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Biomedical subjects

C W Runyan

Publications and source records attributed to C W Runyan.

16 recordsLinked to original sources
PubMed1995

Injuries to women in the United States: an overview.

This review summarizes the descriptive epidemiology of injuries among women in the United States, highlighting major problems as well as needs and opportunities for intervention and research. Injury mortality rates for 1984-88 were calculated from the National Center for Health Statistics mortality data tapes. Additional injury mortality and all injury morbidity information were derived from existing literature. Studies providing gender-specific U.S. injury information during the last ten years were reviewed. Injuries are the leading causes of death for females to age 34 and are responsible for more years of potential life lost than any other cause of death. The lifetime cost of injuries to females is approximately 50 billion dollars annually. Motor vehicle related injuries, falls, and violence are the most significant injury problems for women. Although morbidity is far greater than mortality, access to information about nonfatal injuries is extremely limited. What evidence does exist points to the importance of domestic assault as a major, underrecognized source of preventable injury. Though the greater magnitude of injury among men frequently eclipses the significance of injury as a problem for women, this paper presents evidence that injury is a problem which should feature prominently in the women's health agenda for the nation. There are pressing research needs to understand the changing trends in injuries to females and to identify appropriate intervention strategies. In addition, the study points to the needs for improvement in data systems to document injury morbidity.

Accidental Falls↗
PubMed1992

Risk factors for fatal residential fires.

BACKGROUND: Residential fires are the most important cause of fire-related mortality in the United States. Previous research has concentrated on fatal fires in urban areas; considerably less is known about fatal fires in rural areas. METHODS: We studied fatal and nonfatal residential fires in predominantly rural areas. Using a case-control design, we compared all 151 fatal fires (cases) in single-family dwellings in North Carolina during a 13-month period with a sample of nonfatal fires (controls). Case fires were identified through the medical-examiner system, and control fires that occurred within a few weeks of the case fires were chosen from the records of randomly selected fire departments statewide. For each fire, fire officials were interviewed about the dwelling, the fire, the people involved, and the fire-response system. RESULTS: Although heating incidents were the leading cause of fires, fatal fires were more likely to have been caused by smoking (31 percent of fatal fires vs. 6 percent of nonfatal fires). Mobile homes posed a higher risk of death if a fire occurred (odds ratio, 1.7; 95 percent confidence interval, 1.1 to 2.6), as did the absence of a smoke detector (odds ratio, 3.4; 95 percent confidence interval, 2.1 to 5.6). Smoke detectors were more protective against death in fires involving young children and when no one present was impaired by alcohol or drugs or had a physical or mental disability. The presence of an alcohol-impaired person was the strongest independent risk factor for death in the case of a fire (odds ratio, 7.5; 95 percent confidence interval, 4.4 to 12.7). CONCLUSIONS: Residential fires are most likely to be caused by heating equipment or smoking materials. The risk of death is greatest in fires in mobile homes, in those involving alcohol-impaired persons, and in those in houses without smoke detectors.

Adolescent↗
PubMed1992

Emergency department record keeping and the potential for injury surveillance.

Successful design of injury prevention measures relies on understanding the occurrence and circumstances of injuries, which, in turn, necessitates that good quality data be collected about injured persons. The emergency department (ED) is an important source of injury information. This paper reports the results of a survey of all 129 hospital emergency departments in North Carolina to examine record-keeping practices and determine what information is collected and stored in the EDs. The findings demonstrate that there is considerable variability in the types of data that would be available to a researcher attempting to use ED records. Of special note is the absence of information about the external cause of injury.

Data Collection↗
PubMed1992

Newspapers: a source for injury surveillance?

Newspapers have not been extensively evaluated as an injury surveillance source. We compared clippings with medical examiner records for 45 residential fire deaths and 58 drownings of children to assess extent, completeness, and accuracy of newspaper coverage. Newspapers covered 96% of the fire fatalities and 78% of the drownings and contained more information than medical examiner records on several factors, including fire cause and smoke detector presence, pool fences, warning signs, and supervision of children.

Child↗
PubMed1991

Analysis of US child care safety regulations.

BACKGROUND: With 1.9 million US children cared for in organized group child care, the safety of these children is a public health concern. In the absence of federal policy, each state has developed its own day care safety regulations. METHODS: After creating a set of 36 criteria from three sets of national guidelines, we assessed the safety regulations of 45 states. With a mailed survey of state day care regulatory personnel, we examined the processes of formulating and implementing safety policy in 47 states. RESULTS: For 24 of the 36 items, more than half the states' regulations were below the criteria or failed to mention the topic. Most notable is the inattention to playground safety, choking hazards, and firearms. CONCLUSION: The uneven quality of regulations may be a reflection of a regulatory process that is fragmented, with many different groups sharing authority and with limited involvement of injury prevention specialists.

Child Day Care Centers↗
PubMed1988

Occupational motor vehicle injury morbidity among municipal employees.

