Bullying and harassment have occupied a prominent position in NATN workshops and publications recently. Challenging Behaviours in the Perioperative Environment identifies practices that fall within the definition of these socially and legally unacceptable activities, and provides advice and guidance to victims and those who use bullying or violent behaviours. In this article, the author draws on her own experience of being a victim and provides advice on how to identify and deal with bullying.
While we can legislate all we want and devise countless safety devices, the fact remains that the primary responsibility must be with parents and families. Perhaps the only way this can be accomplished is with a vigorous public awareness and education campaign. If a parent or grandparent could see the devastation caused by these injuries to other children, perhaps they would think twice before allowing a child to operate a power mower or to be a passenger on a riding mower. Young children should never be allowed to play in the vicinity of a person who is operating a mower. Physicians should be involved in this education effort. These injuries are preventable.
The authors investigated whether and how 1 element of a high-performance work system, namely high-quality jobs (composed of extensive training, variety, and autonomy), affects occupational injuries. On the basis of data from the Australian WIRS95 database (N = 16,466; Department of Workplace Relations and Small Business, 1997), high-quality jobs exerted a direct effect on injuries and an indirect effect through the mediating influence of job satisfaction. Conceptual, methodological, and practical issues are discussed.
Relationships between urinalysis testing for substance use, medical expenditures, and the occurrence of injuries at a large manufacturing firm.
- Ozminkowski RJ, Mark TL, Goetzel RZ, Blank D, Walsh JM, Cangianelli L. Am J Drug Alcohol Abuse 2003; 29(1): 151-167.
Correspondence: R.J. Ozminkowski, The MEDSTAT Group, Inc., Ann Arbor, Michigan 48108, USA; (email:ron.ozminkowski@medstat.com).
Drug use among employees continues to be a serious concern for American employers. Over 80% of the large employers in the United States use some form of testing to detect drug use, but this practice is controversial and the cost-effectiveness of drug testing remains largely unknown. This study begins an empirical investigation of the consequences of drug testing by estimating its impact on medical care expenditures and injury rates at a large manufacturing firm in 1996-1999. Multiple regression analyses of a pooled cross-sectional time-series data set were used to separate the impact of drug testing from other factors and to help find the optimal level of testing that was associated with minimum medical expenditures. Results indicated that medical expenditures would be minimized when 42% of the employees in a calendar quarter were drug tested. This implies that, on average, employees should be tested 1.68 times a year. The results also indicated that doubling the testing rate would reduce the odds of incurring any injuries on the job by over half, but the injury rate was already so low that this impact was very small. Hopefully the results of this study will inform the policy debate over drug testing by focusing on real data, as opposed to supposition or political considerations that seem to dominate many discussions.
An evaluation of four types of railway pedestrian crossing safety intervention.
- Lobb B, Harre N, Terry N. Accid Anal Prev 2003; 35(4): 487-494.
Correspondence: Brenda Lobb, Department of Psychology, Division of Science and Technology, The University of Auckland, Tamaki Campus, Private Bag 92019, Auckland, NEW ZEALAND; (email:b.lobb@auckland.ac.nz).
This study evaluated a programme of interventions designed to reduce the incidence of illegal and unsafe crossing of a rail corridor at a city station by boys on their way to and from the adjacent high school in Auckland, New Zealand. The boys were observed crossing before, during, and after implementation of each intervention; in addition, surveys were carried out before and after the programme to discover the boys' attitudes. Rail safety education in school, punishment for every unsafe crossing (continuous punishment), and punishment occasionally for unsafe crossing (intermittent punishment) were associated with significant decreases in unsafe crossing compared with that observed prior to any intervention. General communications about rail safety were not associated with significant decreases in unsafe crossing. When interventions were examined consecutively, unsafe crossing was significantly reduced between the communications and education phases, and even more so between education and continuous punishment, but there was no statistically significant difference in frequency of unsafe crossing between continuous and intermittent punishment. It was concluded that punishment may be more effective in reducing unsafe behaviour in this type of situation than targeted education, and is much more effective than communications to heighten awareness.
Getting off your bike: cycling accidents in Great Britain in 1990-1999.
- Stone M, Broughton J. Accid Anal Prev 2003; 35(4): 549-556.
