Showing papers on "Poison control published in 1997"
TL;DR: Multilevel analyses showed that a measure of collective efficacy yields a high between-neighborhood reliability and is negatively associated with variations in violence, when individual-level characteristics, measurement error, and prior violence are controlled.
Abstract: It is hypothesized that collective efficacy, defined as social cohesion among neighbors combined with their willingness to intervene on behalf of the common good, is linked to reduced violence. This hypothesis was tested on a 1995 survey of 8782 residents of 343 neighborhoods in Chicago, Illinois. Multilevel analyses showed that a measure of collective efficacy yields a high between-neighborhood reliability and is negatively associated with variations in violence, when individual-level characteristics, measurement error, and prior violence are controlled. Associations of concentrated disadvantage and residential instability with violence are largely mediated by collective efficacy.
10,498 citations
TL;DR: This work examines the growing number of studies of survey respondents' global self-ratings of health as predictors of mortality in longitudinal studies of representative community samples and suggests several approaches to the next stage of research in this field.
Abstract: We examine the growing number of studies of survey respondents' global self-ratings of health as predictors of mortality in longitudinal studies of representative community samples. Twenty-seven studies in U.S. and international journals show impressively consistent findings. Global self-rated health is an independent predictor of mortality in nearly all of the studies, despite the inclusion of numerous specific health status indicators and other relevant covariates known to predict mortality. We summarize and review these studies, consider various interpretations which could account for the association, and suggest several approaches to the next stage of research in this field.
7,940 citations
TL;DR: The three leading contributors to the burden of disease are communicable and perinatal disorders affecting children, and the substantial burdens of neuropsychiatric disorders and injuries are under-recognised.
4,425 citations
TL;DR: The Global Burden of Disease Study (GBD) used various data sources and made corrections for miscoding of important diseases (eg, ischaemic heart disease) to estimate worldwide and regional cause-of-death patterns in 1990, and the estimates by cause provide a foundation for a more informed debate on public-health priorities.
4,195 citations
TL;DR: Almost all mental disorders have an increased risk of suicide excepting mental retardation and dementia, which is highest for functional and lowest for organic disorders with substance misuse disorders lying between.
Abstract: BACKGROUND Mental disorders have a strong association with suicide. This meta-analysis, or statistical overview, of the literature gives an estimate of the suicide risk of the common mental disorders.
METHOD We searched the medical literature to find reports on the mortality of mental disorders. English language reports were located on MEDLINE (1966-1993) with the search terms mental disorders', 'brain injury', 'eating disorders', 'epilepsy', 'suicide attempt', 'psychosurgery', with 'mortality' and 'follow-up studies', and from the reference lists of these reports. We abstracted 249 reports with two years or more follow-up and less than 10% loss of subjects, and compared observed numbers of suicides with those expected. A standardised mortality ratio (SMR) was calculated for each disorder.
RESULTS Of 44 disorders considered, 36 have a significantly raised SMR for suicide, five have a raised SMR which fails to reach significance, one SMR is not raised and for two entries the SMR could not be calculated.
CONCLUSIONS If these results can be generalised then virtually all mental disorders have an increased risk of suicide excepting mental retardation and dementia. The suicide risk is highest for functional and lowest for organic disorders with substance misuse disorders lying between. However, within these broad groupings the suicide risk varies widely.
2,587 citations
TL;DR: It is argued that risk management must be modelled by cross-disciplinary studies, considering risk management to be a control problem and serving to represent the control structure involving all levels of society for each particular hazard category, and that this requires a system-oriented approach based on functional abstraction rather than structural decomposition.
2,547 citations
TL;DR: It is suggested that cumulative nocturnal sleep debt had a dynamic and escalating analog in cumulative daytime sleepiness and that asymptotic or steady-state sleepiness was not achieved in response to sleep restriction.
