A two-stage model of peer influence was proposed. The model served as a framework for examining individual and relationship-specific differences in susceptibility to influence. The two stages are (1) The acquisition of a peer context and (2) conforming to the behavior of a peer. Data from a four-wave longitudinal study were used to assess (1) the initial selection of cigarette- and alcohol-using peers and (2) influence from peers. Relationship factors and variables identified as risk factors for substance use were hypothesized to increase susceptibility to peer influence. The results indicated that adolescents who did not value school achievement or spending time with parents were more apt than others to choose friends who smoked cigarettes more than they did. Adolescents who chose friends who drank more than they did not differ from other adolescents on any of the risk factors. Thus, low-risk adolescents were as likely to acquire a friend context where drinking was likely to occur as were adolescents who had more risk factors. When the second stage was examined, only high peer acceptance and high friendship quality resulted in adolescents being more apt to conform to their friend's substance-use behaviors.
Correspondence: F. Javier Alvarez, Department of Pharmacology and Therapeutics, Faculty of Medicine, University of Valladolid, 47005 Valladolid, SPAIN; (email: alvarez@med.uva.es).
OBJECTIVE: The aim of this study is to analyze the consumption patterns of medicaments among motor vehicle drivers who attend 'Medical Driving Test Centers' and the relation between habitual consumption of medicaments and fitness to drive.
METHODS: The study was carried out on 8043 drivers who attended 25 Medical Driving Test Centers.
FINDINGS: 24.7% of drivers chronically consume medicaments while 6.8% consume medicaments along with alcohol every day. Of those who chronically consume medicaments with a warning about the medications on driving, 65.8% were considered 'fit' to drive, 27.3% 'fit with restrictions', 5.1% 'suspended' and 0.4% 'unfit'.
COMMENTS: The results show how frequent the consumption of medicaments along with alcohol is and that the great majority of drivers who take medicaments are considered fit to drive.
Study of excessive temperatures in enclosed vehicles.
- Null J. Department of GeoSciences, San Francisco State University. San Francisco: San Francisco State University, (2003).
The full report with tables and charts is available online HERE.
Correspondence: Jan Null, Department of Geosciences, 509 Thornton Hall, San Francisco State University, 1600 Holloway Ave., San Francisco, CA 94132, USA; (email: jnull+ggweather.com).
CONTEXT: Every year dozens of children tragically die due to hyperthermia (heat stroke) after being left unattended in cars, trucks and vans. Over the past five years in the United States 160 deaths of this type have been documented. Hundreds of other children left in similar situations suffer great bodily harm and these numbers do not include similar consequences to infirm adults or animals.
OBJECTIVE: This study quantifies vehicle temperatures and temperature changes with time under a variety of meteorological circumstances.
METHODS: Temperature sensors were placed two types of vehicles on sunny days with ambient temperatures ranging from 70 F (21C) to 100 F (38C). The initial interior temperature was regulated to equal the ambient temperature. The vehicles were in full sun but the sensors in the vehicles were not subject to direct sunlight and were not in direct contact with any interior surface. Using wireless temperature sensors the ambient outside and the inside vehicle temperatures were sampled every five minutes for at least one hour. Tests were conducted with the windows fully closed and also with the windows partially open (approximately 1.5 inches or 3.8 cm) A secondary vehicle (a white mini-van with light gray interior) was used for some tests. Neither vehicle had tinted windows.
Vehicle selection. The primary test vehicle was a 2000 Honda Accord. The exterior color is dark blue and the interior is a medium gray. The windows are not tinted. The secondary vehicle in the study is a 1997 Honda Odyssey minivan which is white in color with a light gray interior and without tinted windows.
Measurements. Ambient temperatures were recorded with a Davis Instruments Vantage Pro Sensor Suite. Wireless temperature sensors were placed in the test vehicles which transmitted to and were archived in the Vantage Pro base station. The temperature sensors had a resolution of 1 F (0.6C) and an accuracy of +/- 1 F (0.6C). All readings were taken out of direct sunlight.
Experimental procedures. Trials were conducted on a number of cloud-free days with varying ambient temperatures. The vehicles were parked facing at approximately a 45 degree angle away from the sun to minimize direct sunlight through the windshield.
FINDINGS: In the sixteen cases with the windows fully closed, the average temperature rise was 19 F (10.6C) in the first 10 minutes or 82% of the total 60 minute rise. After 20 minutes the average rise was 29 F (16.1C) or 89% of the 60 minute total. At the 30 minute mark the average rise was 33 F (18.3C) or 93% of the 60 minute total rise. The average rise after 60 minutes was 43 F (24C) degrees. In trials that exceeded 60 minutes the interior vehicle readings stabilized.
COMMENTS: When outside temperatures exceed 80 F (26.7C) potentially lethal vehicle temperatures of 105 F (40.6C) or greater can be reached in less than 20 minutes. When the outside temperature exceed 88 F (31.1C) lethal readings can be reached in 10 minutes or less. Only minor mitigation achieved by "cracking" the windows or having a vehicle of larger size or a lighter color.
CONTEXT: The home delivery of counseling and devices intended to prevent child injuries could help parents to adopt safe behavior more efficiently.
OBJECTIVES: The aim of the present study was to adapt and test in France a safety kit designed and used in Quebec (Canada). The intervention program (kit delivery and counseling) was assessed by measuring 6 to 8 weeks after a first home visit the percentage of safety changes adopted by the families included in the survey, compared with the pre-intervention situation; and by evaluating the satisfaction of families with their participation in the survey, and the satisfaction of nurses with the use of this new tool.
METHODS: One hundred families from 4 towns in the Hauts-de-Seine department in the Paris suburbs (Boulogne, Chaville, Sevres, Ville d'Avray) were selected by the social services for home visits by nurses or doctors, when their child reached the age of 6 to 9 months. Selection criteria were usually primipara, medical problem, psychological and/or socio-economic difficulties. During the first visit, 49 families (group 1) (1 family lost for follow-up) received the usual informative and preventive counseling, and a kit including preventive devices and pamphlets about indoor injuries and ways of avoiding them. The other 50 families (group 2) received counseling but not the kit. Between 6 and 8 weeks later, a second home visit was paid to all selected families.