Correspondence: Mervyn Stone, Department of Statistical Science, UCL, Gower Street, WC1E 6BT, London, UK; (email:mervyn@stats.ucl.ac.uk).
The paper extracts and tabulates selected incidence and fatality rates of cycling accidents recorded by the police in Great Britain during 1990-1999, in a database of over 30,000 standardised reports of fatal or serious injury accidents. Since usable estimates of exposure to risk in cycling are not available, the concept of exposure invariance is developed to estimate the relative risk of different sorts of bicycle/vehicle encounter. Any bias from under-reporting of serious injury accidents is shown to be boundable if the probability of under-reporting is constant.
BACKGROUND: The morbidity associated with snakebite envenomation has not been well documented.
METHOD: Using a standardized questionnaire all patients with snakebite reported to a regional poison center during the year 2001 were followed after hospital discharge by telephone until resolution of symptoms.
FINDINGS: One hundred and twenty-eight snakebite cases were reported, of which 16 (12.5%) were lost to follow-up and 31 (24.2%) reported no progression of symptoms beyond puncture and were deemed "dry bites." Eighty-one (63.3%) patients were followed for the duration of symptoms. Age ranged from 1 to 86 years with a mean of 32 years. There were 64 males (79%). The snakes were identified as copperhead (n = 57), unidentified venomous (n = 17), timber rattlesnake (n = 6), and cottonmouth (n = 1). All patients were initially evaluated in a hospital emergency department of which 51 were admitted. Nine patients received antivenin. Of the 37 patients who had a job, 33 lost a mean of 14 days of work (SD +/- 18.1). Mean duration of edema was reported as 11.4 days (S.D +/- 12). Recurrent edema frequently occurred with limb activity. Pain was scored on a scale of 1 to 10, with a mean score of 4.8 (SD +/- 2.7). Mean duration of pain was reported as 7.8 days (SD +/- 6.4). Thirty patients required accommodation for ambulation including crutches (n = 11), limp (n = 11), and no shoes or loose shoes (n = 14). Of the 26 patients bitten on the hand or finger, duration of reduced function persisted for a mean of 14.3 days (SD +/- 10.4) and reduction of hand strength persisted for a mean of 22 days (SD +/- 25.5). Five patients had poorly healing wounds at the bite site which persisted from 14 to 77 days with a mean of 45 days (SD +/- 22.8)
DISCUSSION: In this study snakebite resulted in significant duration and extent of morbidity in a majority of patients.
Correspondence: Karl Peltzer, Health Behavior Research Unit, University of the North, Private Bag X 1106, 0727, Sovenga, SOUTH AFRICA; (email: peltzerk@unin.unorth.ac.za).
The aim of this study was to investigate taxi drivers' superstition and risk perception of accidents as well as risk-taking in an urban area in South Africa. One hundred and thirty drivers of minibuses, so-called "taxis" were interviewed on the basis of: (1) a superstition scale; (2) a risk-taking scale; (3) a list of perceived causes of road traffic accidents. Drivers showed largely superstitious attitudes and expressed a high degree of risk-taking behavior.Superstition was positively correlated with the number of self-reported accidents the drivers had been involved in and the number of accidents they had witnessed. Path analysis revealed a direct path from superstition to accident involvement while the influence of formal education was negligible. Risk-taking was inversely correlated with driving experience and the number of accidents witnessed but not so with the number of accidents involved in. There was no clear pattern of associations between superstition and risk-taking and perceived causes of accidents. Superstition and risk-taking were slightly and inversely correlated with each other. It is concluded that superstition represents an attitude that is associated with a driver's accident risk, and further research on superstitious attitudes among South African drivers is advocated.
A bivariate zero-inflated Poisson regression model to analyze occupational injuries.
- Wang K, Lee AH, Yau KK, Carrivick PJ. Accid Anal Prev 2003; 35(4): 625-629.
Correspondence: Kelvin K. W. Yau, School of Public Health, Curtin University of Technology, P.O. Box U 1987, 6845, WA, Perth, AUSTRALIA; (email:mskyau@cityu.edu.hk).
