bluuebunny/crossref_metadata_2025_split huggingface dataset:
Child seating position and restraint use in three states
Authors: Ferguson Susan A , Wells JoAnn K , Williams Allan F 
Published: October 2002

Objective—Because of risks from deploying airbags to children in front seats, extensive publicity has been aimed at getting them restrained and in rear seats. The objective of this study was to assess restraint use and seating positions among children in vehicles with and without airbags.Method—Surveys were conducted in cities in Michigan, North Carolina, and Texas 1998. Restraint use and seating position were noted for all children, as well as their estimated age, driver belt use, airbag presence, and vehicle license plate number.Results—Fewer children were observed in the front seats of vehicles with passenger airbags (24%) than in vehicles without them (36%). Most of the children seated in front were ages 7–12 (44%–61%), followed by 3–6 year olds (29%–35%). Very few children ages 0–2 were seated in front (5%–12%). The overwhelming majority of children ages 0–2 were restrained. However, children ages 3–6 seated in the front were least likely to be restrained and most likely to be improperly restrained. Restraint use was higher when the driver was belted, but about 30% of 3–6 year olds were unrestrained even with a belted driver.Conclusions—Efforts should continue to educate parents about the importance of correct restraint use and rear seating for children, particularly once children move from child safety seats into adult belts. Efforts also should be made to enforce the seat belt laws that exist in every state.
Effects of recent 0.08% legal blood alcohol limits on fatal crash involvement
Authors: Hingson Ralph , Heeren Timothy , Winter Michael 
Published: October 2002

Objectives—This study assessed whether states that lowered legal blood alcohol limits from 0.10% to 0.08% in 1993 and 1994 experienced post-law reductions in alcohol related fatal crashes.Methods—Six states that adopted 0.08% as the legal blood alcohol limit in 1993 and 1994 were paired with six nearby states that retained a 0.10% legal standard. Within each pair, comparisons were made for the maximum equal available number of pre-law and post-law years.Results—States adopting 0.08% laws experienced a 6% greater post-law decline in the proportion of drivers in fatal crashes with blood alcohol levels at 0.10% or higher and a 5% greater decline in the proportion of fatal crashes that were alcohol related at 0.10% or higher.Conclusions—If all states adopted the 0.08% legal blood alcohol level, 400–500 fewer traffic fatalities would occur annually.
Teenage suicides in northern Sweden: an interview study of investigating police officers
Authors: Lindqvist Per , Johansson Lars 
Published: October 2002

Objective—To disclose recurrent, dynamic, and static factors in teenage suicide involving the suicidee, his/her family, and the community; and to investigate the feasibility of using police as informants for suicide studies.Subjects—All deaths categorised as suicide 1993 through 1995 among teenagers in Northern Sweden (n=15).Method—Semiqualitative interviews with police officers, and, when applicable, general practitioners. Police reports, necropsy protocols, medical records, and conscription data were also analysed.Results—Most suicides occurred in rural and depopulated areas. In contrast to males, females often had a history of overt psychiatric problems with suicide attempts. At least two thirds of the suicides were planned.Conclusion—Cultural and sociopolitical aspects are important in teenage suicide as well as gender differences. Police officers can provide essential information. Identifying teenagers at risk remains difficult, however, due to low baseline rates.
Injuries in Ontario farm children: a population based study
Authors: Bancej C , Arbuckle T 
Published: October 2002

Objectives—To evaluate injury rates, patterns, and risk factors in 4916 Ontario farm children aged 0–18 years.Setting—1765 full time family operated Ontario farms with a husband-wife couple where the wife was of reproductive age.Methods—Injury details were obtained from mothers, while parents and farm operators provided risk factor information retrospectively in a population based mail survey. Rates were calculated based on injury occurrence and person years at risk in different age groups. Descriptive analyses used cross tabulations of injury details by age, sex, and season. Injury risk factors were assessed using multiple logistic regression.Results—Age specific injury rates ranged from 6.3–22.6 per thousand person years, peaking in 1–4 year olds. Although consistently higher for boys, both sexes showed similar trends in age specific rates. Rates likely represent underestimates due to diminished recall of past events. Open wounds to the head/face region were the most prevalent type of injury (17.1%) followed by fractures/dislocations to the upper extremities (14.9%). Mechanism differed by age group, though falls and machinery consistently ranked in the top three. Occurrence peaked in summer.Regression analyses indicated child's sex and parental education were associated with injury risk across age categories. Other risk factors, such as numbers of livestock, parental owner/operator status, and mother's off-site employment, differed between ages.Conclusions—Patterns and risk factors for injuries to farm children are heterogenous across age categories. Observed age differences are useful for targeting prevention initiatives.
Assessing child restraint misuse by parental survey
Authors: Arbogast Kristy B , Durbin Dennis R , Morris Shannon D , Winston Flaura Koplin 
Published: October 2002

