10 June 2002
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An evaluation of warning habits and beliefs across the adult life span.
- Hancock H E, Rogers W A, Fisk A D. Hum Factors 2001; 43(3):343-354.
Correspondence: Holly E. Hancock, Georgia Institute of Technology, Atlanta, USA; hhancock@sev-pop.gtrl.gatech.edu).
Beliefs about warnings and habits associated with reading them were assessed for 863 individuals of various ages. Information gathered for various common household products included (a) how frequently people attend to warning information, (b) the degree of risk they believe is involved during product usage, and (c) how important they believe warnings are for different product types. Also assessed were perceived helpfulness and comprehension for symbols commonly found on product labels or on signs in the environment. Respondents 55 years and older reported reading product warnings more frequently than did younger adults, although they generally perceived warnings as less important. However, no overall age-related differences were found for perceived level of risk involved in using different product types. Although older adults generally perceived symbols to be very helpful when using a particular product, their comprehension levels were poorer than those of younger adults for half of the symbols. Overall, these data suggest that adults of all ages do read warnings on a variety of product types and that they believe warning information is important. This research illustrates the importance of including older adults in usability studies during the development of warning systems, given age-related effects may be associated with some aspects of the warning processing but not others. (Copyright © 2001 Human Factors and Ergonomics Society)
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Behavioral influences of proximal alarms.
- Gilson RD, Mouloua M, Graft AS, McDonald DP. Hum Factors 2001; 43(4):595-610.
Correspondence: Mustapha Mouloua, Department of Psychology, University of Central Florida, Orlando 32816-1390, USA. (email: mouloua@pegasus.cc.ucf.edu).
Confidence in and responses to an unreliable test alarm were studied in the presence of nearby unspecified alarms. The test alarm's reliability rate was represented as averaging "true" only 50% or 60% of the time. Confidence or response rates ranged proportionately from 23% to 97% with the number of active alarms within 5, 6, 7, or 9 annunciator arrays. Adjacent alarms resulted in confidence estimates that were higher (by about 10%) than those with the same number of active alarms spaced up to 3 positions away. Simultaneously activated alarms resulted in a more than 20% increase in "true" responses compared with the same number of alarms offset in time by up to 32 s, regardless of which came first. Active alarms "known" to be functionally related to, or independent of, the test alarm substantially raised or lowered responding but did not completely overcome prior effects. These findings indicate that presumptions that operators' responses are not influenced by nearby alarms, regardless of their function, may be unwarranted. Applications of this research include suggestions to improve responding and training recommendations. (Copyright © 2001 Human Factors and Ergonomics Society)
Effects of warning validity and proximity on responses to warnings.
- Meyer J. Hum Factors 2001; 43(4):563-572.
Correspondence: Joachim Meyer, Department of Industrial Engineering and Management, Ben Gurion University of the Negev, Beer Sheva, Israel; (email: joachim@bgumail.bgu.ac.il).
The effects of a warning's validity and display characteristics on the responses to binary warnings were studied in a categorization task that resembled the control of a simulated production environment. Students performed a visual signal detection task and were aided by a binary warning indicator. Experimental conditions differed in the validity of the warning and its proximity to the judged stimulus. Participants' performance improved over the course of the experiment, and they partly adjusted their responses to the validity of the warnings but continued to respond to nonvalid warnings throughout the experiment. It was particularly difficult to ignore the nonvalid information when it was integrated with the continuous information. There was evidence for nonoptimal use of the information from the warning system, whether it was valid or not valid. The results indicate a possible distinction between two dimensions of users' trust in warning systems: compliance and reliance. Actual or potential implications of this research include improved warning design based on analysis of system and operator characteristics. (Copyright © 2001 Human Factors and Ergonomics Society)
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Spinal injuries resulting from horse riding accidents.
- Silver JR. Spinal Cord 2002; 40(6):264-271.
Correspondence: J.R. Silver, High Street, Wendover, Bucks HP22 6EA, UK.
Injuries sustained as a result of horse riding are common. Serious injuries to the nervous system are the most dangerous. An analysis has been made of 11 papers, new figures produced by surveying Stoke Mandeville, Oswestry and Odstock spinal units and by searching the internet to determine their frequency and distribution. Head injuries outnumber spinal injuries by five to one. In contrast to other sporting accidents, there are more lumbar and thoracic than cervical injuries and more women are injured than men (though this may just be a reflection of the fact that there are more women riders than men). Of all horse riding activities, jumping is most likely to produce a spinal injury. (Copyright © 2002 Nature Publishing Group)
Campfire burns in children: an Australian experience.
