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19 November 2001
We are unable to provide photocopies of any the articles and reports abstracted below. Where possible, links have been provided to the publisher of the material and contact information for the corresponding author is listed. Please consider asking your library to subscribe to the journals from which these abstracts have been gathered.
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The rise and fall of pink disease.
Dally A. Soc Hist Med 1997; 10(2):291-304.
Correspondence: Ann Dalley, Wellcome Institute for the History of Medicine,183 Euston Road, London NW1 2BE, UK, (E-mail: a.dally@wellcome.ac.uk).
This paper explores the social and medical history and context of pink disease (acrodynia), a serious disease of infants and young children that baffled the medical world during the first half of the twentieth century until it was shown to be caused by mercury poisoning. In the English-speaking world the commonest source of the mercury was teething powders, which were widely available and advertised with increasing sophistication. Efforts to control them (such as the BMJ's campaign against 'Secret Remedies') were as yet unsuccessful. The article discusses the social conditions that influenced the existence and recognition of pink disease, the delay in finding its cause, the way in which it was explained as a virus infection or nutritional deficiency and why it seldom occurred outside the teething period. It discusses both professional and lay attitudes to health and diseases during the early twentieth century and provides a model of how the disease developed in a specific social setting and how the medical profession attempted to deal with it within the limitations of contemporary professional thought. The resistance to the evidence of mercury poisoning is typical of resistance to new medical knowledge and declined only when the opponents and skeptics grew old and disappeared from the scene. Meanwhile, the cause having been identified and accepted, pink disease disappeared, but its consequences emerged much later, in an unexpected quarter, as a cause of male infertility.
The psychological cost of learning to kill.
Grossman D. Int J Emerg Ment Health 2001; 3(3):137-144.
Correspondence: Lt. Col. Dave Grossman U.S. Army (Ret.), International Critical Incident Stress Foundation, 10176 Baltimore National Pike, Unit 201, Ellicott City , MD 21042 USA (E-mail: LtColDaveG@aol.com).
Military and law enforcement studies reveal that interpersonal combat is a universal human phobia. Physiological responses include forebrain shutdown and sympathetic arousal. A resistance to killing exists in the midbrain of most healthy members of most species, becoming ascendant when the forebrain shuts down, and can prevent soldiers from performing in combat. The military has increased participation in killing activities from by operantly conditioning responses. Conditioning is achieved through training that closely resembles battle situations and inadvertently occurs when children see violence as entertainment. The price of this conditioning is an increase in post-traumatic stress disorder which can be defrayed through debriefing, social acceptance, and prevention of atrocities. Similar techniques may be used to prevent PTSD in civilian populations involved in tragedies like school shootings.
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Application of radar to detect pedestrian workers near mining equipment.
Ruff TM. Appl Occup Environ Hyg 2001; 16(8):798-808.
Correspondence: Todd M. Ruff, Office for Mining Safety and Health Research, Spokane Research Laboratory, National Institute for Occupational Safety and Health, Spokane, WA, USA. (E-mail: er5@cdc.gov).
Between 1990 and 1996, 133 accidents occurred and 23 mine workers were killed when haulage trucks used in surface mines collided with another smaller vehicle, a mine structure, or a pedestrian worker. These accidents were caused by a lack of visibility from the cab of the truck. Similar accidents are common with other types of equipment, such as front-end loaders and shovels. There are several methods for improving the operator's awareness of objects or people around the equipment including improved mirror designs, video cameras, and sensor technologies. Researchers at the National Institute for Occupational Safety and Health (NIOSH) are evaluating collision warning systems that are based on radar technology. These systems are mounted on the mining equipment to monitor one or more of the blind areas. An alarm is provided to the operator if an object or person enters the radar's detection area. Tests consisted of mounting the systems on a 50-ton-capacity truck typically used in quarries and a 240-ton-capacity truck used at a surface mine. This article summarizes the test procedure and results of evaluations of several off-the-shelf and prototype radar systems. False alarm rates and reliable detection zones for pedestrians were recorded for various mounting configurations on the rear of the trucks. Mounting radar systems on large equipment presents several challenges; however, the technology does show promise for this application.