Objective—To determine the extent to which child restraint system (CRS) misuse can be evaluated by parental survey.Methods—A cross sectional survey was conducted at eight CRS clinics from May to October, 1998. Before CRS inspection, parents were administered a structured interview to identify distinct characteristics of restraint use and misuse. After the interview, a certified child passenger safety technician team independently evaluated the restraint system and identified specific modes of misuse. Parent descriptions of CRS use were compared with observations of the technician and the degree of agreement between the two was assessed for several specific attributes of use.Results—A total of 100 children restrained in convertible CRSs were included in the study. Parents were able to accurately report several aspects of child restraint use—in particular, the attachment and fit of the CRS, the use of the harness clip, and the CRS incline. Parents were less accurate in their characterization of the fit of the child in the CRS. For nearly every item assessed, parents were more accurate in their description of correct compared with incorrect use.Conclusions—Interview tools can be developed that enable parents to describe aspects of CRS use and that screen for correct CRS use. These tools could be administered by telephone to obtain a more representative estimate of the prevalence of CRS misuse or to screen for CRS misuse. This screening would assist in targeting time consuming and costly CRS clinics to those parents who need them the most.
A hospital led promotion campaign aimed to increase bicycle helmet wearing among children aged 11–15 living in West Berkshire 1992–98
Authors: Lee Angela J , Mann Nicholas P , Takriti Rachel 
Published: October 2002

Objectives—To evaluate the effect of a bicycle helmet promotion campaign on helmet wearing among cyclists less than 16 years of age from 1992–98.Setting—Reading, West Berkshire, UK.Methods—A hospital led bicycle helmet promotion campaign targeted at 5–15 year olds. The campaign focused on education with active involvement of the children, parents, schools, and safety organisations. Local media and children's celebrities raised the profile of the campaign and a low cost helmet purchase scheme was also set up. A self administered questionnaire survey of 3000, 11–15 year olds was carried out over the period of the campaign. A control group of 3000 teenagers was obtained from a neighbouring area without a helmet campaign. Accident and emergency (A&E) figures were obtained from the local hospital within the campaign area on all children aged under 16 years, attending with bicycle injuries. Unfortunately, no figures were available from the A&E department in the control area.Results—Self reported helmet use among 11–15 years olds living in the campaign area increased from 11% at the start of the campaign to 31% after five years (p<0.001), with no change in the control group. Hospital casualty figures in the campaign area for cycle related head injuries in the under 16 years age group, fell from 112.5/100 000 to 60.8/100 000 (from 21.6% of all cycle injuries to 11.7%; p<0.005).Conclusions—This hospital led community bicycle helmet promotion campaign directed at young people showed an increase in the number of children reporting that they “always” wore their helmet while cycling. There was a significantly higher rate of helmet wearing than in the control area, and a significant reduction in head injuries.
Children dying in car trunks: how adequate are child death databases?
Authors: Waller Patricia F , Eribes Carmen M 
Published: October 2002

Objective—To determine the frequency of and circumstances surrounding child deaths resulting from inadvertent entrapment in motor vehicle trunks in the US by querying child fatality review databases.Method—A telephone survey was conducted with the persons or offices identified as having primary responsibility for child fatality review programs in each state. The survey requested information on the number of child deaths resulting from trunk entrapments, the ages of the victims, the time period covered by the surveillance system, and variables concerning the circumstances surrounding each incident.Results—All states reported that these deaths are exceedingly rare, with most reporting no such events in recent history. However, state databases could not be readily accessed to identify such deaths. There was enormous interstate variation in guidelines governing the population covered by the child fatality review process. The age range varied greatly from one jurisdiction to another, and often only children in the state's welfare system were included. Interstate differences in practices preclude meaningful compilation of data across jurisdictions.Conclusions—It was not possible to ascertain the incidence of inadvertent entrapment of children in vehicle trunks because there is no consistency in the available databases. A national database of child fatalities, based on standardized guidelines and definitions, is needed to identify causes and magnitude of specific child deaths, in order to design, implement, and evaluate interventions.
Impact of a helmet law on two wheel motor vehicle crash mortality in a southern European urban area
Authors: Ferrando Josep , Plaséncia Antoni , Orós Miquel , Borrell Carme , Kraus Jess F 
Published: October 2002

