bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validation of the ICD/AIS MAP for pediatric use
Authors: Durbin D R , Localio A R , MacKenzie E J 
Published: October 2002

Objective—To determine the performance of the ICD/AIS MAP (© E J MacKenzieet al) as a method of classifying injury severity for children.Methods—Data on all children less than 16 years of age admitted to all designated trauma centers in Pennsylvania from January 1994 through October 1996 were obtained from the state trauma registry. The ICD/AIS MAP was used to convert all injury related ICD-9-CM diagnosis codes into abbreviated injury scale (AIS) score and injury severity score (ISS). Agreement between trauma registry AIS and ISS scores and MAP generated scores was assessed using the weighted κ (κw) coefficient for ordered data and the intraclass correlation coefficient for continuous data.Results—Agreement in ISS scores was excellent, both overall (intraclass correlation coefficient = 0.86, 95% confidence interval (CI) 0.84 to 0.89)), and when grouped into three levels of severity (κw= 0.86, 95% CI 0.85 to 0.87). Agreement in AIS scores across all body regions and ages was also excellent, (κw= 0.86 (95% CI 0.83 to 0.87). Agreement increased with age (κw= 0.78 for children <2 years; κw= 0.86 for older children) and varied by body region, though was excellent across all regions.Conclusions—The performance of the ICD/AIS MAP in assessing severity of pediatric injuries was equal to or better than previous assessments of its performance on primarily adult patients. Its performance was excellent across the pediatric age range and across nearly all body regions of injury.
Law enforcement officers' opinions about gun locks: anchors on life jackets?
Authors: Coyne-Beasley T , Johnson R M 
Published: October 2002

Objectives—One way law enforcement officers support firearm safety is by promoting the use of gun locks. This investigation examined law enforcement officers' willingness to use gun locks on their own guns, as well as their opinions regarding gun locks in general.Setting—Law enforcement officers from an urban agency in the southern region of the United States.Methods—Free keyed cable gun locks were distributed to all law enforcement officers in one agency who wanted one, and then an anonymous questionnaire survey was conducted about their subsequent use of, and attitudes toward, these devices.Results—About half of the 207 officers collected gun locks (n=103). Nearly three quarters (73%) completed and returned the questionnaire. Two thirds reported that they were not using the gun lock they collected (65%), and over half disagreed that gun lock use should be required (56%). Very few cited any actual or potential technical problems with the device. An important reason given for non-use of gun locks related to being able to access the weapon quickly in case of an emergency.Conclusions—The findings highlight the need for further investigation into law enforcement officers' attitudes toward gun locks, the degree to which their attitudes affect their firearm safety counseling, and the need to develop a gun safety device that can be disengaged quickly.
Injuries among teens employed in the homebuilding industry in North Carolina
Authors: Lipscomb H J , Li L 
Published: October 2002

Objective—To describe injuries of teens employed in the residential construction industry and to assess whether their injury experiences are significantly different from those of adults in this high risk industry.Methods and setting—North Carolina homebuilders workers' compensation data for a 41 month period were analyzed. Injuries of teens were identified and described by body part injured, nature, and cause of injury. Proportionate injury ratios were used to summarize and compare the injury experience of teens with those of adult construction workers.Results—Teens had proportionately more injuries to the eye and foot and fewer injuries to the back than adults. They had more cuts and scratches and fewer sprains and strains. They also had proportionately fewer injuries from falls from elevations and overexertion, injuries that account for a significant cost burden in construction. Consistent with these findings, teens had significantly fewer injuries resulting in medical costs or lost time costs of $1000 or more.Conclusions—The analyses indicate that injuries of teens are less serious than those of adults. This finding may indicate that their work exposures are less dangerous than those of adults in comparable broad categories of construction. However, the data also provide documentation of injuries to teens resulting from work at heights, use of power tools, and motor vehicles with the majority of more expensive claims involving one of these exposures. Construction is dangerous work and these results add to the documentation of the need for additional measures to prevent work related injuries among all workers—teens and adults—in this industry.
Kentucky's graduated driver licensing program for young drivers: barriers to effective local implementation
Authors: Steenbergen L C , Kidd P S , Pollack S , McCoy C , Pigman J G , Agent K R 
Published: October 2002