FINDINGS: Between the first and the second visits, the percentage of safety improvement was significantly higher in group 1 (with the kit) than in group 2 (without the kit). This improvement mainly related to the risk of fall (P < 0.02), fire and burns (P < 0.001), poisoning (P < 0.01) and suffocation (P < 0.001). When the analysis was focused on safety improvement related to devices provided in the kit, the difference between the 2 groups was significant: 67.8% of safety improvement in group 1 vs 38.1% in group 2 (P < 0.001). The relative risk (RR) was 1,78 (95% confidence interval (CI): 1,18-2,68). Even for items not related to the devices provided, the difference remained significant: 48.6% in group 1 vs 28.8% in group 2 (P < 0.001); RR =1,31 (95% CI: 1,23-1,40). The perceived usefulness of the kit was discussed in a focus group with all nurses and doctors. On the whole, the judgment was very positive, mainly because the kit facilitated the introduction of the notion of accident prevention in the discussion at home.
COMMENTS: As in the Canadian survey, our results indicate that routine home visits by the social services offer a good opportunity to introduce the subject of child injury prevention. Free delivery of prevention kit and simple counseling allow often deprived families to modify their behavior and to arrange their apartments so as to reduce risks.
Managers' attitudes towards safety and accident prevention.
- Rundmo T and Haleb AR. Saf Sci 2003; 41(7): 557-574.
Correspondence: Torbjorn Rundmo, Department of Psychology, Norwegian University of Science and Technology, 7491, Trondheim, NORWAY; (email: torbjorn.rundmo@sv.ntnu.no).
The aims of the present paper are to determine attitudes towards safety and accident prevention among presidents, vice-presidents and managers in the industrial company Norsk Hydro and to analyse the associations between attitudes, behavioral intentions and behavior. The sample consisted of 210 respondents and the data was collected in 1997 and 1998 among participants at the Hydro Management Safety Training Workshops, which is a safety course for the managers employed by the company. Managers' attitudes are interesting because they may affect behavioral intentions and the managers' behavior related to the achievement of safe working practices. Eight attitudinal dimensions explained up to nearly 40% of the variance in behavior. The study shows that safety attitudes may be an important causal factor for managers' behavioral intentions as well as behavior. High management commitment, low fatalism, high safety priority, and high risk awareness seemed to be particularly important attitudes for managers.
Falls in residential carpentry and drywall installation: findings from active injury surveillance with union carpenters.
- Lipscomb HJ, Dement JM, Nolan J, Patterson D, Li L, Cameron W. J Occup Environ Med 2003; 45(8): 881-890.
Correspondence: Hester J Lipscomb, Department of Community and Family Medicine, Duke University Medical Center, Durham, North Carolina, USA; (email: hester.lipscomb@duke.edu).
Active injury surveillance was conducted with a large, unionized workforce of residential and drywall carpenters over a 3-year period. Injured carpenters were interviewed by trained carpenter investigators and sites were visited where falls occurred. Qualitative information was collected on exposures, risk perception, training, and mentoring. Falls accounted for 20% of injuries. Same-level falls were often related to weather, carrying objects-sometimes with an obstructed view-housekeeping, terrain of the lot, and speed of work. Falls from height occurred from a variety of work surfaces and involved ladders, scaffolding, roofs, work on other unsecured surfaces, unprotected openings, speed, and weather conditions. Recognized fall protection strategies, such as guard rails, toe boards, tying off to appropriate anchors, and guarding openings, would have prevented many of these falls; these practices were not the norm on many sites.
Correspondence: Venkataraman N. Shankar, Department of Civil and Environmental Engineering, University of Washington, Box 352700, Seattle, WA 98195, USA; (email: vns@u.washington.edu).
This paper presents an empirical inquiry into the predictive modeling of crashes involving pedestrians and motorized traffic on roadways. Empirical models based on the negative binomial distribution and mixing distributions, such as the zero-inflated Poisson distribution, are presented and discussed in terms of their applicability to pedestrian crash phenomena. Key modeling issues relating to the presence of excess zeros as well as unobserved heterogeneity in pedestrian crash distributions are addressed. The empirical results show that zero-inflated count distributions, such as the zero-inflated Poisson, are promising methodologies for providing explanatory insights into the causality behind pedestrian-traffic crashes.
- Nelson R, Prinzmetal W. Vis Cogn 2003; 10(6): 715-728.
Correspondence: William Prinzmetal, Psychology Department, University of California, 3210 Tolman Hall #1650,
Berkeley, CA 94720-1650, USA; (email: wprinz@socrates.berkeley.edu).
Studies have found that rolling the visual environment affects observers' perception of gravitational vertical and horizontal and that pitching the environment affects observers' perception of pitch. However, the relationship between these two perceptions is not fully understood. In the present work, observers performed three tasks while in a visual surround whose pitch and roll was manipulated. In the first task, observers adjusted a rod in the frontal-parallel plane to the horizontal (roll). In a second task, they adjusted a rod along a plane parallel to straight-ahead to the vertical (pitch). In the final task ("in-between"), they adjusted a rod midway between the first two conditions. The typical pitch and roll effects were found, as well as a contribution of both pitch and roll to the in-between task. No interaction between pitch and roll effects was found, indicating independent cognitive representations.
Sampling efficiency and internal noise for motion detection, discrimination, and summation.
- Simpson WA, Falkenberg HK, Manahilov V. Vision Res 2003; 43(20): 2125-2132.
By comparing real observers to an ideal observer, previous studies have found that the detection of
static patterns is limited by internal noise and by imperfect sampling efficiency. We developed and applied ideal observer models for the detection, discrimination, and summation of oppositely drifting gratings in Gaussian white noise. The three tasks share a common source of internal noise. The sampling efficiencies were on the order of 1-2% except for much lower efficiency in direction discrimination for faster moving gratings. The efficiency of direction discrimination relative to detection systematically declines as the speed is increased from 1 to 6 Hz. These results suggest that observers use mismatched filters tuned to slow speeds regardless of the signal speed. Human visual motion sensing appears to use distorted representations of the incoming signals, and this distortion is a major limitation to visual performance.
Discrimination of travel distances from 'situated' optic flow.
Frenz H, Bremmer F, Lappe M. Vision Res 2003; 43(20): 2173-2183.
Correspondence: Markus Lappe, Psychologisches Institut II, Westfälische Wilhelms-Universität Münster, 48149, Münster, GERMANY; (email: mlappe@psy.uni-muenster.de).
Effective navigation requires knowledge of the direction of motion and of the distance traveled. Humans can use visual motion cues from optic flow to estimate direction of self-motion. Can they also estimate travel distance from visual motion?Optic flow is ambiguous with regard to travel distance. But when the depth structure of the environment is known or can be inferred, i.e., when the flow can be calibrated to the environmental situation, distance estimation may become possible. Previous work had shown that humans can discriminate and reproduce travel distances of two visually simulated self-motions under the assumption that the environmental situation and the depth structure of the scene is the same in both motions. Here we ask which visual cues are used for distance estimation when this assumption is fulfilled. Observers discriminated distances of visually simulated self-motions in four different environments with various depth cues. Discrimination was possible in all cases, even when motion parallax was the only depth cue available. In further experiments we ask whether distance estimation is based directly on image velocity or on an estimate of observer velocity derived from image velocity and the structure of the environment. By varying the simulated height above ground, the visibility range, or the simulated gaze angle we modify visual information about the structure of the environment and alter the image velocity distribution in the optic flow. Discrimination ability remained good. We conclude that the judgment of travel distance is based on an estimate of observer speed within the simulated environment.
