We prospectively examined the correlation of alcohol intoxication with injury severity, morbidity, and mortality in drivers involved in motor vehicle accidents in a prospective cohort study. The study enrolled 923 injured patients, of whom 421 were legally intoxicated (blood alcohol concentration [BAC] >/= 50 mg/dL) and 502 were nonintoxicated (BAC < 50 mg/dL). The intoxicated drivers had a significantly higher injury severity score (ISS), lower Glasgow Coma Score, lower systolic blood pressure; higher rate in old age, male sex, greater rate of habitual drinking, greater lack of use of safety gear, and greater accident-related morbidity. After logistic regression analysis, alcohol intoxication was not associated with severe injury (ISS >/= 9); however, alcohol intoxication analyzed either as a preinjury or postinjury risk factor, was one of the predictors for morbidity. Severe head injury was the only predictor of mortality. In conclusion, although alcohol intoxication is not associated with an increased incidence of severe injury or mortality in drivers involved in motor vehicle crashes, it is one of the significant predictors for morbidity after injury.
The study was conducted to determine the characteristics of child victims of dog bite accidents. Pediatricians and nurses prospectively collected standardized information on all child victims of dog bites brought in for treatment to six hospital emergency departments (three urban university teaching hospitals and three rural hospitals). One hundred completed questionnaires were collected and analyzed. The frequency of dog bites brought for care to the emergency departments was equivalent to about one-quarter of all road traffic casualties and one-third of burns at home. Of the 100 victims, 65 were bitten at home, and 35 in a public place. The bite accidents that occurred at home concerned children with a median age of 5 years, who were without adult supervision at the time of the accident. The children who were bitten by dogs in public places had a median age of 9 years. For 77 bites, the dog was not familiar to the child. Based on the history, it appeared that 56 out of 65 accidents at home and 11 out of 35 in public places resulted mainly from the children's or adult's behavior.CONCLUSION: To reduce the frequency of dog bites both at home and in public places, education could be the preventive measure with the highest priority. Out of 100 accidents, 67 children might not have been bitten had they and their parents been adequately educated on safe conduct towards dogs.
Construction is one of the most hazardous industries in the United States. Occupational health research to characterize the hazards in construction work has been hampered by the lack of a systematic approach to classification of construction work and its associated hazards. A taxonomy of construction work, a nested system of classification, has been developed to systematize the collection and reporting of exposure assessment data for the characterization and reduction of hazards and the prevention of musculoskeletal injury. This taxonomy subdivides construction work into the categories of stage, operation, task, and activity. It is based on a bidding specification system already in use within the industry and thus provides a terminology common among workers, supervisors, and managers. The identification of tasks and activities that are present in multiple stages and/or trades contributes to the efficiency of exposure data collection and facilitates the generalizabilty to other settings for both exposure data and intervention evaluations. The taxonomy provides a framework and vocabulary that facilitates field work and participatory research activities. It can also potentially be linked to personnel and economic data for estimation of costs of safety and health problems, as well as benefits of interventions. Although developed for construction ergonomics, the taxonomic approach has application to non-routine work in other industry sectors and possibly in occupational health research other than ergonomics.
Causes and consequences of pedestrian injuries in children.
- Mayr JM, Eder C, Berghold A, Wernig J, Khayati S, Ruppert-Kohlmayr A. Eur J Pediatr 2003; 162(3): 184-190.
Correspondence: Johannes Mayer, Department of Paediatric Surgery and Austrian Committee for Injury Prevention in Childhood, University of Graz, Auenbruggerplatz 34, 8036 Graz, Austria, johannes.mayr@kfunigraz.ac.at).
BACKGROUND: Pedestrian-car collisions are in motorised countries one of the leading causes of unintentional-injury-related death and morbidity among children.
OBJECTIVES: The objective of this study was to assess correlations between the mode and the severity or post-traumatic sequels of the injury.
METHODS: A 12-year (1989-2001) retrospective study of children aged 0-16 years injured in pedestrian-motor-vehicle collisions was undertaken. An anonymous survey with questionnaires completed by families was conducted.
