The relationship between external threats and smoking in central Harlem.
(33/1954)
OBJECTIVES: This study assessed the relationship between external risks, such as personal and neighborhood danger, and smoking by using a new theoretical framework based on competing mortality risk models. METHODS: Regression analyses of self-reported data from residents of Central Harlem, New York, surveyed from 1992 through 1994 (n = 695, response rate = 72%) were used to assess the relationship between smoking and 2 measures of external health threats: levels of neighborhood danger and lifetime trauma. RESULTS: Support for the framework was mixed. At the 95% confidence level, exposure to lifetime trauma was positively related to current smoking status but was not related to the number of cigarettes smoked, conditional on being a smoker. Living in a "somewhat unsafe neighborhood" was also statistically significantly related to current smoking status. CONCLUSIONS: Although the framework implies that policies directed at improving the physical and social environment might improve health through their indirect effects on behaviors, little supporting evidence was found. Smoking rates may decrease if exposure to violence and neighborhood danger is reduced. This framework needs to be tested on larger and more information-rich data sets. (+info)
Effectiveness of toughened glassware in terms of reducing injury in bars: a randomised controlled trial.
(34/1954)
OBJECTIVE: To evaluate the effectiveness, in terms of injury prevention, of toughened pint glassware in bars. DESIGN: Randomised controlled trial. SETTING: A random sample of 57 bars in South Wales, West Midlands, and West of England. SUBJECTS: A total of 1229 bar workers. INTERVENTION: Complete replacement of pint glasses with annealed (control) or toughened (intervention) glassware. MAIN OUTCOME MEASURES: Bar staff injuries recorded monthly: number, site, and severity (lifestyle impact; treatment need) of injuries. RESULTS: Ninety eight bar staff experienced 115 injuries: 43 in the control group, 72 in the intervention group. Adjusting for people at risk gave a relative risk (RR) of 1.48 (confidence interval (CI) 1.02 to 2.15). Similarly, adjusting for hours worked gave RR 1.57 (CI 1.08 to 2.29). Thus, injury rate was 60% higher in the intervention group (p<0.05), with no significant difference in severity. Most were hand injuries requiring first aid. Injuries tended to occur simultaneously in more than one body part in the intervention group, reportedly caused by spontaneous disintegration of toughened glassware. Impact resistance testing showed the energy required to break annealed glass (1.8 +/- 0.2 J) was greater than that for toughened glass (1.4 +/- 0.2 J), though the difference was not significant. CONCLUSIONS: Glass with lower impact resistance caused more injuries. "Toughened" glassware had lower impact resistance. Standards for toughening need to be developed. (+info)
Association between illegal drugs and weapon carrying in young people in Scotland: schools' survey.
(35/1954)
OBJECTIVES: To identify the type and extent of weapons being carried among young people in Scotland, and to determine the relation between use of illegal drugs and weapon carrying. DESIGN: Questionnaire school survey. SETTING: Independent schools in central Scotland and schools in Lanarkshire and Perth and Kinross. PARTICIPANTS: 3121 students aged 11 to 16 in 20 schools. MAIN OUTCOME MEASURES: Self completion questionnaire reporting history of drug use and weapon carrying. RESULTS: Overall, 34.1% of males and 8. 6% of females reported having carried a weapon (P<0.0001), ranging from 29.2% of boys aged 11-13 (classes S1 to S2) to 39.3% of boys aged 13-15 (S3 to S4). These values are higher than those in a recent survey of young people in England. Weapon carrying in Lanarkshire was 70% higher for males than in the rural area of Perth and Kinross. Both males and females who had taken drugs were more likely to carry weapons (63.5% of male drug users versus 20.5% of non-users and 22.8% of female drug users versus 3.7% of non-users; both P<0.0001). The proportions of males carrying weapons who used none, one, two, three or four, or five or more illegal drugs were 21%, 52%, 68%, 74%, and 92% respectively. A similar trend was found among females. CONCLUSIONS: Better information is needed on the nature and extent of weapon carrying by young people in the United Kingdom, and better educational campaigns are needed warning of the dangers of carrying weapons. (+info)
Frequency and correlates of intimate partner violence by type: physical, sexual, and psychological battering.
(36/1954)
OBJECTIVES: This study estimated the frequency and correlates of intimate partner violence by type (physical, sexual, battering, or emotional abuse) among women seeking primary health care. METHODS: Women aged 18 to 65 years who attended family practice clinics in 1997 and 1998 took part. Participation included a brief in-clinic survey assessing intimate partner violence. Multiple polytomous logistic regression was used to assess correlates of partner violence by type. RESULTS: Of 1401 eligible women surveyed, 772 (55.1%) had experienced some type of intimate partner violence in a current, most recent, or past intimate relationship with a male partner; 20.2% were currently experiencing intimate partner violence. Among those who had experienced partner violence in any relationship, 77.3% experienced physical or sexual violence, and 22.7% experienced nonphysical abuse. Alcohol and/or drug abuse by the male partner was the strongest correlate of violence. CONCLUSIONS: Partner substance abuse and intimate partner violence in the woman's family of origin were strong risk factors for experiencing violence. Efforts to universally screen for partner violence and to effectively intervene to reduce the impact of such violence on women's lives must be a public health priority. (+info)
Early predictors of adolescent violence.
