Andrea L. Huseth-Zosel

Front Versus Rear Seat Placement of Children Aged 12 or Younger Within Vehicles: A Rural/Urban Comparison in North Dakota

Objective: Research has shown that rear-seated children are 36 to 40 percent safer than front-seated children. Because of the substantial differences in traffic safety culture that appear to exist in rural areas and the limited research regarding seat placement and rurality, this study seeks to contribute to the safety literature by determining at what rate children are riding in the front seat and whether differences exist between rural and urban areas in regards to child front seat placement. Methods: Current child placement frequencies within vehicles were ascertained through direct observations of morning child drop-offs at randomly selected urban and rural elementary schools in eastern North Dakota during November and December of 2009, with a focus on children aged 12 or younger. Two observers wearing orange safety vests and carrying observation sheets were stationed at each elementary school a minimum of 45 min prior to each schools designated start time. Based on the vehicles that entered the schools parking lot/drop-off circle and from which a minimum of one child exited, observers were instructed to record vehicle type, presence of children in the front seat appearing to be younger than 13 years old, availability of room in the back seat, and placement of other children in the vehicle. Results: During November and December of 2009 a total of 537 vehicles were observed at urban schools and 150 vehicles were observed at rural schools. Of the 537 vehicles observed at urban schools, 28.7 percent had children seated in the front seat, whereas 41.3 percent of the 150 vehicles observed at rural schools had front-seated children. Significant urban/rural differences exist in child seat placement, with vehicles in rural areas much more likely to be carrying front-seated children than vehicles in urban areas. Conclusions: Based on a sample of vehicles observed at urban and rural elementary schools in North Dakota, the results of this study indicate that there are significant rural/urban differences in child seat placement.

Socioeconomic differences in the menopausal experience of Chinese women

Objective This study explores the effect of employment status, occupation and education on menopausal symptoms experienced by women in an urban community in China. Study design Cross-sectional survey. Main outcome measures Menopausal symptoms, medication/supplement use to relieve menopausal symptoms, sociodemographic variables. Results Risks for more burdensome menopausal symptoms include less education, non-white collar occupation and unemployment/retirement status. Being employed in a white collar occupation and having higher formal education were protective for hot flashes, dry skin/eyes, heart palpitations and insomnia and were associated with increased usage of medication to alleviate menopausal symptoms. Conclusions As Chinese women age and continue working longer, they will spend increasing amounts of time postmenopausal and in the workplace. The development of worksite-based health programmes would be advantageous to female workers of menopausal age in China.

Health care provider mobility counseling provision to older adults: a rural/urban comparison

Abstract The current study examined rural–urban differences in health care provider (HCP) perceptions, attitudes, and practices related to driving safety/cessation-related anticipatory guidance provision to older adults. A cross-sectional survey was conducted with HCPs in several north central states. Exploratory factor analysis was used to examine dimensions of HCP perceptions and attitudes related to mobility counseling. Binary logistic regression analyses were conducted to determine if HCP rurality was significantly predictive of HPC provision of mobility counseling by age. Rural HCPs were less likely than urban HCPs to provide mobility counseling to their patients aged 75 or older. Rural HCPs were less likely to refer patients to a driving fitness evaluation resource if they had questions related to driving issues, and were less likely to perceive there were adequate resources to help with driving issues. Rural–urban differences in HCP mobility counseling provision may contribute to potential health disparities between urban and rural patients. Both rural and urban HCPs need training about older driver issues, so they may educate their patients about driving safety/cessation. Future research should examine the association between rural–urban differences in HCP mobility counseling provision and rural older adult overrepresentation in motor vehicle injuries and fatalities statistics.