Injury related to motor vehicle use among Baltimore City employees was examined throughout a 34-month period. Among an average of 30,000 municipal employees; representing 7% of the total Baltimore work force, almost 2% of all city employees were injured by motor vehicles each year. Twelve percent of all injuries and 16% of the injury costs were attributable to motor vehicles. In the police department, 43% of all costs were vehicle-related. Compared with other departments, the rate of motor vehicle-related injury was more than 4 times as high in the department of public works and twice as high in the police and fire departments. Injuries related to police cars and department of public works trucks occurred at an annual rate of more than 14 per 100 vehicles. Detailed review of injuries that occurred in 1984 suggests the need for greater seat belt use, built-in crash protection, and designs to reduce falls from trucks.

Accidents, Traffic↗
PubMed1985

Seat belt use laws: the influence of data on public opinion.

Motor vehicle crashes are a major public health problem. Mandatory seat belt use laws capable of lessening the highway death and injury toll have recently received a great deal of public attention. Public opinions toward such laws were assessed in a representative sample of 410 North Carolina drivers. In our experimental design, subjects were randomly assigned to receive one of six types of data expressing the effectiveness of the proposed mandatory and the current voluntary policies. A comparison group received no data. Exposure to data about the effectiveness of the proposed seat belt law was strongly predictive of policy preferences, though the specific type of data did not appear to have an influence. Additional characteristics predictive of policy preferences included attitudes toward other government regulations, beliefs about the effectiveness of seat belts, and personal seat belt use. The findings suggest that health educators need to continue to provide the public with data about potential safety regulations. Furthermore, health educators, to be more effective, should target information toward certain critical beliefs such as those about the relative effectiveness of a particular policy.

Humans↗
PubMed1985

Childhood injuries in North Carolina: a statewide analysis of hospitalizations and deaths.

We report the nature and causes of childhood injuries leading to hospitalization or death in North Carolina. Based on an 89 per cent sample of 1980 hospital discharges of children between 0 and 19 years of age, the overall annual rate of trauma-related hospitalizations was 80 per 10,000. The rate varied from 119 per 10,000 for the 15-19 year age group to 56 per 10,000 for children between ages 5 and 9. Hospitalization rates are lower than those reported elsewhere, although death rates, based on a seven-year period, are higher in the data reported here. Potential reasons for these differences are suggested.

Adolescent↗
PubMed1985

Epidemiologic evidence and motor vehicle policy making.

After being randomly assigned to receive policy effectiveness information expressed as attributable benefit, attributable risk, or relative risk, 318 graduate students were asked to indicate their preferences for the current voluntary seat belt use policy, a mandatory seat belt policy, or mandatory passive restraints. A control group received no data. Exposure to effectiveness information (any type) was significantly associated with favoring either mandatory seat belts or passive restraints over the current policy. Those exposed to attributable benefit or risk data were more apt to make proregulatory choices than subjects exposed to relative risk data. Attitudes toward government regulation and specific views about personal freedom and policy effectiveness were also found to be significant predictors of policy preference.

Accidents, Traffic↗
PubMed1984

A community health education approach to occupant protection.

The goal of enhancing motor vehicle occupant protection is vital to the public's health. Controversies about passive versus active protection and voluntary versus mandatory measures continue. A program which employed a combination of positive reinforcements (incentives) and wide-scale community education succeeded in raising the community seat belt usage rate from 24 to 41% in 6 months. This rate was sustained at 36% at six-month follow-up. This article reviews the major features of the "Seat Belts Pay Off" campaign and its evaluation and considers both theoretical and pragmatic issues pertinent to replicating the program in other community settings.

Adult↗
PubMed1983

Type A behavior: an ecological approach.

The recognized association between Type A behavior and coronary heart disease has prompted efforts to alter the behavior's deleterious components in both individuals who have experienced myocardial infarction and those who are at risk for that disease. Utilizing concepts from psychology, sociology, history, and other disciplines and material from scholarly and popular literature, this paper suggests that instead of singularly concentrating on components at the level of the individual, it is important to view Type A behavior from an ecological perspective, with attention directed at the interpersonal, institutional, and cultural environments of individuals. This perspective will enhance understanding of Type A behavior and possibly stimulate interventions at the primary as well as secondary and tertiary prevention levels.

Achievement↗
PubMed1983

Accidental policy: an analysis of the problem of unintended injuries of childhood.

The problem of childhood injury is examined from an ecological, public health perspective, and a range of preventive and ameliorative strategies is considered. Three policy evaluation criteria--efficiency, freedom of choice, and equity--are discussed. A framework is proposed, and examples given, to assist professionals concerned with mental health and with child health and development in critically analyzing policy options.

Accident Prevention↗
PubMedDate not supplied

Helmet use among competitive cyclists.

The United States Cycling Federation (USCF) decision in 1986 to mandate helmet use in all sponsored races marked a major initiative in cycling safety. Confirming earlier reports about the effectiveness of helmets in preventing injuries, this study also examines the attitudes of 554 USCF members toward the policy and about helmet use in both racing and nonracing situations. Although 64% of the racers reported some hardshell helmet use in training before the policy, 80% used helmets in training after the ruling. Most cyclists favored the USCF policy, although only 19% favored requiring helmet use in all cycling situations. Attitudes about helmet policy and actual use by racers were inconsistent; large percentages of those opposing mandatory helmet use in racing (51%) and in training (76%) used helmets themselves. We suggest possibilities for incremental expansion of helmet use requirements for all riders.

Adolescent↗