The aim of many occupational safety interventions is to reduce the incidence of injury. However, when measuring intervention effectiveness within a period, population-based accident count data typically contain a large proportion of zero observations (no injury). This situation is compounded where injuries are categorized in a binary manner according to an outcome of interest. The distribution thus comprises a point mass at zero mixed with a non-degenerate parametric component, such as the bivariate Poisson. In this paper, a bivariate zero-inflated Poisson (BZIP) regression model is proposed to evaluate a participatory ergonomics team intervention conducted within the cleaning services department of a public teaching hospital. The findings highlight that the BZIP distribution provided a satisfactory fit to the data, and that the intervention was associated with a significant reduction in overall injury incidence and the mean number of musculoskeletal (MLTI) injuries, while the decline in injuries of a non-musculoskeletal (NMLTI) nature was marginal. In general, the method can be applied to assess the effectiveness of intervention trials on other populations at high risk of occupational injury.
A review of burns patients admitted to the Burns Unit of Hospital Universiti Kebangsaan Malaysia.
- Chan KY, Hairol O, Imtiaz H, Zailani M, Kumar S, Somasundaram S, Nasir-Zahari M. Med J Malaysia 2002; 57(4): 418-425.
Correspondence: K.Y. Chan, Division of Plastic & Reconstructive Surgery, Burns Unit, Department of Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000, Cheras, Kuala Lumpur, MALAYSIA; (email: unavailable).
This is a retrospective review of 110 patients admitted to the Burns Units between October 1999 and November 2001. The aim was to determine the burns pattern of patients admitted to hospital UKM. There was an increasing trend for patients admitted. Female to male ratio was 1:2. Children consisted 34% of the total admission. Children had significant higher number of scald burns as compare to adult (p < 0.01). Domestic burns were consist of 75% overall admission. Mean percentage of TBSA (total body surface area) burns was 19%. Thirty percent of patients sustained more than 20% of TBSA. Sixty percent of patients had scald burns. Ninety percents of patients with second degree burns that were treated with biologic membrane dressing or split skin graft. Mean duration of hospital stay was 10 days. Over 70% of patients were discharged within 15 days. Overall mortality rate was 6.3%. The patients who died had significantly larger area of burns of more than 20% TBSA (p < 0.05) and a higher incidence of inhalation injury (p < 0.02). Hence, this study suggests a need for better preventive measures by the authority to prevent burns related accident and the expansion of the service provided by the Burns Unit.
How would setting policy priorities according to cost-benefit analyses affect the provision of road safety?
This paper analyses how setting priorities for road safety strictly according to cost-benefit analysis would affect the provision of road safety in Norway and Sweden. The paper is based on recent analyses of the efficiency of road safety policies in these two countries. The argument sometimes made by critics of cost-benefit analysis, that only a few road safety measures are cost-effective (have benefits greater than costs), is not supported. Cost-effective road safety policies could prevent between 50 and 60% of the current number of road accident fatalities in both Norway and Sweden, if pursued consistently during a period of 10 years (2002-2011). If current policies are continued, only about 10-15% of the current number of road accident fatalities are likely to be prevented during the next 10 years. A number of sources of inefficiency in road safety policy are identified. A source of inefficiency is anything that prevents policy priorities from being set according to cost-benefit analysis. These include: (a) lack of power, which means that national governments do not have the formal authority to introduce a certain road safety measure, in Europe, this applies to new vehicle safety standards, which are passed almost exclusively by the European Union; (b) the existence of social dilemmas, which means that measures that are cost-effective from a societal point of view are not so from the point of view of individual road users; (c) priority given to other policy objectives, in particular regional development. Scarcity of resources, which obtains when public budgets have to be increased to make room for all cost-effective measures, was not found to be a constraint. All cost-effective measures can be funded within current budgets, provided the use of inefficient measures ceases.
Nonfatal fall-related traumatic brain injury among older adults--California, 1996-1999.
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 > or = 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 > or = 65 years are at risk for hospitalization for a fall and that same-level falls are far more common among persons aged > or = 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.
What are older people prepared to do to avoid falling? A qualitative study in London.
- Simpson JM, Darwin C, Marsh N. Br J Community Nurs 2003; 8(4): 152,154-159.
Correspondence: J. Simpson, Centre for Rehabilitation and Ageing, Division of Geriatric Medicine, St George's Hospital Medical School, London, UK; (j.simpson@sghms.ac.uk).