FINDINGS: In this time period, 501 children (average age: 7.9 years) were injured. The lack of visibility of the vehicle (45%) and/or the pedestrian (39%) was the leading cause of injury. The mean injury severity score was 6.0 (1-75) and the mortality rate was 0.8% ( n=4, injury severity scores 47, 75, 75, 75). In this study, 217 questionnaires were analysed. When the children were injured, 37% of them were alone, 32.3% were in the presence of accompanying adults, and 24.0% were in the presence of other children. The latter group suffered the highest injury severity score ( P=0.016). Positive correlations were noted between injury severity score and impact speed ( r=0.31, P<0.001) and the distances that the children were thrown off or transported on the vehicle front ( r=0.29, P<0.001). Physical sequels were reported by 27% of the families, and 23% noted psychological disturbances. A positive correlation was noted between impact speed and the occurrence of physical sequels ( P<0.001). The number of deformed parts per vehicle was correlated to the occurrence of behavioural disturbances ( P<0.004).
DISCUSSION: The incidence of post-traumatic sequels seems to be associated with higher speed at impact, lack of braking attempts, and higher numbers of vehicle parts deformed.
The snowmobile was developed to move people and supplies, and for emergencies in regions where heavy snow prohibited the use of conventional vehicles. Today, snowmobiling has become a popular winter sport enjoyed by more than 2 million people of all ages in North America. However, the modern snowmobile can weigh in excess of 600 pounds and travel at speeds exceeding 90 miles per hour. Each year snowmobile accidents produce approximately 200 deaths and 14,000 injuries. Excess speed, alcohol, driver inexperience, and poor judgment are the leading causes of accidents. Injuries incurred in children and adults often are extremity fractures, but can involve any organ system. Similar to motor vehicle accidents, multisystem trauma occurs frequently with head injury the leading cause of death. Reduction in injury and death rates is urgently needed and can be accomplished through education and legislation.
Playground injury prevention.
- Purvis JM, Hirsch SA. Clin Orthop 2003; 409: 11-19.
Correspondence: John M. Purvis, Pediatric Orthopaedic Specialists of Mississippi, 1190 North State Street, Suite 204, Jackson, MS 39202, USA; (email: jpurvis@mbmc.org).
Playground safety recently has received increasing attention from parents and municipalities. Orthopaedic surgeons treat a large number of the more than 350,000 injuries per year sustained on the play areas of this country's school, home, and community play areas. A parent brings a child to the playground for fun, healthy exercise, and imaginative play. Unfortunately, most parents may not be aware of recommended injury prevention methods. Data from the Consumer Product Safety Commission and other epidemiologic studies document frequency, identify at-risk activities and equipment, give direction for additional research, and guide regulations. It is appropriate for the medical community to lead in this safety effort and to contribute to additional research and advocacy efforts.
Forty million individuals participate in organized softball leagues each year in the United States. Eighteen million additional student athletes and young adults also participate in organized baseball league play. In addition to being two of the most popular team sports in the United States, they also are responsible for a significant percentage of sports-related injuries that are sustained in the United States. Fortunately, numerous interventions independently have been shown to be effective at reducing the injury scenario, which has grown to be of epidemic proportion. Interventions such as break-away bases, batting helmets, face shields on helmets, lighter mass baseballs, and teaching and reiteration of the fundamentals of softball and baseball all have been effective in preventing millions of injuries and billions of dollars in healthcare costs each year in the United States.
Correspondence: Paul W. Esposito, MD, University of Nebraska Medical Center, 981080 Nebraska Medical Center, Omaha, NE 68114, USA; (email: pesposito@chsomaha.org).
As the popularity of trampolines has increased during the past 10 years, so has the number of injuries sustained using them. Whether there is an actual increase in the risk associated with the use of a trampoline for the same number of exposure hours is not known. The marked increase in emergency room visits related to trampoline injuries might reflect only the increased number of trampolines now available for recreational use or the creative manner in which they are being used. The complex factors related to trampolines, their use, and the possible injuries will be discussed. A liberal use of Internet references will be used because this is where much of the advertising and information available to the public regarding trampolines currently is disseminated.
Correspondence: Scott B. Scutchfield, Division of Orthopaedic Surgery, University of Kentucky College of Medicine, Kentucky Clinic, 740 South Limestone, Lexington, KY 40536-0284, USA; (email: wjrose2@uky.edu).