- Choo KL, Fraser JF, Kimble RM. Burns 2002; 28(4): 374-378.
Correspondence: Kelvin L. Choo, Department of Paediatrics and Child Health, Foundation Building, Royal Children's Hospital, Herston Road, Herston, Qld 4029, Australia. email: kelmar97@hotmail.com).
OBJECTIVES: To document and describe the effects of campfire burns on children. To identify the sources of danger contributing to such injuries, so that a prevention strategy can be devised.
METHODS: DESIGN, PATIENTS AND SETTING- Departmental database and case note review of all children with campfire burns seen at the Burns Unit of a tertiary referral children's hospital between January 1999 and June 2001. MAIN OUTCOME MEASURES- Number and ages of children burned; risk factors contributing to the accidents; injuries sustained; treatment required and long-term sequelae.
RESULTS: Thirty-three children, median age 2.5 years, sustained burns, usually to the hands and feet, with eight requiring surgery and the majority requiring some form of scar therapy. Seventy-four percent of the children were burned by hot ashes and coals, usually from the previous night's fire, rather than by open flames.
CONCLUSIONS: Campfires cause serious injuries to children. In particular, hot ashes and coals from inadequately extinguished campfires pose the greatest danger. Increasing the awareness of this easily preventable problem amongst campers is intended through a public education campaign. (Copyright © 2002 Elsevier Publishing Group)
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Sharp injury fatalities in New York City.
- Gill JR, Catanese C. J Forensic Sci 2002; 47(3): 554-557.
Correspondence: J.R. Gill, New York City Office of Chief Medical Examiner, NY 10016, USA.
We reviewed the case records of all fatalities due to sharp injuries in New York City in 1999. The epidemiological profile, circumstances, toxicology results, location, and injuries were examined. There were 120 deaths: 101 homicides, 17 suicides, and 2 accidents. The causes of death included: 112 due to stab(s) with or without incised wounds and 8 pure incised wound fatalities of which 5 were suicides. The detection of ethanol and/or illicit drugs was 61% in the homicide and 12% in the suicide groups. "Defense wounds" were reported in 49% of the homicides and "hesitation" wounds were found in 65% of the suicides. There were no self-inflicted sharp injuries of the face. Deaths due to a single stab wound occurred in 34% (34/101) of the homicides and 24% (4/17) of the suicides. Of these 38 deaths, 58% were of the anterior thorax (chest) and 71% injured the heart and/or great vessels. The remaining deaths with single stab wounds involved the femoral artery, abdominal organs, or head. There were no sharp injury suicides by Hispanics, Asians, or anyone under the age of 18 years. Over half of the suicides at home occurred in the bathroom and 78% of these occurred in the bathtub. Suicide notes were found in 24% of suicides, and an additional 24% verbally expressed a plan to commit suicide. (Copyright © American Society for Testing and Materials).
Pattern of fatal head injuries in Ibadan--a 10 year review.
- Akang EE, Kuti MA, Osunkoya AO, Komolafe EO, Malomo AO, Shokunbi MT, Amutta SB. Med Sci Law 2002; 42(2):160-166.
Correspondence: E.E. Akang, Department of Pathology, University College Hospital, Ibadan, NIGERIA.
Head injury is an important cause of mortality worldwide. The objective of the present study was to analyse the pattern of fatal head injury among patients seen in University College Hospital, Ibadan. The study was based on retrospective investigation of cases of fatal head injury referred by the coroner to the Department of Pathology, University College Hospital, between 1991 and 2000. Pertinent clinical and postmortem findings were extracted from available coroner's autopsy records. There were 529 cases (402 males and 127 females). Their ages ranged from < 1 year to 90 years (mean=33 years), the average age of females (27.8) being less than that of males (34.6) (p=0.00003). 83.8% were road traffic accidents, 8.9% falls from a height, 3.8% assault, and 3% gunshot injuries. 79.1% had a GCS of 8 or less at presentation. The mean survival period of children aged less than 15 years was 2 days while that of adolescents and adults aged 15 years and above was 5.6 days (p=0.02). Subdural (62.4%), subarachnoid (24.6%), epidural (10.2%), and intracerebral (10%) haemorrhages were the major causes of death. Skull fractures occurred in 38.2%, while cerebral contusions occurred in 22.1%. Intracranial infection was relatively uncommon in these patients. The present study has shown that young adults, predominantly males in their most productive years of life, are especially prone to fatal head injury. (Copyright © 2002 Chiltern Publishing)
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Preventing lethal violence in schools: the case for entry-based weapons screening.