Objectives—To examine the implementation of graduated driver licensing (GDL) in Kentucky and to use the data collected to recommend actions to enhance the effectiveness of the GDL program.Methods—Data were acquired from surveys of 700 law enforcement officers and more than 40 judges and from interviews with 100 persons who implement or are affected by Kentucky's GDL program—for example, traffic court judges, licensing clerks, law enforcement officers, insurance agents, driving instructors, parents, and employers of teens. Transcripts from interviews were analyzed using a qualitative data analysis computer program.Results and conclusions—Participants noted a widespread lack of awareness of the night-time driving restriction and a substantial number of young drivers receiving little driving time during the learner permit phase. It appeared that specific GDL provisions can be difficult for judges and law officers to enforce and the penalty of license suspension after several traffic violations may not be a sufficient deterrent. Efforts are needed to increase parental awareness of GDL provisions, GDL purpose, and their teen's traffic violations and to increase parental enforcement of restrictions that are difficult for law enforcement agencies to monitor, such as the night-time driving restriction and the adult supervision requirement.
Controlled evaluation of a community based injury prevention program in Australia
Authors: Ozanne-Smith J , Day L , Stathakis V , Sherrard J 
Published: October 2002

Objective: To evaluate the effects of a community based, all age, all injury prevention program, the Safe Living Program, on injury risk and injury rates.Design: A quasiexperimental population based evaluation using an intervention and comparison community design.Setting: The intervention community (Shire of Bulla, n=37 257) is an outer metropolitan area of Melbourne, Australia. The demographically matched comparison community (Shire of Melton, n=33 592) is located nearby.Subjects and methods: The Safe Living Program in the Shire of Bulla targeted injury reduction in all settings with a focus on high risk groups. Strategies included program publicity, education and training, injury hazard reduction, and environmental change. Baseline and follow up measures of program reach, risk factors, and injury rates in both communities were used to evaluate program process, impact, and outcome.Results: Increase in program awareness was moderate and similar to other community based programs. The program achieved injury hazard reduction on the road, in schools, and, to a more limited extent, in the home. Other changes in injury risk factors could not necessarily be attributed to the program as similar changes were observed in the comparison community. No significant changes were found in rates of injury deaths, hospitalisations, or emergency department presentations in the Shire of Bulla after six years. Self reported household injuries, mostly minor, were reduced in the intervention community, but had been higher at program launch than in the comparison community.Conclusions: The Safe Living Program was unable to replicate the significant reductions in injuries reported in other community based interventions. Replication of apparently successful community based injury prevention programs in different settings and populations requires evidence based interventions, sustained and effective program penetration, reliable data systems to measure change, at least one control community, and sufficient budget and time for effects to be observable.
Adolescent injury morbidity in New Zealand, 1987–96
Authors: Kypri K , Chalmers D J , Langley J D , Wright C S 
Published: October 2002