All-terrain vehicles, including three- and four-wheeled recreation and utility off-road motorized devices, are a serious risk to the public especially to children younger than 16 years. Statistics show the injuries, which often are musculoskeletal in nature, and fatalities are increasing: in 2002, approximately 111,000 people sustained injuries related to all-terrain vehicles. Although agencies such as the Consumer Product Safety Commission initially recognized and restricted three-wheeler sales, they largely have failed to address the problem caused by other all-terrain vehicles during the past 10 years. To reduce the frequency and severity of injuries from all-terrain vehicles, numerous methods have been recognized and discussed. State and federal laws are needed to implement these methods to protect the public; these legislative solutions also are included in the discussion.
OBJECTIVE: Project goals included creating a database for medical incidents at a Minnesota canoe and backpacking camp and identifying those most at risk within this population using one summer's experience.
METHODS: YMCA Camp Widjiwagan employed a total of 123 staff and served 725 campers in summer 2000. This resulted in 9418 camper trail days (CTD), 2497 staff trail days (STD), and 20150 participant days (PD), the evaluation units for this study. Data were collected using routine documentation: treatment logs (TL) for any event that required care, and incident reports (IR) for more serious injuries and near misses. Information was entered into an Access database and analyzed using descriptive statistics and analysis of variance.
FINDINGS: Canoe and backpack trips were compared using staff and camper days (CD). There were 582 TL and 59 IR, including 12 cases that resulted in evacuation to medical care (1/1000 PD). Canoe groups were no more at risk than backpack groups (P = .607), and campers reported more incidents than staff regardless of sex or location of injury (0.4/1000 CD compared with 0.1/1000 CD; P < .001). The camper groups most at risk were those beginning a series of advanced canoe trips (10 IR/1000 CTD; P < .001) and those on the longest, most advanced backpack trips (9 IR/1000 CTD; P < .001).
DISCUSSION: Careful tracking of health incidents and near misses over time can reveal which campers and camper groups are at greatest risk for injuries and illnesses occurring during participation.
BACKGROUND: "Hornussen" is a traditional Swiss team game played in rural areas of Switzerland. A puck made out of hard plastic called "Hornuss" or "Nouss" is hit with a lash like racket into the field. The opposing team has to capture the flying puck with shovel like shields. Eye injuries are rare, however, very severe.
METHODS: We report on three patients who were seen and treated at the university eye clinic Berne in the last four years.
FINDINGS: All injuries were blunt contusions with involvement of the periorbital soft tissues by a hit with the Hornuss. In two cases orbital fractures were observed and in one case there was a rupture of the globe in a pre-injured aphakic eye. Only in one case was there a direct hit to the eye by the Hornuss, the other injuries were caused by indirect hit after the Hornuss bounced off the shovel like shields. No protection gear was used. One patient showed complete recovery, whereas in the other two cases significant impairment remained.
DISCUSSION: Without adequate protection gear, injuries caused by Hornussen are generally severe. The injury pattern with periorbital involvement resembles eye injuries caused by baseballs. This is probably due to the similar size of the balls. The mandatory wearing of protection helmets issued by the federal Hornusser association for young players should be extended as a general requirement for all players.
In the United States, falls are the second leading cause of traumatic brain injury (TBI) hospitalizations overall and the leading cause of TBI hospitalizations among persons aged >65 years. In 1995, TBIs resulted in an estimated $56 billion in direct and indirect costs in the United States. In California, during 1999, a total of 61,475 hospitalizations from falls were reported among persons aged >65 years. Risk factors for falling among older persons included arthritis; impairments in balance, gait, vision, and muscle strength; and the use of four or more prescription medications. As part of CDC's program of state-based TBI surveillance, California hospital discharge data were collected and analyzed to describe fall-related TBIs. This report summarizes the results of that analysis, which support previous findings that persons aged >65 years are at risk for hospitalization for a fall and that same-level falls are far more common among persons aged >65 years than falls from a higher level (e.g., a ladder, chair, or stair). Defining the circumstances of fall injuries and recognizing the type of fall leading to TBI hospitalizations among older persons can help health-care providers conduct risk assessment and management of falls in this population.