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Ten-year research review of physical injuries.
Stoddard FJ, Saxe G. J Am Acad Child Adolesc Psychiatry 2001; 40(10):1128-1145.
Correspondence: Frederick J. Stoddard, Boston Shriners Hospital, 51 Blossom St. Boston 02114, USA. (E-mail: fstoddard@partners.org).
OBJECTIVE: To review the past 10 years of research relevant to psychiatry on injuries in children and adolescents.
METHOD: A literature search of databases for "wounds and injuries, excluding head injuries," was done with Medline and PsycINFO, yielding 589 and 299 citations, respectively. Further searching identified additional studies.
RESULTS: Progress is occurring in prevention, pain management, acute care, psychiatric treatment, and outcomes. The emotional and behavioral effects of injuries contribute to morbidity and mortality. Psychiatric assessment, crisis intervention, psychotherapy, psychopharmacological treatment, and interventions for families are now priorities. Research offers new interventions for pain, delirium, posttraumatic stress disorder, depression, prior maltreatment, substance abuse, disruptive behavior, and end-of-life care. High-risk subgroups are infants, adolescents, maltreated children, suicide attempters, and substance abusers. Staff training improves quality of care and reduces staff stress.
CONCLUSIONS: Despite the high priority that injuries receive in pediatric research and treatment, psychiatric aspects are neglected. There is a need for assessment and for planning of psychotherapeutic, psychopharmacological, and multimodal treatments, based on severity of injury, comorbid psychopathology, bodily location(s), and prognosis. Psychiatric collaboration with emergency, trauma, and rehabilitation teams enhances medical care. Research should focus on alleviating pain, early psychiatric case identification, and treatment of children, adolescents, and their families, to prevent further injuries and reduce disability.
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Violence, alcohol, and completed suicide: a case-control study.
Conner KR, Cox C, Duberstein PR, Tian L, Nisbet PA, Conwell Y. Am J Psychiatry 2001; 158(10):1701-1705.
Correspondence: Kenneth Conner, Center for Study and Prevention of Suicide, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA. (E-mail: kenneth_conner@urmc.rochester.edu).
BACKGROUND: Violent behavior may represent a risk factor for suicide.
OBJECTIVES: To test the hypothesis that violent behavior in the last year of life is associated with completed suicide, even after controlling for alcohol use disorders.
METHODS: The authors analyzed data from the 1993 National Mortality Followback Survey, a nationally representative survey conducted by telephone interview with decedents' next of kin. Data on 753 victims of suicide were compared with data on 2,115 accident victims. Decedents ranged in age from 20 to 64. Dichotomous measures of violent behavior in the past year and history of alcohol misuse were derived by using the four-item CAGE questionnaire. Multiple logistic regression was used to evaluate the interactions of violent behavior with alcohol misuse, gender, and age, respectively, in predicting suicide versus accidental death. Education and race were included as covariates.
RESULTS: Violent behavior in the last year of life was a significant predictor of suicide; the relationship was especially strong in individuals with no history of alcohol misuse, those who were younger, and women.
CONCLUSIONS: Violent behavior distinguished suicide victims from accident victims, and this finding is not attributable to alcohol use disorders alone. Given that violent behavior increases the risk of suicide, violence prevention initiatives may serve to decrease the risk of suicide as well.
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The impact of airbags and seat belts on the incidence and severity of maxillofacial injuries in automobile accidents in New York State.
Mouzakes J, Koltai PJ, Kuhar S, Bernstein DS, Wing P, Salsberg E. Arch Otolaryngol Head Neck Surg 2001; 127(10):1189-1193.
