Much of what we know about students' drinking patterns and problems related to alcohol use is based on survey research. Although local and national survey data are important to alcohol-prevention projects, they do not sufficiently capture the complexity of the alcohol environment. Environmental prevention approaches to alcohol-related problems have been shown to be effective in community settings and researchers have begun to study and adapt such approaches for use on college campuses. Many environmental approaches require systematic scanning of the campus alcohol environment. This study assessed the inter-rater reliability of two environmental scanning tools (a newspaper content analysis form and a bulletin analysis form) designed to identify alcohol-related advertisements targeting college students. Inter-rater reliability for these forms varied across different rating categories and ranged from poor to excellent. Suggestions for future research are addressed.
Correspondence: P.G. Holborn, Explosions and Fire Research Unit, Chemical Engineering Research Centre, South Bank University, 103 Borough Road, London SE1 0AA, UK; (email: holborpg@sbu.ac.uk)
London is a large capital city with a population of approximately seven million people. It shares many problems with other large cities around the world, including deaths due to fire. Many of these fire deaths can be linked to social problems such as poor housing, loneliness, illness, etc.
Data from the London Fire Brigade Real Fire Library -- a unique database of information collected from real fire incidents by dedicated teams of fire investigators operating in the Greater London Area has been used to obtain a range of statistics about fatal fires and fire death victims for the 5-year period from 1996 to 2000. Most deaths occurred in unintentional dwelling fires. The statistical information has therefore been analyzed to identify the main factors involved as to why people die in unintentional dwelling fires and see what lessons can be learnt from these deaths.
Common risk factors identified in the unintentional dwelling fire deaths investigated include smoking, alcohol, old age, disability, illness, living alone, social deprivation and not having a working smoke alarm fitted. Comparisons are also made with the results found from other studies and measures for preventing unintentional dwelling fire deaths are examined.
Smoke alarms and residential fire mortality in the United States: an ecologic study
Correspondence: Mark R. Stevenson, Injury Research Centre, Department of Public Health,The University of Western Australia, Crawley, WA 6009, AUSTRALIA; (email: marks@dph.uwa.edu.au)
Death and injury from residential fires remains a major public health challenge in the United States and operable smoke alarms on each level of a home have been estimated to reduce the risk of death and injuries from residential fires. A multiple-group analytic ecologic study was undertaken with ecologic data at both the group- and individual-level for each state of the United States. The age standardized mortality rates for residential fire in the US was 1.61 per 100,000, with the highest fire-mortality rates occurring in the southeastern states of the US. An estimated 93.6% of US households have a smoke alarm. The findings of the analysis highlight that smoke alarms, when represented at an ecologic-level, have a significant, negative, association with residential fire mortality (eRR=0.92, 95% CI=0.85-0.99). The finding of a negative ecologic association between smoke alarms and residential fire mortality reflects findings reported in studies using individual-level data, namely, that operable smoke alarms provided adequate warning and protection against death in residential fires. The ecologic association identified in this study is not strong and this may be due, in part, to the fact the prevalence rates for smoke alarms used in the study do not reflect the functional status of the alarms.
The validity and reliability of a portable slip meter for determining floor slipperiness during simulated heel strike.
- Gronqvist R, Hirvonen M, Rajamaki E, Matz S. Accid Anal Prev 2003; 35(2): 211-225.
Correspondence: Raoul Gr�nqvist, Liberty Mutual Research Center for Safety and Health, 01748, Hopkinton, MA, USA; (email: raoul.gronqvist@occuphealth.fi).
A previously developed test rig was used as starting point for designing a portable slip meter with two new features. First, an inflatable pneumatic test wheel, consisting of six slider units, was introduced as the impacting contact element relative to floor surface. Second, an inductive trigger was built into the system to facilitate a precise timing of the slider-floor contact during the test. This new test rig was designed to measure transitional friction properties of contaminated floor surfaces during simulated heel strike, which is considered the most critical phase of gait from the slip and fall point of view. Another objective was to quantify the validity and reliability of this test method in the laboratory, but not yet in the field. The measurement process was evaluated on eight wet and oily floor surfaces (vinyl and ceramic tile floorings) using two slider materials (plain, profiled), two normal loads (100, 200N), and two sliding velocities (0.15, 0.30m/s) as independent variables. The outputs of the portable slip meter, in terms of transitional friction coefficients, were compared to force platform-based friction values and to slip resistance values obtained with a slip simulator apparatus for laboratory testing of shoes and floor surfaces. The outputs were also evaluated against slipperiness ratings made by three male subjects in paired comparison trials, in which the subjects walked over eight wet floor surfaces wearing shoes with the plain soling material. The results showed that test option 200N and 0.15m/s led to optimum validity despite its tendency to promote frictional vibrations (stick-slip) in the contact surface. Compared to the lower sliding speed, the higher speed reduced both stick-slip and measurement bias. Test option 200N and 0.30m/s was the most reliable one in this experiment. It yielded lower friction coefficients than any other test option and reduced the likelihood of underestimating slip and fall hazards. The results implied that the minimum friction coefficient was 0.25 for preventing a fall on wet floor surfaces, whereas the limit for preventing a slip was in the range 0.30-0.35. Transitional friction measurement was found to be a valid and reliable indicator for slip resistance. A more accurate control of the normal force during testing is needed for actual field use of the test method.