Objectives: Adolescents are over-represented in injury statistics. New Zealand is privileged in having a hospital discharge database allowing for analysis of non-fatal injury data at a national level. An epidemiological description of adolescent injury morbidity is provided and options for prevention are discussed.Method: People aged 15–19 years admitted to hospital for their injuries in the period 1987–96 were identified from the New Zealand Health Information Service morbidity data files. The manner, causes, and nature of injury were examined. Injury prevention strategies were reviewed.Results: The incidence of hospitalised injury was 1886 per 100 000 person years. The victims were predominantly male (70%). The leading causes of injury were road traffic crashes, sports injuries, and self poisoning. The most common injury diagnoses were head injuries (29%) and limb fractures (21%). Road traffic crashes produced the highest proportion of serious injuries.Conclusions: Road traffic crashes, sports injuries, and self inflicted poisoning, stood out as areas with the greatest potential for reducing the burden of injury in late adolescence. Graduated driver licensing shows promise as an injury prevention measure but remains inadequately implemented. Policies to reduce self inflicted poisoning are of unknown efficacy, and evidence is awaited on the effectiveness of measures to reduce injury in sport.
Socioeconomic differences in injury risks in childhood and adolescence: a nation-wide study of intentional and unintentional injuries in Sweden
Authors: Engström K , Diderichsen F , Laflamme L 
Published: October 2002

Study objective:To measure socioeconomic differences in injuries among different age groups of children and adolescents.Subjects:Children under 20 living in Sweden between 1990 and 1994 (about 2.6 million).Method:A cross sectional study based on record linkage between 15 Swedish national registers. Children were divided into four age groups and allocated to four household socioeconomic status groups. Absolute and relative risks were compiled using children of high/intermediate level salaried employees as the comparison group. Four diagnostic groups were considered: fall, traffic, interpersonal violence, and self inflicted injuries.Results:Injury incidences were relatively low and socioeconomic differences negligible in the 0–4 year olds. Thereafter, significant socioeconomic differences were observed in all diagnostic groups except falls. The highest absolute differences were in traffic injuries, especially among 15–19 year olds, and in self inflicted injuries among 15–19 year old girls. Relative differences were highest in both categories of intentional injuries for the age group 10–14. Social circumstances in the household other than family socioeconomic status affected the social pattern of intentional but not that of unintentional injuries.Conclusions:Socioeconomic differences in injury risks are not necessarily constant over age. Inequalities are particularly high in absolute terms among adolescents 15–19 years old for traffic injuries and in relative terms among 10–14 year olds for intentional injuries.
Risk factors associated with non-fatal adolescent firearm injuries
Authors: Paris C A , Edgerton E A , Sifuentes M , Seidel J S , Lewis R J , Gausche M 
Published: October 2002

Study objective:To identify behavioral, environmental, and sociodemographic risk factors associated with non-fatal firearm injuries among inner city adolescents in the United States.Design:A case-control study in which patients with firearm injury serve as cases and those with medical conditions serve as controls.Setting:A level I trauma center in a metropolitan area serving a predominately lower socioeconomic status population.Participants:Cases were 45 consecutive patients 11–18 years presenting to the emergency department with a non-fatal firearm injury; controls were 50 age and gender matched patients presenting with acute medical problems.Outcome measure:Odds ratios (OR) and associated 95% confidence intervals (CI) as estimates of the magnitude of association between risk factors and non-fatal firearm injury.Results:After adjusting for age, gender and socioeconomic status, multivariate analysis identified four risk factors independently associated with firearm injury: living with less than two parents (OR 3.8, 95% CI 1.2 to 12.2), skipping class (OR 7.1, 95% CI 1.7 to 28.9), previous arrest (OR 6.2, 95% CI 1.9 to 20.7), and being African-American (OR 4.2; 95% CI 1.4 to 14.9).Conclusion:Risk factors for adolescents sustaining a non-fatal firearm injury are sociodemographic and environmental, not just behavioral. Thus interventions that foster protective and supportive environments may help prevent firearm injuries.
Improving the detection of cancer in the screening of mammograms
Authors: Laming D. , Warren R. 
Published: October 2002