Correspondence: Jason Mouzakes, MD, Capital Region Otolaryngology Head and Neck Group, 6 Executive Park Dr, Entrance C, Albany, NY 12203 USA. (E-mail: jmouzakes@pol.net).
BACKGROUND: There has been debate concerning the degree to which airbags have reduced maxillofacial trauma in light of reports of injuries from deployment in low speed crashes.
OBJECTIVE: To evaluate the effect driver-side and passenger-side airbags have had on the incidence and severity of maxillofacial trauma in victims of automobile accidents.
METHODS: Retrospective analysis of all automobile (passenger cars and light trucks) accidents reported in New York State during 1994. Of the 595910 individuals involved in motor vehicle accidents in New York in 1994, 377054 individuals were initially selected from accidents involving cars and light trucks. Of this subset, 164238 drivers and 62755 right front passengers were selected for analysis. Each case is described in a single record with approximately 100 variables describing the accident, eg, vehicle, safety equipment installed and utilized or deployed, occupant position, patient demographics, International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnoses, and procedural treatments rendered. A maxillofacial trauma severity scale was devised, based on the ICD-9-CM diagnoses.
RESULTS: Individuals using airbags and seat belts sustained facial injuries at a rate of 1 in 449, compared with a rate of 1 in 40 for individuals who did not use seat belts or airbags (P<.001). Those using airbags alone sustained facial injuries at the intermediate rate of 1 in 148, and victims using seat belts without airbags demonstrated an injury rate of 1 in 217 (P<.001).
CONCLUSIONS: Use of driver-side airbags, when combined with use of seat belts, has resulted in a decrease in the incidence and severity of maxillofacial trauma.
See report under "Commentary" See report under "Suicide" Exposure to violence and associated health risk behaviors among adolescent girls.
Berenson AB, Wiemann CM, Sharon McCombs S. Arch Pediatr Adolesc Med. 2001; 155(11): 1238-1242.
Correspondence: Abbey B. Berenson, MD, Division of Pediatric and Adolescent Gynecology, Department of Obstetrics and Gynecology, The University of Texas Medical Branch at Galveston, 301 University Blvd, Galveston, TX 77555-0587 (e-mail: abberens@utmb.edu).
OBJECTIVES: To examine the relationship between exposure to violence and health-risk behaviors.
METHODS: Cross-sectional survey. Setting- University-based outpatient family planning clinic. Patients- Sexually active adolescent girls younger than 18 years (N = 517) who presented for contraceptive care. Main Outcome Measures- Prevalence of witnessing or experiencing violence and the associations with health-risk behaviors, including high-risk sexual behaviors, substance use, and self-injury.
RESULTS: Compared with adolescents who had not been exposed to violence, those who had only witnessed violence were 2 to 3 times more likely to report using tobacco and marijuana, drinking alcohol or using drugs before sex, and having intercourse with a partner who had multiple partners. Those who had experienced, but not witnessed violence were at increased risk of these same behaviors and were 2 to 4 times more likely than those who had neither witnessed nor experienced violence to report early initiation of intercourse, intercourse with strangers, multiple partners, or partners with multiple partners, tobacco, alcohol and drug use, or to have positive test results for a sexually transmitted disease. Individuals who had both witnessed and experienced violence demonstrated the greatest risk of adverse health behaviors. These adolescents demonstrated 3 to 6 times greater risk of suicidal ideation (odds ratio [OR], 3.1; 95% confidence interval [CI], 2.2-4.0) or suicide attempts (OR, 4.5; 95% CI, 2.2-9.4), self-injury (OR, 5.8; 95% CI, 2.6-12.9), and use of drugs before intercourse (OR, 6.2; 95% CI, 3.0-12.9) than those who had neither witnessed nor experienced violence.
CONCLUSIONS: Adolescents exposed to violence are at increased risk of multiple adverse health behaviors. Programs designed to improve health outcomes should target this high-risk group.
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