) participated. Thirteen of whom had passed their driving test within three months of the study and were considered novice drivers. The volunteers were presented with a series of pictures that were flashed on a screen. In each case an image of a road sign prime (left bend, right bend, cross-road) or a control image (an X) was followed by a photograph of a road scene, left bend, right bend, cross-road. They were asked to reply using a computer keyboard the correct response to the situation.
  
  RESULTS: Strong priming effects were found for experienced drivers but the effect was much weaker for novice drivers. Experienced drivers responded faster than the novice drivers (F(1,24) = 14.13, p < 0.01) with mean response times of 477 and 614 ms, respectively.
  
  CONCLUSIONS: Not only do road signs have an automatic priming function, but this process is developed with increased experience.

• Overcoming the barriers to disclosure and inquiry of partner abuse for women attending general practice.

  Hagarty KL, Taft AJ. Aust N Z J Public Health 2001; 25(5): 433-437.
  
  Correspondence: Kelsey L. Hegarty, Department of General Practice, The University of Melbourne, 200 Berkeley Street, Carlton, Victoria, 3053, AUSTRALIA (e-mail: k.hegarty@unimelb.edu.au).

  BACKGROUND: Domestic violence is an important problem. The ability of the medical community to intervene is hampered if abused women are reluctant to talk about their problem with their physician.
  
  OBJECTIVES: To determine the barriers to and rates of disclosure of partner abuse by women attending General Practice (GP) physicians.
  
  METHODS: In a qualitative study, abused Melbourne women were interviewed about their experiences with GPs. Following this, adult women attending a random sample of Brisbane general practices were surveyed. Multivariate analyses were conducted on the data, using levels of disclosure and GP inquiry adjusting for cluster effect to obtain prevalence rate ratios.
  
  RESULTS: Thirty-seven per cent of the survey participants (n=1836, response rate 78.5%) admitted to having ever experienced abuse in an adult intimate relationship. One-third (36.7%) of these abused women (n=674) had ever told a GP and 87.8% had never been asked by their GP about partner abuse. Women who disclosed were almost twice as likely than women who have not: to be middle aged, have experienced combined physical, emotional and sexual abuse and be afraid of their partner. They were more than twice as likely to have been asked about abuse. A GP’s good communication skills facilitated disclosure. The main barriers to disclosure were that women saw the problem as their own i.e. internal barriers. The data from the qualitative study (n=20) are used to illustrate these findings.
  
  CONCLUSIONS: Educational interventions that improve GPs’ communication skills might result in increased disclosure and early intervention in partner abuse. GPs need sensitive attitudes, greater skills, knowledge and support to manage the consequences of disclosure.

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Rev. 10-Nov-2001 at 12:46 hours.