Why better operators receive worse warnings.
- Meyer J, Bitan Y. Hum Factors 2002; 44(3): 343-353.
Correspondence: Joachim Meyer, Department of Industrial Engineering and Management, Ben Gurion University of the Negev, Beer Sheva 84105, ISRAEL; (email: joachim@bgumail.bgu.ac.il).
Descriptions of a dynamic warning system usually assign the system certain diagnostic values. Operators should adjust their responses to these values when considering the output of the system for their decisions. This approach is not necessarily appropriate for complex systems that are controlled by human operators. Here the operators' actions are likely to change the frequency of events that should trigger a warning. Consequently the operator will change the predictive value of a warning system that is imperfectly correlated with the monitored events. In general its diagnostic value decreases for better operators. This phenomenon is demonstrated on the example of binary warnings about binary events, and an empirical demonstration of the phenomenon is provided in an experimental study of a process control task. Actual or potential applications of this research include improved understanding of the determinants of operators' responses to warnings, which should help in the design of better warning systems.
For the evaluation of pedestrian protection, the European Enhanced Vehicle-Safety Committee Working Group 17 report is now commonly used. In the evaluation of head injuries, the report takes into account only the hood area of the vehicle. But recent pedestrian accident data has shown the injury source for head injury changing to the windshield and A-pillar from the hood. The head contact points are considered to fall on a parallel to the front shape of the vehicle along the lateral direction, but the rigidity of the outer side construction is different from the center area. The purpose of this study is to consider the reason for the change in injury source for recent vehicle models. The head contact points and contact conditions, speed and angle, are thought to be influenced not only by the vehicle's geometry, but also its construction (rigidity). In this study, vehicle-pedestrian impact simulations were calculated with a finite element model for several hitting positions, including the outer side areas. Full dummy sled tests were conducted to confirm the simulation results. These results show that, for impacts at the outer sides of the vehicle, the head contact points are more rearward than at the vehicle center. In addition, the speed and angle of the head contact were found to be influenced by the pedestrian height.
This paper proposes a new theory to account for the effects of underload on performance. Malleable attentional resources theory posits that attentional capacity can change size in response to changes in task demands. As such, the performance decrements associated with mental underload can be explained by a lack of appropriate attentional resources. These proposals were explored in a driving simulator experiment. Vehicle automation was manipulated at 4 levels, and mental workload was assessed with a secondary task. Eye movements were also recorded to determine whether attentional capacity varied with mental workload. The results showed a clear decrease in mental workload associated with some levels of automation. Most striking, though, were the results derived from the eye movement recordings, which demonstrated that attentional capacity varies directly with level of mental workload. These data fully supported the predictions of the new theory. Malleable attentional resources theory suggests that future vehicle designers should employ their technology in driver support systems rather than in automation to replace the driver. The implications of this theory are discussed with regard to capacity models of attention as well as to the design of future vehicle systems.
Coordinating one hand with two eyes: optimizing for field of view in a pointing task.
- Khan AZ, Douglas Crawford J. Vision Res 2003; 43(4): 409-417.
York Centre for Vision Research, York University, Toronto, Ont. M3J 1P3, CANADA; (email: jdc@yorku.ca).
We previously found that subjects switched 'ocular dominance' as a function of horizontal gaze direction in a reaching task. Here we extend these findings to show that when subjects pointed to targets across the horizontal binocular field, they aligned the fingertip with a vertical plane located between the eyes and the target. This eye-target plane gradually shifted from aligning with the left eye (leftward targets) to between the two eyes (intermediate targets) to the right eye (rightward targets). We suggest that this occurs to optimize eye-hand alignment towards the eye with the best overall field of view.
Motion detection and the coincidence of structure at high and low spatial frequencies.
- Bex PJ, Dakin SC. Vision Res 2003; 43(4): 371-383.
Correspondence: Peter J. Bex, Institute of Ophthalmology, 11-43 Bath Street, EC1V 9EL, London, UK; (email: p.bex@ucl.ac.uk).
We used filtered random dot kinematograms and natural images to examine how motion detection depends the relative locations of structures defined at low and high spatial frequencies. The upper displacement limit of motion (D(max)), the lower displacement limit (D(min)) and motion coherence thresholds were unaffected by the degree of spatial coincidence between high and low spatial frequency structures i.e. whether they were consistent or inconsistent with a single feature. However motion detection was possible between band-pass filtered random dot patterns whose peak frequencies were separated by up to 4 octaves. The first result implicates spatial frequency selective motion detectors that operate independently. The second result implicates a motion system that can integrate the displacements of edges defined by widely separated spatial frequencies. Both are required to account for the two results, and they appear to operate under very similar conditions.