Paracetamol (Acetaminophen) poisoning - impact of pack size restrictions.
- Hughes B, Durran A, Langford NJ, Mutimer D. J Clin Pharm Ther 2003; 2008(4): 307-310.
Correspondence: Nigel Langford, West Midlands Centre for Adverse Drug Reaction Reporting, City Hospital, Dudley Road, Birmingham B18 7QH, UK; (email: nigel.langford@swbh.nhs.uk).
BACKGROUND: Pack sizes of paracetamol (Acetaminophen) available to the public were reduced by legislation in 1998.
OBJECTIVE: To study the effect of the legislation on paracetamol poisoning related admissions to an accident and emergency department and to a tertiary referral liver unit.
METHOD: Data were obtained from the University Hospitals, Birmingham, UK (UHB) Trust Information Service and the Queen Elizabeth Hospital liver unit records on (a) the number of patients admitted to hospital because of paracetamol overdose and (b) the number of patients admitted to the liver unit with parcetamol-induced hepatotoxicity.
FINDINGS: Prior to legislation, an average of 360 people a year were admitted to UHB. However, following the change in legislation the number of admissions has fallen to an average of 250 people per year. This represents a reduction of 31%. Prior to legislation, an average of 76 people per year were admitted to the liver unit. Post-legislation this number has dropped to an average of 38 per year representing a reduction of 50%.
DISCUSSION: Legislation restricting paracetamol pack-size reduced the incidence and severity of poisoning.
The Southern Region Pesticide Safety Education Center: A regional approach to training-the-trainer.
Correspondence: Wayne Buhler, Assistant Professor, Department of Horticultural Science, North Carolina State University, Raleigh, NC 27695, USA; (email: wayne_buhler@ncsu.edu).
The Southern Region Pesticide Safety Education Center was created in 2001 as a "train-the-trainer" program for Cooperative Extension Service agents and state pesticide inspectors from the thirteen-state Southern Region of the United States Department of Agriculture. The goal of the center was to equip Extension agents and state pesticide inspectors with the knowledge and resources necessary for more effective and credible pesticide safety education and regulation. This paper describes the initial program offering of the Center: an on-line (Internet) tutorial and a three-day workshop emphasizing hands-on methods for teaching proper pesticide handling.
Correspondence: Ernesto Caffo, Department of Psychiatry and Mental Health, University of Modena, Largo del Pozzo 71, 41100 Modena, ITALY; (email: caffo@unimo.it).
Each year millions of children are exposed to some form of extreme traumatic stressor. These traumatic events include natural disasters (e.g., tornadoes, floods, hurricanes), motor vehicle accidents, life-threatening illnesses and associated painful medical procedures (e.g., severe burns, cancer, limb amputations), physical abuse, sexual assault, witnessing domestic or community violence, kidnapping, and sudden death of a parent. During times of war, violent and nonviolent trauma (e.g., lack of fuel and food) may have terrible effects on children's adjustment. The events of September 11, 2001 and the unceasing suicidal attacks in the Middle East underscore the importance of understanding how children and adolescents react to disasters and terrorism. The body of literature related to children and their responses to disasters and trauma is growing. Mental health professionals are increasing their understanding about what factors are associated with increased risk (vulnerability) and affect how children cope with traumatic events. Researchers recognize that children's responses to major stress are similar to adults' (reexperiencing the event, avoidance, and arousal) and that these responses are not transient. A review of the literature indicates that PTSD is the most common psychiatric disorder after traumatic experiences, including physical injuries. There is also evidence for other comorbid conditions, including mood, anxiety, sleep, conduct, learning, and attention problems. In terms of providing treatment, CBT emerges as the best validated therapeutic approach for children and adolescents who experienced trauma-related symptoms, particularly symptoms associated with anxiety or mood disorders. The best approach to the injured child requires injury and pain assessment followed by specific interventions, such as pain management, brief consultation, and crisis intervention immediately after the specific traumatic event. Family support also may be necessary to help the family through this difficult period. The main conclusion that arises from the research on resilience in development is that extraordinary resilience and recovery power of children depend on basic human protective systems operating in their favor. This finding has produced a fundamental change in the framework for understanding and helping children at high risk or already in trouble. This shift is evident in a changing conceptualization of the goals of prevention and intervention that currently address competence and problems. Strategies for fostering resilience described in this article should be tested in future controlled psychotherapy trials to verify their efficacy on children's protective factors.
The objective of this study was to conduct a systematic analysis of the literature to assess the efficacy of stretching for prevention of exercise-related injury. Randomized clinical trials (RTCs) and controlled clinical trials (CCTs) investigating stretching as an injury prevention measure were selected. A computer-aided search of the literature was conducted for relevant articles, followed by assessment of the methods of the studies. The main outcome measures were scores for methodological quality based on four main categories (study population, interventions, measurement of effect, and data presentation and analysis) and main conclusions of authors with regard to stretching. One RCT (25%) and three CCTs (100%) concluded that stretching reduced the incidence of exercise-related injury. Three RCTs (75%) concluded that stretching did not reduce the incidence of exercise-related injury. Only two studies scored more than 50 points (maximum score=100 points) indicating that most of the studies selected were of poor quality. Neither of the two highest scoring RCTs showed positive effects for stretching. Due to the paucity, heterogeneity and poor quality of the available studies no definitive conclusions can be drawn as to the value of stretching for reducing the risk of exercise-related injury.
The development of an assessment to evaluate behavioral factors associated with falling.
- Clemson L, Cumming RG, Heard R. Am J Occup Ther 2003; 57(4): 380-388.
Correspondence: Lindy Clemson, School of Occupation & Leisure Sciences, Faculty of Health Sciences, The University of Sydney, PO Box 170, Lidcombe 1825, AUSTRALIA; (email: L.Clemson@fhs.usyd.edu.au).