(37/1954)
OBJECTIVES: This study sought to identify early predictors of adolescent violence and to assess whether they vary by sex and across different types and levels of violence. METHODS: Data from a 5-year longitudinal self-report survey of more than 4300 high school seniors and dropouts from California and Oregon were used to regress measures of relational, predatory, and overall violence on predictors measured 5 years earlier. RESULTS: Deviant behavior in grade 7, poor grades, and weak bonds with middle school predicted violent behavior 5 years later. Attending a middle school with comparatively high levels of cigarette and marijuana use was also linked with subsequent violence. Early drug use and peer drug use predicted increased levels of predatory violence but not its simple occurrence. Girls with low self-esteem during early adolescence were more likely to hit others later on; boys who attended multiple elementary schools were also more likely to engage in relational violence. CONCLUSIONS: Violence prevention programs for younger adolescents should include efforts to prevent or reduce troublesome behavior in school and poor academic performance. Adolescent girls may also profit from efforts to raise self-esteem; adolescent boys may need extra training in resisting influences that encourage deviant behavior. Programs aimed at preventing drug use may yield an added violence-reduction bonus. (+info)
Stalking--a contemporary challenge for forensic and clinical psychiatry.
(38/1954)
BACKGROUND: Stalking is causing pervasive and intense personal suffering and is an area of psychiatry that is currently overlooked. AIMS: To review demographic and clinical characteristics of stalkers as well as the psychological consequences for victims of stalking. METHOD: A Medline and PsycLit search was conducted on stalking, forensic psychiatry, personality disorders, de Clerambault syndrome and erotomania, with respect to the relevance of the articles selected for stalking. RESULTS: Stalkers are best thought of as a heterogeneous group whose behaviour can be motivated by different forms of psychopathology, including psychosis and severe personality disorders. CONCLUSIONS: There is a clear need to arrive at a consensus on a typology of stalkers and associated diagnostic criteria. The effectiveness of psychological and pharmacological treatments have not yet been investigated. Treatment may need to be supplemented with external incentives provided by the legal system. (+info)
Outcome evaluation of a multi-component violence-prevention program for middle schools: the Students for Peace project.
(39/1954)
This study evaluated the effect of Students for Peace, a multi-component violence-prevention intervention, on reducing aggressive behaviors among students of eight middle schools randomly assigned into intervention or control conditions. The intervention, based on Social Cognitive Theory, included the formation of a School Health Promotion Council, training of peer mediators and peer helpers, training of teachers in conflict resolution, a violence-prevention curriculum, and newsletters for parents. All students were evaluated in the spring of 1994, 1995 and 1996 (approximately 9000 students per evaluation). Sixth graders in 1994 were followed through seventh grade in 1995 or eighth grade in 1996 or both (n = 2246). Cohort and cross-sectional evaluations indicated little to no intervention effect in reducing aggressive behaviors, fights at school, injuries due to fighting, missing classes because of feeling unsafe at school or being threatened to be hurt. For all variables, the strongest predictors of violence in eighth grade were violence in sixth grade and low academic performance. Although ideal and frequently recommended, the holistic approach to prevention in schools in which teachers, administrators and staff model peaceful conflict resolution is difficult to implement, and, in this case, proved ineffective. The Students for Peace experience suggests that interventions begin prior to middle school, explore social environmental intervention strategies, and involve parents and community members. (+info)
Crack-cocaine users as victims of physical attack.
(40/1954)
This study evaluates the correlates of physical attack among people who use crack cocaine in Dayton, Ohio. Using a retrospective and prospective natural history design, data from baseline and 1-year follow-up interviews were used to calculate the prevalence of physical attack and the annual rate of physical attack suffered by 440 not-in-treatment crack-cocaine users. Logistic regression was used to determine the correlates of physical attack. The lifetime prevalence of physical attack was 63.0%; the annual rate was 36.8%. At baseline, daily crack users were more likely to report a previous attack since they began using crack (odds ratio [OR], 1.81; 95% confidence interval [CI], 1.18-2.77). Longer duration of crack use was also associated with experiencing an attack (OR, 1.09; 95% CI, 1.04-1.14). Between baseline and 12-month follow-up, the odds of men being attacked were significantly less than those for women (OR, 0.48; 95% CI, 0.23-0.99). Physical attack is widespread among crack-cocaine users, and does not vary by ethnicity. Injuries often result in the need for medical care. Over the short term, women are at increased risk. Accessible and effective drug abuse treatment is needed to diminish the harm this population suffers. (+info)