Given an abstract, generate a keyword (a noun phrase) that best describes the focus or contribution of the paper. Such keywords can be directly from the given abstract or outside it.

Abstract: A mandatory seatbelt use law, the first such law in the nation, became fully in force in New York State as of 1 January, 1985. We studied seatbelt use among drivers and front seat passengers involved in motor vehicle accidents for a 3-month period pre-legislation (Phase 1), and a 5-month period post-legislation (Phase 2), to determine if this type of compulsory law, providing civil fines of $50 for violators, changes seatbelt use behavior. The reported use rate among drivers rose from 21% pre-legislation to 47% post-legislation (p less than 0.01). The use rate among front seat passengers rose from 21% to 40% (not significantly different due to the small number of occupants recorded in this position). A highway survey (Phase 3) noted the use rate in New York City and surrounding counties to be 63%, a marked increase from the published pre-legislation value of 16%. We conclude that mandatory seatbelt use legislation is effective in significantly increasing seatbelt use and urge physicians to seek similar legislation in every state.
Accidents, Traffic

Abstract: The outcome from cardiopulmonary arrest in children in the prehospital and hospital setting is generally poor. The event that compromises the cardiac status is often respiratory embarrassment, and the presenting rhythms are often bradyarrhythmias and asystole. Emergency medical services (EMS) systems have primarily an adult focus and may not be organized to manage optimally the critically ill and injured child. Data from a survey of training programs demonstrate that paramedic and EMT education in pediatric emergencies may be inadequate. Forty-one percent of the programs surveyed had less than 10 hr of pediatric training. Data suggest that EMS providers may not be equipped to manage children effectively. The Los Angeles EMS System for children is described. There are two levels of receiving facilities: Emergency Departments Approved for Pediatrics and Pediatric Critical Care Centers. The system is voluntary and has 85% of the hospitals in compliance with the guidelines. Early recognition of the prearrest state, improved training, and equipping of prehospital care personnel, development of EMS services for children, dissemination of an advanced pediatric life support course, as well as research in pediatric CPR may improve the outcome of resuscitation in the pediatric population.
Adolescence

Abstract: We measured the activity of the enzyme porphobilinogen deaminase in red blood cells of 222 persons. Ninety-seven of 107 patients with acute intermittent porphyria had enzyme activity below the normal range, whereas 55 of 56 patients with other types of porphyria had normal activity. This underscores the utility of this test in confirming the diagnosis of acute intermittent porphyria. Measurement of enzyme activity in 41 families with acute intermittent porphyria demonstrated that deficient activity is inherited as an autosomal dominant trait. Many latent carriers of the genetic defect were identified by family studies, permitting appropriate precautions to avoid potentially lethal porphyric attacks.
Acute Disease