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Biomedical subjects

H Graff

Publications and source records attributed to H Graff.

At least 19 recordsLinked to original sources

Effects of the 65-mph speed limit on rural interstate fatalities in New Mexico.

As a result of federal legislation passed in April 1987, New Mexico was the first state to resume a 65-mph speed limit on rural Interstate highways. We compared the rates of fatal crashes before and after the speed limit change. The rate of fatal crashes in the 1 year after the speed limit was increased was 2.9 per 100 million vehicle-miles traveled, compared with a predicted rate of 1.5 per 100 million vehicle-miles based on the trend of the 5 previous years. When fatal crashes that occurred after the speed limit change were compared with fatal crashes in the 5 previous years, there was no difference in the mean age and sex of the at-fault drivers, mean age and sex of the victims, seat belt use by the victims, or alcohol involvement of the crashes. The increase in fatal crashes can be attributed to an increase in fatal single-vehicle crashes. Vehicles on rural Interstates are traveling at greater rates of speed and a larger proportion of vehicles are exceeding the 65-mph speed limit. The benefits associated with the 65-mph speed limit should be weighed against the increased loss of lives.

Accidents, Traffic

Medical services provided to 2,394 patients at methadone programs in three states.

The type and amount of medical services provided to 2,394 patients in methadone maintenance programs in three states was studied. Data were obtained from on-site confidential interviews with the entire treatment staff at seven programs. It was found that there were marked differences in the number and type of medical staff. Thus, there was ten times more coverage by physicians at some programs than others. In general, there were notable differences in the treatment staff available. Comparable variations among the programs were found with respect to the actual provision of medical services. Thus, the number of patients seen by the medical staff on a weekly basis varied from a high of 185 patients to a low of 36 patients. Similarly, the proportion of each program's patients receiving medical treatment per week varied from 53 to 14 percent. Reasons for those variations in medical services are considered.

Ambulatory Care Facilities

Child restraint law effects on motor vehicle accident fatalities and injuries: the New Mexico experience.

The New Mexico State Legislature passed a child restraint law applicable to children less than 5 years of age that became effective in June 1983. To evaluate the effectiveness of this law, we analyzed traffic accident data for New Mexico from January 1981 through September 1984. During this period, there were 20,972 children younger than 5 years of age in motor vehicle accidents. Restraint usage increased for this age group from a low of about 10% in 1981 to more than 40% in 1984 (P less than 10(-6)). Unrestrained children younger than 5 years of age were five times more likely to be killed and two times more likely to be injured than restrained children. Analysis of motor vehicle accident fatality and injury rates pre- and post-law revealed a 33% reduction in motor vehicle accident fatality rates and a 12.6% reduction in nonfatal injury rates for children younger than 5 years. We conclude that child restraint devices are effective in reducing motor vehicle accident fatalities and injuries in young children and the child restraint law has been effective in increasing child restraint usage and in reducing childhood death and injury in New Mexico.

Accidents, Traffic

Preconditions and consequences of transference interpretations. A clinical-quantitative investigation.

Our aim was to study the preconditions and consequences of transference interpretations by both quantitative and clinical methods. We selected the three specimen psychoanalytic treatments which had been studied most by clinical-quantitative research. For each patient the main data consisted of 16 interpretation contexts. The context of each interpretation included 250 patient words before and 250 patient words after the interpretation. Three judges independently rated these before and after segments for each of the 16 samples from each of the three patients. Judges tended to agree highly in rating these segments on nine variables. The before vs. after ratings showed that each patient had a different but individually typical response to the 16 interpretations, ranging from patient A who usually showed a negative response, to patient B who showed some positive response, to patient C who showed a very positive response. For each of these three patients there was a clear parallel between the positivity of the immediate response to interpretations and the outcome of treatment. Even though we have so far studied only three patients, the consistency of the results suggests that it would be worth testing in a larger group whether a sample of immediate responses to interpretations might predict the eventual outcome of the treatment. Patient factors seem central in explaining the bases for the different response of each of the three patients to transference interpretations. The Health-Sickness Rating Scale ratings showed that patient A and patient B were less healthy initially than patient C--healthier patients may be able to respond better to transference interpretations. Also, the analyses of the segments before the interpretation revealed that even before the interpretation there were differences in the three patients. These were consistent with their differing responses to interpretation; for example, patient A was rated as having less understanding than the other patients even before the interpretations. Another patient factor, the patient's readiness to experience a helping relationship, probably was significant also in explaining the differing response of the three patients to interpretations; they already differed in this experience by the third to fifth sessions, and these differences paralleled their response to interpretation.

Adult

Long-term trends in transference and resistance: a report on a quantitative-analytic method applied to four psychoanalyses.

Quantitative ratings of transference and resistance were made at each session during four psychoanalyses. Ratings were then compared with the treating psychoanalysts' clinical impressions. The two relatively successful analyses showed rising transference and diminishing resistance. The two relatively less successful analyses showed more parallel curves: the long, difficult analysis showed closely associated transference and resistance curves; the failure in analysis revealed a high resistance curve, even while transference increased.

Adult

The methadone clinic: function and philosophy.

Currently, methadone clinics are organised within two models, the metabolic and the psychotherapeutic. These models are seen to lack a completely successful opiate abuse therapy. A new model, the social psychiatric, is proposed to correct the deficiencies of these first two.

Community Mental Health Services

Changing world patterns of drug abuse, 1945-1974.

New patterns of drug abuse have rapidly appeared in the Western world since the Second World War. These patterns are characterized by the rapid introduction and spread of manufactured substances adopted from medicine. Interest has been sustained among illicit users by the search for new mood altering drugs. Both recreational use and multiple drug patterns are becoming increasingly predominant. Western youth has taken the forefront in the new patterns, especially in the rise of marijuana. Sex differentials are rapidly decreasing as more females are smoking. In the United States, hallucinogens have also been abused in large amounts. This reveals an important difference from Europe, where hallucinogen abuse has been low, but amphetamine abuse has been as high or higher than in the United States. Spread has been rapid throughout the populations studied, both from the colleges to the secondary schools, and from country to country, based on current rapid methods of communication and transportation. These data are important in formulating hypotheses for study and control of both epidemic and endemic drug abuse.

Adolescent