- Mawson AR, Lapsley PM, Hoffman AM, Guignard JC. J Health Polit Policy Law 2002; 27(2):243-260.
Correspondence: Anthony R. Mawson, Institute of Epidemiology and Health, Services Research, School of Allied Health Sciences, Jackson State University, 350 West Woodrow Wilson Avenue, Suite 2301-B, Jackson, MS 39213, USA; (email: anthony.r.mawson@jsums.edu).
Violence-related behavior in schools has declined in recent years, but the perception of risk remains high. Disturbingly high percentages of students and teachers report staying home out of fear, and many students bring weapons to school for protection. Current proposals for preventing school violence include punishing the violence-prone, expulsion for weapon carriers, and creating a culture of nonviolence through various behavioral methods like conflict resolution. None of these proposals address the issue of lethal violence and hence personal safety. The risk of lethal violence in schools (related mainly to firearms) could be substantially reduced by creating an effective barrier between firearms and people. This could be achieved by using entry-based weapons detection systems similar to those now used in airports and courts. Decreasing the risk and fear of violence by converting schools into weapons-free zones would also be expected to increase attendance and improve scholastic performance. Randomized, controlled studies should be undertaken to evaluate the efficacy and cost-effectiveness of entry-based weapons detection systems for achieving these outcomes. (Copyright © 2002 Duke University Press)
Lethal Violence in Schools. Commentary.
- Hemenway D. J Health Polit Policy Law 2002; 27(2):267-271.
Correspondence: David Hemenway, Department of Health Policy and Management, Kresge Building, Room 309
677 Huntington Avenue, Boston, MA 02115, USA (email: hemenway@hsph.harvard.edu).
This is a brief summary of the 5 page editorial:
Schools remain among the safest places in America. Less than 1 percent of all homicides among children ages five to nineteen occur in or around school grounds or on the way to and from school. Yet, in terms of lethal violence, our schools are far less safe than those of other developed countries, just as our streets and homes are far less safe.
In the wake of any gun tragedy, the response of one extreme faction in the American gun debate is to ban all guns; the response of the other extreme is to arm all citizens. In 1998-1999, for example, the Wall Street Journal ran op-ed pieces claiming that the way to reduce school lethal violence was to arm teachers and train them in self-defense.
In an article in this issue Mawson et al. suggest a different approach. They do not argue that we should ban firearms or even prevent adolescents from having access to firearms. Instead, they suggest that we should try to ensure that students cannot take their guns into school buildings. This approach is similar to what was done with cowboys in the 1870s -- requiring them to check their guns at the town line -- and with airline passengers since the 1970s -- preventing them from taking their guns on planes. Many other developed nations do not seem to have school shooting problems because adolescents do not have easy access to firearms in the first place.
The public health approach, well described by Mawson et al., emphasizes prevention in addition to punishment. It asserts that it is possible to change the product and the environment to make improper and illegal behavior less likely and less dangerous. The motor vehicle safety story provides an example of a successful public health approach.
But the public health approach envisages a multiprong strategy, particularly if we want to reduce overall violence in schools and not just gun violence. Other policies include training physicians and parents for age-appropriate discussions with adolescents about guns and violence, conflict resolution and anger management training, bullying prevention programs, visual screening techniques to spot students with weapons, teaching student bystanders to limit rather than promote violence and to report firearm threats, architectural design to eliminate dark and hidden spaces where crimes can occur, and so forth. At a societal level, reducing gun ownership rates might make a difference. A 1995 nationally representative school-based sample of adolescents in grades seven through twelve found that access to a gun at home was associated with carrying a gun to school. In addition, we should try to improve firearm storage practices and make it more difficult for adolescents and other unlawful purchasers to obtain firearms in the secondary market (e.g., gun shows).
The motor vehicle model has taught us that it is not enough for policies to focus exclusively on changing the conduct of individuals who may be behaving inappropriately. We also must consider policies that modify the product and the environment. The motor vehicle model also suggests that one policy will not solve the problem, but that many policies together can have a substantial effect. (Copyright © 2002 Duke University Press)
Is a Weapons-Screening Strategy for Public Schools Good Public Policy?