- Forks TP. J Miss State Med Assoc 2002; 43(11): 339-343.
Correspondence: Thomas P. Forks, West Jackson Family Medical Center, Department of Family Medicine, University of Mississippi Medical Center, USA; (email: unavailable).
It is clear from the data that hunting injuries in Mississippi mirror those which occur nationwide. The vast majority of these injuries are easily preventable by following common sense hunting safety rules. As with firearm injuries, tree stand injuries are clearly preventable by following common sense rules (Table 1). Most falls are due to poorly constructed or old wooden tree stands that come apart or become detached from the tree thereby causing the hunter to fall. All bolts and fasteners should be inspected and replaced if found to be defective prior to use of the stand. Old, broken or rotten lumber should be replaced. Tree stands should only be placed in healthy, mature trees with strong healthy limbs. Unfortunately, tree stand hunters seldom wear safety harnesses when hunting. These devices, when used properly (worm around the chest under both arms), can greatly decrease morbidity and mortality associated with falls. To minimize trauma, tree stands should be constructed no greater than 20 feet above ground level. Hunters should be cautioned to wear non-slip boots [table| see text] and to apply a non-slip covering to the floor of their tree stands prior to use of the stands. Other safety tips include the removal of all logs, stones or other obstructions from around the base of the tree. As with all hunters, tree stand hunters are advised to carry a compass, whistle, flashlight and cellular phone with them during their hunt. Hunting equipment, including bows and arrows and all firearms should never be carried up to the stand. This equipment should only be lifted or lowered to or from the stand with the use of a haul line. Hunters must remember the 10 commandments of gun safety (Table 2). Every firearm should be treated as if it were loaded. Firearms should not be pointed at anything other than the intended target and the muzzle must be controlled at all times. The action and barrel should be inspected prior to loading ammunition to ensure that they are clear of obstructions. The target must be clearly identified before discharging the firearm. All firearms must be kept separate from their ammunition and unloaded when not in use. Alcohol and any mind-altering substances (antihistamines, etc) must be strictly avoided when hunting. Hunters should avoid shooting at hard, flat surfaces in an attempt to prevent ricochets, should never pull a loaded gun toward themselves, and should never climb over a fence or other obstacle with a loaded firearm. Additional common sense safety precautions include the use of the "gun safety." The safety should be "on" at all times and switched off only when the rifle is sighted in, on the game just before discharge. This simple precaution may well prevent many of the accidental shootings that occur when firearms are dropped. When firearms are dropped, the hunter must carefully pick up the gun butt first while leaving the muzzle pointed toward the ground. Rifles should be left unloaded until game is sighted and should be loaded only in the immediate anticipation of discharging the firearm at game. Hunters are also advised to hunt in-groups and should notify family members or friends of the approximate time they anticipate entering and leaving the hunting area. Bright orange hunting vests have been shown to greatly increase the hunter's visibility and should always be worn when in the field during hunting season. Hunters are also advised to layer their clothing to prevent cold injuries. A backpack containing a flashlight, compass, prescription medications, first aid kit, cellular phone and high calorie foods should be taken into the field with the hunter. Bow hunters can drastically reduce injuries and death by following a few common sense rules (Table 3). All arrows should remain sheathed until prey is sighted at which time the arrow may be nocked to the bowstring. Bows should never be drawn until the hunter is ready to fire at the target. At all times, the bow and nocked arrow should be pointed in a safe direction. Reminding hunters of the major causes of accidents as well as how to prevent them will help to decrease hunting injury and death rates in Mississippi. Careful planning and safety precautions on the part of all hunters are essential to their own safety as well as that of others.
Correspondence: Colin Macarthur,Paediatric Outcomes Research Team, Division of Paediatric Medicine, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, Ont. M5G 1X8, CANADA; (email: colin.macarthur@sickkids.ca).
This study examined the small area variation in motor vehicle crash fatality rates in the province of Alberta, Canada. Motor vehicle crash fatality rates per 100,000 population (1995-1997, inclusive) were determined for five geographic areas in the province. The rates showed substantial, statistically significant variation across areas, with fatality rates lowest in the urban areas of Calgary and Edmonton, and highest in the rural areas (south, central, and northern Alberta). Examination of area-level predictors-population density, impaired driving citation rates, education level, unemployment levels, and ethnicity-showed that population density and impaired driving rates were associated with motor vehicle crash fatality rates. There was a five-fold difference in annual motor vehicle crash fatality rates between rural (22.9/100,000) and urban areas (4.4/100,000), whereas annual impaired driving rates were around 1.8% in rural areas, compared with 0.6% in urban areas. Because of multicollinearity problems, it was not possible to estimate a multivariable Poisson regression model. In conclusion, rural areas in the province of Alberta demonstrate a significantly higher motor vehicle crash fatality rate, compared with urban areas.