Background—In Spain, a federal road safety law went into effect in the fall of 1992 extending to urban areas the unrestricted use of safety helmets by all two wheel motor vehicle occupants.Objectives—To assess the effect of the law in reducing fatal motorcycle crash injuries; to estimate the number of lives saved; and to determine changes in the distribution of severity and anatomical location of injuries.Methods—Pre-test/post-test design of all deaths of two wheel motor vehicle occupants from 1990–92 (pre-law period) and from 1993–95 (post-law period) detected by the Barcelona Forensic Institute and the city police department. Injuries were coded using the 1990 version of the abbreviated injury scale. Poisson regression methods were used to model trends in mortality ratios and to provide estimates of the number of lives saved.Results—Between 1993 and 1995, 35 lives of two wheel motor vehicle occupants were spared, representing a decrease of 25% in the observed motorcycle crash mortality in the post-law period when compared with what would be expected if no such law had gone into effect. The proportion of deaths with severe head injuries was also reduced from 76% to 67% in the post-law period.Conclusions—This study offers the first evaluation of a helmet law using combined forensic and police data in a large south European urban area where there is widespread use of motorcycles. Our results confirm the effectiveness of the helmet law, as measured by the reduction in the number of deaths and mortality ratios after the law implementation. The findings reinforce the public health benefits of mandatory non-restricted motorcycle and moped helmet use, even in urban areas with lower traffic speeds.
Public opinion about guns in the home
Authors: Kellermann Arthur L , Fuqua-Whitley Dawna S , Sampson Tomoko R , Lindenmann Walter 
Published: October 2002

Objectives—(1) Determine the frequency of gun ownership, acquisition, and transfer; (2) assess gun storage practices; and (3) compare the views of firearm owning and non-owning adults regarding the protective value of keeping a gun in the home.Setting and methods—Over three different time periods (1995, 1996, and 1999) stratified, random digit telephone surveys were conducted in a five county area of metropolitan Atlanta, Georgia. Five hundred adults (aged 21+ years) responded to each survey.Results—The proportion of Atlanta area households reporting firearm ownership was generally stable over this interval (38%, 40%, and 35% respectively). The percentage of gun owning households containing a handgun (approximately 75%) was stable as well. In 1995, more than half of gun owning households kept one or more guns unlocked; since that time, the trend has been gradually downward. In 1995, 44% of gun owning respondents kept one or more guns loaded, compared with 38% in 1996 and 40% in 1999. A majority of respondents to all three surveys (55%) agreed with the statement “A home with a gun is less secure than a home without a gun, because a gun can be involved in an accidental shooting, suicide or family homicide”. Among five home security measures, respondents rated a burglar alarm most effective, and keeping a gun in the home least effective.Conclusions—In Atlanta, many households keep a firearm for protection, but they are ambivalent about the associated risks. These findings suggest that education about gun safety should include a discussion of the risks of unsafe storage, and non-lethal alternatives for home security.
Maternal socioeconomic characteristics and infant mortality from injuries in the Czech Republic 1989–92
Authors: Bobak Martin , Pikhart Hynek , Koupilová Ilona 
Published: October 2002

Objectives—Infant and childhood mortality from injuries in Central and Eastern Europe is high but little is known about its determinants. This study examined whether maternal socioeconomic characteristics predict infant mortality from injuries in the Czech Republic.Methods—Data on all live births registered in the Czech Republic 1989–91 (n=387 496) were linked with the national death register, 1989–92, using the unique national identification number. Effects of maternal socioeconomic characteristics, birth weight and gestational age, recorded in the birth register, on the risk of death from external causes (ICD-9 800–999) were estimated using logistic regression.Results—Of the 195 linked infant deaths from external causes (rate 50/100 000 live births), 73% were from suffocation. After controlling for other factors, the risk of death was higher in boys, declined with increasing maternal education (odds ratio for primaryvuniversity education 3.5, 95% confidence interval 1.5 to 8.6), maternal age, birth weight and gestational age, and was increased in infants of unmarried mothers and of mothers with higher parity. The effect of education appeared stronger in married mothers and in mothers of low parity.Conclusion—The risk of infant death from external causes in this population was strongly associated with maternal and family characteristics.
Safety behavior of in-line skaters
Authors: Osberg J Scott , Stiles Sarah C 
Published: October 2002

Objectives and setting—Injuries from in-line skating have risen sharply in many cities around the world. To understand risk taking behavior and safety practices associated with urban in-line skating, 2210 outdoor skaters were observed in Boston, Massachusetts.Methods—Estimated age, gender, use of helmets, wrist guards, elbow and kneepads were recorded. Skaters were coded as beginner, average, or advanced, and skating locations were classified as street, sidewalk, or bicycle path.Results—About 60% of skaters wore wrist guards, but only 5.7% wore helmets. Males wore less protective equipment than females, and were more likely to skate on streets. Beginners and advanced skaters wore more protective gear than average skaters. Surprisingly, street skaters wore less protective gear than skaters on sidewalks or paths.Conclusions—Renewed focus on the importance of wearing helmets is needed. Given the higher injury risks for males, clinicians and public health experts need to target male skaters in prevention efforts. In addition, average and advanced skaters need to be convinced that even though they have improved, it is still important to wear protective gear.
Acceptability of baseball face guards and reduction of oculofacial injury in receptive youth league players: Figure 1
Authors: Danis Ronald P , Hu Kuolung , Bell Mason 
Published: October 2002

