Bart Hammig

Academic Achievement, Violent Victimization, and Bullying Among U.S. High School Students

The authors examined the relationship between adolescents’ experiences with violent victimization and academic achievement. Data from the 2009 Youth Risk Behavior Survey were analyzed for males (N = 8,537) and females (N = 7,816). Multinomial logistic regression analyses were employed to estimate the relationship between academic achievement and violent victimization. Among males and females, 6.6% and 4.4%, respectively, earned grades of mostly Ds or Fs during the past year. Among males, those earning mostly Ds or Fs had an increased odds of having been injured in a fight (adjusted odds ratio [OR] = 2.2, 95% confidence interval [95% CI]: 1.5-3.3) or threatened at school (OR = 2.0, 95% CI: 1.3-2.9) when compared to males who earned mostly As or Bs. Moreover, those who earned mostly Cs were at increased odds of having been threatened at school when compared to males who earned mostly As or Bs (OR = 1.4, 95% CI: 1.1-1.9). Among females, those earning mostly Ds or Fs had a higher odds of having been bullied at school (OR = 1.6, 95% CI: 1.1-2.3 ), threatened at school (OR = 1.5, 95% CI: 1.1-2.3), or violently victimized by an intimate partner (OR = 2.0, 95% CI: 1.4-3.0) when compared to females who earned mostly As or Bs. Similar findings were observed when examining females earning mostly C grades. Academic achievement is linked to victimization patterns among male and female adolescents. Although the temporality of the relationship is unclear, the strength of the associations increase as academic achievement decreases.

Influence of Professional Preparation and Class Structure on Sexuality Topics Taught in Middle and High Schools

BACKGROUND This study examined the impact of professional preparation and class structure on sexuality topics taught and use of practice-based instructional strategies in US middle and high school health classes. METHODS Data from the classroom-level file of the 2006 School Health Policies and Programs were used. A series of multivariable logistic regression models were employed to determine if sexuality content taught was dependent on professional preparation and /or class structure (HE only versus HE/another subject combined). Additional multivariable logistic regression models were employed to determine if use of practice-based instructional strategies was dependent upon professional preparation and/or class structure. Years of teaching health topics and size of the school district were included as covariates in the multivariable logistic regression models. RESULTS Findings indicated professionally prepared health educators were significantly more likely to teach 7 of the 13 sexuality topics as compared to nonprofessionally prepared health educators. There was no statistically significant difference in the instructional strategies used by professionally prepared and nonprofessionally prepared health educators. Exclusively health education classes versus combined classes were significantly more likely to have included 6 of the 13 topics and to have incorporated practice-based instructional strategies in the curricula. CONCLUSIONS This study indicated professional preparation and class structure impacted sexuality content taught. Class structure also impacted whether opportunities for students to practice skills were made available. Results support the need for continued advocacy for professionally prepared health educators and health only courses.

Injuries associated with the use of riding mowers in the United States, 2002-2007

CONTEXT To examine injuries among patients treated in an emergency department (ED) related to the use of a riding lawn mower. DESIGN AND SETTING Data were obtained from the National Electronic Injury Surveillance System for the years 2002-2007. National estimates of ED visits for injuries associated with the use of a riding lawn mower were analyzed. Narrative text entries were categorized to provide a detailed record of the circumstances precipitating the injury. Average annual rates were calculated and logistic regression analyses were employed to determine risk estimates for patient disposition and demographic characteristics related to ED visits for injuries associated with riding mowers. RESULTS From 2002 through 2007, there were an estimated 66,341 ED visits for injuries related to the use of riding lawnmowers in the U.S., with an average annual rate of 6.0 ED visits per 100,000 males, and 1.6 ED visits per 100,000 females. Older adults had higher rates of ED visits for injuries (7.2/100,000) than younger age groups. The most common injuries involved contusions (24%); sprains/strains (22%) and fractures (17%). The majority of patients (90%) were treated and released the same day. Results of logistic regression analyses revealed that older adults were more likely to be hospitalized when compared to younger age groups; and incidents involving rollovers [OR=5.45 (95% CI=3.22-9.23)] and being run over [6.01 (95% CI 3.23-11.17)] were more likely to result in hospitalization when compared to all other circumstances of injury. CONCLUSIONS Riding mowers present injury patterns and circumstances that are different than those reported for push mowers. Circumstances related to injuries and age groups affected were varied, making prevention of riding mower injuries challenging. APPLICATION/IMPACT: Findings support the need to increase awareness and/or change the design of riding mowers with respect to risk of rollover injuries.