Correspondence: Peter J. Aspinall, Centre for Health Services Studies, University of Kent at Canterbury, Tunbridge Wells, UK; (email: p.j.aspinall@ukc.ac.uk).
BACKGROUND: Studies have consistently reported higher rates of suicide amongst Irish migrants in Britain than in the population as a whole. Leavey offers a hypothetical model to explain such rates that incorporates lack of social cohesion and integration meshed with the inability to establish an authentic identity and other contributory factors.
METHODS: Systematic review methodologies are used to examine the central tenets of this explanatory framework. Some of the macro-level ecological associations in the model are critically evaluated in the context of findings from the 1991 Census and government social and household panel surveys.
DISCUSSION: The evidence base suggests that statements on social isolation and reluctance to use health care services are questionable and Irish migration is shown to be much more heterogeneous than the model suggests. Only small positive, and as yet unreplicated, associations have been established between identity and health behavior in a non-representative sample and evidence is lacking of Irish stoicism and anti-Irish racism as putative risk factors. Epidemiological studies show that adjusting suicide rates for social class explains virtually none of the excess in Irish migrants, although higher risks for unmarried persons are reported. Explanations in the literature for higher rates of migrant suicide are discussed. Studies based on individual-level analysis and record linkage are urgently needed to explain the high rates.
A cohort of 4729 junior college students in an urban and a rural area in Taiwan was followed up for a period of 20 months. Students' characteristics, including riding exposures, as well as human, vehicular, and environmental factors were collected using one initial and three follow-up questionnaires. The Anderson-Gill (AG) multiplicative intensity model was used to determine the risk of a motorcycle crash over time while also allowing for the modeling of multiple events. The average response rate for the four assessments was 92%. The adjusted relative hazard (RH) for students living in the rural as opposed to the urban area for crashes was 1.67 at the beginning of the study but decreased to 0.66 by the end. Past motorcycle crash history, number of riding days, average riding distance, risk-taking level, alcohol consumption, and traffic violations were all significantly associated with an increased risk of being involved in a crash. Conversely, increasing age, riding experience, and automobile licensure were related to a decreased risk of crashing. Furthermore, helmet use was not independently related to the risk of crashing. In conclusion, a high-risk group predisposed to involvement in a motorcycle crash, including both non-injury and injury-related crashes, can be identified using selected risk factors for crash prevention among young riders.
Correlation of head injury to vehicle contact points using crash injury research and engineering network data.
Correspondence: Ram Nirula, Harborview Injury Prevention and Research Center, Harborview Medical Center, University of Washington, P.O. Box 359960, 325 Ninth Avenue, 98104-1520, Seattle, WA, USA; (email: rnirula@u.washington.edu).
Head injury is the most common cause of morbidity and mortality in motor vehicle crashes. Efforts to improve vehicle design, which minimize forces exerted to the occupant's head, may lead to a reduction in the frequency and severity of head injury. We therefore set out to identify mechanisms producing severe head injury in motor vehicle crashes (MVC) derived from the crash injury research and engineering network (CIREN) database. CIREN combines crash site analysis, vehicle damage assessment, and occupant kinematics in relation to the occupant's injuries. From the Seattle CIREN database of 101 cases, compiled from 1997 to 1998, we selected those crashes in which the occupant sustained severe head injury (abbreviated injury score, AIS >/=4) for analysis. We examined crash mechanism, energy transfer, point of head contact, vehicle intrusion and resulting injuries. There were 15 cases with severe head injury. These were primarily due to side impacts (n=10) in comparison to front impacts (n=5). The average net change in velocity (delta velocity, DV) was 15mile/h (range 4-29mile/h). In cases where the primary point of head contact could be elucidated the B-pillar predominated (4 cases, 33.3%) followed by the striking external object (2 cases, 16.7%), A- (1 case, 8.3%) and C- (1 case, 8.3%) pillars, roof side rail (1 case, 8.3%), windshield header (1 case, 8.3%), windowsill (1 case, 8.3%) and airbag (1 case, 8.3%).In this series the predominant mechanism of head injury was lateral impacts, especially those in which the victims' heads struck the B-pillar. The need for improved head protection from lateral impacts is indicated.
Effects of Red Light Cameras on Violations and Crashes: A Review of the International Literature
Red light running is a frequent cause of motor vehicle crashes and injuries. A primary countermeasure for red light running crashes is police traffic enforcement. In recent years, many police agencies have begun using automated red light cameras as a supplement to conventional enforcement methods. The present study reviewed and evaluated available evidence in the international literature regarding the effectiveness of cameras to reduce both red light violations and crashes. Camera enforcement generally reduces violations by an estimated 40-50%. In terms of crash effects, most studies contain methodological flaws that, to varying degrees, either overestimate (failure to adjust for regression to the mean) or underestimate (comparison with nearby signalized intersections affected by cameras) crash effects. Mindful of these limitations, the research generally indicates that camera enforcement can significantly reduce injury crashes at signalized intersections, in particular right-angle injury crashes. Most studies reported increases in rear-end crashes following camera installation. Taken together the studies indicate that, overall, injury crashes, including rear-end collisions, were reduced by 25-30% as a result of camera enforcement.