All nonfederal, acute care hospitals in California are required to report hospital discharges to the Office of Statewide Health Planning and Development. All first admissions with an injury diagnosis must be coded for external cause of injury (E-code); E-codes are listed in >99% of these records. For this report, cases were limited to first admissions. Hospitalization records of transfers, fatal cases, and out-of-state residents were excluded by matching sex, date of birth, and a record linkage number (i.e, an encrypted social security number). Hospital discharge records were coded according to the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). TBI cases were defined by the most recent CDC surveillance definition, in which any of the 25 diagnoses include one of the following nature-of-injury diagnosis codes: 800.0--801.9 (fracture of the vault of the skull), 803.0--804.9 (other and unqualified skull fracture), 850.0--854.1 (intracranial injury including concussion, laceration, and hemorrhage), or 959.01 (head injury, unspecified). The primary cause of injury for falls (E880--E886, E888) was analyzed by mechanism. Age was categorized into one younger comparison group (aged 0--64 years) and three older groups (aged 65--74 years, 75--84 years, and >85 years). Incidence rates were calculated per 100,000 population by using mid-year population estimates of California residents for each year.
During 1996--1999, a total of 29,761 fall-related TBI hospitalizations were reported; of these, 28,009 (94%) patients were discharged, and 1,752 were deceased. A total of 1,252 (71%) of fatal fall-related TBI hospitalizations were among those aged >65 years. Overall, the nonfatal fall-related TBI hospitalization rate was 21.1 per 100,000 population (95% confidence interval = 20.8--21.3) (Table 1). Hospitalization rates increased with age; the highest rate (223.0) was among persons aged >85 years. Compared with persons aged 0--64 years, the rate ratio of hospitalizations was 3.1 for persons aged 65--74 years, 7.6 for those aged 75--84 years, and 16.4 for those aged >85 years. Overall, males were hospitalized more frequently (59%) than females. Although 70% of hospitalizations among those aged <65 years were among males, females accounted for 56% of hospitalizations among those aged >65 years. For those aged >65 years, whites represented 78% of hospitalizations and had the highest rate (25.4) among all racial/ethnic populations.
In 9,364 (33%) hospitalizations, the type of fall was coded "other and unspecified" (E888). Among the 18,645 specified falls, the pattern differed by age group (Table 2). Among persons aged 0--64 years, 75% of falls were from at least one level. Among persons aged >65 years, 60% of falls were on the same level. For the three older population groups, the proportion of specified falls on the same level also varied: 52% among persons aged 65--74 years, 61% among those aged 75--84 years, and 66% among those aged >85 years. By race/ethnicity for all age groups, the proportion of specified falls on the same level was 40% for whites, 31% for blacks, 23% for Hispanics, 36% for Asians/Pacific Islanders, and 33% for American Indians/Alaska Natives.
Among persons aged 0--64 years, 13,792 (86%) were discharged with only self-care or unskilled care provided. The remainder were sent to another facility or discharged with in-home health services or outpatient rehabilitation. Among persons aged >65 years, the number discharged was 4,927 (41%). The proportion of persons discharged home decreased with increasing age. For those aged >85 years, the number discharged was 1,071 (30%) compared with 2,083 (41%) for those aged 75--84 years and 1,773 (54%) for those aged 65--74 years.
Prevalence of traumatic brain injury amongst children admitted to hospital in one health district: a population-based study.
- Hawley CA, Ward AB, Long J, Owen DW, Magnay AR. Injury 2003; 34(4): 256-260.
Correspondence: Carol A. Hawley, Centre for Health Services Studies, University of Warwick, CV4 7AL, Coventry, UK; (email: c.a.hawley@warwick.ac.uk).
There is a dearth of information regarding the prevalence of brain injury, serious enough to require hospital admission, amongst children in UK. In North Staffordshire, a register of all children admitted with traumatic brain injury (TBI) has been maintained since 1992 presenting an opportunity to investigate the incidence of TBI within the region in terms of age, cause of injury, injury severity and social deprivation. The register contains details of 1553 children with TBI, two-thirds of whom are male. This population-based study shows that TBI is most prevalent amongst children from families living in more deprived areas, however, social deprivation was not related to the cause of injury. Each year, 280 per 100,000 children are admitted for >/=24h with a TBI, of these 232 will have a mild brain injury, 25 moderate, 17 severe, and 2 will die. The incidence of moderate and severe injuries is higher than previous estimates. Children under 2 years of age account for 18.5% of all TBIs, usually due to falls, being dropped or non-accidental injuries (NAIs). Falls account for 60% of TBIs in the under 5 years. In the 10-15 age group road traffic accidents (RTAs) were the most common cause (185, 36.7%). These findings will help to plan health services and target accident prevention initiatives more accurately.
Risk factors for childhood major and minor head and other injuries in a nationally representative sample.