The purpose of this study was to report the development of the Falls Behavioral (FaB) Scale for Older People, an assessment designed to evaluate behavioral factors that could potentially protect against falling. Instrument development included content analysis, expert review, and factor analysis. Ten behavioral dimensions were identified including Cognitive Adaptations, Protective Mobility, Avoidance, Awareness, Pace, Practical Strategies, Displacing Activities, Being Observant, Changes in Level, and Getting to the Phone. The final 30-item scale had a Content Validity Index of 0.93. Test-retest reliability was ICC = 0.94 (p < .01). Construct validity was established by showing that, as expected, scale scores were positively associated with increasing age (rs = 0.46, p < .01) and negatively associated with greater physical mobility (rs = -0.68, p < .01). People who had fallen utilized safer behaviors than those who had not reported a fall (p < .05) providing a benchmark for using the scale in future studies. The FaB is an easily completed, reliable, and valid tool for determining the presence or absence of protective behaviors. It has potential to assist in goal setting for falls prevention and to evaluate behavioral outcomes of fall prevention programs.
Correspondence: Lise Miauton, Adolescent Health Research Unit, Institute of Social and Preventive Medicine, University of Lausanne, Bugnon 17, 1005, Lausanne, SWITZERLAND; (email: unavailable).
The objective was to evaluate the prevalence of chronic conditions (CC) in adolescents in Switzerland; to describe their behavior (leisure, sexuality, risk taking behavior) and to compare them to those in adolescents who do not have CC in order to evaluate the impact of those conditions on their well-being. The data were obtained from the Swiss Multicenter Adolescent Survey on Health, targeting a sample of 9268 in-school adolescents aged 15 to 20 years, who answered a self-administered questionnaire. Some 11.4% of girls and 9.6% of boys declared themselves carriers of a CC. Of girls suffering from a CC, 25% (versus 13% of non carriers; P=0.007) and 38% of boys (versus 25%; P=0.002) proclaimed not to wear a seatbelt whilst driving. Of CC girls, 6.3% (versus 2.7%; P=0.000) reported within the last 12 months to have driven whilst drunk. Of the girls, 43% (versus 36%; P=0.004) and 47% (versus 39%; P=0.001) were cigarette smokers. Over 32% of boys (versus 27%; P=0.02) reported having ever used cannabis and 17% of girls (versus 13%; P=0.013) and 43% of boys (versus 36%; P=0.002) admitted drinking alcohol. The burden of their illness had important psychological consequences: 7.7% of girls (versus 3.4%; P=0.000) and 4.9% of boys (versus 2.0%; P=0.000) had attempted suicide during the previous 12 months. Conclusion: experimental behaviors are not rarer in adolescents with a chronic condition and might be explained by a need to test their limits both in terms of consumption and behavior. Prevention and specific attention from the health caring team is necessary.
Safety diagnosis criteria - development and testing.
- Tinmannsvik RK and Hovden J. Saf Sci 2003; 41(7): 575-590.
Correspondence: Ranveig Kviseth Tinmannsvik, Norwegian University of Science and Technology, Department of Industrial Economics and Technology Management, N-7065, Trondheim, NORWAY; (email: ranveig.k.tinmannsvik@iot.ntnu.no).
Criteria for evaluating occupational safety in industrial organizations have been developed and tested. These criteria were designed for use in safety diagnoses, i.e. planned and systematic investigations of the organization and the administrative procedures to control safety. The safety criteria were derived from previous performed safety management analyses and safety audit tools. A questionnaire survey was carried out in order to validate the criteria for evaluating safety in industrial organizations. Production personnel, safety professionals and line managers from 14 companies (aluminum production plants and meat production industry) answered the questionnaire. Strong correlation were found between the respondents' overall evaluation of safety and the evaluations of safety specific factors (management factors mainly to promote safety), while the injury frequency rate was strongly correlated to the evaluations of general management factors (management factors to improve the production system and organization in general). The overall evaluation of safety correlated significantly with the injury frequency rate. This indicates that the proposed Safety Diagnosis Criteria can provide a valid measurement of safety in industrial organizations.
Graphical approach to replacement policy of a k-out-of-n system subject to shocks.
Correspondence: Muh-Guey Juang, Department of Sport Management, National Taiwan College of Physical Education, Chia-yi, Taiwan, ROC; (email: mgjuang@mars.ntcpe.edu.tw).
This paper examines the problem of determining an optimal age replacement by incorporating minimal repair, planned replacement, and unplanned replacement into a k-out-of-n system subject to shocks. In particular, two kinds of solution procedures are discussed to obtain the optimal replacement age, one is a straightforward procedure, and the other is a graphical approach based on the Total Time on Test (TTT) concept. A statistical solution procedure for estimating the optimal replacement time is proposed, and the optimal policies are obtained directly from real data.
Direct costs and patterns of injuries among residential carpenters, 1995-2000.
- Lipscomb HJ, Dement JM, Behlman R. J Occup Environ Med 2003; 45(8): 875-880.
Correspondence: Hester J Lipscomb, Department of Community and Family Medicine, Duke University Medical Center, Durham, North Carolina, USA; (email: hester.lipscomb@duke.edu).
Workers' compensation records for residential contractors were combined with hours worked provided by the union to examine injury rates and costs among union carpenters between 1995 and 2000. Brief text descriptions were reviewed to describe more costly injuries. Costs per hour worked decreased over 6 years, largely because of declines in rates and mean costs for falls from elevations. Higher costs were associated with injuries from falls, raising framed walls, setting steel I-beams, and pneumatic nail guns. Prevention priorities should include fall protection; methods to safely set steel beams, raise and brace framed walls; and steps to prevent injuries from pneumatic tools. Cost data provide an important measure that is useful in focusing prevention; combined with even limited descriptions of injuries target areas for intervention can be identified based on frequency or severity.
The Safe Schools/Healthy Students (SS/HS) initiative: Lessons learned from implementing comprehensive youth development programs.
- Furlong M, Paige LZ, Osher D. Psychol Schs 2003; 40(5): 447-456.
Correspondence: Michael Furlong, Gevirtz Graduate School of Education, Center for School-Based Youth Development, Santa Barbara, CA 93106, USA; (email: mfurlong@education.ucsb.edu).
This article provides an overview of a special issue of Psychology in the Schools that examines the implementation of the Safe Schools/Healthy Students (SS/HS) Initiative in seven local communities. An overview of the SS/HS Initiative is provided. Critical lessons learned from the seven sites are discussed with a focus on the special role that school psychologists can play in implementing these complex violence prevention programs.
Promoting safe schools and healthy students in rural Pennsylvania.
- Welsh J, Domitrovich CE, Bierman K, Lang J. Psychol Schs 2003; 40(5): 457-472.
Correspondence: Janet Welsh, Penn State Prevention Research Center, 106 Henderson Building, University Park, PA, 16802, USA; (email: jaw900@psu.edu).
