Risk Of Unintentional Injury Research Articles

Depressive Symptoms and Sleepiness Among Latino Farmworkers in Eastern North Carolina

ABSTRACT Depression and sleepiness are both risk factors for occupational accidents and unintentional injury. Relatively little is known about the experiences of these risk factors in the immigrant Latino farmworker population. This analysis uses prospective panel data from a sample of Latino farmworkers in eastern North Carolina that were collected at monthly intervals during the 2008 agricultural season to (1) describe depressive symptoms and daytime sleepiness among immigrant Latino farmworkers across the agricultural season; (2) delineate associations of depressive symptoms with sleepiness across time; and (3) determine whether depressive symptoms precede sleepiness, or if sleepiness precedes depressive symptoms. Results indicated that 45% of farmworkers experienced elevated depressive symptoms across the season, whereas 20% experienced elevated sleepiness. Elevated depressive symptoms were more common among farmworkers living in barracks, and less common among those living in trailers. Sleepiness was more common among women than men. There was no evidence that depressive symptoms contributed to sleepiness, or that sleepiness contributed to depressive symptoms. The pattern of results suggests that a substantial proportion of Latino farmworkers experience levels of depressive symptoms or sleepiness that places them at risk for occupational accident or unintentional injury. The results also suggest that depressive symptoms and sleepiness do not cause each other; rather, the association of depressive symptoms with sleepiness hints at the possibility of a common physiologic mechanism such as circadian disruption.

Caregiver Perspectives on Unintentional Injury Risk in Children With an Autism Spectrum Disorder

Unintentional injury risk research for children with an autism spectrum disorder (ASD) is currently limited. This article presents findings from a two-phase investigation of caregiver perspectives regarding unintentional injury risk in children with an ASD. Results indicate that children with an ASD exhibit elevated rates of risk-taking behaviors compared with peers, which increases the likelihood of more frequent and severe injuries. In addition, although ASD symptom severity positively correlated with risk-taking behavior and frequency of injury, children with an ASD were rarely rated as high risks for injury by caregivers. Implications are discussed in the context of pediatric health service provision.

Cocaine-related medical and trauma problems

The purpose of this retrospective study was to describe the spectrum of medical and trauma complications associated with self-reported cocaine use. Patient databases of 23 emergency departments were searched for consultations related to cocaine use between January 2007 and December 2008. The population included 569 men (84.4%) and 105 women (15.6%): 505 (74.9%) patients were nondependent cocaine users and 169 (25.1%) were dependent cocaine users. The majority of patients (63.8%) used other drugs in combination with cocaine. Psychiatric symptoms were most frequently reported (60.9%), followed by cardiopulmonary (38.2%), gastrointestinal (22.5%), neurological (20.8%) and constitutional (17.2%) symptoms. Of psychiatric complaints, anxiety was the most common (31.5%). Sex-adjusted and age-adjusted odds ratio (OR) showed that palpitations were associated within 12 h of cocaine use [OR 2.05; 95% confidence interval (CI): 1.12-3.76], and psychotic symptoms (OR 3.05; 95% CI: 1.02-9.18) and hallucinations (OR 7.50; 95% CI: 1.12-50.31) were associated within more than 12 h of the use of cocaine. In a comparison of dependent and nondependent cocaine users, after adjusting for age and sex, cardiopulmonary symptoms (OR 1.56; 95% CI: 1.08-2.24) and paranoia (OR 2.14; 95% CI: 1.08-4.24) were associated with nondependent use of cocaine, and lethargy (OR 7.14; 95% CI: 1.55-35.56) was associated with dependent use of cocaine. The primary cause of trauma was unintentional injuries (32.4%). Sex-adjusted and age-adjusted OR showed a major risk for unintentional injuries with nondependent use of cocaine (OR 6.17; 95% CI: 1.38-42.29). The study shows that cocaine users experience diverse symptoms and may present with a wide range of physical findings.

Cannabis Use and Traffic Injuries

Cannabis Use and Traffic Injuries

Unhealthy and unsafe practices associated with symptoms of depression among injured patients

