|
|
March 23, 2001
- Sickness, absence, and rehabilitation: what hope of change? Waldron HS. J R Soc Med, 2001; 94(3):105-106.
The Health and Safety Executive (similar to OSHA in the USA) “has been a great disappointment” in its efforts to make UK working conditions safe. Occupational health services available to British workers are “patchy at best”, with delays in treatment possibly worsening work-related disabilities. The editorial calls for government agencies to ensure that company directors and board members face the prospect of a jail sentence if health and safety laws are broken.
Full text available online: http://www.roysocmed.ac.uk/pub/j03-01sickdays.pdf.
- Adolescent Suicide Attempts: Risks and Protectors. Borowsky IW, Ireland M, Resnick MD. Pediatrics, 2001; 107(3):485-493.
Objective. In 1997, suicide was the third leading cause of death among 10- to 19-year-olds in the United States, with the greatest increases in suicide rates in the previous decade experienced by black and other minority youth. The purpose of this study was to identify risk and protective factors for suicide attempts among black, Hispanic, and white male and female adolescents.
Methods. We used data from the National Longitudinal Study of Adolescent Health, conducted in 1995 and 1996. A nationally representative sample of 13 110 students in grades 7 through 12 completed 2 in-home interviews, an average of 11 months apart. We examined Time 1 factors at the individual, family, and community level that predicted or protected against Time 2 suicide attempts.
Results. Perceived parent and family connectedness was protective against suicide attempts for black, Hispanic, and white girls and boys, with odds ratios ranging from 0.06 to 0.32. For girls, emotional well-being was also protective for all of the racial/ethnic groups studied, while a high grade point average was an additional protective factor for all of the boys. Cross-cutting risk factors included previous suicide attempt, violence victimization, violence perpetration, alcohol use, marijuana use, and school problems. Additionally, somatic symptoms, friend suicide attempt or completion, other illicit drug use, and a history of mental health treatment predicted suicide attempts among black, Hispanic, and white females. Weapon-carrying at school and same-sex romantic attraction were predictive for all groups of boys. Calculating the estimated probabilities of attempting suicide for adolescents with increasing numbers of risk and protective factors revealed that the presence of 3 protective factors reduced the risk of a suicide attempt by 70% to 85% for each of the gender and racial/ethnic groups, including those with and without identified risk factors.
Conclusions. In these national samples of black, Hispanic, and white youth, unique and cross-cutting factors derived from a resiliency framework predicted or protected against attempting suicide. In addition to risk reduction, promotion of protective factors may offer an effective approach to primary as well as secondary prevention of adolescent suicidal behavior.
Full text available online: http://www.pediatrics.org/
- Pedestrian deaths following collisions with heavy goods vehicles. Wyatt JP, Martin A, Beard D, Busuttil A. Med Sci Law, 2001; 41(1):21-25.
Pedestrian fatalities following collisions with heavy goods vehicles ('lorries') in south-east Scotland were studied between 1992 and 1998. Data sources included police and ambulance reports, forensic medicine records, hospital casenotes and the Scottish Trauma Audit Group database. All injuries were scored according to the Abbreviated Injury Scale, yielding Injury Severity Scores (ISS). Sixteen pedestrians (mean age 60.2 years) died after being hit by a lorry. Actions of pedestrians were implicated in causing all the collisions--four of which appeared to be suicides. Four of the apparently accidental deaths involved pedestrians with significant blood alcohol levels. Thirteen pedestrians were dead when found. Ten pedestrians had an ISS of 75, having a total of 13 injuries acknowledged to be unsurvivable (Abbreviated Injury Scale = 6), largely to the head and chest. The unsurvivable injuries reflect huge forces, explaining why only a small proportion of the pedestrians survived to hospital. There is little potential to reduce the number of deaths by improving hospital treatment, rather the focus needs to be directed towards injury prevention. Although pedestrians appeared to be responsible for the collisions, the results suggest it may be more feasible and effective to direct injury prevention measures towards lorry drivers.
- Antipersonnel Land Mines: A Vector for Human Suffering (Editorial). Cobey JC, Raymond NA. Ann Intern Med, 2001; 134(5):421-422.
Antipersonnel land mines are an epidemic afflicting the world's poorest, war-wrecked nations, maiming and killing scores of civilians each year. Sleeping in the soil of over 88 countries, these mines are deadly remnants of past and present armed conflict. Not only do they kill or injure more than 2000 people per month, their very presence stymies efforts by developing nations to reclaim land for industry and agriculture. This editorial lays out the issues, illuminates the US stand on the 1997 Mine Ban Treaty, and recommends that physicians lend their credibility and support to the U.S. Campaign to Ban Land Mines.
Available online at: http://www.annals.org/
- Correlates of violent assault among young male primary care patients. Rich JA; Sullivan LM. J Health Care Poor Underserved, 2001; 12(1):103-112.
Correlates of violent assault (defined here as having been shot, stabbed, shot at, or beaten) were identified among young male primary care patients. Data were analyzed from a cohort of young men ages 17 to 29 during their initial visits to an urban primary care facility. Each underwent a clinical assessment, including a self-report health inventory and provider history. In multivariable analysis, history of incarceration (odds ratio [OR] = 6.29, 95 percent confidence interval [CI], 2.34-16.89), having children (OR = 3.06, 95 percent CI, 1.30-7.17), and a high school education or less (OR = 0.69, 95 percent CI, 0.50-0.96) were significantly associated with increased likelihood of violent assault. Patients reporting more serious traumatic experiences, such as incarceration, witnessing violence, or carrying a weapon, had the highest risk (OR = 9.91, 95 percent CI, 4.0-24.57). These findings may help primary care physicians identify young men at risk for violence and foster better interventions.
Back to "New This Week" Menu
|
|