- Toby J. J Health Polit Policy Law 2002; 27(2):261-265.
Correspondence: Jackson Toby, Department of Sociology, Rutgers University, 54 Joyce Kilmer Avenue, Piscataway, NJ 08854 USA (email: jtoby@rci.rutgers.edu).
This is a brief summary of the 5 page editorial:
It is easier to prevent a crime by making the crime target inaccessible than to change the motivation of the potential offender. Thus, locks on steering columns reduce auto thefts, and burglar alarms reduce household burglaries. This is what Ronald V. Clarke calls "situational crime prevention." Is this strategy appropriate for preventing lethal violence in schools? Can "entry-based weapons-screening" cope with the problem of school violence effectively?
I have doubts that it can. School violence has certainly become a problem in American public schools, especially secondary schools, but the violence is mostly nonlethal and a humdrum extension of adolescent aggressiveness: a shakedown in the boys' toilet or an enemy punched. I call it "everyday school violence" to distinguish it from an irrational massacre like the one that took place in Columbine High School in Littleton, Colorado. Irrational lethal violence in schools is very rare -- and motivated quite differently from the everyday violence that is the bane of inner-city schools. Everyday school violence can turn lethal, but weapons screening cannot easily prevent such an outcome; a great many objects found in schools for legitimate purposes can be used aggressively. The line between lethal weapons and nonlethal tools or eating utensils is not as clear as one might think. This problem is the same one that airport and aircraft security personnel have to deal with. Banning knives poses problems for passengers who may require them to cut their meat. But in the wake of the 11 September terrorist capture of four airliners, passengers now accept inconveniences aboard aircraft; a ban on useful utensils seems a small price for added safety from hijackers. On the other hand, school shops, laboratories, and cafeterias cannot operate in the future in any way like they have in the past if similar bans were put in place.
A further complication is that some school violence, including lethal violence, takes place in areas around the school, in school buses, or on the streets used by students coming to or going from school rather than in school buildings. One explanation for guns and knives that students carry in school stems from their fear that they will be attacked or robbed on the way to or from school.
It would be wonderful if the principle of situational crime prevention were a practical solution to the school violence problem. Walk-through detectors attract interest because they offer a technological fix for what is otherwise an intractable problem. Let me recapitulate the reasons why I doubt that it is a practical approach for all schools and all school systems:
1. Lethal school violence as opposed to nonlethal everyday school violence is comparatively rare in most school systems. The cost involved in setting up a system that may prevent such rare events is very great.
2. Schools are architecturally unsuited to perimeter defense. Most schools have too many doors and windows through which a student friend in the school can admit former students (or enrolled students) with weapons. Magnetic door locks with alarms attempt to deal with this problem -- but they do so imperfectly.
3. It is extremely inconvenient to keep out of schools everything that can be turned into lethal weapons because (a) school shops and classrooms use tools that are in effect weapons and (b) quite ordinary objects like nail files and cutlery can be utilized as weapons. Who thought before 11 September that a jumbo jet could become a lethal weapon?
I myself would choose another imperfect strategy. On the assumption that currently enrolled students perpetrate most attempts at lethal violence, prevent some murders at school by giving more options to kids miserable at school for whatever reason. For those old enough to drop out and go to work, make it more socially acceptable to stop school for a while and try a job in the real world. For unhappy younger children too, more options are possible. Alternative schools, charter schools, and private and parochial schools available through voucher programs are already in place for the sake of educational effectiveness, and this development should help with the school violence problem also. The guiding principle should be: Try not to trap kids, because trapped kids can become dangerous to their classmates, their teachers, and themselves. School massacres are rare, and even nonlethal, everyday violence is the exception, not the rule; increased options for unhappy kids could make school violence rarer still. (Copyright © 2002 Duke University Press)
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The significance of suicide notes in the elderly.
- Salib E, Cawley S, Healy R. Aging Ment Health 2002; 6(2):186-190.
Correspondence: Liverpool University, Liverpool, UK and Hollins Park Hospital, Warrington, UK.
