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Biomedical subjects

K E Powell

Publications and source records attributed to K E Powell.

At least 37 records · Page 2Linked to original sources
PubMed1998

Identification of nearly fatal suicide attempts: Self-Inflicted Injury Severity Form.

The Self-Inflicted Injury Severity Form (SIISF) was developed as an epidemiological research tool for identifying individuals in hospital emergency departments who have life-threatening self-inflicted injuries. Data were collected from 715 patients with self-inflicted injuries in two large hospitals. In 295 of these cases, a second set of data was independently collected for assessment of interrater reliability. Validity was assessed by comparing the SIISF results with simultaneously collected Risk-Rescue Ratings. Assessment of interrater reliability found that only 2.4% of physicians disagreed on the suicide method used. The kappa statistic for method used was .94, indicating excellent agreement. The SIISF was found to distinguish between severe and less severe injuries. Thus, it appears to provide a simple method to distinguish patients who have life-threatening self-inflicted injuries.

Adolescent↗
PubMed1997

Physical activity, functional limitations, and the risk of fall-related fractures in community-dwelling elderly.

This case-control study examines the association of vigorous and mild physical activity with fall-related fractures in a community-dwelling population age 65 and older in South Florida. Vigorous physical activity was defined as exercising, doing heavy housecleaning, or other hard labor three or more times per week in the month prior to the index date; mild physical activity was defined as the number of hours per day subjects reported spending on their feet. A case was any subject who sustained a fall-related fracture (ICD-9CM-800 through ICD-9CM-829) over a 21-month period (n = 471). Controls were at 10% random sample selected from the Health Care Financing Administration Medicare files (n = 712). The presence of any limitation in activities of daily living (ADL) significantly modified the effect of vigorous physical activity. Physically active subjects with no limitations (ADL = 0) were less likely to sustain a fall-related fracture than were inactive subjects with an adjusted odds ratio (aOR) of 0.6, (0.5-0.8 95% CI), and active subjects with any limitation (ADL > or = 1) had an aOR of 3.2 (1.1-9.8 95% CI). Limiting this analysis to 159 hip fracture cases produced similar results. Mild physical activity was not associated with fracture. These results suggest that vigorous physical activity is associated with a lower fracture risk among elderly persons who have no limitation in ADL and with a higher risk among those with any limitations.

Accidental Falls↗
PubMed1997

Nurses' logs as an evaluation tool for school-based violence prevention programs.

Programs for preventing violence among youth should be evaluated to determine if they are effective. Nurses' logs appear to be a useful tool for evaluating school-based violence prevention programs. The logs provide a record of students' visits to the school nurse that can be used to determine if a violence prevention program is associated with a reduction in fighting- and other injury-related nurse visits. This method has many strengths: it is simple and inexpensive, it does not interrupt the school routine, it permits school-level rather than student-level data collection, it provides a ready "baseline," and it allows continuous data collection. However, potential limitations do exist. For example, the method may provide insufficient information and may be affected by factors unrelated to the intervention. School officials can increase the usefulness of the logs by encouraging standardization and providing training in their use.

Adolescent↗
PubMed1997

Estimating intruder-related firearm retrievals in U.S. households, 1994.

To estimate the frequency of firearm retrieval because of a known or presumed intruder, the authors analyzed data from a 1994 national random digit dialing telephone survey (n = 5,238 interviews). Three mutually exclusive definitions of firearm retrieval were constructed: (1) retrieved a firearm because there might be an intruder, (2) retrieved a firearm and saw an intruder, and (3) retrieved a firearm, saw an intruder, and believed the intruder was frightened away by the gun. Of 1,678 (34%) households with firearms, 105 (6%) retrieved a firearm in the previous 12 months because of an intruder. National projections based on these self-reports reveal an estimated 1,896,842 (95% CI [confidence interval] = 1,480,647-2,313,035) incidents in which a firearm was retrieved, but no intruder was seen; 503,481 (95% CI = 305,093-701,870) incidents occurred in which an intruder was seen, and 497,646 (95% CI = 266,060-729,231) incidents occurred in which the intruder was seen and reportedly scared away by the firearm. Estimates of the protective use of firearms are sensitive to the definitions used. Researchers should carefully consider both how these events are defined and the study methods used.