Each year, some 20.9 million US adults suffer from a diagnosable depressive disorder (Kessler, Chiu, Demler & Walters, 2005). Greater numbers have subclinical depressive symptoms, which are associated with increased risk of major depression, physical disability, and medical illness (Kessler, Berglund, Demler, Jin & Walters, 2005; World Health Organization, 2004). Depression, a major contributing factor to deliberate self-harm (McLean, Maxwell, Platt, Harris, & Jepson, 2008), is also associated with increased unintentional injury risk (American Geriatrics Society [AGS], British Geriatrics Society, & American Academy of Orthopaedic Surgeons, 2001, Tiesman et al., 2006). Mood disorders are common in patients presenting for acute injury (Richmond Hollander, Ackerson, Robinson, Gracias, Shults & Amsterdam, 2007). The potential connection between depressive symptoms and poor health and safety practices, which may further contribute to risk of injury, disability and illness, has not been fully delineated (Cannella & Scoloveno, 2003; Yarcheski, Mahon, Yarcheski, & Cannella, 2004). Many studies investigating this relationship have focused solely on young people (Allgower, Wardle, & Steptoe, 2001; Babiss & Gangwisch, 2009; Mahon, Yarcheski, & Yarcheski, 2001; Melnyk et al., 2006; Yarcheski, Mahon, & Yarcheski, 2004), while those investigating adults have been limited by the practices assessed (i.e. physical activity alone) (Farmer, Locke, Moscicki, Dannenberg, Larson & Radloff, 1988) or their restricted study samples (Igna, Julkunen, Vanhanen, Keskivaara, & Verkasalo, 2008; Bonnet, Irving, Terra, Nony, Berthezene & Moulin, 2005; Gazmararian, Baker, Parker, & Blazer, 2000). Only one population-based study has examined a wide variety of health practices among a large sample of adults of all ages (Strine, Mokdad, Dube, Balluz, Gonzalez, Berry & Kroenke, 2008), finding positive associations between current or lifetime depression and smoking, physical inactivity, binge drinking, and heavy drinking. A similar, negative association between depression and safety behaviours (e.g., seat belt use), which are also important health-promoting practices, has been reported in a few studies of young people (Allgower et al., 2001; Mahon et al., 2001; Yarcheski, Mahon, & Yarcheski, 2004) and in one study of adult farm residents (Stallones & Beseler, 2004). However, there is little available evidence on the relationship between safety practices and depressive symptoms in the general adult population. Further, although studies have found that depressive symptoms are an important risk factor for acute injury (AGS et al., 2001; Cox, Kenardy, & Hendrikz, 2008; Richmond et al., 2007; Richmond et al., 2009; Stoddard & Saxe, 2001; Tiesman et al., 2006), we found no studies examining the association between safety or health practices and depression among trauma patients.

Policies for alcohol restriction and their association with interpersonal violence: a time-series analysis of homicides in Cali, Colombia

Cali, Colombia, has a high incidence of interpersonal violence deaths. Various alcohol control policies have been implemented to reduce alcohol-related problems. The objective of this study was to determine whether different alcohol control policies were associated with changes in the incidence rate of homicides. Ecologic study conducted during 2004-08 using a time-series design. Policies were implemented with variations in hours of restriction of sales and consumption of alcohol. Most restrictive policies prohibited alcohol between 2 a.m. and 10 a.m. for 446 non-consecutive days. Moderately restrictive policies prohibited alcohol between 3 a.m. and 10 a.m. for 1277 non-consecutive days. Lax policies prohibited alcohol between 4 a.m. and 10 a.m. for 104 non-consecutive days. In conditional autoregressive negative binomial regressions, rates of homicides and unintentional injury deaths (excluding traffic events) were compared between different periods of days when different policies were in effect. There was an increased risk of homicides in periods when the moderately restrictive policies were in effect compared with periods when the most restrictive policies were in effect [incidence rate ratio (IRR) 1.15, 90% confidence interval (CI) 1.05-1.26, P = 0.012], and there was an even higher risk of homicides in periods when the lax policies were in effect compared with periods when the most restrictive policies were in effect (IRR 1.42, 90% CI 1.26-1.61, P < 0.001). Less restrictive policies were not associated with increased risk of unintentional injury deaths. Extended hours of sales and consumption of alcohol were associated with increased risk of homicides. Strong restrictions on alcohol availability could reduce the incidence of interpersonal violence events in communities where homicides are high.

The association of activity level, parent mental distress, and parental involvement and monitoring with unintentional injury risk in fifth graders

ObjectiveExtend findings with young children by examining the strength of association of activity level, parent mental distress, and parental involvement and monitoring with fifth graders’ unintentional injuries. MethodsOrdinal logistic regression models were used to predict unintentional injury frequency among 4745 fifth-graders. Examined predictors included demographics, parent reports of mental distress, temperamental activity level (tendency to be fidgety, restless, and constantly in motion), and parental involvement and monitoring in adolescents’ lives. ResultsHigher levels of both activity level and parent mental distress predicted more frequent injuries. ConclusionsAs has been found with younger children, unintentional injuries in fifth graders are associated with both parent and child characteristics. The result is discussed in the context of adolescent development. Implications include those for injury prevention (multi-dimensional prevention strategies that incorporate environmental modifications as well as training of youth and parents) and future research (study of potential mechanisms behind injury risk behavior via longitudinal and experimental research; study of injury risk during this phase of child development).

