Marsha E. Wolf

The cost and frequency of hospitalization for fall-related injuries in older adults

Using a population-based hospital discharge registry with E codes, we examine the 1989 hospitalizations of older adults in Washington State for fall-related injuries. Fall-related trauma accounted for 5.3% of all hospitalizations of older adults, with hospital charges totaling

PSYCHOACTIVE MEDICATIONS AND INJURIOUS MOTOR VEHICLE COLLISIONS INVOLVING OLDER DRIVERS

53,346,191, and resulted in discharge to nursing care more often than other such hospitalizations. An annual hospitalization rate of 13.5 per 1000 persons and an annual cost of

Barriers to seeking police help for intimate partner violence

92 per person is reported. The importance of preventing fall-related injuries in older adults is discussed.

Rates and relative risk of hospital admission among women in violent intimate partner relationships.

Older drivers have the second highest risk for motor vehicle collisions of any age group, after adolescents. Psychoactive medications may place older drivers at increased risk for injurious motor vehicle collisions. We conducted a population-based matched case-control study of older drivers who were involved in injurious crashes during 1987 and 1988. The 234 cases and 447 controls were members of a large Seattle-based health maintenance organization. Use of antidepressants and opioid analgesics by older drivers was associated with increased risk for injurious motor vehicle collisions. Compared with non-users, current users of cyclic antidepressants had an adjusted relative risk (RR) of 2.3 [95% confidence interval (CI) = 1.1–4.8]. Opioid analgesic use was also associated with an elevated crash risk (adjusted RR = 1.8; 95% CI = 1.0–3.4). We found no evidence of a doserelated effect with either class of drug. Current use of benzodiazepines or sedating antihistamines had little association with increased risk for injurious collisions. (Epidemiology 1994;5:591–598)

Medical conditions and motor vehicle collision injuries in older adults

Intimate partner violence is underreported to police. A study was conducted utilizing focus group methodology to identify womens perceptions of the barriers to seeking police help for intimate partner violence (IPV). Facilitators used a structured format with open-ended questions for five focus group sessions that were recorded and subsequently analyzed using Ethnograph software. Participants were 41 women identified from social service agencies in an urban setting serving IPV women with diverse ethnic and cultural backgrounds. Participants identified many barriers for victims, which fell within the following three themes: (1) Predisposing characteristics — situational and personal factors; (2) fears and negative experiences with police response; and (3) fears of possible repercussions. Participants also described positive experiences with police and generated a “wish list” for improving police response to IPV. Policies and actions that can be taken by police and social service agencies to address the barriers IPV victims face in seeking police help are discussed.

Footwear style and risk of falls in older adults.

OBJECTIVES This study assessed the history of hospitalization among women involved in violent intimate relationships. METHODS In this 1-year retrospective cohort study, female residents of King County, Washington, who were aged 18 to 44 years and who had filed for a protection order were compared with nonabused women in the same age group. Outcome measures included overall and diagnosis-specific hospital admission rates and relative risk of hospitalization associated with abuse. RESULTS Women known to be exposed to a violent intimate relationship were significantly more likely to be hospitalized with any diagnosis (age-specific relative risks [RRs] ranging from 1.2 to 2.1), psychiatric diagnoses (RR = 3.6, 95% confidence interval [CI] = 2.8, 4.6), injury and poisoning diagnoses (RR = 1.8, 95% CI = 1.2, 2.8), digestive system diseases (RR = 1.9, 95% CI = 1.3, 2.9), and diagnoses of assault (RR = 4.9, 95% CI = 1.1, 22.1) or attempted suicide (RR = 3.7, 95% CI = 1.6, 9.2) in the year before filing a protection order. CONCLUSIONS This study showed an increased relative risk of both overall and diagnosis-specific hospitalizations among abused women. Intimate partner violence has a significant impact on womens health and use of health care.

Biomechanical properties of shoes and risk of falls in older adults

OBJECTIVE To determine whether medical conditions that can impair sensory, cognitive, or motor function increase the risk of injury due to motor vehicle collision in older drivers.

Do protection orders affect the likelihood of future partner violence and injury

Objectives: To determine how the risk of a fall in an older adult varies in relation to style of footwear worn.

A case-control study of the effectiveness of bicycle safety helmets in preventing facial injury.

Objectives: To determine the relationships between the biomechanical properties of shoes worn in a cohort of healthy older adults and the risk of falling.

Who gets protection orders for intimate partner violence

BACKGROUND Approximately 20% of U.S. women who experience intimate partner violence (IPV) annually obtain a civil protection order (CPO). The effect of these orders on future abuse has been estimated in only a few studies, with mixed results. The objective of this study was to assess the effect of a CPO on the risk of future self-reported IPV and injury. METHODS In this prospective cohort study of 448 adult female Seattle WA residents with IPV between October 1997 and December 1998, interviews were conducted at baseline, 5 months, and 9 months after the index incident. Odds ratios (ORs) estimated risks of contact; unwelcome calls or visits; threats; weapon threats; psychological, sexual, or physical abuse or injury; and abuse-related medical care among women who obtained a CPO after the index incident, compared with those who did not. RESULTS Women who obtained a CPO following the index IPV incident had significantly decreased risk of contact by the abuser (OR=0.4); weapon threats (OR=0.03); injury (OR=0.3); and abuse-related medical care (OR=0.2) between the first and second follow-up interviews. Stronger decreases in risk were seen among women who had maintained the CPO throughout follow-up, which were significant for contact by the abuser (OR=0.2); weapon threats (OR=0.02); psychological abuse (OR=0.4); sexual abuse (OR=0.2); physical abuse (OR=0.3); injury (OR=0.1); and abuse-related medical care (OR=0.1) between first and second follow-up interviews. CONCLUSIONS CPOs are associated with decreased likelihood of subsequent physical and nonphysical IPV.