Abstract: To determine whether a cumulative sleep debt (in a range commonly experienced) would result in cumulative changes in measures of waking neurobehavioral alertness, 16 healthy young adults had their sleep restricted 33% below habitual sleep duration, to an average 4.98 hours per night [standard deviation (SD) = 0.57] for seven consecutive nights. Subjects slept in the laboratory, and sleep and waking were monitored by staff and actigraphy. Three times each day (1000, 1600, and 2200 hours) subjects were assessed for subjective sleepiness (SSS) and mood (POMS) and were evaluated on a brief performance battery that included psychomotor vigilance (PVT), probed memory (PRM), and serial-addition testing, Once each day they completed a series of visual analog scales (VAS) and reported sleepiness and somatic and cognitive/emotional problems. Sleep restriction resulted in statistically robust cumulative effects on waking functions. SSS ratings, subscale scores for fatigue, confusion, tension, and total mood disturbance from the POMS and VAS ratings of mental exhaustion and stress were evaluated across days of restricted sleep (p = 0.009 to p = 0.0001). PVT performance parameters, including the frequency and duration of lapses, were also significantly increased by restriction (p = 0.018 to p = 0.0001). Significant time-of-day effects were evident in SSS and PVT data, but time-of-day did not interact with the effects of sleep restriction across days. The temporal profiles of cumulative changes in neurobehavioral measures of alertness as a function of sleep restriction were generally consistent. Subjective changes tended to precede performance changes by 1 day, but overall changes in both classes of measure were greatest during the first 2 days (P1, P2) and last 2 days (P6, P7) of sleep restriction. Data from subsets of subjects also showed: 1) that significant decreases in the MSLT occurred during sleep restriction, 2) that the elevated sleepiness and performance deficits continued beyond day 7 of restriction, and 3) that recovery from these deficits appeared to require two full nights of sleep. The cumulative increase in performance lapses across days of sleep restriction correlated closely with MSLT results (r = -0.95) from an earlier comparable experiment by Carskadon and Dement (1). These findings suggest that cumulative nocturnal sleep debt had a dynamic and escalating analog in cumulative daytime sleepiness and that asymptotic or steady-state sleepiness was not achieved in response to sleep restriction.
2,040 citations
TL;DR: It is concluded that the socioeconomic impact of hip fractures will increase markedly throughout the world, particularly in Asia, and that there is an urgent need to develop preventive strategies,particularly in the developing countries.
Abstract: The aims of this study were to estimate the present and future incidence of hip fracture world-wide. From a survey of available data on current incidence, population trends and the secular changes in hip fracture risk, the numbers of hip fractures expected in 2025 and 2050 were computed. The total number of hip fractures in men and women in 1990 was estimated to be 338000 and 917000 respectively, a total of 1.26 million. Assuming no change in the age- and sex-specific incidence, the number of hip fractures is estimated to approximately double to 2.6 million by the year 2025, and 4.5 million by the year 2050. The percentage increase will be greater in men (310%) than in women (240%). With modest assumptions concerning secular trends, the number of hip fractures could range between 7.3 and 21.3 million by 2050. The major demographic changes will occur in Asia. In 1990, 26% of all hip fractures occurred in Asia, whereas this figure could rise to 37% in 2025 and to 45% in 2050. We conclude that the socioeconomic impact of hip fractures will increase markedly throughout the world, particularly in Asia, and that there is an urgent need to develop preventive strategies, particularly in the developing countries.
1,932 citations
TL;DR: It is shown that errors on the SART can be predicted by a significant shortening of reaction times in the immediately preceding responses, supporting the view that these errors are a result of 'drift' of controlled processing into automatic responding consequent on impaired sustained attention to task.
1,748 citations
TL;DR: A simple predictive model based on two risk factors can be used by physical therapists to quantify fall risk in community-dwelling older adults and Identification of patients with a high fall risk can lead to an appropriate referral into a fall prevention program.