Falls prevention strategies form a significant part of recent government policy relating to older people. In this article we report a qualitative study to examine the extent to which older people are willing to adopt any of the following strategies in order to avoid falling; balance and lower limb strengthening exercises, home safety advice, and 'taking care'. A sample of community-dwelling inpatients who were more or less afraid of falling were interviewed. Some older people blamed their own unsafe behaviour rather than hazards in their home for falls, so taking care (moving slowly, holding on, being vigilant to and avoiding danger) was a widespread strategy. The benefits of exercise in falls prevention were poorly understood and there was little enthusiasm for exercising especially if it was perceived to be inappropriate in old age or painful. Awareness of home hazards and taking measures against them was common but home visits tended to be regarded as intrusive. Inadequate negotiation about adaptations was widespread and led to resentment and unwillingness to cooperate. Building on the widespread 'taking care' strategy may help educated older people in safe behaviour. Health professionals should encourage older people to exercise and when making home safety visits should confer with their clients, taking their preferences about adaptations into account.
BACKGROUND: Mental disorders affect young people disproportionately and are increasing in prevalence. Knowledge about depression in adolescents and skill in its management lags behind that for adults. Depression is the most common mental disorder and untreated depression is associated with significant adverse effects. Depression is also a major predictor of suicidal behaviour and suicide. The role of the general practitioner in the treatment of adolescent depression is of considerable public health and clinical importance.
OBJECTIVE: The aim of this paper is to highlight the major differences between adolescent and adult depression in relation to detection, assessment and treatment.
DISCUSSION: The new Commonwealth Government's Better Outcomes in Mental Health Initiatives and Incentives provide an opportunity for GPs to improve their knowledge and skills in the detection, assessment and treatment of mental disorders. It is hoped that this paper will encourage GPs to include the topic of adolescent depression in their learning objectives.
Suicide ideation among parents bereaved by the violent deaths of their children.
Correspondence: S.A. Murphy, Department of Psychosocial and Community Health, Box 357263, School of Nursing, University of Washington, Seattle, WA 98195-7263, USA; (email: samurphy@washington.edu).
Suicidal behaviors of parents bereaved by a child's suicide have received considerable attention by researchers, but deaths by other violent causes have not. We observed 175 bereaved parents for five years following three types of violent death: accidents, homicides, and suicides. The results showed that the incidence of suicidal ideation (SI) among the study parents was 13% (n = 34) over the 5 years and 9% (n = 24) at the initial data collection four months after the death of an adolescent or young adult child. Comparisons of study parents grouped by the presence or absence of SI showed that after corrections were made for the number of t-tests conducted, statistically significant differences on three of four outcome variables remained (mental distress, depression, and posttraumatic stress disorder [PTSD], but not on acceptance of the child's death). The groups also differed significantly on four of seven mediating variables examined. The hypothesis that parents whose children died by suicide would report the highest incidence of suicidal ideation was not supported. Regression analyses showed that SI was a significant predictor of depression one year, but not five years, after the violent death of a child. The hypothesis that SI would predict both depression and PTSD one year postdeath was not supported. Clinical and policy recommendations are offered.
Correspondence: Jeremy Broughton, Transport Research Laboratory Limited, Old Working Road, Crowthorne, RG45 6AU, Berkshire, UK;(email: jbroughton@trl.co.uk).
The term 'secondary safety' refers to the protection that a vehicle provides its occupants when involved in an accident. This paper studies information from the British database of road accident reports between 1980 and 1998, to estimate the reduction in the number of occupant casualties over these years which may be attributed to improvements to secondary safety in cars.The paper shows that the proportion of driver casualties who are killed or seriously injured (KSI) is lower for modern cars than for older cars. The reduction of this proportion is used to assess the improvement in secondary safety. Statistical models are developed to represent the proportion with 'year of first registration' as one of the independent variables, although only an incomplete assessment of the benefits of improved secondary safety can be made with the available data. The assessment compares the number of casualties that would have been expected if secondary safety had remained at the level found in cars first registered in 1980 with the actual casualty numbers. It is estimated that improved secondary safety reduced the number of drivers KSI by at least 19.7% in 1998, in comparison with what might have occurred if all cars had had that lower level of secondary safety. This figure relates to all cars on the road in 1998, and rises to 33%, when confined to the most modern cars (those which were first registered in 1998).