The Safe Schools/Healthy Students (SS/HS) Initiative is currently underway in the Tyrone Area School District. Tyrone is a rural community characterized by high levels of poverty, unemployment, and youth problems including substance use and alienation from school and community. Its strengths include strong administrative leadership and prior successful collaboration with Penn State University. The goals of the SS/HS Initiative involve reducing risk and building competencies for students and their families through integration of law enforcement and mental health into school-based prevention efforts. The programs include early childhood, elementary, and secondary school components; and also district-wide components that span these developmental levels. Despite challenges associated with the integration of different professional perspectives into the school environment, the Tyrone SS/HS Initiative has been quite successful. Program evaluation is varied, and reflects the different programs and student populations served. Currently, plans for sustaining and institutionalizing SS/HS programs are underway in Tyrone.
Safe Schools/Healthy Students initiative: Pinellas County, Florida.
- Armstrong KH, Massey OT, Boroughs M, Bailey R, LaJoie D. Psychol Schs 2003; 40(5): 481-501.
Correspondence: Kathleen Hague Armstrong, University of South Florida, Department of Child and Family Studies, 13301 N. Bruce B. Downs Blvd., Tampa, FL 33612-3807, USA; (email: karmstrong@fmhi.usf.edu).
The Safe Schools/Healthy Students (SS/HS) Initiative in Pinellas County, FL, emerged as a part of a broader local effort to implement creative educational and mental health programs to support children and families. This initiative focused on capacity building, prevention, and intervention efforts and comprehensive evaluation to address the barriers to learning and enhance healthy development. This article describes Pinellas County's plan, and highlights the instrumental roles played by school psychologists, which included grant writing, program and resource coordination, clinical services, program evaluation, staff training, parent advocacy, and steering committee membership. Promising outcomes and generalization of these findings to other communities is also discussed.
Creating synergy through collaboration: Safe schools/ healthy students in Salinas, California.
Correspondence: Ken Feske, Safe Schools/Healthy Students, Salinas Union High School District, 546 Lincoln Avenue, Salinas, CA 93901, USA; (email: kfeske@salinas.k12.ca.us).
In Salinas, a city of 150,000 on the Central Coast of California, an $8 million federal grant program is helping children and their families grapple with issues pertaining to violence, substance abuse, mental health, and academic success. In just two years, the program has helped educators and service providers deter school crime, provide on-campus therapy to troubled youth, increase participation in parenting programs, and decrease truancy at several schools. Most importantly, the Salinas initiative has helped providers coordinate services to children and families who need them most. Project directors say that approach will be crucial as they search for new ways to sustain Safe Schools/Healthy Students (SS/HS)-funded programs.
Face fidelity: Perspectives from a local evaluation of the Safe Schools/Healthy Students Initiative.
The creation of a federal Safe Schools/Healthy Students (SS/HS) Initiative reflects a growing level of concern across the United States that many children do not feel safe at school, and that teachers must receive a new level of training to better equip themselves to manage a diverse student population. PROJECT BLUE was funded during the first phase of this initiative and proposed to provide students in its District with a range of services to improve school safety, decrease school violence, decrease alcohol and drug use, and improve student mental health. The local evaluation team collected information regarding project implementation and its impact on school safety, school climate, and teacher preparedness to manage student misbehavior. Selected results are highlighted in the article. However, the primary purpose of this article is to document lessons learned from the evaluation of this project. Lessons learned are presented in four areas: leadership, communication, system change efforts, and local evaluation of federal initiatives.
Rural underpinnings for resiliency and linkages (rural): A safe schools/healthy students project.
Rural Underpinnings for Resiliency and Linkages (RURAL) is an example of a Safe Schools/Healthy Students (SS/HS) project. RURAL provides services to children and families in a rural Kansas county. The county's rates of juvenile alcohol and illicit drug use are higher than state averages. The RURAL project was designed to enhance existing partnerships among three school districts, the local community mental health center, law enforcement, the regional prevention center, and Fort Hays State University. A significant number of evidence-based strategies were implemented in the schools and community in a short period of time. Using a public health approach to increase school safety and promote healthy behaviors, RURAL introduced strategies designed to provide universal prevention for the school population, early intervention for at-risk children and families, and intensive services for those with the greatest needs. Services were provided to students (preschool-young adults) and their families. School psychologists held key roles in the development, implementation, and management of the project. Preliminary evaluation findings are presented, and the importance of local process and outcome evaluation is discussed.
Correspondence: Marla E. Eisenberg, Division of General Pediatrics and Adolescent Health, School of Medicine and Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis 55455, USA; (email: eisen012@umn.edu).
CONTEXT: Verbal harassment, such as bullying and hate speech, has received considerable attention recently, but less is known about weight-based teasing and its potential harmful effects on young people's psychosocial well-being.
OBJECTIVE: To determine the associations of weight-based teasing and body satisfaction, self-esteem, depressive symptoms, and suicidal ideation and suicide attempts using a large sample of adolescents.
DESIGN: Secondary analysis of survey and anthropometric data. SETTING: Ethnically and socioeconomically diverse communities in the urban and suburban school districts of the Minneapolis/St Paul metropolitan area.
PARTICIPANTS: A school-based sample of 4746 adolescents in grades 7 to 12 at 31 public middle schools and high schools.
MAIN OUTCOME MEASURES: Weight-based teasing from peers or family members, body satisfaction, self-esteem, depressive symptoms, and suicidal ideation and suicide attempts.
FINDINGS: Of the eligible students, 81.5% participated; 30.0% of adolescent girls and 24.7% of adolescent boys were teased by peers, and 28.7% of adolescent girls and 16.1% of adolescent boys were teased by family members. Approximately 14.6% of adolescent girls and 9.6% of adolescent boys reported teasing from both of these sources. Teasing about body weight was consistently associated with low body satisfaction, low self-esteem, high depressive symptoms, and thinking about and attempting suicide, even after controlling for actual body weight. These associations held for adolescent boys and girls, across racial, ethnic, and weight groups. Furthermore, teasing from 2 sources was associated with a higher prevalence of emotional health problems than either teasing from a single source or no teasing.
COMMENTS: Physicians and other health care providers should recognize the importance of weight-based teasing for young patients. Policy, programs, and education should focus on increasing awareness of what constitutes weight-based teasing, its potentially harmful effects on adolescents' emotional well-being, and reduction of this behavior.
Risk of suicide in twins: 51 year follow up study.
- Tomassini C, Juel K, Holm NV,, Skytthe A, Christensen K. BMJ 2003; 327(7411): 373-374.
Correspondence: Kaare Christensen, Danish Twin Registry, Institute of Public Health, University of Southern Denmark, Sdr Boulevard 23A, DK-5000 Odense, DENMARK; (email: kchristensen@health.sdu.dk).