Abstract: Background and Purpose. The objective of this retrospective case-control study was to develop a model for predicting the likelihood of falls among community-dwelling older adults. Subjects. Forty-four community-dwelling adults (≥65 years of age) with and without a history of falls participated. Methods. Subjects completed a health status questionnaire and underwent a clinical evaluation of balance and mobility function. Variables that differed between fallers and nonfallers were identified, using t tests and cross tabulation with chi-square tests. A forward stepwise regression analysis was carried out to identify a combination of variables that effectively predicted fall status. Results. Five variables were found to be associated with fall history. These variables were analyzed using logistic regression. The final model combined the score on the Berg Balance Scale with a self-reported history of imbalance to predict fall risk. Sensitivity was 91%, and specificity was 82%. Conclusion and Discussion. A simple predictive model based on two risk factors can be used by physical therapists to quantify fall risk in community-dwelling older adults. Identification of patients with a high fall risk can lead to an appropriate referral into a fall prevention program. In addition, fall risk can be used to calculate change resulting from intervention.
1,679 citations
TL;DR: In a cohort of ambulatory older adults, whether spatial‐temporal measures of foot placement during gait can predict the likelihood of future falls or whether these measures are more likely to be indicative of adaptations associated with pre‐existing fear of falling is investigated.
Abstract: OBJECTIVE: To determine, in a cohort of ambulatory older adults, whether spatial-temporal measures of foot placement during gait can predict the likelihood of future falls or whether these measures are more likely to be indicative of adaptations associated with pre-existing fear of falling.
DESIGN: Prospective cohort study.
SETTING: Baseline gait measurements were performed in a gait and balance laboratory; subsequent history of falling was monitored prospectively for 1 year in two self-care facilities.
PARTICIPANTS: Fourteen male and 61 female consecutive volunteers (mean age = 82, SD = 6) who were independent in activities of daily living and able to walk 10 m unaided.
MEASUREMENTS: Spatial gait parameters were derived from digitized “footprints”; temporal parameters were derived using footswitches. A clinical activity-based gait assessment was also performed. The dependent variables were pre-existing fear of falling (reported at baseline) and future falling (experiencing one or more falls during the 1-year follow-up).
MAIN RESULTS: Reduced stride length, reduced speed, increased double-support time, and poorer clinical gait scores were associated with fear but showed little evidence of an independent association with falling. Conversely, increased stride-to-stride variability in stride length, speed, and double-support was associated independently with falling but showed little evidence of relationship to fear. Increased stride width showed some evidence of association with both falling and fear. Stride-to-stride variability in speed was the single best independent predictor of falling.
CONCLUSIONS: Changes in gait cited previously as risk factors for falling, i.e., decreased stride length and speed and prolonged double support, may in fact be stabilizing adaptations related to fear of falling. Stride-to-stride variability in the control of gait is an independent predictor of falling and may be a useful measure for identifying high-risk individuals and evaluating preventive interventions. Stride width may also be a useful outcome measure. Contrary to common expectation, a wider stride does not necessarily increase stability but instead seems to predict an increased likelihood of experiencing falls.
TL;DR: In this paper, a cognitive-energetical framework for the analysis of effects of stress and high workload on human performance is presented, where a two-level compensatory control model provides the basis for a mechanism of resource allocation through an effort monitor, sensitive to changes in the level of regulatory activity, coupled with a supervisory controller which can implement different modes of performance-cost tradeoff.
TL;DR: In this paper, a new theoretical framework, executive-process interactive control (EPIC), is introduced for characterizing human performance of concurrent perceptual-motor and cognitive tasks, and computational models may be formulated to simulate multiple-task performance under a variety of circumstances.
Abstract: A new theoretical framework, executive-process interactive control (EPIC), is introduced for characterizing human performance of concurrent perceptual-motor and cognitive tasks. On the basis of EPIC, computational models may be formulated to simulate multiple-task performance under a variety of circumstances. These models account well for reaction-time data from representative situations such as the psychological refractory-period procedure. EPIC's goodness of fit supports several key conclusions: (a) At a cognitive level, people can apply distinct sets of production rules simultaneously for executing the procedures of multiple tasks; (b) people's capacity to process information at "peripheral" perceptual-motor levels is limited; (c) to cope with such limits and to satisfy task priorities, flexible scheduling strategies are used; and (d) these strategies are mediated by executive cognitive processes that coordinate concurrent tasks adaptively.
TL;DR: In this paper, the authors examined the long-term effects of home visitation by nurses on women's life course and child abuse and neglect in a semi-urban community in New York.