Correspondence: I. M. Bernhoft, Danish Transport Research Institute, Knuth-Winterfeldts Alle, Bygning 116 Vest, DK-2800 kgs., Lyngby, DENMARK; (email:imb@dtf.dk).
On 1 March 1998, the Danish per se limit was lowered from 0.08 to 0.05% blood alcohol concentration (BAC) for motor vehicle drivers. Based on accident data and drivers' drinking habits before and after the amendment, the effect of the new limit has been evaluated. Interviews revealed a significant decrease in the number of drinks that drivers allow themselves to drink within a 2-h period before driving. The proportion of drivers, who would not drink at all or only have one drink, increased from 71% before the amendment to 80% after the amendment. Drivers with changed drinking habits most often stated the lower limit as the main reason for having less alcohol. However, based on accident data from the first year after the amendment, this has not resulted in a marked decrease in the proportion of injury accidents with impaired motor vehicle drivers (BAC>/=0.05%) compared to all injury accidents. On the contrary, the proportion of fatal accidents with drink-drivers compared to all fatal accidents has increased in the after-period. The total number of drink-driving sentences were a little larger in 1999 than in 1997 because of the lower limit, but a significant change from higher towards lower alcohol levels can be seen.
Sleep debt, sleepiness and accidents among males in the general population and male professional drivers.
- Carter N, Ulfberg J, Nystrom B, Edling C. Accid Anal Prev 2003; 35(4): 613-617.
Correspondence: Ned Carter, Department of Medical Sciences/Occupational and Environmental Medicine, University Hospital, SE-751 85, Uppsala, SWEDEN; (email:ned.carter@medsci.uu.se).
Men from the general population and male professional lorry and bus drivers were surveyed with regard to sleep habits and motor vehicle and other types of accidents. A random sample of 4000 men in the general population of Dalarna County in mid-Sweden were mailed a questionnaire and served as referents. A total of 1389 male professional lorry and bus drivers from this county responded to the same questionnaire. A total of 161 of the drivers also underwent a sleep study in their homes.The proportion of total accidents was higher among the professional drivers as compared with the males in the population, P=0.03. Reports on traffic accidents were the same in both groups, but the professional drivers reported more accidents at leisure compared with referents, P<0.0001. Accidents of any kind, traffic accidents included, among those affected by both snoring and apneas, were not reported more in either of the groups. At the sleep study, 17% of those examined received the diagnosis of obstructive sleep-apnea syndrome (OSAS).The professional drivers reported proportionally more sleep debt than the referents, P<0.001. Among referents, traffic accidents at leisure, traffic accidents while commuting and accidents at work increased in proportion to sleep debt (P<0.001, 0.006 and 0.002, respectively). The finding that self-perceived sleep debt may have an adverse effect on males in the general population and male professional drivers concerning accident likelihood should have an impact on prevention. These results stress the need to educate the general population on the importance of complying with our biological need of sleep.
A behavioral comparison between motorcyclists and a matched group of non-motorcycling car drivers: factors influencing accident risk.
Motorcyclists and a matched group of non-motorcycling car drivers were assessed on behavioral measures known to relate to accident involvement. Using a range of laboratory measures, we found that motorcyclists chose faster speeds than the car drivers, overtook more, and pulled into smaller gaps in traffic, though they did not travel any closer to the vehicle in front. The speed and following distance findings were replicated by two further studies involving unobtrusive roadside observation. We suggest that the increased risk-taking behavior of motorcyclists was only likely to account for a small proportion of the difference in accident risk between motorcyclists and car drivers. A second group of motorcyclists was asked to complete the simulator tests as if driving a car. They did not differ from the non-motorcycling car drivers on the risk-taking measures but were better at hazard perception. There were also no differences for sensation seeking, mild social deviance, and attitudes to riding/driving, indicating that the risk-taking tendencies of motorcyclists did not transfer beyond motorcycling, while their hazard perception skill did.
The distraction effects of phone use during a crucial driving maneuver
- Hancock, PA, Leschb, M and Simmons, L. Accid Anal Prev 2003; 35(4): 501-514.