CONTEXT: Strong family ties and commitments are known to be important in the prevention of suicide. Having parents alive and together, being married, and having young children are negatively correlated with risk of suicide. The presence of siblings, however, has rarely been looked at in studies of suicide or attempted suicide. A Danish register study found no protective effect associated with having siblings, but neither the age nor the sex of siblings was considered. Twins represent a unique sibling relationship. They not only share the same family and social environment at least for the first part of their lives, but they also show a higher level of closeness both in terms of the number of years spent together before leaving the parental home and in the frequency of contacts afterwards.
OBJECTIVE: We investigated whether the suicide rate in twins was different to that in the general population.
METHODS: Through the population based Danish twin registry we identified same sex twins born from 1870 to 1930 and established date and cause of death from 1943 to 1993 through the Danish registry of causes of death. We included 21 653 individual twins alive on 1 January 1943, 13 318 (62%) of whom died during the follow up.
From 1951 we coded the cause of death according to the ICD-6, ICD-7, and ICD-8 (international classification of diseases, sixth, seventh, and eighth editions). For deaths from before 1951 we used the coding system of the Danish registry of causes of death. Here we report on the deaths coded as suicide (1943-50: Danish registry codes 900-930; 1951-68: ICD-6 and 7 codes 970-979; 1969-93: ICD-8 codes 950-969). We calculated the expected number suicides in the twin population by multiplying the observed person years with suicide rates for Denmark stratified for sex, one year age group, and five year calendar period. Standardized suicide rates were calculated as the observed number of suicides divided by the expected number of suicides.
FINDINGS: As previously reported the twin cohorts had a mortality pattern similar to that in the general population (standardized mortality 0.95 for men and 0.98 for women). However, twins had a substantially lower suicide rate compared with the general population, with 211 observed suicides versus 292.8 expected, corresponding to a standardized suicide rate of 0.74 for men (95% confidence interval 0.62 to 0.88) and 0.69 for women (0.55 to 0.86) (table). The suicide risk for twins was consistently lower for both men and women in all six 10 year birth cohorts. We also considered the risk of suicide stratified by cohorts and follow up time (1-25 years and 25 years). All strata consistently showed a reduced suicide risk for twins, indicating no age or cohort differences. Furthermore, the suicide rate was of similar size in monozygotic and dizygotic twins.
COMMENTS: Twins have a reduced risk of suicide, which supports the hypothesis that strong family ties reduce the risk for suicidal behavior. This finding was consistent across cohorts, sex, and zygosity. As we used population based register data there was little room for selection bias. The strongest risk factor for suicide is mental illness, but other Danish register studies have found mental illness to be slightly more common among twins than among singletons. This should lead to a higher proportion of twins committing suicide compared with the general population, but our findings show exactly the opposite, further underscoring the importance of strong family ties.
Risk factors for male and female suicide decedents ages 15-64 in the United States. Results from the 1993 National Mortality Followback Survey.
Correspondence: Hsiang-Ching Kung, National Center for Health Statistics, Centers for Disease Control and Prevention, 3311 Toledo Road, Room 7318, Hyattsville, MD, 20782, USA; (email: hck0@cdc.gov).
CONTEXT: Few controlled studies have examined possible gender differences in risk factors for suicide. This paper examined the associations of certain risk factors with suicide among males and females aged 15-64, and the variation in the associations by gender.
METHODS: A case-control study was constructed from the 1993 National Mortality Followback Survey in the United States. Information concerning age, race, education, living arrangement, marijuana use, excessive alcohol consumption, access to a firearm, depressive symptoms, and mental health service utilization was collected via death certificate and proxy respondent. Decedents between the ages of 15 and 64 who died by suicide were compared with those who died of natural causes. Logistic regression analysis was used to examine the associations between risk factors and suicide in males and females.
FINDINGS: In comparison to those who died of natural causes, we found that marijuana use, excessive alcohol consumption, and access to a firearm increased the odds of suicide for both genders. For male decedents, the presence of depressive symptoms was more frequently reported for the suicide decedents in the 45-64 age group, and the proportion of mental health service use was higher among suicide decedents who did not complete high school. For female decedents, depressive symptoms were related to suicide in all age groups, and the use of mental health services was more frequent in the suicides of the 15-29 and 45-64 age groups.
COMMENTS: The risk factors of marijuana use, excessive alcohol use, and firearm accessibility in the last year of life increased the odds of suicide in both genders. When compared to natural deaths, depressive symptomatology was common in female suicide decedents, whereas it was only associated with older age among male suicide decedents. The interactions of mental health service use with demographic factors suggested possible gender differences in suicide risk associated with severity of mental disorders, as well as the likelihood of treatment seeking.
The impact of parental status on the risk of completed suicide.
CONTEXT: Although some studies suggest that parenthood is associated with a reduced suicide risk, the impact of children on parental suicide has rarely been documented.
METHODS: This study investigates the impact of parental status on the risk of completed suicide in the context of other risk factors. A nested case-control design is used, matching for age, sex, and calendar time. The study is based on 4 Danish longitudinal registers, including 18,611 suicides of individuals aged 18 to 75 years from January 1, 1981, to December 31, 1997, and 372,220 matched control subjects. Information about children and subject's individual background is retrieved and merged. Data are analyzed using conditional logistic regression, yielding odds ratios interpreted as incidence rate ratios.
FINDINGS: The presence of children is protective against suicide in parents in terms of having children and, to a higher degree, having a young child; these effects exist even when adjusted for marital, socioeconomic, and psychiatric status; and their influences are much stronger in women than in men. At the same time, parents of children with a hospitalized psychiatric disorder and parents of children who have died are at an increased risk for suicide. A child dying during early childhood has a strong effect on suicide in parents, and a suicidal death of a child increases the risk of parental suicide more than a nonsuicidal death. The suicide risk is particularly high in the first month after losing a child.
COMMENTS: The impact of children on parental suicide can be protective because of having children. It can also be negative, for example, when losing a child, particularly if the child dies during early childhood; the risk is particularly high during the first month after the loss.
Dimensions of suicidal behavior according to patient reports.
- Diaz FJ, Baca-Garcia E, Diaz-Sastre C, Garcia Resa E, Blasco H, Braquehais Conesa D, Saiz-Ruiz J, De Leon MD J. Eur Arch Psychiatry Clin Neurosci 2003; 253(4): 197-202.
Correspondence: F.J. Diaz, Dept. of Statistics, Universidad Nacional Medellin, COLUMBIA; (email: unavailable).