Environmental risk factors for injuries in UK primary school aged children

AimFactors previously associated with the risk of unintentional injury in primary school aged children include a range of child and family variables. Risk factors in the environment have been seldom...

Unintentional childhood injury burden, risks, and outcomes at the paediatric emergency unit in Kampala

Unintentional Childhood Injury burden, outcomes and risks are assessed in Kampala. Proportional incidence rates, percentages and injury odds are computed; risk trends are constructed. Five hundred and fifty-six childhood injuries...

Alcohol and injury in Atlantic Canada: creating a culture of safer consumption

Alcohol places individuals at increased risk of intentional and unintentional injuries, including suicide, violence, motor vehicle collisions and falls. The culture of alcohol consumption in Atlantic Canada contributes to the...

“Please keep an eye on your younger sister”: sibling supervision and young children's risk of unintentional injury

ObjectivesParental supervision reduces young children's risk of unintentional injuries, but supervision by older siblings has been shown to increase risk. The current study explored how this differential risk of injury...

A brief motivational interview in a pediatric emergency department, plus 10-day telephone follow-up, increases attempts to quit drinking among youth and young adults who screen positive for problematic drinking.

Adolescents in their late teens and early 20s have the highest alcohol consumption in the United States; binge drinking peaks at age 21-25 years. Underage drinking is associated with many negative consequences, including academic problems and risk of intentional and unintentional injuries. This study tested the effectiveness of pediatric emergency department (PED) screening and brief intervention to reduce alcohol consumption and associated risks. A three-group randomized assignment trial was structured to test differences between intervention (I) and standard assessed control (AC) groups in alcohol consumption and alcohol-related behaviors from baseline to 12 months and to compare the AC group with a minimally assessed control (MAC) group to adjust for the effect of assessment reactivity on control group behavior. Patients aged 14-21 years were eligible if they screened positive on the Alcohol Use Disorders Identification Test (AUDIT) or for binge drinking or high-risk behaviors. The MAC group received a resource handout, written advice about alcohol-related risks, and a 12-month follow-up appointment. Patients in the AC group were assessed using standardized instruments in addition to the MAC protocol. The I group received a peer-conducted motivational intervention, referral to community resources and treatment if indicated, and a 10-day booster in addition to assessment. Measurements included 30-day self-report of alcohol consumption and alcohol-related behaviors, screens for depression and posttraumatic stress disorder, and self-report of attempts to quit, cut back, or change conditions of use, all repeated at follow-up. Motor vehicle records and medical records were also analyzed for changes from baseline to 1-year follow-up. Among 7,807 PED patients screened, 1,202 were eligible; 853 enrolled (I, n = 283; AC, n = 284; MAC, n = 286), with a 12-month follow-up rate of 72%. At 12 months, more than half of enrollees in Reaching Adolescents for Prevention (RAP) attempted to cut back on drinking, and over a third tried to quit. A significantly larger proportion of the I group made efforts to quit drinking and to be careful about situations when drinking compared to AC enrollees, and there was a numerically but not significantly greater likelihood (p = 0.065) among the I group for efforts to cut back on drinking. At 3 months, the likelihood of the I group making attempts to cut back was almost triple that of ACs. For efforts to quit, it was double, and for trying to be careful about situations when drinking, there was a 72% increase in the odds ratio (OR) for the I group. Three-month results for attempts were sustained at 12 months for quit attempts and efforts to be careful. Consumption declined in both groups from baseline to 3 months to 12 months, but there were no significant between-group differences in alcohol-related consequences at 12 months or in alcohol-related risk behaviors. We found a pattern suggestive of assessment reactivity in only one variable at 12 months: the attempt to cut back (73.3% for the I group vs. 64.9% among the AC group and 54.8% among the MAC group). Brief motivational intervention resulted in significant efforts to change behavior (quit drinking and be careful about situations while drinking) but did not alter between-group consumption or consequences.

Childhood Behavior Problems and Unintentional Injury: A Longitudinal, Population-Based Study

Although an association between behavior problems and childhood injuries has been established, the majority of studies have been cross-sectional and comorbidity has not been taken into account. The purpose of this study was to prospectively assess the relationship between behavior problems and the risk of unintentional injury in a population-based sample of Canadian children aged 4 to 11 years. This prospective cohort study considered data from Cycles 1 and 2 of the Canadian National Longitudinal Survey of Children and Youth. The outcome was injury in Cycle 2 (2 years later). The exposure was the presence of behavior problems in Cycle 1, defined as children with hyperactivity only, aggression only, anxiety only, hyperactivity with aggression, hyperactivity with anxiety, aggression with anxiety, and hyperactivity with aggression and anxiety. All groups were compared to children with no behavior problems. Covariates included child-related, parental, and social-environmental factors. The final weighted longitudinal sample included 2,209,886 children, of which 11.4% were injured in Cycle 2. None of the behavior groups were at significant risk of injury 2 years later. However, children who lived with a single/no parent and children who did not live with a biological parent had a significantly greater risk of injury. After controlling for confounders, children who lived with a single/no parent had more than twice the risk of having an injury. We need to look beyond behavior problems, and possibly at family and environmental factors, to reduce the burden of injuries in the Canadian population.

