Biomedical subjects

Jess F Kraus

Publications and source records attributed to Jess F Kraus.

17 recordsLinked to original sources

PubMed2006

Injuries to high school football athletes in California.

BACKGROUND: Among all high school sports, football has the highest rate of injury. Prior research has been limited primarily because of challenges in surveillance, defining injuries, and measuring exposures. HYPOTHESIS: Football injury patterns differ across player and session characteristics. STUDY DESIGN: Descriptive epidemiology study. METHODS: More than 5000 football players from 87 high schools in California were observed for 2 seasons (2001 and 2002). School representatives were trained to collect data on injuries, player characteristics, and daily exposures. Data were analyzed using descriptive statistics and clustered Poisson regression. RESULTS: Players sustained 25.5 injuries per 100 players, 9.3 injuries per 10,000 player-hours, and 8.4 injuries per 100 session-hours. Session rates were highest during games, on artificial turf (13.8 of 100), during foggy weather (25.1 of 100), and on clear evenings (21 of 100). Offensive and defensive backfielders had about a 20% increased rate of injury compared with linemen. The adjusted injury rate for starters was 60% higher than the rate for nonstarters (relative rate, 1.6; 95% confidence interval, 1.4-1.9). CONCLUSION: Risk profiles differed by experience, playing position, and surface types. We recommend future sports injury research that measures time-dependent exposures at the individual level and for various types of environmental playing conditions.

Adolescent↗

PubMed2006

Employee and customer injury during violent crimes in retail and service businesses.

OBJECTIVES: We sought to compare the frequency and risk factors for employees and customers injured during crimes in retail (convenience, grocery, and liquor stores) and service businesses (bars, restaurants, motels). METHODS: A total of 827 retail and service businesses in Los Angeles were randomly selected. Police crime reports (n=2029) from violent crimes that occurred in these businesses from January 1996 through June 2001 were individually reviewed to determine whether a customer or an employee was injured and to collect study variables. RESULTS: A customer injury was 31% more likely (95% confidence interval [CI]=1.11, 1.51) than an employee injury during a violent crime. Customer injury was more frequent than employee injury during violent crimes in bars, restaurants, convenience stores, and motels but less likely in grocery or liquor stores. Injury risk was increased for both employees and customers when resisting the perpetrator and when the perpetrator was suspected of using alcohol. Customers had an increased risk for injury during crimes that occurred outside (relative risk [RR]=2.01; 95% CI=1.57, 2.58) and at night (RR=1.79; 95% CI=1.40, 2.29). CONCLUSIONS: Security programs should be designed to protect customers as well as employees.

Crime↗

PubMed2005

Seat position and the risk of serious thoracoabdominal injury in lateral motor vehicle crashes.

CONTEXT: Previous studies have suggested that motor vehicle occupants seated on the near-side of a lateral impact have a higher proportion of thoracoabdominal injuries. However, due to limitations in previous studies, the true association between seat position, side of lateral impact, and thoracoabdominal injury is unclear. OBJECTIVE: To assess the relationship between seat position (i.e., near-side, middle-seat, and far-side, regardless of row), side of lateral motor vehicle crash (MVC), and serious thoracoabdominal injury after adjusting for important crash factors. DESIGN: National population-based cohort of adult subjects involved in MVCs and included in the National Automotive Sampling System Crashworthiness Data System database (NASS CDS) from 1995 to 2003. PATIENTS: Occupants aged > or =16 years involved in MVCs where the highest external deformation of the vehicle was located on the right or left side (i.e., lateral). MAIN OUTCOME MEASURE: Serious thoracic or abdominal injury, defined as an Abbreviated Injury Scale (AIS) > or =3 in the thoracic or abdominal body region. RESULTS: Fifteen thousand, one hundred and sixty persons involved in primary lateral MVCs were represented in the NASS CDS database during the 9-year period. There were 1867 (2%) persons with serious thoracic injuries and 507 persons (0.5%) with serious abdominal injuries. In multivariable logistic regression models that adjusted for important crash factors and the NASS CDS sampling design, seat position was a strong effect modifier of the association between side of lateral impact and serious thoracic (p<0.0001) and abdominal (p=0.0009) injury, with the risk of serious thoracic and abdominal injury highest for occupants seated on the near-side of the crash. The mean probability of injury was higher for near-side and middle-seat occupants compared to far-side occupants, and the probability of thoracic injury was approximately four times higher than that of abdominal injury for all seat positions. CONCLUSIONS: There is a strong, synergistic relationship between seat position and side of lateral MVC in assessing risk of serious thoracic and abdominal injury among adult occupants. The probability of serious thoracoabdominal injury increases with increasing proximity of seat position to side of the crash and the risk of thoracic injury is higher than abdominal injury for all seat positions.