An Overview of Research Advances in Road Traffic Trauma in China
Correspondence: Zhengguo Wang, Research Institute of Surgery, Institute for Traffic Medicine, Daping Hospital, Third Military Medical University, Chongqing, PEOPLE'S REPUBLIC OF CHINA; (email: unavailable).
With rapid development of social economies, road traffic accidents (RTAs) have continued to increase, and have become the "primary public hazard" to humans. Road traffic trauma (RTT) is a major cause of death in young people of all motorized countries. This article reviews the current advances in RTT research, in order to find some approaches to improving traffic administration and reducing RTAs and RTT. All available data were collected from government, literature, our own research, and conference proceedings. Statistical analysis from every country showed that human factors were still the main cause of RTAs, accounting for more than 90%. Vehicle and road factors caused 3-5% and less than 2% of the total RTAs, respectively. Approximately 85% of RTAs were caused by 21 to 45-year-olds. About 50% of deaths due to RTAs in the United States were related to drinking. In China, RTAs due to driver drinking accounted for 0.29-1.48%. About 6-8% of drivers were prone to RTA, causing 30-40% of RTAs. Seat belts are an effective way to prevent casualties, reducing mortality and morbidity by 13-50%. In China, about 70% of RTAs were related to bicycles. Prehospital emergency treatment is very important. About 35% of deaths may be avoided if the injured receive early and effective treatment. From 1983 to 1992 the mortality of RTT increased by 13% in 18 developing countries, while it decreased by 18% in 13 developed countries, indicating the importance of comprehensive treatment of traffic administration. In addition many advances have been made in basic scientific research of RTT, such as development of serial bioimpact machines and investigation of biomechanical and biochemical mechanisms of impact injuries. In this century, RTAs and RTT are predicted to continue to increase in many countries, especially in developing ones. Full cooperation and comprehensive treatment should be performed in order to improve traffic safety.
How Future Trends in Societal Aging, Air Bag Availability, Seat Belt Use, and Fleet Composition Will Affect Serious Injury Risk and Occurrence in the United States
- Kent R, Funk J, Crandall J. Traf Inj Prev 2003; 4(1): 24-32.
Correspondence: Richard Kent, Department of Mechanical and Aerospace Engineering, University of Virginia, Charlottesville, Virginia, USA; (email:rwk3c@virginia.edu).
The objective of this study was to quantify the importance of societal aging relative to other factors that are known to affect injury risk. An aging population's effect on Maximum Abbreviated Injury Scale (MAIS) 3+ injury trends for passenger car drivers in frontal crashes was projected and compared to the effects of projected changes in fleet composition, changes in seat belt usage, and changes in air bag availability. It was determined that increased frailty due to an aging population will result in 19,816 to 43,568 additional injuries to passenger car drivers in frontal crashes from 1996 to 2012. Aging was shown to have an effect similar to the increased presence of light trucks in the fleet (a cumulative increase of approximately 47,428 injuries). Aging and changing fleet composition were shown to have a smaller effect than the projected increases in seat belt use or air bag availability, though the effect of increased belt use is not much greater than the effect of aging. After 2012, however, air bag availability and seat belt use will plateau, while societal aging will continue.
Reliability of Police-Reported Information for Determining Crash and Injury Severity
Posted speed limit and police-reported injury codes are commonly used by researchers to approximate vehicle impact and occupant injury severity. In-depth crash investigations, however, produce more precise measures of crash and injury severity: change in velocity (delta-V) for crash severity and Abbreviated Injury Scale (AIS) scores for injury severity. A comparison of data from police crash reports with that gathered by National Automotive Sampling System (NASS) investigators highlighted the inadequacy of speed limit and police injury codes as proxies for delta-V and AIS injury severity. In general, delta-V increased with speed limit and higher values of AIS were associated with higher police-coded injury severity, but there were a number of anomalies. In particular, 49% of the drivers coded by police as having incapacitating injuries actually had sustained no more than minor injuries. This overstatement of injury severity was less frequent among male (44%) and elderly (37%) drivers than among female (53%) and nonelderly (50%) drivers. Also, 79% of the investigated vehicles that crashed on roads posted at 60 mph (96 km/h) or higher experienced a delta-V less than 25 mph (40 km/h). Safety studies depending on data from only police reports to establish injury or crash severity therefore could produce erroneous results.
Collision and Violation Involvement of Drivers Who Use Cellular Telephones
- Wilson J, Fang M, Wiggins S, Cooper P. Traf Inj Prev 2003; 4(1): 45-52.
