Haikang Shen

Violence and injury in marital arguments: risk patterns and gender differences.

OBJECTIVES Community-based research on violence against women typically focuses on marital arguments rather than on resulting injuries. This study investigated patterns of victimization, violence perpetration, and injury in marital arguments. METHODS Data from the National Survey on Families and Households and binomial and multinomial logit models were used to analyze characteristics of those who experienced physical violence, as well as to determine who was the perpetrator and who was the victim. RESULTS Men and women reported similar behaviors during verbal arguments. Young persons, urban dwellers, the less educated, those with low incomes, and Blacks were more likely to report that there had been physical violence in their marriages in the past year. Ethnicity, income, education, and number and age of children at home were not associated consistently with injury of the wife, the husband, or both. CONCLUSIONS Persons who report physical violence in their marriage are very similar to those who are at increased risk of interpersonal violence in general. The co-occurrence of street and other nonfamily violence with spousal violence may be a fruitful area for future research.

Physical Complaints, Medical Service Use, and Social and Employment Changes Following Mild Traumatic Brain Injury: A 6–month Longitudinal Study

Using a prospective, dual-cohort study design in which selected preinjury factors were controlled, we present outcomes of 235 patients in a case cohort and 235 patients in a comparison cohort following emergency-department-diagnosed mild traumatic brain injury (MTBI). Symptoms, medical services use, and social and employment concerns were evaluated 6 months after the injury. After adjusting for preinjury characteristics, headaches, dizziness, vision difficulties, memory or learning problems, and alcohol intolerance were found to occur significantly more often in the MTBI cohort than in the comparison cohort. Problems sleeping, use of prescribed medications, and changes in employment were less likely in the MTBI cohort. Although MTBI is not life threatening, our findings suggest that 6 months after injury persons still have related health problems that require routine medical management.

The Effect of Drug Treatment on Criminal Behavior among Adolescents in DATOS-A

This study examined criminal activity among 1,167 adolescents who participated in a community-based substance abuse treatment study (Drug Abuse Treatment Outcome Studies for Adolescents) (DATOS-A). The primary goals of this study were to assess the effect of substance abuse treatment on adolescent crime and to identify the patient characteristics that were most closely associated with reductions in crime during the posttreatment period. Results confirmed that among adolescents who had engaged in criminal activity during the 12 months prior to entering DATOS-A treatment, reductions in alcohol or marijuana use were independently associated with significant reductions in the likelihood of committing crimes during the 12-month follow-up period. The present study also provides further support for emphasizing dynamic rather than static patient characteristics to predict the likelihood of continued drug-related offending among substance-abusing adolescents.

Injuries to high school football athletes in California

Background Among all high school sports, football has the highest rate of injury. Prior research has been limited primarily because of challenges in surveillance, defining injuries, and measuring exposures. Hypothesis Football injury patterns differ across player and session characteristics. Study Design Descriptive epidemiology study. Methods More than 5000 football players from 87 high schools in California were observed for 2 seasons (2001 and 2002). School representatives were trained to collect data on injuries, player characteristics, and daily exposures. Data were analyzed using descriptive statistics and clustered Poisson regression. Results Players sustained 25.5 injuries per 100 players, 9.3 injuries per 10 000 player-hours, and 8.4 injuries per 100 session-hours. Session rates were highest during games, on artificial turf (13.8 of 100), during foggy weather (25.1 of 100), and on clear evenings (21 of 100). Offensive and defensive backfielders had about a 20% increased rate of injury compared with linemen. The adjusted injury rate for starters was 60% higher than the rate for nonstarters (relative rate, 1.6; 95% confidence interval, 1.4-1.9). Conclusion Risk profiles differed by experience, playing position, and surface types. We recommend future sports injury research that measures time-dependent exposures at the individual level and for various types of environmental playing conditions.

LOWER EXTREMITY INJURIES FROM MOTORCYCLE CRASHES: A COMMON CAUSE OF PREVENTABLE INJURY

Lower extremity injuries are among the most common injuries sustained by motorcycle riders in crashes and often lead to extended and costly medical treatment and permanent disability. This study characterizes lower extremity injuries in a group of 700 motorcycle riders in crashes in Los Angeles County from July 1, 1988, through October 31, 1989. Motorcycle crash fatalities (n = 163) were identified through the Los Angeles County Coroners office, and nonfatally injured riders (n = 537) were identified at four of the ten level I and level II trauma centers in the county. Lower extremity injuries were diagnosed in 301 (56%) of nonfatally injured and in 75 (46%) of fatally injured riders. Fractures were the most common lower extremity injury and were diagnosed in 52% and 42% of riders with nonfatal and fatal injuries, respectively. Over a third of all fractures were to the tibia or fibula. Drivers and passengers did not differ in their risk for lower extremity injuries. Multiple-vehicle collisions resulted in a higher risk of lower extremity injuries than did single-vehicle collisions. The highest risk for lower extremity fractures was observed among riders in broadside collisions in which another vehicle struck the motorcycle (risk ratio = 2.7). Modifications in vehicle design and rider apparel may prevent some lower extremity injuries in motorcycle crashes.