Abstract: Context. —Home-visitation services have been promoted as a means of improving maternal and child health and functioning. However, long-term effects have not been examined. objective. —To examine the long-term effects of a program of prenatal and early childhood home visitation by nurses on women's life course and child abuse and neglect. Design. —Randomized trial. Setting. —Semirural community in New York. Participants. —Of 400 consecutive pregnant women with no previous live births enrolled, 324 participated in a follow-up study when their children were 15 years old. Intervention. —Families received a mean of 9 home visits during pregnancy and 23 home visits from the child's birth through the second birthday. Data Sources and Measures. —Women's use of welfare and number of subsequent children were based on self-report; their arrests and convictions were based on self-report and archived data from New York State. Verified reports of child abuse and neglect were abstracted from state records. Main Results. —During the 15-year period after the birth of their first child, in contrast to women in the comparison group, women who were visited by nurses during pregnancy and infancy were identified as perpetrators of child abuse and neglect in 0.29 vs 0.54 verified reports ( P P =.02), 65 vs 37 months between the birth of the first and a second child ( P =.001), 60 vs 90 months' receiving Aid to Families With Dependent Children ( P =.005), 0.41 vs 0.73 behavioral impairments due to use of alcohol and other drugs ( P =.03), 0.18 vs 0.58 arrests by self-report ( P P Conclusions. —This program of prenatal and early childhood home visitation by nurses can reduce the number of subsequent pregnancies, the use of welfare, child abuse and neglect, and criminal behavior on the part of low-income, unmarried mothers for up to 15 years after the birth of the first child.
TL;DR: To define the patient population that might benefit from cartilage grafting, 31,516 knee arthroscopies were reviewed and the majority were articular cartilage lesions; grade III lesions of the patella were the most common and Grade IV lesions were predominantly located on the medial femoral condyle.
Abstract: Although articular cartilage injuries of the knee are common, injured cartilage has a limited ability to heal. Recent data suggest that articular cartilage grafting may provide treatment for these injuries. To define the patient population that might benefit from cartilage grafting, 31,516 knee arthroscopies were reviewed. Between June 1991 and October 1995, 53,569 hyaline cartilage lesions were documented in 19,827 patients. The majority were articular cartilage lesions; grade III lesions of the patella were the most common. Grade IV lesions were predominantly located on the medial femoral condyle. Patients under 40 years of age with grade IV lesions accounted for 5% of all arthroscopies; 74% of these patients had a single chondral lesion (4% of the arthroscopies). No associated ligamentous or meniscal pathology was found in 36.6% of these patients.
TL;DR: Although studies have emphasized high stability of aggression over time, data show that a substantial proportion of aggressive youth desist over time.
Abstract: Different manifestations of aggression from childhood to early adulthood are reviewed to establish how early manifestations are related to later manifestations. Similarities and differences in manifestations of aggression between the two genders are noted. Developmental sequences and pathways from minor aggression to violence are highlighted. Long-term escalation is contrasted with short-term escalation at older ages. Although studies have emphasized high stability of aggression over time, data show that a substantial proportion of aggressive youth desist over time. Temperamental, emotional, and cognitive aspects of aggression are reviewed, either as precursors or co-occurring conditions to aggression. Selected processes in the realms of the family, peers, and neighborhoods are highlighted that are known to be associated with juvenile aggression. Cumulative, long-term causes are contrasted with short-term causes, and causes associated with desistance in aggression are reviewed.
TL;DR: The use of cellular telephones in motor vehicles is associated with a quadrupling of the risk of a collision during the brief time interval involving a call, suggesting that having a cellular telephone may have had advantages in the aftermath of an event.
