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PubMed1998

Characteristics of toddlers and preschoolers exhibiting severe psychiatric disturbance.

The present study reports data collected on 137 toddler and preschool children admitted for acute, psychiatric inpatient hospitalization. Utilizing a comprehensive chart review survey developed by the authors, information was obtained regarding presenting problems, family psychiatric history, family legal problems, child maltreatment in order to examine factors contributing to the need for psychiatric hospitalization. Extremely dangerous behaviors were displayed by these youngsters, placing themselves and others at significant risk of harm. The frequency of occurrence of factors that contributed to these severe adjustment difficulties was alarming. Implications regarding service needs for these young children are discussed.

Aggression↗
PubMed2005

Messages from teens on the big screen: smoking, drinking, and drug use in teen-centered films.

Smoking, drinking, and drug use endure as popular yet dangerous behaviors among American teenagers. Films have been cited as potential influences on teens' attitudes toward and initiation of substance use. Social cognitive theory suggests that teen viewers may be especially likely to learn from teen models who they perceive as similar, desirable, and attractive. Yet, to date, no studies systematically have analyzed teen characters in films to assess the frequency, nature, and experienced consequences of substance use depictions. Assessments of content are necessary precursors to effects studies because they can identify patterns of representations that warrant further examination. Accordingly, a content analysis of top grossing films from 1999, 2000, and 2001 was conducted. Overall, two-fifths of teen characters drank alcohol, one-sixth smoked cigarettes, and one-seventh used illicit drugs (N=146). Almost no differences existed between substance users and nonusers with regard to physical attractiveness, socioeconomic status (SES), virtuosity, or gender. Drinkers and drug users were unlikely to suffer any consequences--let alone negative consequences--in either the short or long term. Characters rarely were shown refusing offers to drink or do drugs, or regretting their substance usage. Girls were more likely than boys to be shown engaging in multiple substance use activities (e.g., smoking and drinking). Overall, recent teen-centered films may teach teen viewers that substance use is relatively common, mostly risk-free, and appropriate for anyone.

Adolescent↗
PubMed2004

Skiing and snowboarding injuries and their impact on the emergency care system in South Tyrol: a restrospective analysis for the winter season 2001--2002.

OBJECTIVES: To evaluate the incidence and the pattern of skiing and snowboarding injuries in South Tyrol and their impact on the emergency medical system in the winter season 2001--2002 in an attempt to rationalize and improve the emergency care and assist in prevention strategies. METHODS: All medical records of patients referred to our emergency department (ED) that sustained a skiing or snow-boarding injury during the study period were retrospectively reviewed. Age, sex, local or non-local residency, type of injury, data and time of accident, type of transport to the hospital, hospital admission or ED discharge, Injury Severity Score, outcome (including mortality) were evaluated. On site mortality data were obtained from the emergency call-center registry. Ski resorts utilization was estimated from the data published by the Regional Office of Cable Transport. RESULTS: For the period analyzed approximately 2,500,000 skier and snowboarder days were recorded in the whole region of which about 500,000 were attributed to the four nearby ski resorts that refer to our hospital. Of the 1087 patients, 794 were skiers and 294 were snowboarders. Snow-boarders were younger than skiers (mean age 20 and 36 respectively, p = 0.001). Females were equally represented in the two groups. Male patients, children, senior skiers and non-local residents suffered from more severe injuries than their corresponding classes (p < 0.01, p = 0.002, p = 0.02, p = 0.000 respectively). Critical injuries (ISS > or = 25) were homogeneously spread in the groups, with the exception of the non-local resident patients that showed a higher incidence (p < 0.02). No difference in severity was found between skiers and snowboarders. The incidence was 2.05 per 1,000 skier-days. Mortality rate was 1.6 per 1,000,000 skier-days. The pattern of injury was different: snowboarders showed more forearm and wrist trauma and skiers more lower extremity injuries. 208 patients were hospitalized and the mean length of stay was 4.5 days. Head trauma and fractures were the most common diagnosis of admission. The lack of field triage led to 12% of unjustified helicopter transfer and 9.6% of avoidable ambulance transport. CONCLUSIONS: Incidence, pattern of injuries and mortality from skiing and snowboarding accidents in South Tyrol resemble those reported in other part of the world. Nevertheless, strategies for prevention are needed. The routine use of helmets should be enforced by law. Dangerous behaviors should be prosecuted. Skiers and snowboarders should be made aware that skiing beyond their technical ability can be life-threatening.

Adolescent↗
PubMed2001

Socioeconomic, demographic, occupational, and health factors associated with participation in a long-term epidemiologic survey: a prospective study of the French GAZEL cohort and its target population.