Abdominal Injuries↗

PubMed2005

Steering wheel deformity and serious thoracic or abdominal injury among drivers and passengers involved in motor vehicle crashes.

STUDY OBJECTIVE: We assess the relationship between steering wheel deformity and serious thoracic or abdominal injury among drivers and front seat passengers involved in motor vehicle crashes, while adjusting for important crash factors. METHODS: This was a national population-based cohort of adults involved in motor vehicle crashes from 1995 to 2002 and included in the National Automotive Sampling System Crashworthiness Data System database. Participants were front seat occupants aged 16 years or older involved in motor vehicle crashes with collision. Outcome measure was serious thoracic or abdominal injury, defined as an Abbreviated Injury Scale score greater than or equal to 3 in these body regions. RESULTS: There were 42,860 persons involved in motor vehicle crashes and seated in the driver or front passenger seat whose data were available for analysis. Five hundred fifty-four (1.3%) persons had serious thoracic injuries, and 169 (0.4%) persons had serious abdominal injuries. In multivariable logistic regression models that adjusted for important crash factors and the National Automotive Sampling System Crashworthiness Data System sampling design, increasing steering wheel deformity was associated with serious thoracic injury in drivers (odds ratio [OR] for each 5-cm increase in steering wheel deformity 1.28, 95% confidence interval [CI] 1.04 to 1.59) and front seat passengers (OR 1.77, 95% CI 1.26 to 2.49). Increasing steering wheel deformity was associated with serious abdominal injury in front seat passengers (OR 1.45, 95% CI 1.11 to 1.89) but not in drivers (OR 0.95, 95% CI 0.79 to 1.15). CONCLUSION: Steering wheel deformity is an independent predictor of serious thoracic injury in drivers and front seat passengers and is associated with serious abdominal injury among front seat passengers. For these occupants, the risk of these injuries increases incrementally with increasing steering wheel deformity.

Abbreviated Injury Scale↗

PubMed2005

Acculturation and reported intimate partner violence among Latinas in Los Angeles.

This study sought to understand the relationship between acculturation and reporting intimate partner violence (IPV) among Latinas. A cross-sectional interviewer-administered survey was conducted at public health care clinics throughout Los Angeles County. Logistic regression was used to estimate the effect of acculturation on reporting IPV. An increasing trend of reporting IPV was observed among Latinas who were more acculturated (chi-square = 41.02, p = .0006). Highly acculturated Latinas were more likely to report IPV compared with least acculturated Latinas (prevalence odds ration = 2.18, 95% confidence level = 0.98, 4.89) and moderately acculturated Latinas were more likely to report IPV compared with least acculturated Latinas (prevalence odds ration = 1.29, 95% confidence level = 0.69, 2.43). Culturally competent IPV prevention programs may be the key to significantly reducing the number of women exposed to this serious public health problem.

Acculturation↗

PubMed2004

Injuries to the head among children enrolled in special education.