Five factor analyses with limitations explored the Suicidal Intent Scale (SIS) subscales reflecting suicidal behavior dimensions. This larger sample study conducts an exploratory factor analysis of the SIS. Two large samples of suicide attempters (N= 435 and N= 252) from a general hospital were studied. The validity of SIS subscales obtained from the factor analysis was investigated by examining the association between the subscales and clinical variables. There were two factors: expected lethality and planning. In both samples, male gender and depression tended to be associated with higher scores in both subscales (small to medium effect sizes). Hospitalization was associated with higher scores in both SIS subscales (medium to large effects) suggesting that these subscales were reasonably good predictors of suicide attempt severity. Clinicians assessing patient reports to establish the severity of suicide attempts need to ask questions regarding both dimensions: expected lethality and planning.
Douglas W. Harwood, Midwest Research Institute, 425 Volker Boulevard, Kansas City, MO 64110-2299, USA; (email: dharwood@mriresearch.org).
OBJECTIVES: This paper presents the results of an evaluation of the safety effects of providing left- and right-turn lanes for at-grade intersections. The research not only evaluated the safety effectiveness of left- and right-turn lane improvements, but also compared the performance of these three alternative approaches in making such evaluations.
METHODS: Geometric design, traffic control, traffic volume, and traffic accident data were gathered for a total of 280 improved intersections, as well as 300 similar intersections that were not improved during the study period. The types of improvement projects evaluated included installation of added left-turn lanes, added right-turn lanes, and extension of the length of existing left- or right-turn lanes. An observational before-after evaluation of these projects was performed using several alternative evaluation approaches. Three contrasting approaches to before-after evaluation were used: the yoked comparison or matched-pair approach, the comparison group approach, and the Empirical Bayes approach. The research developed quantitative safety effectiveness measures for installation design improvements involving added left-turn lanes and added right-turn lanes.
FINDINGS: Added left-turn lanes are effective in improving safety at signalized and unsignalized intersections in both rural and urban areas. Installation of a single left-turn lane on a major-road approach would be expected to reduce total intersection accidents at rural unsignalized intersections by 28 percent for four-leg intersections and by 44 percent for three-leg intersections. At urban unsignalized intersections, installation of a left-turn lane on one approach would be expected to reduce accidents by 27 percent for four-leg intersections and by 33 percent for three-leg intersections. At four-leg urban signalized intersections, installation of a left-turn lane on one approach would be expected to reduce accidents by 10 percent.
Added right-turn lanes are effective in improving safety at signalized and unsignalized intersections in both rural and urban areas. Installation of a single right-turn lane on a major-road approach would be expected to reduce total intersection accidents at rural unsignalized intersections by 14 percent and accidents at urban signalized intersections by 4 percent. Right-turn lane installation reduced accidents on individual approaches to four-leg intersections by 27 percent at rural unsignalized intersections and by 18 percent at urban signalized intersections.
For both left- and right-turn lane improvements, the results obtained from this research are within the range of all previous studies reported in the literature.
In the various evaluations performed, the effectiveness of turn-lane improvements in reducing fatal and injury accidents was greater than for total accidents, in some cases, and less than for total accidents in others. Overall, there is no indication that any type of turn lane improvement is either more or less effective for different accident severity levels.
The research concluded that the Empirical Bayes evaluation method provided the most accurate and reliable results.
Dynamic behavior of a closed loop driver-car-caravan system.
- Festa P, Mangialardi L, Mantriota G. Int J Vehicle Des 2003 31(4): 408-426.
Correspondence: Giacomo Mantriota, Dipartimento di Ingegneria Meccanica e Gestionale - Politecnico
di Bari Viale Japigia, 182-70126 Bari, ITALY; (email: mantriota@poliba.it).
This work studies the influence of the driver on the dynamic behavior of a car-caravan (car-trailer) system. A plane closed-loop 4 DOF linearized model was developed and the feedback was achieved with a compensation tracking model. The analysis of driver-car interaction was studied through the correlation of different ways of driving and effects on the dynamic response. Moreover, this work shows the influence on the stability of car speed and some design parameters such as the position of the caravan's centroid and cornering stiffness of the axle. The effects on the stability induced by different design choices were verified through the simulation of an obstacle avoidance maneuver.
Safety Impacts of SUVs, Vans, and Pickup Trucks in Two-Vehicle Crashes.
- Toy EL and Hammitt JK. Risk Anal 2003; 23(4): 641.
Policy makers, vehicle manufacturers, and consumers have shown growing concern about the relative safety of sport utility vehicles (SUVs), vans, pickups, and cars. Empirical analysis of real-world crashes is complicated by the possibility that apparent relationships between vehicle type and safety may be confounded by other factors, such as driver behavior and crash circumstances. This study compares different vehicle types with respect to their crashworthiness (self-protection) and aggressivity (risk to others) in crashes between two passenger vehicles. The U.S. Crashworthiness Data System is used to analyze detailed information on 6,481 drivers involved in crashes during 1993-1999. Logistic regression analysis is used to model the risk of serious injury or death to a driver, conditional on a crash occurring. Covariates include the body type of each vehicle in the crash; the driver's age, gender, and restraint use; and the configuration of the crash. A unique feature of this study is the use of "delta-v" to represent the joint effects of vehicle mass and crash severity. While estimated effects are somewhat sensitive to the injury severity level used as the outcome variable, SUVs, vans, and pickups appear to be more aggressive and may be more crashworthy than cars. Effects of pickups are most pronounced. Drivers in pickups face less risk of serious injury than car drivers (odds ratio [OR], 0.35; 95% confidence interval [CI], 0.20-0.60), and drivers who collide with pickups experience more than twice the risk than those who collide with a car (OR, 2.18; 95% CI, 1.03-4.62). While vehicle mass and crash severity contribute to the apparent crashworthiness and aggressivity of passenger vehicles, other vehicle characteristics associated with body type (e.g., the stiffness and height of the underlying structure of the vehicle) also influence safety risks.
The Speeding Attitude Scale and the Role of Sensation Seeking in Profiling Young Drivers at Risk.
Correspondence: Brian J. Bigelow, Department of Psychology, Laurentian University, Ramsey Lake Rd., Sudbury, Ontario, P3E 2C6 CANADA; (email: bbigelow@laurentian.ca).
Seven driving attitude scales representing driving behaviors and beliefs about driving were created and initially validated using 257 undergraduate students (168 females, 89 males) in Study 1. However, the Speeding Attitude Scale (SAS) accounted for most of the strength of the intercorrelations among these scales and discriminant classification analyses showed that SAS dominated the other scales as a sufficient explanation for having speeding tickets. Study 2, using 180 students (75 males, 105 females), replicated findings regarding the significant but low correlation between SAS and speeding tickets, and was significantly correlated with Zuckerman's Sensation Seeking Scale (SSS). Replication also showed that males had higher SAS scores and more speeding tickets. Accidents were typically a function of sex, increasing age, and variables related to recent accident history. Objective sources of speeding attitude confirmation may enhance the future validity of the SAS. Potential interventions for being a safe passenger and attitudinal control in the training of young drivers were discussed.