Suicide notes are traditionally considered as markers of the severity of the suicide attempt and are said to provide valuable insight into the thinking of suicide victims before the fatal act. Few studies have described the characteristics of elderly suicide note-writers and their final thoughts. This study is a retrospective view of suicide notes obtained from coroners' records of all elderly suicides in Cheshire over a period of 10 years, 1989-1998. Out of 125 suicides, 54 (43%) had suicide notes, which were reported in the coroner's records. Of these there were 31 (57%) male and 23 (43%) female subjects. Elderly suicide note-leavers were more likely to be unknown to psychiatric services (p < 0.01) and to have used a non-violent method of suicide (p < 0.01). Sex, marital status, social isolation, mental or physical morbidity did not appear to be linked with leaving a suicide note. More cases that took an overdose, used plastic bags, electrocuted themselves, or used car exhaust also left suicide notes. Those who died by more violent means such as hanging, drowning, jumping from height, immolation or wounding appeared less likely to have left a suicide note. No statistically significant difference in the content of the suicide notes was observed in relation to sex or age. Many elderly are isolated and may have no one to write a note to, while others have lost the ability to express themselves. Therefore, it is not possible to say that the different incidence of note leaving observed for suicide was due to differing levels of suicidal intent. Although only a proportion of elderly suicide victims leave suicide notes, the absence of a suicide note must not be considered an indicator of a less serious attempt. (Copyright © 2002 Taylor & Francis)
Association between physical illness and suicide among the elderly.
- Quan H, Arboleda-Florez J, Fick GH, Stuart HL, Love EJ. Soc Psychiatry Psychiatr Epidemiol 2002; 37(4):190-197.
Correspondence: Hude Quan, Department of Community Health Sciences, University of Calgary, Alberta, CANADA; (email: hquan@ucalgary.ca).
BACKGROUND: Only a few small studies have explored the association between various physical illnesses and suicide in the elderly and they have produced inconsistent results. Thus, we undertook this larger study to more definitively assess the association between elderly suicide and physical illness.
METHODS: This case-control study compared the proportion with physical illnesses among 822 cases who committed suicide with that among 944 controls who died due to motor vehicle accident at age 55 years or over in Alberta, Canada.
RESULTS: Compared to the motor vehicle accident deaths, the elderly who committed suicide were more likely to have cancer, ischemic heart disease, chronic pulmonary disease, peptic ulcer, prostatic disorder, depression and other psychiatric illnesses. There was no significant difference in the proportion of cerebrovascular disease and diabetes mellitus between the case and control groups before adjustment of demographic and clinical characteristics. After adjustment of these variables, the elderly with any of the following illnesses were more likely to die by suicide than those without the illness: cancer (adjusted odds ratio [95% confidence interval]: 1.73 [1.16-2.58]), prostatic disorder (excluding prostatic cancer, 1.70 [1.16-2.49]), chronic pulmonary disease among the married (1.86 [1.22-2.83]), depression (6.70 [4.72-9.50]) or other psychiatric illness (2.16 [1.68-2.76]). There was no evidence that ischemic heart disease, cerebrovascular disease, peptic ulcer and diabetes mellitus might be associated with suicide in the elderly.
CONCLUSIONS: Cancer, prostatic disorder, chronic pulmonary disease among the married and psychiatric illness appear to be associated with suicide among the elderly. (Copyright © 2002 Steinkopff Verlag)
Burden of illness and suicide in elderly people: case-control study.
- Waern M, Rubenowitz E, Runeson B, Skoog I, Wilhelmson K, Allebeck P. BMJ 2002; 324(7350): 1355.
Correspondence: Margda Waern, Section of Psychiatry, Institute of Clinical Neuroscience, Gothenburg University, Sahlgrenska University Hospital, S-413 45 Gothenburg, SWEDEN; (email: margda.waern@neuro.gu.se).
OBJECTIVES: To study the association between physical illness and suicide in elderly people. Design: Case-control with illness determined from interviews with relatives of people who committed suicide and with control participants and from medical records.
METHODS: Setting: Gothenburg and two surrounding counties (210 703 people aged 65 years and over). Participants: Consecutive records of people who had committed suicide and had undergone forensic examination (46 men, 39 women) and living control participants from the tax register (84 men, 69 women). Main outcome measures: Physical illness rated in 13 organ systems according to the cumulative illness rating scale-geriatrics; serious physical illness (organ category score 3 or 4); overall score for burden of physical illness.