Correspondence: Ratilal Lalloo, Department of Community Oral Health, Oral Health Centre, University of the Western Cape, Private Bag X08, Mitchells Plain 7785, SOUTH AFRICA; (email: ratilal@public-health.ucl.ac.uk).
OBJECTIVES: To assess the relationship between demographic, socioeconomic, family type and behavioural factors and childhood major and minor head and other injuries.
METHODS: Design, subjects and setting: A cross-sectional study, on a large nationally representative sample of 5913 children aged 4-15 years (Health Survey for England, 1997). Main outcome measures: Frequency of major and minor head and other injuries.
FINDINGS: There were no significant associations between any of the socioeconomic factors and family type and major and minor injuries, except for major head injuries in children who lived in families receiving more than one social or financial benefit. Boys were 1.5 times more likely to suffer major head and other injuries than girls. Older children were significantly more likely to experience major and minor other injuries, but less likely to have major and minor head injuries, compared to younger children. High scores for conduct disorder and emotional symptoms were significant risk factors for other major injuries, while high scores for hyperactivity and conduct disorder were significantly related to major and minor head injuries. The risk factors assessed were often stronger for major than for minor injuries, and stronger for head than other injuries.
DISCUSSION: Boys and children who exhibit certain behavioural problems such as high levels of hyperactivity were significantly more likely to report major and minor injuries affecting the head region.
Assessment of Iowa farmers' perceptions about auger safety.
- Freeman SA, Schwab CV, Pollard T. J Agric Saf Health 2003; 9(1): 61-74.
Correspondence: Steven A. Freeman, Department of Agricultural and Biosystems Engineering, 218 Industrial Education Building II, Iowa State University, Ames, IA 50011-3130, USA; (email: sfreeman@iastate.edu).
A survey of Iowa farmers was conducted to assess the farmers' perceptions and beliefs regarding auger safety and how these perceptions are put into practice. A questionnaire was designed to obtain information on the following auger-related topics: recognition of safe practices and appropriate shielding, personal practices and behaviors, risk perception, and personal beliefs. A random sample of 400 Iowa farmers (arrayed by county) was selected to be representative of Iowa farms. The response to the mailed survey was 23%. Some returned surveys were eliminated because the respondent was retired or did not own/operate augers, resulting in 57 usable questionnaires.
Survey responses indicate that the majority of Iowa farmers who participated in this study can correctly identify appropriate shielding for auger intake that meet or exceed ASAE standards. Survey responses suggest that it is common practice in Iowa for youth (age 13 to 19) to operate augers. Iowa farmers in this study perceive the most important contributing factors to auger-related injuries to be operating an auger without shielding, failure to pay attention on the job, moving augers in a raised position, and using hand or feet to redirect the flow of grain. Survey results also indicate that carelessness is perceived to be the leading cause of auger-related injuries, and that auger related injuries can be avoided by having respect for the equipment, being careful, and using common sense. The results also show that the Iowa farmers who participated in this study commonly perform auger-related practices (e.g., moving an auger in a raised position) that they identify as being unsafe.
Kathleen Fisher, School of Nursing, College of Health and Human Development, The Pennsylvania State University, 600 Centerview Dr, 1300 ASB/A110, Hershey, PA 17033, USA; (email: kmf103@psu.edu).
BACKGROUND: Pediatric nurse practitioners, especially those working in the school settings, often interact with children and teachers who confront school violence. This descriptive study was conducted to obtain teachers' insights into the problems of school violence.
METHODS: Voluntary questionnaire surveys were distributed to 536 elementary, middle, and high school teachers in a suburban school district in central Pennsylvania. Seventy-four percent returned usable surveys (n = 393). Data were tabulated and results are presented as percentages, frequencies, and chi-square analysis.
FINDINGS: Fifty-six percent of teachers believed that violence or the threat of violence had a direct impact on the quality of education they are able to provide. Elementary school teachers were more likely to be victims of a physical assault by a student (P =.0006) and more likely to fear parents (P =.002) than were other teachers.
DISCUSSION: Even in suburban schools, teachers are likely to be victimized and fear students or their parents. This fear adversely affects the quality of education provided. Pediatric nurse practitioners play a significant role in addressing this public health concern.
Developmental trajectories toward violence in middle childhood: course, demographic differences, and response to school-based intervention.
- Aber JL, Brown JL, Jones SM. Dev Psychol 2003; 39(2): 324-348.