The purpose of this paper is to examine personal and health factors, both at the beginning of the study and thereafter, associated with participation in the GAZEL cohort, set up in 1989 in a large French company. The authors used logistic regression to analyze the associations between participation and data available for both participants (n = 20,093) and nonparticipants (n = 24,829). Higher participation was associated with male sex, marriage, children, managerial status, and residence in particular regions. Among men, lower participation was associated with sick leave in the year before recruitment and afterwards. During follow-up, participation was negatively associated with several groups of diseases, especially those associated with alcohol consumption. The risk of upper respiratory and digestive tract and lung cancer during follow-up was higher among nonparticipants. The same phenomenon occurred among women, but less markedly, for cancers of the breast and genital organs. During follow-up, mortality among men was higher among nonparticipants, especially for alcohol-related diseases. The association among women was less strong. Among men, but not among women, diseases caused by alcohol, smoking, or dangerous behavior were the primary reason for the health differences observed between participants and nonparticipants. Overall, the most important determinants of participation were cultural factors and lifestyle behaviors.

Absenteeism↗
PubMed1998

Effects of televised safety models on children's risk taking and hazard identification.

OBJECTIVE: To examine effects of televised safety models on children's willingness to take physical risks and their ability to identify injury hazards in common situations. METHODS: Sixty children, between the ages of five and eight years, were exposed to one of three TV stimulus programs: (1) a safety educational videotape, in which actors engaged in dangerous behavior, suffered injuries, and then enacted alternative safe behaviors; (2) an animated cartoon, which portrayed characters engaged in safety behaviors incidental to the main story line; or (3) the same cartoon program edited to omit the scenes depicting safety behavior. Children's willingness to take physical risks was measured before and after the TV stimulus by a series of pictorial child-relevant scenarios in which they could indicate the level of risk they would take. They also completed pretest and posttest measures of hazard identification, in which they were to identify injury hazards in several pictorial scenarios. RESULTS: Exposure to the safety educational videotape decreased children's willingness to take physical risks and increased their identification of injury hazards. Exposure to the animated cartoon with incidental safety components did not affect risk taking, but did increase ability to identify hazards. CONCLUSIONS: Findings are interpreted as evidence of observational learning and priming of thematically related knowledge by the television stimuli. Implications for safety educational curricula are discussed.

Analysis of Variance↗
PubMedDate not supplied

Automobile carburetor- and radiator-related burns.

Seventy-nine persons who had sustained automobile engine carburetor- and radiator-related burns were admitted to Grady Memorial Hospital Burn Unit between June 1, 1984 and September 30, 1990. Forty patients with carburetor-priming flame burns had a mean age of 31.5 years, a mean burn size of 13.4% total body surface area, and a mean length of stay of 13.8 days. There were 37 male patients. Four patients had an inhalation injury. Twenty-two surgical procedures were performed on 13 patients. One patient was an innocent bystander, and one patient died. The clothing of 16 patients had ignited, which resulted in larger, deeper burns and in one death. Burns predominantly involved the right sides of the face, head, and torso; the right upper extremity; and the right hand. Thirty-nine patients had scald burns that were associated with uncapping a radiator. These patients had a mean age of 29.6 years, a mean burn size of 8.9% total body surface area, and a mean length of stay of 6.4 days. There were 36 male patients and three innocent bystanders. One autografting procedure was performed, and there were no deaths in this group of patients. The burn-prone person is the young adult male. The circumstances that result in such dangerous behavior are predictable, and resultant burn injuries are preventable.

Accidents, Occupational↗
PubMed1992

Soda pop vending machine injuries: an update.

Soda pop vending machine tipping continues to be a dangerous behavior that can result in lethal or crippling injuries. This study analyzes 64 cases of injuries secondary to crushing by a soda machine. All were male victims except one. The average age was 19.8 years with a range of 5-39 years. Thirteen victims sustained multiple trauma. Fifteen victims were killed. Increased public awareness coupled with support by the government and private industry has contributed to a sharp reduction in incidence of accidents and improved public safety.

Accident Prevention↗
PubMed2002

Taking a stand: an adolescent girl's resistance to medication.

Therapists and clients encounter pressure to seek medication for adolescent depression and dangerous behaviors. A review of current research indicates that medical practitioners prescribe antidepressants for adolescents despite questionable efficacy, side effects, and frequent refusal. Adolescent girls' expressions of distress expose them to systems that promote medication prescription. A critical look at medical, gender, and adolescent discourses sheds light on drug prescription as standard practice and highlights its impact on adolescent girls' agency, voice, and community connection. Resistance to medication is reconsidered as an act of personal and political choice. Amy, a 16-year-old girl, and her therapist describe strategies for managing depression without medication.

Adolescent↗
PubMed1990

Alexithymia and acquired immune deficiency syndrome.

Patients positive for human immunodeficiency virus (HIV) may resort to hibernation or unceasing hyperactivity to eject overpainful representations and affects. In these states overwhelming emotions can be at the origin of somatic disorders and can precipitate the onset of the acquired immune deficiency syndrome. A psychotherapy such as relaxation which can relieve excessive emotional tension and stimulate the representation of emotions in words and images seems to me to be particularly suitable for these patients. This type of psychotherapy soothing and containing, helps them to give up their dangerous behavior and to become less vulnerable to the HIV.