RESULTS: Visual impairment (odds ratio 7.0, 95% confidence interval 2.3 to 21.4), neurological disorders (3.8, 1.5 to 9.4), and malignant disease (3.4, 1.2 to 9.8) were associated with increased risk for suicide. Serious physical illness in any organ category was an independent risk factor for suicide in the multivariate regression model (6.4, 2.0 to 20.0). When the sexes were analysed separately, serious physical illness was associated with suicide in men (4.2, 1.8 to 9.5) as was high burden of physical illness (2.8, 1.2 to 6.5). Such associations were not seen in women, possibly because of the small sample size.
CONCLUSIONS: Visual impairment, neurological disorders, and malignant disease were independently associated with increased risk of suicide in elderly people. Serious physical illness may be a stronger risk factor for suicide in men than in women. (Copyright © 2002 BMJ)
Informant-specific correlates of suicidal behavior in a community survey of 12- to 14-year-olds.
- Breton JJ, Tousignant M, Bergeron L, Berthiaume C. J Am Acad Child Adolesc Psychiatry 2002; 41(6):723-730.
Jean-Jacques Breton, Riviere-des-Prairies Hospital, Montreal, Quebec, Canada. (email: jj.breton.hrdp@ssss.gouv.qc.ca).
OBJECTIVES: To arrive at a better estimation of informant-specific correlates of suicidal behavior in young adolescents and to see how agreements and discrepancies between child and parent informants can contribute to the development of research and interventions.
METHOD: The weighted sample from the Quebec Child Mental Health Survey conducted in 1992 included 825 adolescents, aged 12 to 14 years, and their parents. The adolescent and one parent were questioned by two different interviewers. The response rate was 80.3%. Three categories of independent variables were assessed: adolescent, family, and socioeconomic characteristics. Logistic regression models were based on the adolescent and parent informant reports.
RESULTS: Parents identified 6 of the 59 adolescents having reported suicidal ideation and 2 of the 36 adolescents having reported suicide attempts. Two informant-specific models of correlates of suicidal behavior were found. The adolescent model included internalizing and externalizing mental disorders, family stressful events, and parent-adolescent relationship difficulties, while the parent model included perceiving a need for help for the adolescent, parent's depressive disorders, and parent-adolescent relationship difficulties.
CONCLUSION: The study shows the relevance of considering informant-specific correlates of suicidal behavior in the development of research and interventions targeting youths suicidal behavior. (Copyright © 2002 American Academy of Child and Adolescent Psychology)
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Speech-based interaction with in-vehicle computers: the effect of speech-based e-mail on drivers' attention to the roadway.
- Lee JD, Caven B, Haake S, Brown TL. Hum Factors 2001; 43(4):631-640.
John D. Lee, Department of Industrial Engineering, University of Iowa, 4108 Seamans Center, Iowa City, Iowa, 52242 USA; (email: jdlee@engineering.uiowa.edu).
As computer applications for cars emerge, a speech-based interface offers an appealing alternative to the visually demanding direct manipulation interface. However, speech-based systems may pose cognitive demands that could undermine driving safety. This study used a car-following task to evaluate how a speech-based e-mail system affects drivers' response to the periodic braking of a lead vehicle. The study included 24 drivers between the ages of 18 and 24 years. A baseline condition with no e-mail system was compared with a simple and a complex e-mail system in both simple and complex driving environments. The results show a 30% (310 ms) increase in reaction time when the speech-based system is used. Subjective workload ratings and probe questions also indicate that speech-based interaction introduces a significant cognitive load, which was highest for the complex e-mail system. These data show that a speech-based interface is not a panacea that eliminates the potential distraction of in-vehicle computers. Actual or potential applications of this research include design of in-vehicle information systems and evaluation of their contributions to driver distraction. (Copyright © 2001 Human Factors and Ergonomics Society)
The twilight envelope: a user-centered approach to describing roadway illumination at night.
- Andre J, Owens DA. Hum Factors 2001; 43(4):620-630.
Correspondence: Jeffrey Andre, Virginia School of Psychology, James Madison University, Harrisonburg 22807, USA; (email: andrejt@jmu.edu).
Visual recognition functions, such as acuity and contrast sensitivity, deteriorate rapidly over the declining luminances found during civil twilight. Thus civil twilight, a critical part of the transition between daylight and darkness, represents lighting conditions that may be useful to describe artificial illumination. Automotive headlamps project a three-dimensional beam that ranges from illumination levels comparable to daylight at the vehicle to the dark limit of civil twilight (3.3 1x) at some distance ahead. This twilight envelope is characterized as a distance beyond which foveal visual functions are severely impaired, and thus it provides a general, functional description of the useful extent of the headlamp beam. This user-centered approach to describing illumination is useful for characterizing visibility when driving at night or in other artificially lit environments. This paper discusses the twilight envelope approach and its application to intervehicle variations in headlamp systems. Actual or potential applications of this research include user-centered description of artificial illumination and driver/pedestrian safety education. (Copyright © 2001 Human Factors and Ergonomics Society)
Posttraumatic stress disorder after motor vehicle accidents: 3-year follow-up of a prospective longitudinal study.