Adult↗
PubMed1996

School-associated violent deaths in the United States, 1992 to 1994.

OBJECTIVES: To conduct the first nationwide investigation of violent deaths associated with schools in the United States, to quantify the risk of school-associated violent death, and to identify epidemiologic features of these deaths. DESIGN: Descriptive case series. SETTING: United States, July 1, 1992, through June 30, 1994. METHODS: School-associated violent deaths were identified by study collaborators and through 2 online news databases. Police reports, medical examiners' records, and interviews with police and school officials provided detailed information about each case. RESULTS: In a 2-year period, 105 school-associated violent deaths were identified. The estimated incidence of school-associated violent death was 0.09 per 100 000 student-years. Students in secondary schools, students of minority racial and ethnic backgrounds, and students in urban school districts had higher levels of risk. The deaths occurred in communities of all sizes in 25 different states. Homicide was the predominant cause of death (n = 85 [80.9%]), and firearms were responsible for a majority (n = 81 [77.1%]) of the deaths. Most victims were students (n = 76 [72.4%]). Both victims and offenders tended to be young (median ages, 16 and 17 years, respectively) and male (82.9% and 95.6%, respectively). Approximately equal numbers of deaths occurred inside school buildings (n = 31 [29.5%]), outdoors but on school property (n = 37 [35.2%]), and at off-campus locations while the victim was in transit to or from school (n = 37 [35.2%]). Equal numbers of deaths occurred during classes or other school activities (n = 46 [43.8%]) and before or after official school activities (n = 46 [43.8%]). CONCLUSIONS: School-associated violent deaths were more common than previously estimated. The epidemiologic features of these deaths were similar to those of homicides and suicides that occur elsewhere. A comprehensive approach that addresses violent injury and death among young people at school and elsewhere in the community is suggested.

Adolescent↗
PubMed1996

Childhood homicide, suicide, and firearm deaths: an international comparison.

This article is intended to provide a better understanding of the incidence of violent deaths among children under 15 years of age in highly industrialized countries/areas. We found that rates of violent childhood deaths are not uniform in the industrialized world and that rates in the United States greatly exceed those in the other countries and areas. In fact, total firearm deaths among children are 12 times higher in the United States than in all of the other countries or areas combined; childhood homicide rates are 5 times higher; and childhood suicide rates are twice as high. Five countries or areas, 3 of which are in Asia, reported no firearm deaths among children under 15 years old. These findings suggest the value of conducting further research to explore these cross-national differences.

Adolescent↗
PubMed1995

A review of selected school-based conflict resolution and peer mediation projects.

Many U.S. schools are implementing curricula and other activities to reduce interpersonal violence among students. Most involve conflict resolution or peer mediation (CR/PM) training. Little is known about the effectiveness or manner of implementing these projects. This paper examines nine projects supported by four state health departments. Available data suggest some projects may modify youths' self-reported attitudes about violent behavior, improve school discipline, and reduce absenteeism. The review also revealed considerable variation in implementation, especially in the role of professionally trained consultants and amount of teacher and student training. More attention should be paid to evaluating CR/PM projects. Some data suggest they may contribute positively to community efforts to reduce violence among youth, but insufficient information exists to know which projects best serve which students, and how projects should be implemented. Until consensus emerges, project personnel should carefully assess the implementation and impact of their activities. Routinely collected data, such as disciplinary actions, can be used for evaluation, often with only minor modification.

Adolescent↗
PubMed1995

Suicide prevention from a public health perspective.

The public health approach to health problems provides a strong framework and rationale for developing and implementing suicide prevention programs. This approach consists of health-event surveillance to describe the problem, epidemiologic analysis to identify risk factors, the design and evaluation of interventions, and the implementation of prevention programs. The application of each of these components to suicide prevention is reviewed. Suggestions for improving surveillance include encouraging the use of appropriate coding, reviewing suicide statistics at the local level, collecting more etiologically useful information, and placing greater emphasis on analysis of morbidity data. For epidemiologic analysis, greater use could be made of observational studies, and uniform definitions and measures should be developed and adopted. Efforts to develop interventions must include evaluating both the process and the outcome. Finally, community suicide prevention programs should include more than one strategy and, where appropriate, should be strongly linked with the community's mental health resources. With adequate planning, coordination, and resources, and the public health approach can help reduce the emotional and economic costs imposed on society by suicide and suicidal behavior.