Correspondence: P. A. Hancock, Department of Psychology, Institute for Simulation and Training, University of Central Florida, 411 Phillips Hall, Orlando, FL 32765, USA; (email:phancock@pegasus.cc.ucf.edu).
Forty-two licensed drivers were tested in an experiment that required them to respond to an in-vehicle phone at the same time that they were faced with making a crucial stopping decision. Using test track facilities, we also examined the influence of driver gender and driver age on these dual-task response capacities. Each driver was given task practice and then performed a first block of 24 trials, where one trial represented one circuit of the test track. Half of the trials were control conditions in which neither the stop-light was activated nor was the in-vehicle phone triggered. Four trials required only stop-light response and a further four, phone response only. The remaining four trials required the driver to complete each task simultaneously. The order of presentation of specific trials was randomized and the whole sequence was repeated in a second block giving 48 trials per driver. In-vehicle phone response also contained an embedded memory task that was evaluated at the end of each trial circuit. Results confirmed our previous observation that in the dual-task condition there was a slower response to the light change. To compensate for this slowed response, drivers subsequently brake more intensely. Most importantly, we recorded a critical 15% increase in non-response to the stop-light in the presence of the phone distraction task which equates with increased stop-light violations on the open road. These response patterns varied by driver age and driver gender. In particular, age had a large effect on task components that required speed of response to multiple, simultaneous demands. Since driving represents a highly complex and interactive environment, it is not possible to specify a simplistic relationship between these distraction effects and outcome crash patterns. However, we can conclude that such in-vehicle technologies erode performance safety margin and distract drivers from their critical primary task of vehicle control. As such it can be anticipated that a causal relation exists to collision events. This is a crucial concern for all in-vehicle device designers and for the many safety researchers and professionals seeking to reduce the adverse impacts of vehicle collisions.
Correspondence: Cara Krulewitch, Department of Child, Women's, and Family Health, University of Maryland at Baltimore, School of Nursing, USA; (email:Krulewitch@son.umaryland.edu).
Homicide has remained the third leading cause of death among girls aged 10 to 19 for more than a decade. Recent research indicates that pregnant or postpartum teens are three times more likely to be victims of homicide compared to their nonpregnant counterparts. These findings portray a compelling picture that leads the authors to investigate the relationship between homicide and pregnancy among teens in Maryland. The purpose of this study is to compare women whose deaths had been evaluated by the medical examiner and who had evidence of pregnancy to women without evidence of pregnancy, with a particular focus on adolescents; 329 (17.7%) adults and 66 (32.7%) adolescents were victims of homicide. Adolescent homicide victims were 3.7 (1.2 to 11.8) times more likely to be pregnant compared to adult homicide victims. The rate of homicide was nearly double in all women who were pregnant. Further research is necessary to evaluate factors associated with these risks so that the future generation and society are protected.
The political economy of urban homicide: assessing the relative impact of gender inequality on sex-specific victimization.
This research examines the ways in which the changing political economy of urban areas has contributed differently to the homicide victimization rates of females and males across US cities. Recent research, while relatively limited, has presented disparate results regarding the effect of gender inequality on urban sex-specific victimization. Our work further explores this relationship by taking into account relative gender disparities in income, education, labor market opportunities, and politics in an examination of sex-specific homicide victimization in 1990. Key to this current investigation is the evaluation of feminist and lifestyle arguments that suggest that structural gender inequality has a unique effect on female victimization. Overall, our findings reveal gender inequality to be a significant predictor of both male and female urban homicide. While these findings suggest mixed support for theoretical arguments regarding gender inequality, further analyses reveal significant differences in specific types of gender inequality on victimization patterns across genders. These additional results highlight the need for greater attention toward both methodological and theoretical issues when examining the interconnections between gender, political economy, and violence in research.
Developing a center for Hispanic youth violence prevention.
- Mirabal-Colon B. P R Health Sci J. 2003; 22(1): 89-91.
Correspondence: B. Mirabal-Colon, Center for Hispanic Youth Violence Prevention, Filius Institute, University of Puerto Rico, PO Box 364984, San Juan, PUERTO RICO; (email: unavailable).
