Showing papers on "Poison control published in 1987"

Perception of risk.

Abstract: Studies of risk perception examine the judgements people make when they are asked to characterize and evaluate hazardous activities and technologies. This research aims to aid risk analysis and policy-making by providing a basis for understanding and anticipating public responses to hazards and improving the communication of risk information among lay people, technical experts, and decision-makers. This work assumes that those who promote and regulate health and safety need to understand how people think about and respond to risk. Without such understanding, well-intended policies may be ineffective.

Peer relations and later personal adjustment: Are low-accepted children at risk?

Abstract: In this review, we examine the oft-made claim that peer-relationship difficulties in childhood predict serious adjustment problems in later life. The article begins with a framework for conceptualizing and assessing children's peer difficulties and with a discussion of conceptual and methodological issues in longitudinal risk research. Following this, three indexes of problematic peer relationships (acceptance, aggressiveness, and shyness/withdrawal) are evaluated as predictors of three later outcomes (dropping out of school, criminality, and psychcpathology). The relation between peer difficulties and later maladjustment is examined in terms of both the consistency and strength of prediction. A review and analysis of the literature indicates general support for the hypothesis that children with poor peer adjustment are at risk for later life difficulties. Support is clearest for the outcomes of dropping out and criminality. It is also clearest for low acceptance and aggressiveness as predictors, whereas a link between shyness/withdrawal and later maladjustment has not yet been adequately tested. The article concludes with a critical discussion of the implicit models that have guided past research in this area and a set of recommendations for the next generation of research on the risk

Transactional theory and research on emotions and coping

Abstract: In this article we examine the fundamental premises of our cognitive‐relational theory of emotion and coping and assess our progress in examining them through 10 years of programmatic empirical res...

Evaluating trauma care: the triss method. trauma score and the injury severity score

Abstract: Evaluation of trauma care must be an integral part of any system designed for care of seriously injured patients. However, outcome review should offer comparability to national standards or norms. The TRISS method offers a standard approach for evaluating outcome of trauma care. Anatomic, physiologic, and age characteristics are used to quantify probability of survival as related to severity of injury. TRISS offers a means of case identification for quality assurance review on a local basis, as well as a means of comparison of outcome for different populations of trauma patients. Methods for calculating statistics associated with TRISS are presented. The Z and M statistics are explained with the nonstatistician in mind. We feel this article is a source for those interested in developing or upgrading trauma care evaluation.

Unrealistic optimism about susceptibility to health problems: conclusions from a community-wide sample

Abstract: A mailed questionnaire was used to obtain comparative risk judgments for 32 different hazards from a random sample of 296 individuals living in central New Jersey. The results demonstrate that an optimistic bias about susceptibility to harm-a tendency to claim that one is less at risk than one's peers—is not limited to any particular age, sex, educational, or occupational group. It was found that an optimistic bias is often introduced when people extrapolate from their past experience to estimate their future vulnerability. Thus, the hazards most likely to elicit unrealistic optimism are those associated with the belief (often incorrect) that if the problem has not yet appeared, it is unlikely to occur in the future. Optimistic biases also increase with the perceived preventability of a hazard and decrease with perceived frequency and personal experience. Other data presented illustrate the inconsistent relationships between personal risk judgments and objective risk factors.

Post-traumatic stress disorder in the general population. Findings of the epidemiologic catchment area survey.

Abstract: There have been numerous studies of post-traumatic stress disorder in trauma victims, war veterans, and residents of communities exposed to disaster. Epidemiologic studies of this syndrome in the general population are rare but add an important perspective to our understanding of it. We report findings on the epidemiology of post-traumatic stress disorder in 2493 participants examined as part of a nationwide general-population survey of psychiatric disorders. The prevalence of a history of post-traumatic stress disorder was 1 percent in the total population, about 3.5 percent in civilians exposed to physical attack and in Vietnam veterans who were not wounded, and 20 percent in veterans wounded in Vietnam. Post-traumatic stress disorder was associated with a variety of other adult psychiatric disorders. Behavioral problems before the age of 15 predicted adult exposure to physical attack and (among Vietnam veterans) to combat, as well as the development of post-traumatic stress disorder among those so exposed. Although some symptoms of post-traumatic stress disorder, such as hyperalertness and sleep disturbances, occurred commonly in the general population, the full syndrome as defined by the Diagnostic and Statistical Manual of Mental Disorders, third edition, was common only among veterans wounded in Vietnam.