Morbidity associated with four-wheel all-terrain vehicles and comparison with that of motorcycles.
- Acosta JA, Rodriguez P. J Trauma 2003; 55(2): 282-284.
Correspondence: Jose A. Acosta, Medical Center Administration, Puerto Rico Trauma Center, P.O. Box 2129, San Juan, Puerto Rico 00922-2129; (email: macosta@centennialpr.net).
CONTEXT: The U.S. Consumer Product Safety Commission in their annual report (2001) of all-terrain vehicle (ATV) deaths and injuries concluded that in the late 1990s there had been a gradual increase in the number of deaths and injuries related to ATV collisions. The objective of our study was to describe the morbidity of four-wheel all-terrain vehicle collisions (ATVCs) and compare them with motorcycle collision (MCC) victims.
METHODS: This was a 24-month (April 2000-November 2002) retrospective review of all trauma patients admitted. Statistical significance was defined at p < 0.05.
FINDINGS: A total of 2,380 blunt trauma patients were admitted, of which 74 (3.1%) were ATVC victims and 169 (7.1%) were MCC victims. The average age was 23.9 +/- 9.4 years for ATVC victims and 29.1 +/- 11.5 years (p < 0.001) for MCC victims. The median Injury Severity Score was 16.0 for the ATVC group and 13 for the MCC group (p = 0.106). ATVC patients had a higher incidence of head and neck injuries (56%) than MCC patients (30%) (p < 0.001). The incidence of chest and abdominal injuries was similar between groups. Mortality occurred in 15 of 74 (20%) ATVC patients and 24 of 169 (14.2%) MCC patients (p = 0.236).
COMMENTS: This study demonstrates that ATVCs are associated with significant morbidity and mortality. When compared with MCCs, ATVCs have similar mortality and a much higher incidence of head injuries. National tracking of ATVCs should be continued and improved in an effort to assist legislators in enacting laws protecting the riders of ATVs.
Correspondence: Sharon Telleen, Department of Sociology (M/C 312), University of Illinois at Chicago, 1007 W. Harrison Street, Chicago, IL 60607, USA; (email: telleen@uic.edu).
The Safe Schools/Healthy Students Initiative in Morton High School District 201, Cicero, IL, used a social ecological systems perspective to implement its goals. Social-emotional learning and violence-prevention strategies were provided at the levels of the community, school, and individual. Creation of a safe school environment cut across developmental levels from preschool through high school. Intervention activities were universal/preventive, school, and targeted/individual. Finally, the project sought to develop a consortium infrastructure to institutionalize and sustain integrated services.
Delinquency and Violence as Affect-Control: Reviving the Subcultural Approach in Criminology.
Work on delinquent and violent subcultures in criminology has focused on the relationship between holding values (attitudes, beliefs, etc.) in support of delinquency or violence and actual involvement in these activities. However, empirical research on this relationship is inconsistent. Heeding arguments from the sociology of culture and psychology, I suggest that these inconsistent findings result from conceptual oversimplification and inadequate measurement. I propose that an alternative approach to examining subcultural delinquency and violence grounded in affect control theory overcomes these problems. Specifically, I argue that an affect control theory approach to the study of delinquent and violent subcultures shows promise by providing 1) theoretical rigor rooted in the tradition of structural symbolic interactionism; 2) a well-honed measurement procedure founded upon several decades of psychometric research; 3) a developing methodology for identifying subcultural meaning systems; and, 4) a computer simulation program which can be used to generate hypotheses regarding behavior from survey input. Additionally, I demonstrate how the affect control theory approach outlined herein addresses key questions raised by Kornhauser's (1978) classic critique of "cultural deviance theory." Directions for future research are indicated.
Social support reduces the impact of partner violence on health: application of structural equation models.
- Coker AL, Watkins KW, Smith PH, Brandt HM. Prev Med 2003; 37(3): 259-267.
Correspondence: Ann L. Coker, University of Texas Health Science Center, Center for Health Promotion and Prevention Research, School of Public Health, 77225, Houston, TX, USA; (email: acoker@sph.uth.tmc.edu).
Intimate partner violence (IPV) is associated with poorer health, yet pathways through which IPV affects either mental or physical health are not well characterized. Structural equation modeling was used to test a model in which physical-IPV and battering were considered as separate independent variables. The sample included 191 women currently experiencing either physical IPV or battering. Emotional support provided to women experiencing IPV was hypothesized to mediate the impact of IPV on current mental and physical health (dependent variables).Higher scores on emotional support were associated with better physical (beta = -0.23, P < 0.01) and mental health (beta = -0.27, P < 0.001). Physical IPV was directly associated with poorer mental health (beta =.023, P < 0.01) and indirectly associated with poorer physical health (beta = 0.18, P < 0.001) and mental health (beta = -0.04, P < 0.05), primarily through battering. Higher battering scores were directly associated with less emotional support (beta = -0.33, P < 0.001) and indirectly associated with poorer physical (beta = 0.12, P < 0.01) and mental health (beta = 0.09, P < 0.01), primarily through emotional support. Model diagnostics indicated a good fit (chi(2) = 20.44, P = 0.37, GFI = 0.98, CFI = 0.99, RMSEA = 0.02).Higher levels of emotional support may modify the effect of IPV on health. Interventions to increase social and emotional support to abused women may reduce mental and physical health consequences.
"Like, what am I supposed to do?": adolescent girls' health concerns in their dating relationships.
- Banister EM, Jakubec SL, Stein JA. Can J Nurs Res 2003; 35(2): 16-33.
Correspondence: Elizabeth M. Banister, School of Nursing, University of Victoria, Box 1700, Victoria, British Columbia V8W 2Y2, CANADA; (email: ebaniste@uvic.ca).
This ethnographic study explored the health-related concerns, within dating relationships, of 40 female adolescents aged 15 and 16. The results reveal a complex interaction of male/female relational dynamics and socialization processes in these relationships. To avoid behaviors risky to their health, participants had to negotiate power relationships with partners and peers; yet, paradoxically, any increase in their power could increase the threat of violent confrontation, loss of power, and further health compromises. The girls' desire to have a dating partner outweighed their desire to avoid health threats such as substance abuse and violence. This dynamic can be understood in terms of patriarchal power imbalances. These findings point to the gravity of adolescent girls' health issues and the need for interventions that challenge mainstream culture and that foster empowerment among female adolescents.