Acquired Immunodeficiency Syndrome↗
PubMed1975

Dangerousness and civil commitment of the mentally ill: some public policy considerations.

The author discusses "dangerousness to others" as a ground for involuntary civil commitment of the mentally ill, suggesting that there is often a confounding of legal/public-policy concerns and mental health concerns in issues related to this concept. The questionable nature of the presumption of dangerousness in mental patients and the overprediction of dangerous behavior for this group indicate that such commitment processes may circumvent legal safeguards designed to ensure due process. The author recommends that psychiatrists and other mental health professionals assume greater responsibility for the ways in which their services are used in these proceedings.

Alcoholism↗
PubMed1997

The clinical risk management of stalking: "someone is watching over me....".

I have offered ten guidelines for the clinical risk management of stalking: a team approach, personal responsibility for safety, documentation and recording, no initiated contact, protection orders, law enforcement and prosecution, treatment if indicated, segregation and incarceration, periodic violence risk assessment, and the importance of dramatic moments. Although criminal stalking is not expected in mental health practice, the interpersonal anguish that often erupts in psychotherapy, and the reporting of relational intrusions that disrupt the safety of treatment, may foreshadow such distressing and potentially dangerous behavior. It is my hope that the clinician will be prepared for such untoward events, and these guidelines will shape an appropriate professional response. For as Racine wrote in 1667, "The heart that can no longer love passionately, must with fury hate." (Andromache, 1, trans. Robert Henderson).

Anger↗
PubMed1990

The formal treatment contract in the inpatient management of borderline personality disorder.

Formal, written contracts between the patient and the treatment team have been shown to be useful in the inpatient management of borderline personality disorder by fostering a therapeutic alliance, containing dangerous behavior, and protecting the integrity of the treatment. The author discusses the advantages and disadvantages of such contracts and points out several common contractual errors, including making a contract too restrictive, allowing the contract to substitute for psychotherapy, and using the contract as a means of defense or punishment. She provides 12 guidelines, for formulating successful contracts, beginning with the need to clearly state the purpose of the treatment plan mutually agreed on by patient and staff.

Adult↗
PubMed1995

Management of primary sleep disorders among elderly persons.

Sleep complaints are common in geriatric patients. The clinician's first task is to separate sleep problems originating in the physiologic changes of aging from those originating in pathological processes. Normal elderly persons have greater difficulty falling asleep and staying asleep, compared with younger persons, and sleep is qualitatively more shallow with more involuntary movements and abnormal breathing. Sleep complaints reach a pathological level as elders begin to experience deterioration of function during their period of normal wakefulness, manifested as excessive sleepiness, concentration deficits, and mood changes, or the emergence of bizarre or dangerous behavior during sleep. Sleep disorders are associated with excess physical and psychiatric morbidity and are treatable. An approach focused on sleep-related syndromes is a useful basis for rational treatment, and the treatment of many sleep disorders can be provided without expensive sleep laboratory testing.

Aged↗
PubMed2006

Juvenile sex offenders compared to non-sex offenders: a review of the literature 1995-2005.

An unresolved but clinically important issue in the literature on juvenile delinquency is to what extent juvenile sex offenders resemble non-sex offenders with respect to individual, familial, and environmental characteristics. The current article reviewed published studies (1995-2005) comparing sex offenders with non-sex offenders. The 17 articles meeting the inclusion criteria suggest that differences exist between sex offenders and non-sex offenders on personality characteristics, behavioral problems, history of sexual abuse, nonsexual offending, and peer functioning. Inconsistent results were found for demographic factors, family functioning and background, antisocial attitudes, and intellectual and neurological functioning. Although it is likely that sex offenders can be differentiated from nonsex offenders on a number of characteristics, caution is warranted because of methodological differences between studies and small samples size. Also, studies show that sex offenders are a heterogeneous group. Further research should take into account this heterogeneity by including sex offenders from clearly circumscribed groups and investigating characteristics specifically related to sexual behavior.

Adolescent↗
PubMed2001

Caregivers in crisis: moving a relative with Alzheimer's to assisted living.

The experience of moving a relative with Alzheimer's disease (AD) to an assisted living facility (ALF) was examined in this secondary data analysts of 20 interviews with family caregivers. Crisis theory was used as guiding framework for the analysis. Findings indicate that all elements of a crisis were evident among caregivers in the process of moving their relative to an ALF. Dangerous behaviors resulting from the relative's cognitive decline led to caregiver fear and anxiety, which served as crisis precipitants. Perceived lack of family support in conjunction with physical and psychological exhaustion were crisis mediators. These factors, along with the caregiver's failed attempts to keep their relative at home, caused the crisis process to move toward the outcome of ALF placement. A better understanding of the crises that surround placement issues will assist nurses in planning interventions for the growing number of families faced with this issue.

Adaptation, Psychological↗