- Mayou RA, Ehlers A, Bryant B. Behav Res Ther 2002; 40(6):665-675.
Correspondence: Anke Ehlers, Department of Psychology, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF, UK; (email: a.ehlers@iop.kcl.ac.uk).
The paper presents a 3-year follow-up of a prospective longitudinal study of posttraumatic stress disorder (PTSD) after motor vehicle accidents (J. Abnormal Psychol., 107 (1998) 508). Participants were 546 patients who had been assessed when attending an emergency clinic shortly after a motor vehicle accident, and at 3 months and 1 year afterwards. The prevalence of posttraumatic stress disorder PTSD at 3 years was 11%. Maintaining psychological factors, i.e. negative interpretation of intrusions, rumination, thought suppression and anger cognitions, were important in predicting the persistence of PTSD at 3 years, as were persistent health and financial problems after the accident. Other predictors were female sex, hospital admission for injuries, perceived threat and dissociation during the accident, and litigation. (Copyright © 2002 Elsevier Science)
Falling asleep while driving and automobile accidents among patients with obstructive sleep apnea-hypopnea syndrome.
- Shiomi T, Arita AT, Sasanabe R, Banno K, Yamakawa H, Hasegawa R, Ozeki K, Okada M, Ito A. Psychiatry Clin Neurosci 2002; 56(3): 333-334.
Correspondence: Toshiaki Shiomi, Sleep Disorders Center, Aichi Medical University School of Medicine, 21 Karimata, Yazako, Nagakute-cho, Aichi 480-1195, JAPAN; (email:toshiaki@amugw.aichi-med-u.ac.jp).
Among 448 patients with obstructive sleep apnea-hypopnea syndrome (OSAHS), 40 patients (8.9%) had been involved in one or more automobile accidents during the preceding 5 years. The main cause of these accidents was falling asleep while driving. Excessive sleepiness during driving was associated with an Epworth sleepiness scale (ESS) score of > 11 and/or an apnea-hypopnea index (AHI) of > 15. The automobile accident rate among 182 patients with severe OSAHS (AHI > 30) was significantly higher than the rate among 106 simple snorers (AHI < 5). Although four of the simple snorers were involved in automobile accidents, their ESS scores were all very high (15 or more). (Copyright © 2002 Blackwell Science)
Motorcycle exhaust burns in children.
- Roberts R, Kelson E, Goodall-Wilson D, Kimble R. Burns 2002; 28(4):367-369.
Correspondence: Roy Kimble, Department of Paediatrics and Child Health, University of Queensland, 3rd Floor, Foundation Building, Royal Children's Hospital, Herston, Qld 4029, AUSTRALIA; (email: royk@mailbox.uq.edu.au).
OBJECTIVES: To document and describe motorbike exhaust burns on children.
DESIGN, PATIENTS AND SETTING: Departmental database and case note review of all children with motorbike exhaust burns seen at the Stuart Pegg Paediatric Burns Centre, Brisbane between January 1996 and October 2001. MAIN OUTCOME MEASURES: Number and age of children burned, circumstances of the injury, burns sustained, treatment required and long-term sequelae.
RESULTS: Twenty-four children, median age 8 years, sustained thermal burns, most commonly to the right lower leg. Thirteen children required surgery, and 17 required chronic scar management.
CONCLUSIONS: We have identified motorbike exhausts as a cause of burns in children. The injuries received resulted in significant morbidity to these children and warrants a campaign aimed at reducing the incidence of such injuries. (Copyright © 2002 Elsevier Science)
Case studies in contact burns caused by exhaust pipes of motorcycles.
- Lai CS, Lin TM, Lee SS, Tu CH, Chen IH, Chang KP, Tsai CC, Lin SD. Burns 2002; 28(4):370-373.
Correspondence: C.S. Lai, The Division of Plastic and Reconstructive Surgery, Department of Surgery, Chung-Ho Memorial Hospital, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, 807, ROC, Kaohsiung, Taiwan (email: ipras2@cc.kmu.edu.tw).