Youth violence is a serious public health problem, described by the Surgeon General's Report on Youth Violence (2001). Homicide is the second cause of death for the 15-24 age population in the USA and Puerto Rico; intentional injuries also result in significant morbidity. Youth are at greater risk of being victims than perpetrators of violence. African American and Hispanic youth are at particular risk. Effective, community-based initiatives to prevent youth violence are necessary to interrupt the cycle of violence. In 2000, the Centers for Disease Control and Prevention of the Department of Health and Human Services awarded grants to establish ten Academic Centers of Excellence for Youth Violence Prevention. This article describes the development of the Center for Hispanic Youth Violence Prevention, of the FILIUS Institute of the University of Puerto Rico.
The relative effects of intimate partner physical and sexual violence on post-traumatic stress disorder symptomatology.
- Bennice JA, Resick PA, Mechanic M, Astin M. Violence Vict 2003; 18(1): 87-94.
Correspondence: J.A. Bennice, University of Missouri, St. Louis 63121, USA; (email: unavailable).
This study examined the relative effects of intimate partner physical and sexual violence on Post-Traumatic Stress Disorder (PTSD) symptomatology. Severity of physical and sexual violence as well as PTSD severity were assessed in a sample of 62 help-seeking battered women. The results of this study were consistent with prior research, finding significant and positive relationships between physical and sexual violence as well as sexual violence and PTSD symptoms. In order to further clarify these relationships, the unique effects of sexual violence on PTSD were examined after controlling for physical violence severity. Results indicated that sexual violence severity explained a significant proportion of the variance in PTSD severity beyond that which was already accounted for by physical violence severity. These findings have important implications for mental health and social service professionals who work with battered women.
An overview of reported youth violence in Puerto Rico.
- Velez CN. P R Health Sci J. 2003; 22(1): 61-67.
Correspondence: C.N. Velez, Department of Biostatistics and Epidemiology, Graduate School of Public Health, Center for Hispanic Youth Violence Prevention, Filius Institute, University of Puerto Rico, San Juan, PUERTO RICO; (email: unavailable).
OBJECTIVES: The purpose of this paper is to describe the prevalence of school and youth violence in Puerto Rico based on several representative samples surveyed in the Island during the 1990's. BACKGROUND: Reviewing the available data on youth violence is necessary in order to decide the best strategies to follow in developing new ways to prevent and monitor it.
METHODS: Three surveys were reviewed in this paper: The Youth Risk Behavior Survey conducted by the Center for Disease Control (1991, 1995, 1997); The Methods for the Epidemiology of Child and Adolescent Mental Disorders Study (1991); and the Youth Survey (1997-98).
FINDINGS: It was found that the prevalence of reported school violence in Puerto Rico tends to be somewhat lower than the prevalence reported in other sites of the U.S.A. Age and gender has a dramatic influence in the reports of youth violence in Puerto Rico. Male students are three times as likely to carry weapons than females and almost twice as likely to report hurting someone than females. Less than 10% of the male students ages 12-13 report carrying a weapon while fully 30% of those 18 year olds reported carrying a weapon. Being arrested also increases from only 3% in the youngest students surveyed to 10% on the oldest group (18 or older).
DISCUSSION: The CDC has recently reported that since the early 90's there has been a decrease in reported school violence in the U.S.A. This analysis of youth surveys replicated a similar tendency for Puerto Rican youngsters. Implications for prevention programs are discussed.
Domestic violence incidents with children witnesses. Findings from Rhode Island surveillance data.
- Gjelsvik A, Verhoek-Oftedahl W, Pearlman DN. Womens Health Issues 2003; 13(2):68-73.
Correspondence: Annie Gjelsvik, Department of Community Health, Brown University, Providence, Rhode Island, USA; (email:annie_gjelsvik@brown.edu).
In this study we analyze factors associated with children witnessing police-reported domestic violence (DV) and determine the age distribution of children witnessing. Rhode Island Department of Health surveillance data (1996-1998) from police forms were used to assess demographic characteristics of victims, characteristics of incidents, whether children were present, and children's ages. Victim gender, age, race/ethnicity, relationship to suspect, and whether the victim was assaulted were all strong predictors of children witnessing a DV incident. Almost half (48%) of the children who witnessed DV incidents were less than 6 years old. To reach these young children, prevention and intervention programs will need to target parents and caretakers of young children and/or pediatricians.