Correspondence: Jean Wilson, Insurance Corporation of British Columbia, Victoria, British Columbia, CANADA; (email: unavailable).
The study sample consisted of 3,869 drivers, split approximately 50/50 between observed cell phone users and those observed not using cell phones (labeled "nonusers"). Cell phone use was determined by a snapshot observation made on city streets. The sample represented 54% of those originally observed, for whom a match was obtained for both vehicle license plate and for gender and estimated age group of the observed driver and that of the driver named in the vehicle policy. Data were obtained from records of insurance claims, police-reported collisions and violations, following a strict protocol to protect individual privacy. The dependent measures were at-fault crash claims and "inattention" violations. A logistic regression model controlled for age, gender, exposure (represented by not-at-fault crash claims), alcohol-related offenses, and aggressive driving offenses. The study also involved a comparison of the contributing factors and collision configurations of police-reported collisions involving the users and "nonusers" in the sample. Drivers observed using cell phones had a higher risk of an at-fault crash than did the "nonusers," although the difference was not significant for males. There was no apparent effect on "inattention" violations. The cell phone users also had a higher proportion of rear-end collisions. The violation pattern of cell phone users suggests that they are, in general, riskier drivers. These differences likely reflect lifestyle, attitude and personality factors. It is essential to control for these factors in assessing the direct risk attributable to cellular telephone use.
Risk attitude reversals in drivers' route choice when range of travel time information is provided.
- Katsikopoulos KV, Duse-Anthony Y, Fisher DL, Duffy SA. Hum Factors 2002; 44(3):466-473.
Correspondence: Konstantinos V. Katsikopoulos, University of Massachusetts, Amherst, Massachusetts, USA; (email: katsikop@ecs.umass.edu).
Automobile drivers were recently found to be risk averse when choosing among routes that had an average travel time shorter than the certain travel time of a route considered as a reference. Conversely, drivers were found to be risk seeking when choosing among routes that had an average travel time longer than the certain travel time of the reference route. In a driving simulation study in which the reference route had a range of travel times, this pattern was replicated when the reference range was smaller than the ranges of the available routes. However, the pattern was reversed when the reference range was larger than the ranges of the available routes. We recently proposed a simple heuristic model that fit the relatively complex data quite well. Actual or potential applications of this research include the design of variable message signs and of route choice support systems.
Age and visual impairment decrease driving performance as measured on a closed-road circuit.
Correspondence: Joanne M. Wood, Center for Eye Research, Queensland University of Technology, Brisbane, Queensland, AUSTRALIA; (email: jwood@qut.edu.au).
In this study the effects of visual impairment and age on driving were investigated and related to visual function. Participants were 139 licensed drivers (young, middle-aged, and older participants with normal vision, and older participants with ocular disease). Driving performance was assessed during the daytime on a closed-road driving circuit. Visual performance was assessed using a vision testing battery. Age and visual impairment had a significant detrimental effect on recognition tasks (detection and recognition of signs and hazards), time to complete driving tasks (overall course time, reversing, and maneuvering), maneuvering ability, divided attention, and an overall driving performance index. All vision measures were significantly affected by group membership. A combination of motion sensitivity, useful field of view (UFOV), Pelli-Robson letter contrast sensitivity, and dynamic acuity could predict 50% of the variance in overall driving scores. These results indicate that older drivers with either normal vision or visual impairment had poorer driving performance compared with younger or middle-aged drivers with normal vision. The inclusion of tests such as motion sensitivity and the UFOV significantly improve the predictive power of vision tests for driving performance. Although such measures may not be practical for widespread screening, their application in selected cases should be considered.
Strategy development in dealing with violence against employees in the workplace.
- Fleming P, Harvey HD. J R Soc Health 2002; 122(4): 226-232.
Correspondence: P. Flemming, Faculty of Life and Health Sciences, University of Ulster, Jordanstown Campus, Shore Road, Newtownabbey, Co. Antrim BT37 0QB, NORTHERN IRELAND; (email: p.fleming@ulster.ac.uk).
The creation of health promoting workplaces is a key development in contemporary workplace health. This paper focuses on the issue of workplace violence and the efforts which must be made to address its prevention and to deal with its consequences as a contribution towards developing a health promoting workplace. A critical overview of the issue as it is currently addressed in the international literature is a precursor to the formulation of an inclusive definition of workplace violence. This forms the basis for a framework for the development and implementation of workplace violence policies. The framework takes account of needs assessment, policy formulation in terms of prevention, incident management and reporting, and post-incident support strategies. The needs for effective education and training and good internal and external communications are also explored. The paper concludes by highlighting the necessity for workplaces to take seriously the need for a coherent and well-planned workplace violence strategy.
Violent behavior among urban youth attending alternative schools.
- Escobar-Chaves SL, Tortolero SR, Markham C, Kelder SH, Kapadia A. J Sch Health 2002; 72(9): 357-362.