Abstract: Background Because of a belief that the use of cellular telephones while driving may cause collisions, several countries have restricted their use in motor vehicles, and others are considering such regulations. We used an epidemiologic method, the case–crossover design, to study whether using a cellular telephone while driving increases the risk of a motor vehicle collision. Methods We studied 699 drivers who had cellular telephones and who were involved in motor vehicle collisions resulting in substantial property damage but no personal injury. Each person's cellular-telephone calls on the day of the collision and during the previous week were analyzed through the use of detailed billing records. Results A total of 26,798 cellular-telephone calls were made during the 14-month study period. The risk of a collision when using a cellular telephone was four times higher than the risk when a cellular telephone was not being used (relative risk, 4.3; 95 percent confidence interval, 3.0 to 6.5). The relative ri...
TL;DR: While inductive analysis of existing data demonstrate more similarities than differences in pain experience between females and males, deductive analysis suggests important operational sex differences in its production.
Abstract: Are there sex differences in pain? For experimentally delivered somatic stimuli, females have lower thresholds, greater ability to discriminate, higher pain ratings, and less tolerance of noxious stimuli than males. These differences, however, are small, exist only for certain forms of stimulation and are affected by many situational variables such as presence of disease, experimental setting, and even nutritive status. For endogenous pains, women report more multiple pains in more body regions than men. With no obvious underlying rationale, some painful diseases are more prevalent among females, others among males and, for many diseases, symptoms differ between females and males. Sex differences in attitudes exist that affect not only reporting, coping, and responses to treatment, but also measurement and treatment. So many variables are operative, however, that the most striking feature of sex differences in reported pain experience is the apparent overall lack of them. On the other hand, deduction from known biological sex differences suggests that these are powerful sex differences in the operation of pain mechanisms. First, the vaginal canal provides an additional route in women for internal trauma and invasion by pathological agents that puts them at greater risk for developing hyperalgesia in multiple body regions. Second, sex differences in temporal patterns are likely to give rise to sex differences in how pain is "learned" and stimuli are interpreted, a situation that could lead to a greater variability and wider range of pains without obvious peripheral pathology among females. Third, sex differences in the actions of sex hormones suggest pain-relevant differences in the operation of many neuroactive agents, opiate and nonopiate systems, nerve growth factor, and the sympathetic system. Thus, while inductive analysis of existing data demonstrate more similarities than differences in pain experience between females and males, deductive analysis suggests important operational sex differences in its production.
TL;DR: Data from the Kuopio Ischaemic Heart Disease Risk Factor Study were used to examine the associations between measures of SES reflecting different stages of the lifecourse, health behaviours, and psychosocial characteristics in adulthood in a population-based study of 2674 middle-aged Finnish men.
TL;DR: An individual programme of strength and balance retraining exercises improved physical function and was effective in reducing falls and injuries in women 80 years and older in Dunedin, New Zealand.
Abstract: Objective: To assess the effectiveness of a home exercise programme of strength and balance retraining exercises in reducing falls and injuries in elderly women. Design: Randomised controlled trial of an individually tailored programme of physical therapy in the home (exercise group, n=116) compared with the usual care and an equal number of social visits (control group, n=117). Setting: 17 general practices in Dunedin, New Zealand. Subjects: Women aged 80 years and older living in the community and registered with a general practice in Dunedin. Main outcome measures: Number of falls and injuries related to falls and time between falls during one year of follow up; changes in muscle strength and balance measures after six months. Results: After one year there were 152 falls in the control group and 88 falls in the exercise group. The mean (SD) rate of falls was lower in the exercise than the control group (0.87 (1.29) v 1.34 (1.93) falls per year respectively; difference 0.47; 95% confidence interval 0.04 to 0.90). The relative hazard for the first four falls in the exercise group compared with the control group was 0.68 (0.52 to 0.90). The relative hazard for a first fall with injury in the exercise group compared with the control group was 0.61 (0.39 to 0.97). After six months, balance had improved in the exercise group (difference between groups in change in balance score 0.43 (0.21 to 0.65). Conclusions: An individual programme of strength and balance retraining exercises improved physical function and was effective in reducing falls and injuries in women 80 years and older. Key messages Modifiable risk factors for falls in elderly people have been well defined; they include loss of muscle strength and impaired balance A programme to improve strength and balance in women aged 80 years and older can be set up safely with four home visits from a physiotherapist This programme reduced falls and moderate injuries appreciably over the subsequent year in Dunedin, New Zealand The benefit was most noticeable in elderly people who fell often
TL;DR: When cats responded to a sudden change of a visual pattern, neuronal activity in cortical areas exhibited synchrony without time lags; this synchrony was particularly strong between areas subserving related functions.