Objective Examination of figures from screening at several different centres, and from the incidence of interval cancers in those programmes, suggests that a single radiologist reading by him/herself would miss 16 to 31% of cancers detectable in the mammograms. This study investigates how the accuracy of breast cancer screening could be improved. Method Draw a comparison between screening for breast cancer and other inspection tasks that have been studied in the experimental psychological laboratory to suggest two low cost fixes that might improve the accuracy of breast cancer screening. Recommendations (1) Radiologists should not work for more than half an hour at a time; (2) two radiologists double reading should inspect the same series of mammograms in inverse order; (3) there should be a clerical check to see whether the efficiency of detection decreases with time on task; and (4) a more sophisticated engineering of the screening procedure might be accomplished by assembling a library of mammograms for which the correct diagnosis is known. If these library mammograms were mixed randomly with those to be inspected in some suitable ratio, it would then be possible to provide the radiologist with immediate feedback on the accuracy of (some of) his/her diagnoses. From experimental studies of inspection tasks this should improve diagnostic accuracy. These recommendations, of course, require evaluation in field trials.
Screening for colorectal cancer by faecal occult blood test: comparison of immunochemical tests
Authors: Castiglione G. , Zappa M. , Grazzini G. , Rubeca T. , Turco P. , Sani C. , Ciatto S. 
Published: October 2002

Objective To compare two immunochemical faecal occult blood tests based on reversed passive haemagglutination (RPHA) or latex agglutination (Hdia) in a population based screening setting. Method Hdia was interpreted according to three positivity thresholds: 100, 150, or 200 ng of haemoglobin/mg of specimen solution. A total of 5844 subjects were recruited into the study, from 17 432 invited subjects aged 50–70. Results Positivity rates were 3.3% for RPHA, Hdia100 3.5%, Hdia150 2.5%, Hdia200 2.0%. Among subjects complying with the diagnostic work up, colorectal cancer (CRC) was detected in 19 subjects (17 RPHA positive, 16 Hdia100 positive, 15 Hdia150 positive, 14 Hdia200 positive) and high risk adenoma/s in 41 subjects (28 RPHA positive, 32 Hdia100 positive, 29 Hdia150 positive, 25 Hdia200 positive). The prevalence of screen positive CRC in the population was for RPHA 2.9‰, Hdia100 2.7‰, Hdia150 2.6‰, Hdia200 2.4‰. The prevalence of screen positive high risk adenomas in the population was for RPHA 4.8‰, Hdia100 5.5‰, Hdia150 5.0‰, Hdia200 4.3‰. Conclusion Hdia100 was as sensitive as RPHA for cancer and high risk adenomas. As Hdia is less technically complex than RPHA, it is a valid alternative to the latter, provided that full automation of the development procedure is available. Increasing the positivity threshold of Hdia up to 150 or 200 ng of haemoglobin/mg of specimen solution is not advisable as the increase in specificity is too small to justify the corresponding decrease in the detection of screen positive cancers in the population.
Strategic options for antenatal screening for syphilis in the United Kingdom: a cost effectiveness analysis
Authors: Connor N. , Roberts J. , Nicoll A. 
Published: October 2002

Objective Antenatal screening for syphilis is well established in the United Kingdom. The prevalence of syphilis is now very low, prompting the question as to whether this screening programme is still necessary. This paper aims at identifying possible screening strategy options for the programme and comparing their effectiveness and cost effectiveness. Methods The cost of the screening programme in the United Kingdom was estimated. This was based on the cost of screening tests, treatment, and follow up of infected women and their infants. This information was obtained from laboratories, antenatal clinics, and genitourinary medicine clinics. Epidemiological data from a survey of women treated for syphilis in pregnancy were analysed to identify groups at increased risk of syphilis. Strategic options for the screening programme were then identified. The effectiveness, number needed to treat, and cost effectiveness of these options were compared. Results Antenatal screening in the United Kingdom detected at least 40 pregnant women who need treatment for syphilis every year. This means that 18 602 women are screened for every woman detected who needs treatment for syphilis. The marginal annual cost of this screening programme in the United Kingdom is £672 366. This is equivalent to 90p per woman screened, or £16 670 to detect one woman who needs treatment for syphilis. The screening programme could be targeted geographically at pregnant women in the Thames regions. This option has the potential to save £482 185. Other strategic options are to target pregnant women in non-white ethnic groups, or those born outside the United Kingdom. These targeted options would each detect between 70% and 77% of women needing treatment for syphilis. These options could potentially save £592 938 and £562 691 respectively. Conclusions Targeting or stopping the screening programme would save relatively little money. Although selectively screening groups by country of birth or by ethnic group could detect at least 70% of cases, this would be politically and practically difficult. Targeting by region would also be effective, but would pose similar ethical and medicolegal problems. These facts and the changing international epidemiology of syphilis lead us to recommend that the current universal antenatal screening for syphilis should continue.
Usefulness of thyroxine and free thyroxine filter paper measurements in neonatal screening for congenital hypothyroidism of preterm babies
Authors: Gruñeiro-Papendieck L. , Prieto L. , Chiesa A. , Bengolea S. , Bossi G. , Bergadá C. 
Published: October 2002