Risky Driving Behaviors for Older Adults: Differences by Veteran’s Status

Veterans are at an increased risk of being injured or killed in motor vehicle crashes, potentially due to their proclivity to engage in risky driving behaviors. However, most research in this area has focused on driving behaviors of veterans who have recently returned home after deployment. No research has focused on risky driving behaviors of older veterans (aged 65 or older) and if risky driving behaviors extend beyond the time period immediately following return from deployment. The purpose of this research is to determine if differences exist in risky driving behaviors of veterans and non-veterans aged 65 or older. This study used data from the 2011 National Health and Aging Trend Study (NHATS), a nationally representative, longitudinal survey of community-dwelling, Medicare beneficiaries aged 65 or older. Binary logistic regression analyses were conducted in 2017 to determine if veteran’s status was predictive of specific risky driving behaviors. Veteran’s status was found to be predictive of specific driving behaviors for adults aged 65 and older, with non-veterans significantly more likely than veterans to: not currently drive; avoid driving at night; avoid driving alone; avoid driving on busy roads or highways; and avoid driving in bad weather. The results of this study highlight the need to further understand the effects of veteran’s status on risky driving behaviors among older adults, specifically, whether veteran’s status compounds driving-related risks associated with aging-related physical and mental changes.

Parental perceptions of child placement within vehicles: a focus group study

ABSTRACT Although rear-seating children in motor vehicles results in fewer injuries and fatalities in motor vehicle crashes, many children continue to be front-seated. This study seeks to identify parental barriers to rear-seating children in motor vehicles and strategies to increase child rear seat placement. Focus groups were conducted with parents of children 12 or younger to determine barriers to rear seating and strategies to increase child rear seat placement. Barriers to rear seat placement identified include the logistics of transporting multiple children with limited rear seat availability, the potential of children to harm themselves if rear-seated, and peer pressure. Parents felt there should be no option to sit elsewhere within the vehicle to help normalize rear-seating. Successful interventions to increase child rear seat placement should focus on parental barriers to rear-seat their children in vehicles, including normalizing rear seat placement, and determining approaches to make rear-seat placement with multiple children uncomplicated.

Predictors of health care provider anticipatory guidance provision for older drivers

ABSTRACT Objective: The objective of this study was to determine the frequency of health care provider (HCP) driving safety/cessation-related anticipatory guidance provision and predictors of driving safety-related anticipatory guidance provision by HCPs. Methods: HCPs in several central/upper Midwest states were surveyed about frequency of anticipatory guidance provision (n = 265). Results: More than half of HCPs stated that they frequently or always provide driving safety/cessation-related anticipatory guidance to patients aged 85 or older, 38.7% provided this guidance to patients aged 75 to 84, and 13.7% to patients aged 65 to 74. Predictors of driving safety/cessation-related anticipatory guidance provision differed by patient age. For patients aged 65–74, HCP personal experience with a motor vehicle crash (either the HCP themselves or a friend/family member) was significant in predicting anticipatory guidance provision. However, for patients aged 75 and older, significant predictors included HCP rural practice, HCP age, and percentage of HCP patients who were older adults. Conclusion: HCP counseling provision related to driving issues differs by patient age and several HCP characteristics, including HCP rurality, age, and personal experience with motor vehicle crashes. Because aging results in physical and mental changes that affect driving and can be identified by HCPs, HCPs are in a position to counsel patients on the potential impacts of aging on the act of driving. Future research should examine the reasons for the differences in anticipatory guidance provision found in this study.

Menopause and the risk of metabolic syndrome among middle-aged Chinese women

Objective This study explored the relationship between menopause and metabolic syndrome (MetS), stroke, hyperlipidemia, diabetes and hypertension. Study design This cross-sectional study surveyed 440 women in Yuci, China in 2012. Main outcome measures MetS, diabetes, hypertension, hyperlipidemia, stroke, and behavioral and demographic variables. Results The prevalence of MetS in this study was 40.28% to 49.66% (p=0.065) among pre- and post-menopausal women, respectively, after adjusting for age. Conclusions The prevalence of diabetes, stroke, hypertension, and hyperlipidemia was higher among post- than pre-menopausal women. Health screenings for women in China should consider the increased risk for metabolic disorders during the postmenopausal stage of life.