Abstract: INFORMATION processing in the cerebral cortex invariably involves the activation of millions of neurons that are widely distributed over its various areas. These distributed activity patterns need to be integrated into coherent representational states. A candidate mechanism for the integration and coordination of neuronal activity between different brain regions is synchronization on a fine temporal scale1–3. In the visual cortex, synchronization occurs selectively between the responses of neurons that represent related features2–5 and that need to be integrated for the generation of coherent percepts; neurons in other areas of the cerebral cortex also synchronize their discharges6–10. However, little is known about the patterns and the behavioural correlates of synchrony among widely separated cortical regions. Here we report that synchronization occurs between areas of the visual and parietal cortex, and between areas of the parietal and motor cortex, in the awake cat. When cats responded to a sudden change of a visual pattern, neuronal activity in cortical areas exhibited synchrony without time lags; this synchrony was particularly strong between areas subserving related functions. During reward and inter-trial episodes, zero-time-lag synchrony was lost and replaced by interactions exhibiting large and unsystematic time lags.
TL;DR: The performance impairment caused by fatigue is compared with that due to alcohol intoxication, and it is shown that moderate levels of fatigue produce higher levels of impairment than the proscribed level of alcohol intoxication.
Abstract: Reduced opportunity for sleep and reduced sleep quality are frequently related to accidents involving shift-workers1,2,3 Poor-quality sleep and inadequate recovery leads to increased fatigue, decreased alertness and impaired performance in a variety of cognitive psychomotor tests4 However, the risks associated with fatigue are not well quantified Here we equate the performance impairment caused by fatigue with that due to alcohol intoxication, and show that moderate levels of fatigue produce higher levels of impairment than the proscribed level of alcohol intoxication
TL;DR: NISS should replace ISS as the standard summary measure of human trauma and provide a better fit throughout its entire range of prediction.
Abstract: Objectives : The Injury Severity Score (ISS) has served as the standard summary measure of anatomic injury for more than 20 years. Nevertheless, the ISS has an idiosyncrasy that both impairs its predictive power and complicates its calculation. We present here a simple modification of the ISS called the New Injury Severity Score (NISS), which significantly outperforms the venerable but dated ISS as a predictor of mortality. Design: Retrospective calculation of NISS and comparison of NISS with prospectively calculated ISS. Materials and Methods: The NISS is defined as the sum of the squares of the Abbreviated Injury Scale scores of each of a patient's three most severe Abbreviated Injury Scale injuries regardless of the body region in which they occur. NISS values were calculated for every patient in two large independent data sets: 3,136 patients treated during a 4-year period at the American College of Surgeons' Level I trauma center in Albuquerque, New Mexico, and 3,449 patients treated during a 4-year period at the American College of Surgeons' Level I trauma center at the Emanuel Hospital in Portland, Oregon. The power of NISS to predict mortality was then compared with previously calculated ISS values for the same patients in each of the two data sets. Measurements and Main Results: We find that NISS is not only simple to calculate but more predictive of survival as well (Albuquerque: receiver operating characteristic (ROC) ISS = 0.869, ROC NISS = 0.896, p < 0.001; Portland: ROC ISS = 0.896, ROC NISS = 0.907, p < 0.004). Moreover, NISS provides a better fit throughout its entire range of prediction (Hosmer Lemeshow statistic for Albuquerque ISS = 29.12, NISS = 8.88; Hosmer Lemeshow statistic for Portland ISS = 83.48, NISS = 19.86). Conclusion: NISS should replace ISS as the standard summary measure of human trauma.
Journal Article•
TL;DR: The Behavioral Risk Factor Surveillance System (BRFSS) is a state-based telephone survey of the civilian, non-institutionalized, adult (persons > or =18 years of age) population.