Case Report: Injuries Associated with Interactive Game Consoles: Preliminary Data

Abstract The use of motion-sensing video game software has provided users with the ability to mimic movements in many sports such as baseball, tennis, and boxing. Epidemiology on injuries and overuse of motion-sensing video game systems is minimal because the systems have only been available for 2 years. This case series report presents preliminary data on injuries related to the game systems from the first full year of use. Methods included the use of secondary data from the National Electronic Injury Surveillance System for 2007. The query found 21 cases of injury related to the use of the “Wii” video game system (Nintendo of America Inc., Redmond, WA). Results indicated that females were more prone to injuries, and the mean age was 16 years. Most injuries were soft tissue in nature and located in the shoulders, hands and fingers, and the face and neck region. Our discussion includes prevention strategies for reducing injury risk when playing motion-sensing video games.

The relationship between professional preparation and class structure on health instruction in the secondary classroom.

BACKGROUND The aim of the present study was to examine the impact of professional preparation and class structure on health content delivery and time spent delivering content among required health education classes in the United States. METHODS Data from the classroom-level file of the 2006 School Health Policies and Programs Study were utilized. A series of multivariable logistic regression models were employed to determine if instruction of content was dependent on professional preparation and/or class structure. Years of teaching health topics and size of the school district were included as covariates in the multivariable logistic models. We also conducted a multivariable logistic regression model to examine if time spent teaching each topic area was dependent upon professional preparation and/or class structure. RESULTS Findings indicated that professionally prepared teachers were significantly more likely to deliver content in 6 of 12 health topic areas when compared to untrained teachers. Class structure was also an important predictor of content delivery among many topic areas. Teachers who taught classes that were devoted to health instruction were significantly more likely to deliver content in the following topic areas: alcohol/drug prevention, tobacco prevention, sexuality, pregnancy, human immuno virus and sexually transmitted disease prevention, emotional/mental health and suicide, and violence prevention. CONCLUSIONS Research concerning the relationship between professional preparation and teaching outcomes is scant. The present study indicates that health content coverage and time spent on instruction are associated with both professional preparation and class structure for many health content areas.

Injury-related visits and comorbid conditions among homeless persons presenting to emergency departments.

OBJECTIVES The authors examined the clinical characteristics of homeless patients presenting to emergency departments (EDs) in the United States, with a focus on unintentional and intentional injury events and related comorbid conditions. METHODS The study included a nationally representative sample of patients presenting to EDs with data obtained from the 2007 through 2010 National Hospital Ambulatory Medical Care Survey (NHAMCS). Descriptive and analytical epidemiologic analyses were employed to examine injuries among homeless patients. RESULTS Homeless persons made 603,000 visits annually to EDs, 55% of which were for injuries, with the majority related to unintentional (52%) and self-inflicted (23%) injuries. Multivariate logistic regression analyses revealed that homeless patients had a higher odds of presenting with injuries related to unintentional (odds ratio [OR]=1.4. 95% confidence interval [CI]=1.1 to 1.9), self-inflicted (OR=6.0, 95% CI=3.7 to 9.5), and assault (OR=3.0, 95% CI=1.5 to 5.9) injuries. CONCLUSIONS A better understanding of the injuries affecting homeless populations may provide medical and public health professionals insight into more effective ways to intervene and limit further morbidity and mortality related to specific injury outcomes.