Introduction Low thyroxine (T4) with normal thyroid stimulating hormone (TSH) is a well known condition in preterm (PT) infants. The establishment of T4 and freeT4 (FT4) values in filter paper dried blood spots in PT could provide useful information in the neonatal period. Objective To study T4 and FT4 levels in dried blood filter paper samples of PT and full term (FT) babies. Methods We measured T4 by fluoroimmunoassay (FIA) DELFIA and TSH by IFMA DELFIA (Wallac Inc Turku, Finland) in 193 PT (26 to 37 weeks of gestational age (GA)) in samples from the first and second week of life and in 153 FT babies in the first week of life. In 131 PT and 31 FT we determined FT4 in filter paper blood spots using FIA (Alonso Fernandez J). Infants were grouped according to GA. Results There was a significant difference in T4 between PT and FT (p < 0.001). The lowest T4 levels were at 26 to 29 weeks GA. T4 values were lower in the second week. FT4 in PT up to 35 weeks GA, during the first week, was significantly different with FT infants (G1 to G3 p < 0.01, G4 p < 0.05). FT4 values in the first and second weeks of life did not vary. Conclusions T4 values were significantly lower in PT than in FT neonates, increasing with GA. PT infants had low T4 with normal FT4 values. This could suggest a decreased thyroxine binding globulin (TBG) or decreased protein binding and/or an adaptative mechanism that would not require therapeutical intervention.
Family history and risk of colorectal cancer: implications for screening programmes
Authors: Benhamiche-Bouvier A-M. , Lejeune C. , Jouve J-L. , Manfredi S. , Bonithon-Kopp C. , Faivre J. 
Published: October 2002

Objective To estimate the lifetime risk of colorectal cancer in the general population and in first degree relatives of patients with sporadic colorectal cancer or adenoma. Main outcomes measuresThe cumulative risk of colorectal cancer (0–74) in the general population combined with the relative risk of colorectal cancer and the prevalence of different groups of subjects with family history of colorectal tumour allows the calculation of cumulative risks in these groups. Results The lifetime risk of colorectal cancer was 1 in 23 in men and 1 in 40 in women. In males, 0.5% in the 55–59 age group and 4.5% in the 70–74 age group will develop a colorectal cancer. The corresponding values in females were 0.4% and 2.5%. The cumulative risk at age 74 varied between 7.7% (one family member affected) and 25.6% (two affected) in males, and 4.3% and 14.3% respectively in females. The risk in the 40–44 year age group for individuals with one first degree relative affected before 45 years of age was 0.5%, similar to that of those aged 45–49 with one first degree relative affected with a colorectal cancer or a large adenoma (> 1 cm). Conclusions These results suggest that screening in the general population should start at 50 or 55. The lifetime risk is high enough (over 10%) among individuals with one affected first degree relative before age 45, or with at least two affected first degree relatives, to warrant colonoscopic screening. The data provide a basis for recommendations that relatives of these patients should enter screening programmes at age 40 to 44.