Abstract: PROBLEM/CONDITION: High-risk behaviors (e.g., cigarette smoking, excessive alcohol consumption, and physical inactivity) and lack of preventive health care (e.g., screening for cancer) are associated with chronic disease- and injury-related morbidity and mortality. States use the Behavioral Risk Factor Surveillance System (BRFSS) to collect data about these modifiable health behaviors and to monitor trends and changes in the prevalence of behavioral risk factors in state populations. BRFSS data also are used to monitor progress toward the year 2000 national health objectives. REPORTING PERIOD: 1994 and 1995. DESCRIPTION OF SYSTEM: The BRFSS is a state-based telephone survey of the civilian, noninstitutionalized, adult (persons > or =18 years of age) population. In 1994, 49 states and the District of Columbia participated in the BRFSS; in 1995, 50 states participated. RESULTS: As in previous years, there were state-specific variations in the prevalences of high-risk behaviors, awareness of certain medical conditions, use of preventive health services, and health-care coverage. Selected findings for 1995 were that 22.4% of adults reported being current cigarette smokers (range: 13.2%-27.8%); the percentage of adults who reported driving after drinking too much alcohol ranged from 0.6% to 5.2% (median: 2.3%); and among adults aged > or =65 years, 36.8% (range: 11.4%-46.6%) reported ever having had a pneumococcal vaccination and 59.2% (range: 44.2%-70.0%) reported having had an influenza vaccination within the past 1 year. INTERPRETATION: State-specific variations in prevalence may reflect differences in population composition, socioeconomic factors, state laws enacted to discourage high-risk behaviors, levels of effort to screen for certain diseases and physiological conditions, and other factors. ACTION TAKEN: States continue to use the BRFSS to monitor risk factors associated with chronic disease- and injury-related morbidity and mortality and to develop public health programs and policies to address these problems. BRFSS data continue to be important in assessing progress toward national year 2000 and state health objectives. Language: en
TL;DR: Insight is provided into the circumstances and consequences of falls among independent community-dwelling older adults and some possible ways of preventing falls are suggested.
Abstract: BACKGROUND: knowledge of the circumstances and consequences of falls in older adults is important for understanding the aetiology of falls as well as for effective clinical assessment and design of fall prevention strategies. Such data, however, are relatively scarce, especially in community-dwelling elders. METHOD: accidental falls (including their circumstances and consequences) occurring in 96 male and female participants between 60 and 88 years of age were monitored prospectively for 1 year. After the monitoring period, participants were divided into three groups based on fall status: non-fallers (n = 46), one-time fallers (n = 27) and recurrent fallers (n = 23). Frequency distributions were created for selected circumstances and consequences of falls and the prevalence of these consequences were examined. RESULTS: 50 participants (52%) fell during the 1 year period, amassing 91 falls. Trips and slips were the most prevalent causes of falls, accounting for 59% of falls. Falls most often occurred during the afternoon and while subjects walked on level or uneven surfaces. Fallers most commonly attributed falls to hurrying too much. Fractures resulted from five of the 91 falls and eight other falls resulted in soft tissue injuries that required treatment by a physician. There were no differences between one-time and recurrent fallers in the circumstances and consequences of falls. However, several notable differences were found between men (n = 20) and women (n = 30) who fell. Falls by men most often resulted from slips whereas falls by women most often resulted from trips. Moreover, women and men differed in the time of the year in which falls occurred, with men falling most often during winter and women during summer. CONCLUSIONS: the results of this study provide insight into the circumstances and consequences of falls among independent community-dwelling older adults and suggest some possible ways of preventing falls. Preventive services, however, should not solely target recurrent fallers, nor should the type of services necessarily differ for one-time and recurrent fallers. Language: en
TL;DR: Myopic loss aversion as discussed by the authors is the combination of a greater sensitivity to losses than to gains and a tendency to evaluate outcomes frequently, and it has been shown that investors are more willing to accept risks if they evaluate their investments less often.