Correspondence: J. Lawrence Aber, National Center for Children in Poverty, Joseph L Mailman School of Public Health, Columbia University, New York, New York 10032, USA; (email: jla12@columbia.edu).
The present study addressed 3 questions concerning (a) the course of developmental trajectories toward violence over middle childhood, (b) whether and how the course of these trajectories differed by demographic subgroups of children, and (c) how responsive these trajectories were to a universal, school-based preventive intervention. Four waves of data on features of children's social-emotional development known to forecast aggression/violence were collected in the fall and spring over 2 years for a highly representative sample of 1st to 6th grade children from New York City public elementary schools (N = 11,160). Using hierarchical linear modeling techniques, synthetic growth curves were estimated for the entire sample and were conditioned on child demographic characteristics (gender, family economic resources, race/ethnicity) and amount of exposure to components of the preventive intervention. Three patterns of growth--positive linear, late acceleration, and gradual deceleration--characterized the children's trajectories, and these trajectories varied meaningfully by child demographic characteristics. Most important, children whose teachers taught a high number of lessons in the conflict resolution curriculum demonstrated positive changes in their social-emotional developmental trajectories and deflections from a path toward future aggression and violence.
Initial behavior outcomes for the peacebuilders universal school-based violence prevention program.
Correspondence: Daniel J. Flannery, Institute for the Study and Prevention of Violence, Kent State University, 230 Auditorium Building, Kent, Ohio 44242, USA; (email: dflanne1@kent.edu).
PeaceBuilders is a universal, elementary-school-based violence prevention program that attempts to alter the climate of a school by teaching students and staff simple rules and activities aimed at improving child social competence and reducing aggressive behavior. Eight matched schools (N > 4,000 students in Grades K-5) were randomly assigned to either immediate postbaseline intervention (PBI) or to a delayed intervention 1 year later (PBD). Hierarchical linear modeling was used to analyze results from assessments in the fall and spring of 2 consecutive school years. In Year 1, significant gains in teacher-rated social competence for students in Grades K-2, in childself-reported peace-building behavior in Grades K-5, and reductions in aggressive behavior in Grades 3-5 were found for PBI but not PBD schools. Differential effects in Year 1 were also observed for aggression and prosocial behavior. Most effects were maintained in Year 2 for PBI schools, including increases in child prosocial behavior in Grades K-2. Implications for early universal school-based prevention and challenges related toevaluating large-scale prevention trials are discussed.
Correspondence: Marc Starnes, National Highway Traffic Safety Administration, National Center for Statistics and Analysis,
400 Seventh Street, S.W., NPO-120, Washington, DC 20590, USA; (email: unavailable).
NHTSA's National Center for Statistics and Analysis (NCSA) analyzed data from the Fatality Analysis Reporting System (FARS) to investigate the association between the restraint use of child passengers involved in a crash and their drivers. In addition, National Occupant Protection Use Survey (NOPUS) data were examined regarding general restraint use patterns of children and their drivers. Results show that children are more likely to be restrained when their driver is restrained, and the restraint use of children has improved greatly since the mid-1990s.
The relationship between driver and child passenger restraint use among fatally injured child passengers age 0 - 15.
- Starnes M. NHTSA Research Notes, 2003; (DOT HS 809 558).
Correspondence: Marc Starnes, National Highway Traffic Safety Administration, National Center for Statistics and Analysis,
400 Seventh Street, S.W., NPO-120, Washington, DC 20590, USA; (email: unavailable).
NHTSA's National Center for Statistics and Analysis (NCSA) recently completed an examinatio n of data from the Fatality Analysis Reporting System (FARS) to investigate the association between the restraint use of child passengers fatally injured in a crash and their drivers. Results show that children are more likely to be restrained when their driver is restrained, and children are more likely to be unrestrained as they become older.
Teenage driver safety: should graduated drivers licensing be universal?
The number of motor vehicle deaths has decreased significantly in the last quarter century. However, there remain a disproportionate number of automobile crashes involving teenage drivers. Studies have shown these accidents are related to several, possibly behavioral, factors, including driver error, speeding, and increasing numbers of passengers. The injuries and fatalities also involve a disproportionate number of teenage passengers. A three-stage Graduated Drivers Licensure process has been adopted by 34 states to try to address this potentially preventable problem. The Graduated Drivers Licensure involves a very well-supervised permit period, a lengthened provisional period that includes advanced drivers' education and supervised practice, and finally a full license. Studies from Maryland, California, Oregon, Florida, Michigan, North Carolina, and Kentucky have shown significant decreases in the crash rates among teenage drivers. The Graduated Drivers Licensure, if adopted as a national standard, may be effective in decreasing the toll of teenage driving accidents.