Injury risk compensation in children with disabilities: could assistive technology devices have a dark side?

Purpose. This review article investigates the role of assistive technology (AT) devices and other contextual aspects as unintentional injury risk factors in children with disabilities.Method. A literature review was conducted to identify and review empirical studies that examined the role of AT devices, protective equipment (PE), and other consumer products in the risk-taking behaviors of children and their parents.Results. Nine original empirical studies and one systematic review examining changes in the risk-taking behaviors or injury levels associated with children's PE and other products were identified and critically reviewed. None of the articles specifically addressed the compensatory effect of AT devices. Since evidence of changes in the risk tolerance of children and their parents after the introduction of PE and other products for children exists, it is conceivable under certain conditions that AT devices could interact with other known risk factors to promote injury risk-taking behaviors in children and their parents.Conclusions. Outcomes of this review and current thinking about the interaction of health conditions and contextual factors provide a theoretical underpinning to explore the causal association among unintentional injury risk factors and AT device use by children with disabilities.

Negative Freedom and Death in the United States

Personal freedoms have been characterized as "positive" (freedom to pursue opportunities) and "negative" (freedom from external constraints on decision making). An ecological analysis of US data revealed a strong positive association (r = 0.41; P = .003) between state-level negative personal freedom (defined in terms of regulation of personal behavior) and state-level age-adjusted rates of unintentional injury. A conceptual emphasis on positive freedom construed as freedom to pursue a life without risk of unintentional injury could help motivate a conversation to improve public health.

Intelligence in early adulthood and subsequent risk of unintentional injury over two decades: cohort study of 1 109 475 Swedish men

BackgroundThere is growing evidence of an inverse association between intelligence (IQ) and unintentional injuries.MethodsAnalyses are based on a cohort of 1 109 475 Swedish men with IQ measured in early...

Does childcare influence socioeconomic inequalities in unintentional injury? Findings from the UK Millennium Cohort Study

BackgroundIn recent decades the proportion of infants and young children being cared for in childcare has increased. Little is known about the impact that non-parental care has on childhood unintentional...

Preventing Unintentional Pediatric Injuries at Evacuation Centers

Injury to children 1 to 14 years of age is the leading cause of death worldwide. The US has made concerted efforts to reduce the injury death rate to children by 45%. Such success depends on a multifaceted strategy that requires local, community coalitions and effective customized solutions. During a natural disaster, the risk of injury for children increases with the movement to a "safe environment." Implementation of low cost, effective injury prevention has a salutary impact upon the lives of children and can reduce the risk of preventable unintentional injury during a natural disaster.

Configural Approaches to Temperament Assessment: Implications for Predicting Risk of Unintentional Injury in Children

This study used two configural approaches to understand how temperament factors (surgency/extraversion, negative affect, and effortful control) might predict child injury risk. In the first approach, clustering procedures were applied to trait dimensions to identify discrete personality prototypes. In the second approach, two- and three-way trait interactions were considered dimensionally in regression models predicting injury outcomes. Injury risk was assessed through four measures: lifetime prevalence of injuries requiring professional medical attention, scores on the Injury Behavior Checklist, and frequency and severity of injuries reported in a 2-week injury diary. In the prototype analysis, three temperament clusters were obtained, which resembled resilient, overcontrolled, and undercontrolled types found in previous research. Undercontrolled children had greater risk of injury than children in the other groups. In the dimensional interaction analyses, an interaction between surgency/extraversion and negative affect tended to predict injury, especially when children lacked capacity for effortful control.

Brief Report: Unintentional Injury Risk among Children with Sensory Impairments

Pediatric injuries result from a multifaceted process involving a range of individual, interpersonal, and environmental influences. One risk that remains poorly understood is the role of children's perception and perceptual disabilities. Injury counts (parent-report of injuries requiring professional medical treatment over the past year) in three groups of children were compared: those without vision or hearing sensory impairments, those with deficits who use eyeglasses or hearing aids, and those with deficits who do not use aids as recommended. A national sample of 7391 5-year-olds in the National Head Start/Public School Early Childhood Transition Demonstration Study was studied. Injury counts over the past year were higher among children with sensory impairments, and higher still among children with sensory impairments who did not use prescribed sensory aids. Awareness of increased injury risk among children with hearing and vision impairment could help professionals protect children from injury.