Abstract: Myopic loss aversion is the combination of a greater sensitivity to losses than to gains and a tendency to evaluate outcomes frequently. Two implications of myopic loss aversion are tested experimentally. 1. Investors who display myopic loss aversion will be more willing to accept risks if they evaluate their investments less often. 2. If all payoffs are increased enough to eliminate losses, investors will accept more risk. In a task in which investors learn from experience, both predictions are supported. The investors who got the most frequent feedback (and thus the most information) took the least risk and earned the least money. Language: en
TL;DR: Meta-analysis was used to review 177 primary prevention programs designed to prevent behavioral and social problems in children and adolescents and found most categories of programs had the dual benefit of significantly reducing problems and significantly increasing competencies.
Abstract: Used meta-analysis to review 177 primary prevention programs designed to prevent behavioral and social problems in children and adolescents. Findings provide empirical support for further research and practice in primary prevention. Most categories of programs produced outcomes similar to or higher in magnitude than those obtained by many other established preventive and treatment interventions in the social sciences and medicine. Programs modifying the school environment, individually focused mental health promotion efforts, and attempts to help children negotiate stressful transitions yield significant mean effects ranging from 0.24 to 0.93. In practical terms, the average participant in a primary prevention program surpasses the performance of between 59% to 82% of those in a control group, and outcomes reflect an 8% to 46% difference in success rates favoring prevention groups. Most categories of programs had the dual benefit of significantly reducing problems and significantly increasing competencies. Priorities for future research include clearer specification of intervention procedures and program goals, assessment of program implementation, more follow-up studies, and determining how characteristics of the intervention and participants relate to different outcomes.
TL;DR: The authors found that children tended to approve more of aggression as they grew older and that this increase appeared to be correlated with increases in aggressive behavior.
Abstract: Normative beliefs have been defined as self-regulating beliefs about the appropriateness of social behaviors. In 2 studies the authors revised their scale for assessing normative beliefs about aggression, found that it is reliable and valid for use with elementary school children, and investigated the longitudinal relation between normative beliefs about aggression and aggressive behavior in a large sample of elementary school children living in poor urban neighborhoods. Using data obtained in 2 waves of observations 1 year apart, the authors found that children tended to approve more of aggression as they grew older and that this increase appeared to be correlated with increases in aggressive behavior. More important, although individual differences in aggressive behavior predicted subsequent differences in normative beliefs in younger children, individual differences in aggressive behavior were predicted by preceding differences in normative beliefs in older children.
TL;DR: Interference with work or school was significantly more pronounced in persons with full PTSD than in those with only partial symptoms, although the latter were significantly more occupationally impaired than traumatized persons without PTSD.
Abstract: OBJECTIVE: Full and partial posttraumatic stress disorder (PTSD) following trauma exposure were examined in a community sample in order to determine their prevalence and their relative importance and functional significance. METHOD: A standardized telephone interview with a series of trauma probes and a DSM-IV PTSD checklist was administered to a random sample of 1,002 persons in a midsized Midwestern Canadian city. The authors determined current (i.e., 1-months) prevalence rates of full PTSD, i.e., all DSM-IV criteria, and partial PTSD, i.e., fewer than the required number of DSM-IV criterion C symptoms (avoidance/numbing) or criterion D symptoms (increased arousal). Additional questions about interference with functioning were also posed. RESULTS: The estimated prevalence of full PTSD was 2.7% for women and 1.2% for men. The prevalence of partial PTSD was 3.4% for women and 0.3% for men. Interference with work or school was significantly more pronounced in persons with full PTSD than in those with only partial symptoms, although the latter were significantly more occupationally impaired than traumatized persons without PTSD. CONCLUSIONS: These findings in an epidemiologic sample underscore observations from patient and military groups that many traumatized persons suffer from a subsyndromal form of PTSD. These persons with partial PTSD, although somewhat less impaired than persons with the full syndrome, nonetheless exhibit clinically meaningful levels of functional impairment in association with their symptoms. This subthreshold form of PTSD may be especially prevalent in women. Additional study of partial PTSD is warranted. Language: en
TL;DR: This investigation investigated the usefulness of the sign “stops walking when talking” in predicting falls and found that some frail elderly patients stop walking when they start a conversation with a walking companion, presumably because walking demands attention and they stop when they are expected to do two things at once.