Goals—To assess the relative injury reduction effect and acceptability of face guards on batter's helmets.Methods—A non-randomized prospective cohort study among 238 youth league baseball teams in Central and Southern Indiana during the 1997 season. Coaches, parents, and players were asked to respond to pre-season and post-season questionnaires. Approximately one half of the teams were supplied with face guard helmets (intervention); all others used this protection at their discretion (comparison).Results—Parents, players, and coaches on the intervention teams reported a reduction in the incidence of oculofacial injuries compared with comparison team respondents (p=0.04). There was no reported adverse effect of face guard use on player performance.Conclusions—Helmet face guards should be required for batters to prevent facial injuries in baseball.
Population preventable fraction of bicycle related head injuries
Authors: Kopjar Branko 
Published: October 2002

Objective—This study analyzes the population attributable fraction (PAF) of bicycle head injuries due to non-helmet use.Methods—The concept of the PAF and Levin's formula for its calculation were used to develop mathematical models for estimation of: (i) attributable fraction of bicycle related head injuries in the population due to non-helmet use, (ii) expected proportion of helmeted cases among all head injuries, and (iii) estimate of the helmet use rate in the population based on patient case information. The PAF was calculated for a sample of injuries from Stavanger, Norway.Results—Levin's formula was used to calculate the PAF. Two additional mathematical models were developed for calculating the expected proportion of helmeted cases and the estimation of the helmet use rate in the population. The calculation examples for all models were shown. It was estimated that 133 out of 210 injuries could have been avoided in Stavanger between 1990 and 1996 if all children aged 0–14 had used helmets.Conclusions—If applied correctly, the PAF is a valid and useful indicator for the population effects of bicycle helmets. The models developed in this study may help to better interpret and predict the population effects of helmet promotion interventions.
Gun use in the United States: results from two national surveys
Authors: Hemenway D , Azrael D , Miller M 
Published: October 2002

Objectives—To determine the relative incidence of gun victimization versus self defense gun use by civilians in the United States, and the circumstances and probable legality of the self defense uses.Methods—National random digit dial telephone surveys of the adult population were conducted in 1996 and 1999. The Harvard surveys appear unique among private surveys in two respects: asking (1) open ended questions about defensive gun use incidents and (2) detailed questions about both gun victimization and self defense gun use. Five criminal court judges were asked to assess whether the self reported defensive gun uses were likely to have been legal.Results—Even after excluding many reported firearm victimizations, far more survey respondents report having been threatened or intimidated with a gun than having used a gun to protect themselves. A majority of the reported self defense gun uses were rated as probably illegal by a majority of judges. This was so even under the assumption that the respondent had a permit to own and carry the gun, and that the respondent had described the event honestly.Conclusions—Guns are used to threaten and intimidate far more often than they are used in self defense. Most self reported self defense gun uses may well be illegal and against the interests of society.
National estimates of non-fatal firearm related injuries other than gunshot wounds
Authors: Hootman J M , Annest J L , Mercy J A , Ryan G W , Hargarten S W 
Published: October 2002

Objective—To characterize non-fatal firearm related injuries other than gunshot wounds (non-GSWs) treated in hospital emergency departments in the United States that occur during routine gun handling and recreational use as well as violence related use of a firearm.Methods—Cases were identified through the National Electronic Injury Surveillance System (NEISS). During the study period, 1 January 1993 through 31 December 1996, NEISS consisted of a nationally representative sample of 91 hospitals in the United States having at least six beds and providing 24 hour emergency services.Results—An estimated 65 374, or an average of 16 300 per year, non-fatal, non-GSWs were treated in American hospital emergency departments during the four year study period. Fifty seven per cent of all the non-fatal, non-GSWs were violence related, most of which involved being struck by a firearm. The majority of unintentional non-fatal, non-GSWs were self inflicted and occurred during routine gun handling or recreational use of a firearm; 43% of these injuries resulted from gun recoils.Conclusions—Non-fatal, non-GSWs make a notable contribution to the public health burden of firearm related injuries. Firearm related injury prevention programs should focus on not only the reduction of gunshot wounds but also the reduction of unintentional and violence related non-GSWs.