Life Threat and Posttraumatic Stress in School-age Children

Abstract: • One hundred fifty-nine children (14.5% of the student body) were sampled after a fatal sniper attack on their elementary school playground. Systematic self-reports of posttraumatic stress disorder (PTSD) symptoms were obtained by use of a child PTSD Reaction Index. Analysis of variance revealed significant differences by exposure but not by sex, ethnicity, or age. Additional analyses were conducted of individual item response, overall severity of PTSD reaction, symptom grouping, and previous life events. The results provide strong evidence that acute PTSD symptoms occur in school-age children with a notable correlation between proximity to the violence and type and number of PTSD symptoms. Sampling at approximately one month after the trauma provided adequate delineation among exposure groups. The symptom profile of highly exposed children lends validity to the diagnosis of acute PTSD in childhood.

Urban black violence: The effect of male joblessness and family disruption

Abstract: This paper examines the relationships among unemployment, crime, and family disruption in the black "underclass." The main hypothesis tested is that the effect of black adult male joblessness on black crime is mediated largely through its effects on family disruption. The study examines race-specific rates of robbery and homicide by juveniles and adults in over 150 U.S. cities in 1980. The results show that the scarcity of employed black men increases the prevalence of families headed by females in black communities. In turn, black family disruption substantially increases the rates of black murder and robbery, especially by juveniles. These effects are independent of income, region, race and age composition, density, city size, and welfare benefits and are similar to the effects of white family disruption on white violence. The paper concludes that there is nothing inherent in black culture that is conducive to crime. Rather, persistently high rates on black crime appear to stem from the structural linka...

Sex and Death in the Rational World of Defense Intellectuals

Abstract: Author(s): Cohn, Carol | Abstract: This paper is the beginning of an analysis of the nature of nuclear strategic thinking; its emphasis is on the role of a specialized language that I call \"technostrategic.\" I have come to believe that this language both reflects and shapes the nature ofthe American nuclear strategic project; that it plays a central role in allowing defenseintellectuals to think and act as they do; and that all of us who are concerned about nuclear weaponry and nuclear war must give careful attention to the role of language we and others choose to use -- who it allows us to communicate with, and what it allows us to think as well as say.

Psychotropic Drug Use and the Risk of Hip Fracture

Abstract: To assess the risk of hip fracture associated with the use of four classes of psychotropic drugs, we performed a case-control study of 1021 patients with hip fractures and 5606 controls among elderly Medicaid enrollees. Persons treated with hypnotics-anxiolytics having short (less than or equal to 24 hours) elimination half-lives had no increased risk of hip fracture. By contrast, a significantly increased risk was associated with current use of hypnotics-anxiolytics having long (greater than 24 hours) elimination half-lives (odds ratio, 1.8; 95 percent confidence interval, 1.3 to 2.4), tricyclic antidepressants (odds ratio, 1.9; 95 percent confidence interval, 1.3 to 2.8), and antipsychotics (odds ratio, 2.0; 95 percent confidence interval, 1.6 to 2.6). The risk increased in relation to the doses of drugs in these three classes. An analysis for possible confounding by dementia did not alter the results. Previous but noncurrent use of drugs in these classes conferred no increase in risk. Although a cause-and-effect relation was not proved, these data support the hypothesis that the sedative and autonomic effects of psychotropic drugs increase the risk of falling and fractures in elderly persons. The results suggest the need for studies of this association in other populations and for evaluation of newer psychotropic drugs with fewer undesirable sedative and autonomic effects.