A survey of gun collection and use among three groups of veteran patients admitted to veterans affairs hospital treatment programs.
- Freeman TW, Roca V, Kimbrell T. South Med J 2003; 96(3): 240-243.
Correspondence: Thomas W. Freeman, Mental Health Service, Central Arkansas Veterans Healthcare System, and the Department of Psychiatry, University of Arkansas School of Medical Sciences, Little Rock, AR, USA; (email: thomas.freeman@med.va.gov).
BACKGROUND: An important risk factor for suicide is psychiatric illness, but only a limited amount of work has been directed at assessing the use of firearms and other weapons by select psychiatric populations at high risk for violent acts.
METHOD: Patients with combat-related posttraumatic stress disorder (PTSD), patients with schizophrenia, and patients undergoing rehabilitation for substance abuse were asked to complete a weapons-use survey and measures of psychopathology.
FINDINGS: The PTSD patients surveyed related owning more than four times as many firearms as other subjects and reported significantly higher levels of potentially dangerous firearm-related behaviors than the other psychiatric subjects surveyed.
DISCUSSION: High levels of aggression, impulsive and dangerous weapon use, and ready weapon availability may be significant factors in gun-related violence in the PTSD patient population. Additional prospective research is needed to determine whether gun ownership or certain types of weapon use in this population is associated with future acts of violence.
Family processes and delinquency: the consistency of relationships by ethnicity and gender.
Correspondence: Cynthia Perez McCluskey, School of Criminal Justice, Julian Samora Research Institute, Michigan State University, 560 Baker Hall, East Lansing, MI 48824, USA; (email: perez.mccluskey@ssc.msu.edu).
This paper examines the relationship between family processes and delinquency. A multiethnic sample was utilized to determine whether the impact of parental attachment, involvement and supervision on delinquency is consistent across Latino, White and African American youth. Analysis of two waves of data from the 1997 National Longitudinal Survey of Youth indicates that relationships are not identical across ethnic and gender groups. Group differences uncovered by the current study are consistent with earlier research on family processes and suggest that both ethnicity and gender are important considerations when estimating the influence of the family on delinquent behavior. Theoretical and policy implications of group differences are discussed.
Longitudinal relations between children's exposure to TV violence and their aggressive and violent behavior in young adulthood: 1977-1992.
- Huesmann LR, Moise-Titus J, Podolski CL, Eron LD. Dev Psychol 2003; 39(2): 201-221.
Correspondence: L. Rowell Huesmann, Research Center for Group Dynamics, Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor 48106, USA; (email: huesmann@umich.edu).
Although the relation between TV-violence viewing and aggression in childhood has been clearly demonstrated, only a few studies have examined this relation from childhood to adulthood, and these studies of children growing up in the 1960s reported significant relations only for boys. The current study examines the longitudinal relations between TV-violence viewing at ages 6 to 10 and adult aggressive behavior about 15 years later for a sample growing up in the 1970s and 1980s. Follow-up archival data (N = 450) and interview data (N = 329) reveal that childhood exposure to media violence predicts young adult aggressive behavior for both males and females. Identification with aggressive TV characters and perceived realism of TV violence also predict later aggression. These relations persist even when the effects of socioeconomic status, intellectual ability, and a variety of parenting factors are controlled.
Violent children: bridging development, intervention, and public policy.
- Pettit GS, Dodge KA. Dev Psychol 2003; 39(2): 187-188.
Correspondence: Gregory S. Pettit, Department of Human Development and Family Studies, College of Human Sciences, Auburn University, Alabama 36849, USA; (email: gpettit@auburn.edu).
Childhood violence is a major public health and social policy concern in the United States. Scientists and policymakers alike have increasingly turned their attention to the causes of childhood violence and the extent to which its course can be modified through well-planned preventive interventions. However, it is not apparent that policymakers draw upon basic research findings in formulating their priorities and policies, nor is it apparent that developmental scientists incorporate policy considerations and prevention findings into their research frameworks and designs. The goal of this special issue on violent children is to begin to bridge the gaps among basic developmental science, prevention science, and public policy.