Analytic Approaches for Assessing Long-Term Treatment Effects Examples of Empirical Applications and Findings

Analytic approaches, including the structural equation model (autoregressive panel model), hierarchical linear model, latent growth curve model, survival/event history analysis, latent transition model, and time-series analysis (interrupted time series, multivariate time-series analysis) are discussed for their applicability to data of different structures and their utility in evaluating temporal effects of treatment. Methods are illustrated by presenting applications of the various approaches in previous studies examining temporal patterns of treatment effects. Recent advancements in these longitudinal modeling approaches and the accompanying computer software development offer tremendous flexibility in examining long-term treatment effects through longitudinal data with varying numbers and intervals of assessment and types of measures. A multimethod assessment will contribute to a more complete understanding of the complex phenomena of the long-term courses of substance use and its treatment.

Exploring the causal relationship between exposure to the 1994 northridge earthquake and pre- and post- earthquake preparedness activities

Whether, when, and why individuals prepare for disasters are major concerns of disaster preparedness researchers. Using population-based survey data collected after the 1994 Northridge earthquake, multinomial logistic models are imposed to examine if preparedness activities were adopted after the quake because of quake-related financial loss, physical and emotional injury, and proximity to the earthquake epicenter and shaking. The extent to which people invest in sustained preparedness was also examined by comparing the preparedness activities occurring both before and after the earthquake. The results indicated that exposure to physical, financial, and emotional injuries, and to shaking increased post-quake preparedness. Engaging in certain types of pre-quake preparedness increased the likelihood of post-quake preparedness. Post-quake preparedness is not affected by socioeconomic status or demographic factors, except that married persons are more likely to prepare in all situations and immigrants are more likely to adopt post-quake preparedness activities.

Restraining Orders in California A Look at Statewide Data

The authors tabulated statewide administrative data for all types of restraining orders. On June 6, 2003, there were 227,941 active restraining orders against adults in California; most were for domestic violence. Rates of restraining orders (i.e., restrained persons) were highest for men, African Americans, and 25- to 34-year-olds. In 72.2% of the orders, a woman was to be protected and a man was to be restrained; in 19.3%, the restrained and protected persons were of the same sex. Although state law prohibits the purchase or possession of a firearm by persons against whom a restraining order is issued, 9.2% of the orders documented no firearm restrictions.

Homicide risk among immigrants in California, 1970 through 1992.

According to the death certificates of the 65,510. California residents who died of homicide from 1970 through 1992, foreign-born persons are overrepresented in the homicides of California residents. Analysis of homicide data for 15- to 34-year-olds (n = 38,774), who account for a majority of all homicide victims indicated that immigrant-to-nonimmigrant risk patterns differed by ethnicity and across time. During the 23-year study period, foreign-born Whites, Hispanics, and Asians and others were at significantly higher risk and foreign-born Blacks were at a statistically similar risk of homicide compared with their US-born counterparts (risk ratio = 2.12, 1.24, 1.72, and 0.60, respectively).

Coroner-reviewed infant and toddler deaths. Many "undetermineds" resemble homicides.

Although homicide is a leading cause of death of infants and toddlers, there is some suspicion that an unknown number of additional deaths are unrecognized homicides. The authors used California mortality data from 1969 to 1991 to examine 12,246 injury deaths that occurred before age 5. Characteristics of the dead child, injury event, and postmortem were compared for accidents, homicides, and undetermtned deaths. A logistic model was developed to differentiate homicides from accidental deaths and then was used to predict whether undetermined deaths were likely to be homicides or accidents. Unlike accidental deaths, undetermineds and homicides had similar distribution patterns of age, race, sex, and place of injury. The predictive model indicates that 43.8% of the undetermined injury deaths were similar to homicides on several characteristics. True rates of homicide for infants and toddlers may, unfortunately, be nearly one fifth and one tenth higher, respectively, if the undetermined deaths that resemble homicides are taken into account.