Focus Group Interview: An Underutilized Research Technique for Improving Theory and Practice in Health Education

Abstract: The purpose of this article is to increase awareness about and stimulate interest in using focus group interviews, a qualitative research technique, to advance the state-of- the-art of education and learning about health. After a brief discussion of small group process in health education, features of focus group interviews are presented, and a theoretical framework for planning a focus group study is summarized. Then, litera ture describing traditional and health-related applications of focus group interviews is reviewed and a synthesis of methodological limitations and advantages of this tech nique is presented. Implications are discussed regarding: need for more inductive qualitative research in health education; utility of focus group interviews for research and for formative and summative evaluation of health education programs; appli cability of marketing research to understanding and influencing consumer behav ior, despite notable distinctions between educational initiatives and marketing; and need...

Stress fractures in athletes. A study of 320 cases

Abstract: We analyzed cases of 320 athletes with bone scan-positive stress fractures (M = 145, F = 175) seen over 3.5 years and assessed the results of conservative management. The most common bone injured was the tibia (49.1%), followed by the tarsals (25.3%), metatarsals (8.8%), femur (7.2%), fibula (6.6%), pelvis (1.6%), sesamoids (0.9%), and spine (0.6%). Stress fractures were bilateral in 16.6% of cases. A significant age difference among the sites was found, with femoral and tarsal stress fractures occurring in the oldest, and fibular and tibial stress fractures in the youngest. Running was the most common sport at the time of injury but there was no significant difference in weekly running mileage and affected sites. A history of trauma was significantly more common in the tarsal bones. The average time to diagnosis was 13.4 weeks (range, 1 to 78) and the average time to recovery was 12.8 weeks (range, 2 to 96). Tarsal stress fractures took the longest time to diagnose and recover. Varus alignment was found frequently, but there was no significant difference among the fracture sites, and varus alignment did not affect time to diagnosis or recovery. Radiographs were taken in 43.4% of cases at the time of presentation but were abnormal in only 9.8%. A group of bone scan-positive stress fractures of the tibia, fibula, and metatarsals (N = 206) was compared to a group of clinically diagnosed stress fractures of the same bone groups (N = 180), and no significant differences were found. Patterns of stress fractures in athletes are different from those found in military recruits. Using bone scan for diagnosis indicates that tarsal stress fractures are much more common than previously realized. Time to diagnosis and recovery is site-dependent. Technetium99 bone scan is the single most useful diagnostic aid. Conservative treatment of stress fractures in athletes is satisfactory in the majority of cases.

Visual guidance of walking through apertures: body-scaled information for affordances.

Abstract: A necessary condition for visually guided action is that an organism perceive what actions are afforded by a given environmental situation. Warren (1984) proposed that an affordance such as the climbability of a stairway is determined by the fit between properties of the environment and the organism and can be characterized by optimal points, where action is most comfortable or efficient, and critical points, where a phase transition to a new action occurs. Perceiving an affordance, then, implies perceiving the relation between the environment and the observer's own action system. The present study is an extension of this analysis to the visual guidance of walking through apertures. We videotaped large and small subjects walking through apertures of different widths to determine empirically the critical aperture-to-shoulder-width ratio (A/S) marking the transition from frontal walking to body rotation. These results were compared with perceptual judgments of "passability" under static and moving viewing conditions. Finally, we tested the hypothesis that such judgments are based on intrinsic or body-scaled information specifying aperture width as a ratio of the observer's eyeheight. We conclude (a) that the critical point in free walking occurs at A/S = 1.30, (b) that static monocular information is sufficient for judging passability, and (c) that the perception of passability under such conditions is based on body-scaled eyeheight information.

Childhood sexual and physical abuse as factors in adult psychiatric illness

Abstract: Using objective measures, the authors found a high rate of childhood sexual and physical abuse in a sample of 66 female psychiatric inpatients. Childhood abuse experiences were correlated with severity of adult psychiatric symptoms. The authors explore the usefulness of adult psychological symptoms, diagnoses, and prescribed medications as factors in the identification of patients who have histories of early sexual and physical abuse.