2015 Legislative update of e-cigarette youth access and exposure laws.

BACKGROUND As of November 15, 2013, 22 states had passed laws explicitly addressing youth access to electronic cigarettes (e-cigarettes); by 2014, this increased to 41 states. Also in 2014, more than 13.4% of youth in the U.S. reported using e-cigarettes, making e-cigarette use more prevalent than conventional cigarette use (9.2%). METHODS We examined 221 bills addressing youth access and exposure to e-cigarettes between January 1 and November 1, 2015. Text searches on individual state general assembly websites and secondary sources were employed for data collection. Laws were analyzed using seven measures identified to protect adolescents from nicotine initiation and use. RESULTS Two states (MI, PA) and Washington D.C. do not regulate the sale or distribution of e-cigarettes to youth as of November 1, 2015. Additionally, seventeen states have passed laws requiring e-cigarettes to use child-safety packaging to minimize unintended poisoning. As of July 1, 2016, four states (KS, LA, MN, and NC) will tax e-cigarettes. Oregon prohibits the use of e-cigarettes in cars with children under 18years of age, and Wyoming requires the public health department to develop educational campaigns to better educate the state on the risks of nicotine and tobacco products. CONCLUSION While states are closing the gap of youth nicotine exposure, there remains a need to protect youth from e-cigarettes access, which can cause adverse health effects of brain development, lung function and potentially lead to addiction. Recommendation for the FDA to regulate e-cigarettes federally would close this regulation gap and protect youth across the U.S.

Health Education Counseling During Pediatric Well-Child Visits in Physicians’ Office Settings

Objective. The current study assessed factors associated with health education counseling during well-child visits. Methods. Data from the 2007-2010 National Ambulatory Medical Care Survey (NAMCS) were used to examine well-child visits made to physicians’ offices in the United States. Logistic regression models examined the relationship between the provision of health education counseling and selected covariates. Health education provisions measured included injury prevention, nutrition, exercise, tobacco use, and weight reduction. Results. A total of 4837 well-child visits were identified during the study period, which is equivalent to a weighted estimate of 43.4 million well-child visits annually. Multivariate analyses indicated that the length of the well-child visit was the predominant factor associated with delivery of health education counseling. Conclusions. Provider education and counseling of patients concerning health behaviors were implemented at a low level. Time spent with the patient was associated with the majority of health education counseling. Implications for pediatric practice are discussed.

Influence of professional preparation and class structure on HIV, STD, and pregnancy prevention education

Objective: The purpose of this study was to determine if education about human immunodeficiency virus (HIV)/sexually transmitted disease (STD) and pregnancy prevention is dependent on professional preparation and/or class structure. Design: A secondary data analysis of the 2006 School Health Policies and Programmes Study (SHPPS) was conducted. Setting: Data were obtained from the health education classroom level questionnaire of the 2006 SHPPS. Methods: A series of multivariable logistic regression models (N = 34) were computed to determine if instruction of HIV/STD and/or pregnancy prevention content was dependent on professional preparation and/or class structure. Results: Professionally prepared health educators were found to be significantly more likely than their counterparts to teach about teenage age pregnancy risks, teenage pregnancy impacts, finding information/services related to pregnancy, finding information/services related to HIV, and HIV diagnosis/treatment. These topics and three others (methods of contraception, signs/symptoms of HIV and compassion for persons with HIV/AIDS) were significantly more likely to be taught in health-only classes versus combination classes. Conclusion: Findings from the current study support the need for professionally prepared educators and stand-alone class structure in terms of providing the most effective sexual health education.

Pediatric Injuries Associated With Fireplaces, United States, 2002-2007

Objective: To examine injuries among pediatric patients treated in an emergency department (ED) related to contact with a fireplace. Methods: Data were obtained from the National Electronic Injury Surveillance System for the years 2002 through 2007. National estimates of ED visits for injuries associated with fireplaces were analyzed. Average annual rates were calculated, and logistic regression analyses were used to determine risk estimates for patient demographic characteristics related to ED visits for injuries associated with fireplaces. Results: From 2002 through 2007, there were an estimated 8000 ED visits annually for injuries related to fireplaces in the United States, with an average annual rate of 18.8 ED visits per 100,000 children aged birth through 10 years. The most common injuries involved lacerations (66%), burns (10%), and contusions (10%). Most injuries occurred to the face (46%) or head (31%). Most patients (98%) were treated and released the same day. Results of logistic regression analyses revealed that children aged birth to 3 years (odds ratio, 12.2; 95% confidence interval, 9.1-16.5) and children aged 4 to 6 years (odds ratio, 4.8; 95% confidence interval, 3.5-6.5) were more likely present in an ED for a fireplace-related injury when compared with older children aged 7 to 10 years. Conclusions: Further research is warranted in the areas of etiology, injury prevention interventions, health communications, and surveillance to facilitate more effective injury prevention efforts.