Adolescent↗
PubMed1994

The public health burdens of sedentary living habits: theoretical but realistic estimates.

Quantitative estimates indicate that sedentary living is responsible for about one-third of deaths due to coronary heart disease, colon cancer, and diabetes--three diseases for which physical inactivity is an established causal factor. Presumably, if everyone were highly active the death rate from these three disease would be only two-thirds of the current rate. Not everyone will become highly active, however. Assuming smaller increases in physical activity practices, mortality from these three conditions combined could be reduced by as much as 5-6%, or 30,000-35,000 deaths per year. Overall mortality in the United States might be reduced about 1-1.5%. The greatest gains would accrue from strategies that encourage those who report no leisure-time physical activity to do some and that encourage those who are irregularly active to participate in 30 or more minutes of light to moderate activity for 5 or more d.wk-1. Mortality is only one aspect of public health burdens that would be reduced by greater participation in regular physical activity. Quality of life, which we have not attempted to quantify, would also improve.

Colonic Neoplasms↗
PubMed1993

Public health policy for preventing violence.

The current epidemic of violence in America threatens not only our physical health but also the integrity of basic social institutions such as the family, the communities in which we live, and our health care system. Public health brings a new vision of how Americans can work together to prevent violence. This new vision places emphasis on preventing violence before it occurs, making science integral to identifying effective policies and programs, and integrating the efforts of diverse scientific disciplines, organizations, and communities. A sustained effort at all levels of society will be required to successfully address this complex and deeply rooted problem.

Adolescent↗
PubMed1992

Homicide surveillance--United States, 1979-1988.

From 1979 through 1988, 217,578 homicides occurred in the United States, an average of greater than 21,000 per year. Homicide rates during this 10-year period were about 1.5 times higher than the rates during the 1950s. The national homicide rate of 10.7/100,000 in 1980 was the highest ever recorded. Homicide occurs disproportionately among young adults. Among the 15- to 34-year age group, homicide is the fourth most common cause of death among white females, the third most common cause among white males, and the most common cause among both black females and black males. In 1988, nearly two-thirds (61%) of homicide victims were killed with a firearm, 75% of these with a handgun. More than half (52%) of homicide victims were killed by a family member or acquaintance, and about one-third (35%) of homicides stemmed from a conflict not associated with another felony. The homicide mortality rate among young black males 15-24 years of age has risen 54% since 1985. Ninety-nine percent of the increase was accounted for by homicides in which the victim was killed with a firearm. The surveillance data summarized in this report should assist public health practitioners, researchers, and policymakers in addressing this important public health problem.

Adolescent↗
PubMed1992

Physiological, anthropometric, and training correlates of running economy.

Potential physiological, anthropometric, and training determinants of running economy (RE) were studied in a heterogeneous group of habitual distance runners (N = 188, 119 males, 69 females). RE was measured as VO2 (ml.kg-1.min-1) during level treadmill running at 161 m.min-1 (6 mph) (VO2-6). Examined as potential determinants of RE were heart rate and ventilation while running at 6 mph (HR6, VE6), VO2max (ml.kg-1 x min-1), % fat, age, gender, height, weight, estimated leg mass, typical training pace, training volume, and sit-and-reach test performance. RE was entered as the dependent variable and the potential determinants as independent variables in zero-order correlation and multiple regression analyses. Zero-order correlation analysis found VO2max, HR6, and VE6 to be significantly, positively correlated with VO2-6 (P < 0.001). Multiple regression analysis, in which the independent effect of each predictor variable was examined, revealed VO2-6 to be positively correlated with VO2max (P < 0.001), HR6 (P < 0.001), VE6 (P < 0.001), and age (P < 0.05) and negatively correlated with weight (P < 0.01). These findings indicate that, in a diverse group of runners, better RE (VO2-6) is associated with lower VO2max, lower submaximal exercise VE and HR, lower age, and greater weight.

Adult↗