Visual Motion Processing and Sensory-Motor Integration for Smooth Pursuit Eye Movements

Abstract: The function of smooth pursuit is to keep the fovea pointed at a small visual target that moves smoothly across a patterned background. Chemical lesions, single cell recordings, and behavioral measures have shown that the cortical motion processing pathways form the afferent limb for pursuit. Important areas include at least the striate cortex and the middle temporal visual area, and probably the medial superior temporal visual area and the posterior parietal cortex. We argue that the visual inputs are transmitted through a simple sensory motor interface in the pons, to the efferent limb in the brain stem and cerebellum. The efferent limb uses neural velocity memory to maintain pursuit automatically. We present evidence that the velocity memory is provided, at least in part, by eye velocity positive feedback between the flocculus of the cerebellum and the brain stem. Finally, we use a computer model to show how the maintenance of pursuit can be simulated on a millisecond time scale. The structure and internal elements of the model are based on the biological experiments reviewed in our paper. In the past five years, progress on the neural basis of pursuit eye movements has been rapid. Several areas of research have made substantial contributions, by using combinations of new and conventional methods. Many of the pathways that contribute to pursuit have been identified, and their physiological activity and functions are becoming understood. Continuing progress promises to yield an understanding of one specific form of visually guided movement, at the level of neuronal circuits and behavior, in the primate.

The spring in the arch of the human foot

Abstract: Large mammals, including humans, save much of the energy needed for running by means of elastic structures in their legs and feet. Kinetic and potential energy removed from the body in the first half of the stance phase is stored briefly as elastic strain energy and then returned in the second half by elastic recoil. Thus the animal runs in an analogous fashion to a rubber ball bouncing along. Among the elastic structures involved, the tendons of distal leg muscles have been shown to be important. Here we show that the elastic properties of the arch of the human foot are also important.

The Shaken Baby Syndrome: A Clinical, Pathological, and Biomechanical Study

Abstract: Because a history of shaking is often lacking in the so-called "shaken baby syndrome," diagnosis is usually based on a constellation of clinical and radiographic findings. Forty-eight cases of infants and young children with this diagnosis seen between 1978 and 1985 at the Children's Hospital of Philadelphia were reviewed. All patients had a presenting history thought to be suspicious for child abuse, and either retinal hemorrhages with subdural or subarachnoid hemorrhages or a computerized tomography scan showing subdural or subarachnoid hemorrhages with interhemispheric blood. The physical examination and presence of associated trauma were analyzed; autopsy findings for the 13 fatalities were reviewed. All fatal cases had signs of blunt impact to the head, although in more than half of them these findings were noted only at autopsy. All deaths were associated with uncontrollably increased intracranial pressure. Models of 1-month-old infants with various neck and skull parameters were instrumented with accelerometers and shaken and impacted against padded or unpadded surfaces. Angular accelerations for shakes were smaller than those for impacts by a factor of 50. All shakes fell below injury thresholds established for subhuman primates scaled for the same brain mass, while impacts spanned concussion, subdural hematoma, and diffuse axonal injury ranges. It was concluded that severe head injuries commonly diagnosed as shaking injuries require impact to occur and that shaking alone in an otherwise normal baby is unlikely to cause the shaken baby syndrome.

Injuries in runners

Abstract: Sixty runners belonging to two clubs were followed for 1 year with regard to training and injury. There were 55 injuries in 39 athletes. The injury rate per 1,000 hours of training was 2.5 in long-distance/marathon runners and 5.6 to 5.8 in sprinters and middle-distance runners. There were significant differences in the injury rate in different periods of the 12 month study, the highest rates occurring in spring and summer. In marathon runners there was a significant correlation between the injury rate during any 1 month and the distance covered during the preceding month (r = 0.59). In a retrospective analysis of the cause of injury, a training error alone or in combination with other factors was the most common injury-provoking factor (72%). The injury pattern varied among the three groups of runners: hamstring strain and tendinitis were most common in sprinters, backache and hip problems were most common in middle-distance runners, and foot problems were most common in marathon runners.

Rates of Crime and Unemployment: An Analysis of Aggregate Research Evidence

Abstract: The unemployment/crime rate relationship (U-C) has been described recently as “inconsistent,” “insignificant,” and “weak.” Prior assessments of the U-C relationship have used no more than 18 U-C studies, and no more than 7 with 1970s data. In this paper, I review the findings of 63 U-C studies, 40 of which involve data from the 1970s when unemployment rose dramatically. My analysis shows the conditional nature of the U-C relationship. Property crimes, 1970s data, and sub-national levels of aggregation produce consistently positive and frequently significant U-C results. I discuss the implications of these results and argue that it is premature to abandon “this now well-plowed terrain” and suggest potentially fruitful paths for future studies of the U-C relationship.