Contact burns caused by the exhaust pipe of motorcycles are rarely reported. We performed retrospective studies of such cases in 78 patients with complete records. The majority of victims were unmarried (75.7%), young (<25 years, 70.5%), and female (69.3%), dressed mostly in short pants or mini skirts (75.7%). The burn accident occurred mostly in late spring and early summer (52.7%), during rush hours (57.7%), and during parking the motorcycles (65.4%). The burn wounds located mostly on the lateral aspect (46.2%) of the lower leg, usually took 3-4 weeks for complete healing. Continuous monitoring of the exhaust pipe and its outside cover on moving motorcycles showed that the temperature reached 170-250 and 40-60 degrees C, respectively.For the prevention of these injuries, our suggestions include well-designed external shield with adequate separation from the exhaust pipe, motorcycle parking lots of adequate width (> 120cm), the wearing of trousers by motorcyclists, decrease of the density of motorcycle traffic, and development of the electric assisted cycle in place of the fuel-driven motorcycle. (Copyright © 2002 Elsevier Science)
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Tattoos and body piercings as indicators of adolescent risk-taking behaviors.
- Carroll ST, Riffenburgh RH, Roberts TA, Myhre EB. Pediatrics 2002; 109(6):1021-10217.
Correspondence: Sean T. Carroll, Adolescent Medicine Division, Department of Pediatrics, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, California 92134-5000 USA; (email: sean.carroll@haw.tamc.amedd.army.mil).
OBJECTIVES: This study assessed tattoos and body piercings as markers of risk-taking behaviors in adolescents.
METHODS: A 58-question survey, based on the 1997 Centers for Disease Control and Prevention Youth Risk Behavior Survey, was offered to all adolescent beneficiaries that came to the Adolescent Clinic. The survey contained standard Youth Risk Behavior Survey questions that inquire about eating behavior, violence, drug abuse, sexual behavior, and suicide. Questions about tattoos and body piercings were added for the purposes of this study.
RESULTS: Participants with tattoos and/or body piercings were more likely to have engaged in risk-taking behaviors and at greater degrees of involvement than those without either. These included disordered eating behavior, gateway drug use, hard drug use, sexual activity, and suicide. Violence was associated with males having tattoos and with females having body piercings. Gateway drug use was associated with younger age of both tattooing and body piercing. Hard drug use was associated with number of body piercings. Suicide was associated with females having tattoos and younger age of both tattooing and body piercing. Tattoos and body piercings were found to be more common in females than males.
CONCLUSIONS: Tattoos and/or body piercings can alert practitioners to the possibility of other risk-taking behaviors in adolescents, leading to preventive measures, including counseling. Tattoo and body piercing discovery should be an important part of a health maintenance visit to best direct adolescent medical care. (Copyright © 2002 American Academy of Pediatrics)
A newspaper surveillance study of homicide-suicide in the United States.
- Malphurs JE, Cohen D. Am J Forensic Med Pathol 2002;23(2):142-148.
Donna Cohen, Ph.D., Department of Aging & Mental Health, University of South Florida, 13301 Bruce B. Downs Blvd, Tampa, FL 33612 USA; (email: cohen@mirage.fmhi.usf.edu).
The objective of this study was to identify the number and subtypes of homicide-suicides in the United States by age group and state over a 3-year period from 1997 through 1999. A total of 673 homicide-suicides, including 674 perpetrators and 779 victims, were identified from Internet searches of 191 national newspapers, and they were classified according to a modified Hanzlick-Koponen typology. One quarter of the homicide-suicides were perpetrated by persons 55 years or older, and 77% were spousal/consortial, higher than the 57% observed in the younger age group; 11% of the older homicide-suicides were familial, compared with 16% in the younger age group. Whereas only 3% of older homicide-suicides were infanticide/pedicide, 16% of the younger homicide-suicides involved parents killing their children. Forty-five states, including the District of Columbia, reported a homicide-suicide during the 3-year period, and they occurred most frequently in Florida (163), California (98), Texas (36), and New York (35). Newspaper surveillance is useful to identify where homicide-suicides are occurring most frequently, but they are underestimates of the true prevalence. However, the number of incidents detected is large enough that the cases detected may be a fairly representative sample. (Copyright © 2002 Lippincott Williams & Wilkins)
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