Correspondence: Soledad L. Escobar-Chaves, Center for Health Promotion and Prevention Research, School of Public Health, University of Texas Health Science Center at Houston, 7000 Fannin, 26th Floor, Houston, TX 77030, USA; (email: soledad.l.escobar-chaves@uth.tmc.edu).
This study described violent behavior and aggression among youth attending alternative schools, and examined sociodemographic factors associated with such violence. The study involved 494 students attending 10 alternative schools in Houston, Texas. Data were collected between November 2000 and February 2001 by audio-enabled laptop computers equipped with headphones. Students self-reported an average of 11.8 aggressive acts during the week prior to the survey. Students reported a 30-day weapon carrying prevalence of 22.7%; 30-day gun carrying prevalence of 11.1%; 30-day knife or club prevalence of 17.2%; 12-month fighting prevalence of 50.6%; and 12-month prevalence of injuries due to fighting of 6.5%. Association between demographic variables, self-reported aggressive behavior, and other forms of aggression was examined using multivariate logistic regression. Students were divided into four mutually exclusive violence-related categories: no fighting and no weapon (referent), fighting only, carrying weapon only, fighting and weapon carrying. Student aggression was significantly associated with fighting and weapon carrying, with incremental increases at each level (OR 1.1 per unit of increase, 95% CI 1.1-1.2) and in presence of the covariates. Among Houston's alternative school students, the prevalence of violent behavior (weapon carrying, gun carrying, knife or club carrying, fighting, and treatment by a doctor or nurse for injuries) is higher compared to regular high school students. Aggression related strongly to weapon carrying and fighting in the sample. Data indicate alternative school youth urgently need prevention and treatment programs to help them live in safer environments.
Violence and Health: The United States in a Global Perspective.
- Mercy JA, Krug EG, Dahlberg LL, Zwi AB. Am J Public Health 2003; 93(2): 256-261.
Correspondence: James A. Mercy, National Center for Injury Prevention and Control, Centers for Disease Control, 4770 Buford Highway, NE, MS K-60, Atlanta, GA 0341-3724, USA; (email: jam2@cdc.gov).
(Published by American Journal of Public Health)
Violence is a public health problem that can be understood and changed. Research over the past 2 decades has demonstrated that violence can be prevented and that, in some cases, prevention programs are more cost-effective than other policy options such as incarceration. The United States has much to contribute to-and stands to gain much from-global efforts to prevent violence. A new World Health Organization initiative presents an opportunity for the United States to work with other nations to find cost-effective ways of preventing violence and reducing its enormous costs.
Do protection orders affect the likelihood of future partner violence and injury?
- Holt VL, Kernic MA, Wolf ME, Rivara FP.
Am J Prev Med 2003; 24(1): 16-21.
Correspondence: Victoria L. Holt, Department of Epidemiology, School of Public Health and Community Medicine (Holt, Kernic, Wolf, Rivara), University of Washington, Seattle, Washington, USA; ( vholt@u.washington.edu).
Approximately 20% of U.S. women who experience intimate partner violence (IPV) annually obtain a civil protection order (CPO). The effect of these orders on future abuse has been estimated in only a few studies, with mixed results. The objective of this study was to assess the effect of a CPO on the risk of future self-reported IPV and injury. In this prospective cohort study of 448 adult female Seattle WA residents with IPV between October 1997 and December 1998, interviews were conducted at baseline, 5 months, and 9 months after the index incident. Odds ratios (ORs) estimated risks of contact; unwelcome calls or visits; threats; weapon threats; psychological, sexual, or physical abuse or injury; and abuse-related medical care among women who obtained a CPO after the index incident, compared with those who did not. Women who obtained a CPO following the index IPV incident had significantly decreased risk of contact by the abuser (OR=0.4); weapon threats (OR=0.03); injury (OR=0.3); and abuse-related medical care (OR=0.2) between the first and second follow-up interviews. Stronger decreases in risk were seen among women who had maintained the CPO throughout follow-up, which were significant for contact by the abuser (OR=0.2); weapon threats (OR=0.02); psychological abuse (OR=0.4); sexual abuse (OR=0.2); physical abuse (OR=0.3); injury (OR=0.1); and abuse-related medical care (OR=0.1) between first and second follow-up interviews. CPOs are associated with decreased likelihood of subsequent physical and nonphysical IPV.
Female intimate partner homicide: a population-based study.
Correspondence: Kathryn E. (Beth) Moracco, Pacific Institute for Research and Evaluation, 1229 E. Franklin Street, 2nd Floor, Chapel Hill, NC 27514-3307, USA; (email: moracco@pire.org).
OBJECTIVES: To identify the patterns of female intimate partner homicide, to describe the nature of the partner relationships between victims and perpetrators, and to determine the extent of intimate partner violence (IPV) preceding the homicide.
METHODS: We reviewed North Carolina medical examiner records and conducted telephone interviews with law enforcement officers about partner homicides of women age 15 and older occurring in North Carolina from 1991 to 1993.