Eyeheight-scaled information about affordances: a study of sitting and stair climbing.

Abstract: Previous work has shown that both the perceived and actual critical (maximum) heights of surfaces that afford "sitting on " and "climbing on" can be expressed as constant proportions of each actor's leg length. The current study provides evidence that these judgments of critical action boundaries are based on an existing source of size and distance information that is already scaled with reference to the actor's eyeheight. In Experiment 1 changes in judgments of "perceived eyeheight" (an index of the intrinsic scalar) as a function of viewing distance were shown to be highly correlated with changes in the maximum height that was perceived to afford sitting on or climbing on. In Experiments 2 and 3 observers wore 10-cm blocks and made judgments about whether the heights of various surfaces afforded sitting or climbing. The use of eyeheight-scaled information as the basis for their estimates predicted the obtained pattern of errors in these judgments. With a modicum of experience wearing the blocks, however, observers were able to retune accurately their critical action boundary to a degree that would not have been predicted from their consistent overestimation of the height of the block on which they were standing. These results have implications for understanding how observers obtain information about their specific action boundary.

Family relationships and delinquency

Abstract: Family interaction and attachment assume prominent roles in social control theories of delinquency. However, the degree of conceptualization and the measurement strategies generally employed arguably are inadequate to capture the real dynamic quality of such relationships and to specify their effects on delinquency involvement. The purpose of this research is to distinguish more precisely those family interaction mechanisms which are associated with delinquency. The analysis, based on a sample of 824 adolescents, leads to the specification of seven distinct family interaction dimensions: control and supervision, identity support, caring and trust, intimate communication, instrumental communication, parental disapproval of peers, and conflict. Compared with research based on a single attached-unattached dimension, this multidimensional model gives a much more complete and precise sense of the kind of relationships which exist between parents and their more or less delinquent children. In addition, the analysis shows that the family interaction variables have similar effects on delinquency in both-parent, mother-only, and mother/stepfather homes. The analysis by race, sex, and race-sex subgroups suggests, however, that while there is a core of family attachment dimensions that is important for all adolescents, there are several important subgroup differences.

Post Sexual Abuse Trauma: Data and Implications for Clinical Practice

Abstract: The incidence and long-term effects of childhood sexual abuse were studied in a clinical sample of 152 adult women. Approximately 44% of female clients presenting to a health center crisis service reported a childhood history of sexual victimization. Prior victimization was associated with increased dissociation, sleep disturbance, tension, sexual problems, and anger on a Crisis Symptom Checklist, as well as greater current use of psychoactive medications, and more frequent histories of suicide attempts, substance addiction, and revictimization. Long-term psychological effects of sexual abuse are interpreted within both a developmental context and in terms of Post Traumatic Stress Disorder. Implications of the current data and related literature for mental health workers are briefly discussed.

Verbal report methods in clinical research on alcoholism: response bias and its minimization.

Abstract: Verbal report procedures, such as interviews, tests and questionnaires, have become the dominant method to obtain clinical data on alcohol abuse and its modification through treatment. The extent to which this method provides reliable and valid information for research purposes, and how its accuracy and usefulness can be enhanced, is examined. A review of methodological studies in the alcohol literature shows that although the information obtained from alcoholics and heavy drinkers tends to be reliable and valid, there can be considerable variability in accuracy, depending on the sensitivity of the information sought, the specificity of the validation criteria, the personal characteristics of the respondents and the demand characteristics of the task. It is suggested that the question of whether verbal report procedures are valid or invalid is less important than the issue of how they can be improved to the point that confidence can be placed in their findings. To facilitate this process, methodological t...

The “Drunken Bum” Theory of Wife Beating

Abstract: We examine the belief that physical abuse of wives is strongly determined by drunkenness and socioeconomic status using interview data from a nationally representative sample of 5,159 families. Our findings show that excessive drinking is associated with higher wife abuse rates, but alcohol use is not an immediate antecedent ofviolence in the majority of families. The combination of blue-collar status, drinking, and approval of violence is significantly associated with the highest rate of wife abuse. Of the three factors, cultural approval of violence by men against women has the strongest association with wife abuse. Although our results provide support for the drunken bum theory of wife beating, they also demythologize the stereotype because they show that alcohol is far from being a necessary or sufficient cause of wife abuse.

Falls and fractures in patients with Alzheimer-type dementia

Abstract: The prevention of fall-related injuries in patients with Alzheimer-type dementia (ATD) is hampered by an incomplete understanding of their causes. We studied falls and fractures in 157 ATD patients, including 117 with three-year follow-up. Initially all but one patient could walk; 31% reported falls. During follow-up, 50% either fell or became unable to walk. The fracture rate during follow-up (69/1000/y) was more than three times the age- and sex-adjusted fracture rate in the general population. Features of both ATD and comorbid conditions contributed to the risk of falls and fractures. In particular, patients who experienced toxic reactions to drugs on entry into the study were more likely to report they had fallen prior to entry (odds ratio, 4.9; 95% confidence interval, 1.78 to 13.3), and patients who wandered were more likely to sustain fractures (odds ratio, 3.6; 95% confidence interval, 1.25 to 10.4) during the follow-up period, including hip fractures for which the odds ratio of 6.9 (95% confidence interval, 1.66 to 28.6) was unexpectedly high. Preventive measures may be possible, including controlling wandering, avoiding toxic reactions to drugs, and treating comorbid illnesses. (JAMA1987;257:1492-1495)

Long-term effects of losing a spouse or child in a motor vehicle crash

Abstract: In this article we examine the long-term effects of the sudden, unexpected loss of a spouse or child. In the spouse study, interviews were conducted with 39 individuals who had lost a spouse in a motor vehicle crash 4 to 7 years ago and with 39 matched controls. In the parent study, interviews were conducted with 41 parents who had lost a child in a crash and with 41 matched controls. Control respondents were matched to bereaved respondents case-by-case on the basis of sex, age, income, education, and number and ages of children. Significant differences between bereaved spouses and controls were revealed on several indicators of general functioning, including depression and other psychiatric symptoms, social functioning, psychological well-being, reactivity to good events, and future worries and concerns. For the most part, these differences persisted when variables such as present family income and present marital status were statistically controlled. Comparisons between bereaved and control parents also revealed significant differences on some measures of general functioning (especially depression), but these were not as pervasive as the differences obtained in the spouse study. Responses to questions about current thoughts and feelings suggest that the deceased continued to occupy the thoughts and conversations of bereaved spouses and parents. Moreover, a large percentage of respondents (from 30% to 85%, depending on the question), continued to ruminate about the accident or what might have been done to prevent it, and they appeared to be unable to accept, resolve, or find any meaning in the loss. Taken together, the data provide little support for traditional notions of recovery from the sudden, unexpected loss of a spouse or child.

Mortality among the elderly in the Alameda County study: behavioral and demographic risk factors

Abstract: We studied the association between behavioral and demographic risk factors and 17-year mortality in members of the Alameda County (California) Study who were 60-94 years of age at baseline. In this age group, increased risk of death is associated with being male, smoking, having little leisure-time physical activity, deviating from moderate weight relative to height, and not regularly eating breakfast. These increased risks were independent of age, race, socioeconomic position (SEP), other behavioral risk factors, and baseline physical health status. Further examination of the group aged 70 or more revealed the same patterns of heightened risk.

Gender segregation in childhood.

Abstract: Publisher Summary This chapter argues that gender segregation is a powerful phenomenon of childhood. The extent of its occurrence does depend on situations arranged by adults for children's interactions and therefore cross-cultural and within-culture situational variations make a great deal of difference in the amount of interactive contact male and female children have with one another. The implication of analysis is that, over and above situational variation, there are forces for children to segregate themselves spontaneously in situations, such as school playgrounds where there are large numbers of children and where a child's behavior is open to the observation of other children. The chapter suggests that gender segregation results from a combination of several forces, including the dominance relations between the sexes, age-specific avoidance of romantic or sexually toned relationships, and gender labeling. The last is of paramount importance and may account, in part, for both the dominance relationships and sexual avoidance.