FINDINGS: Most women were killed in homes (80%) and with guns (66%). One hundred thirty-five women (of 293 cases) were killed by marital partners, 47 of them former partners. Nonmarital partners killed 158 women, 46 of them former partners. Intimate partner violence was noted in two-thirds of the cases, 70% of those involving marital partners and 64% involving nonmarital partners. Homicides by former nonmarital partners were the most likely to have been preceded by IPV (78%). One hundred six victims with histories of IPV had contact with law enforcement or judicial systems in the year before death.
DISCUSSION: Legal and health care professionals should be aware that women are vulnerable to both IPV and homicide from both nonmarital and former partners as well as from current husbands.
Personal awareness of domestic violence: implications for health care providers.
Correspondence: Susan B. Sorenson, School of Public Health, University of California, Los Angeles, 650 C.E. Young Dr, South, Los Angeles, CA 90095-1772, USA; (email: sorenson@ucla.edu).
OBJECTIVES: To estimate how many Californians know a victim of domestic violence, to examine their knowledge of certain characteristics of the violence, and to estimate and examine such knowledge among specific demographic groups.
METHOD: A total of 3713 California adults (similar numbers of whites, blacks, Hispanics, Korean Americans, Vietnamese Americans, and other Asian Americans) completed a random-digit-dial interview. Respondents were asked whether a friend, relative, or coworker had been threatened or harmed by an intimate partner. Weights were applied to the cross-sectional sample to obtain estimates for the general population. Descriptive statistics and multivariate regressions were used with the full sample.
FINDINGS: Nearly half (45.5%) of the adult general population of California knows a victim of domestic violence (DV); 40.5% know a woman and 5.0% know a man. More than one-third of the population (35.7%) knew the victim while the abuse was happening. Although 86.5% of those who reported knowing a DV victim indicated that the victim incurred physical harm, only 18.3% of the injured victims were reported to have sought medical care. Gender was the most consistent respondent predictor: Men were less likely to know someone who was a victim of DV and to have specific information about the violence. Ethnic differences were fewer, but distinctions among groups were documented.
DISCUSSION: Knowing a victim of DV is common among California adults. Implications for medical practice are discussed in terms of the ethnicity, gender, and work force status of the population served and geographic location of the medical practice.
What violence prevention research can tell us about developmental psychopathology.
- Tolan PH, Gorman-Smith D. Dev Psychopathol 2002; 14(4): 713-729.
Correspondence: Patrick H. Tolan, Institute for Juvenile Research, University of Illinois at Chicago, 840 S. Wood Street, Chicago, IL 60612, USA; (email: tolan@uic.edu).
This article reviews major issues of a developmental psychopathology understanding of youth violence and related insights gained from violence prevention efforts to date. Based in a perspective that emphasizes three areas of knowledge, epidemiology, risk factors and models, and developmental trajectories, findings are reviewed that help clarify theoretical propositions about the developmental patterns, influences, and pathways related to youth violence. Extant research is able to support several major contentions of basic developmental psychopathology theories of youth violence. Support is most robust for risk factors central to prevailing models of the development of youth violence. In addition to noting current knowledge contributions, the review suggests areas of needed additional analytic progress and theoretical extension to refine knowledge and expand understanding of the development of violence risk and its prevention.
Hospitalization for firearm-related injuries in the United States, 1997.
- Coben JH, Steiner CA. Am J Prev Med 2003; 24(1): 1-8.
Correspondence; Jeffrey H. Coben, Center for Outcomes and Effectiveness, Research Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services, Rockville, Maryland, USA; (email: jcoben@wpahs.org).
Firearm-related injuries are a serious public health problem in the United States. Despite the magnitude of this problem, prior national estimates of nonfatal, firearm-related morbidity have been limited to an emergency department-based surveillance system. The objective of this study was to assess and report the information available on firearm-related injuries in an existing national database, derived from hospital discharge data. Cross-sectional analysis of the 1997 Nationwide Inpatient Sample (NIS), a stratified probability sample of 1012 nonfederal community hospitals from 22 states. The database was queried using E codes to identify firearm-related injuries. The SUDAAN software program was used to convert raw counts into weighted counts that represent national estimates and 95% confidence intervals (CIs).An estimated 35,810 (95% CI, 32,615-38,947) cases nationwide were identified, of which 86% were male. Assault was the leading cause of firearm-related hospitalization, followed by unintentional injury. The mean length of stay (LOS) for patients with a firearm-related assault was 6 days. Seven percent of all firearm cases died during the hospitalization. The total estimated hospital charges for firearm-related injuries in the United States in 1997 was over $802 million, and 29% of the patients admitted for this condition were uninsured. Firearm-related injuries rank highest among all conditions in the number of uninsured hospital stays, and the average LOS is much longer compared to other medical conditions. National estimates derived from the NIS are consistent with previous estimates, and NIS provides additional information not available from other data sources.