BACKGROUND: Injuries to the head comprise 20% to 39% of all school-related injuries. Head injuries among special education students have not been adequately described. OBJECTIVES: (1) To examine the incidence and characteristics of head injuries in children enrolled in special education and (2) to determine the factors that increase the risk of sustaining a head injury compared with an injury to another part of the body. METHODS: Pupil Accident Reports for 6769 students enrolled in 17 of 18 special education schools in 1 large urban school district during the academic years 1994-1998 were reviewed, and information on the nature of injury, external cause, and activity was abstracted. Head-injured and nonhead-injured cases were identified and compared by race, sex, age, characteristics of injury, and disability category. RESULTS: Six hundred ninety-seven injury events were reported during the 4-year study period. The overall injury rate was 4.7 injuries per 100 student-years. Two hundred five children (29.4%) sustained injuries to the head, and the rate of head injury was 1.3 injuries per 100 student-years. Falls were the leading cause of injury. Head injuries were most commonly associated with physical education and unstructured play and usually occurred on the playground. Disproportionately more head than nonhead injuries were sustained in the classroom (12% vs 8%) and the bathroom (9% vs 3%). Compared with children with emotional/mental disabilities, children with multiple disabilities had the highest risk of a head injury (incidence density ratio, 2.4 [95% confidence interval, 1.6-3.5]), followed by children with physical disabilities (incidence density ratio, 1.8 [95% confidence interval, 1.1-3.1]). There appeared to be no significant difference in the rate of head injury by sex and age. CONCLUSIONS: Modifications of the classroom, bathroom, and playground environments might reduce the risk of head injuries in children enrolled in special education. Special modifications and increased supervision may, in particular, reduce the risk of head injury for children with physical and multiple disabilities.

Adolescent↗

PubMed2004

Compliance to a Workplace Violence Prevention Program in small businesses.

BACKGROUND: Robberies are the leading motive for work-related homicide and assault. Interventions to reduce robberies and related injuries have been limited to convenience stores, and evaluations have not addressed compliance as a factor in program effectiveness. SETTING/PARTICIPANTS: A total of 314 intervention and 96 control businesses were included in this intervention evaluation. INTERVENTION: The Workplace Violence Prevention Program provided a customized robbery and violence prevention program to a stratified random sample of 314 small, high-risk businesses in Los Angeles City. An additional 96 comparison businesses did not receive the intervention. The intervention included individualized consultation, printed materials, training brochures, and a video. Interventions were conducted from August 1997 through August 2000. MAIN OUTCOME MEASURES: For both intervention and comparison businesses, a comprehensive security program assessment was conducted at baseline and at 3- and 12-month follow-up visits. Crime rates in intervention and comparison businesses were examined for 12 months pre- and post-intervention with the use of police reports. RESULTS: By the second follow-up visit, compliance to the intervention program was significant for each program component. Employee training was the most frequently implemented intervention component. Neighborhood crime level, primary language spoken by the business owner, and the number of employees were all related to compliance. Although crime rates generally increased for all businesses from the pre- to post-intervention periods, businesses with high compliance to the program experienced a decrease in overall violent crime and robbery. CONCLUSIONS: Participating businesses were willing to voluntarily implement components of the intervention program, and greater implementation was related to reductions in robbery and violent crime.

Crime↗

PubMed2004

Effects of the California graduated driver licensing program.

PROBLEM: On July 1, 1998, in an effort to ameliorate the problem of high teenage driver crash rates, California implemented a graduated driver licensing system (GDLS). METHOD: Data on injury crashes of 16- and 17-year-old drivers from a pre-GDLS year were compared with data from two post-GDLS years. Per-capita crash rate ratios were adjusted for changes in crash rates of 25- to 34-year-old drivers, who were unaffected by the GDLS. Prevented numbers and 95% confidence intervals were estimated. RESULTS: Fatal or severe injury crash rates were significantly lower during each of the two post-GDLS years (adjusted rate ratios (RR)=0.72 and 0.83, for 2000 vs. 1997 and 2001 vs. 1997, respectively). Significant rate reductions were observed for all crash types, particularly for struck object (RR=0.71 and 0.80, for 2000 vs. 1997 and 2001 vs. 1997, respectively) and non-collision (RR=0.63 and 0.72, for 2000 vs. 1997 and 2001 vs. 1997, respectively). Minor injury crash rates were also lower during post-GDLS years (RR=0.87 and 0.90, for 2000 vs. 1997 and 2001 vs. 1997, respectively). Percent reductions were notably larger during the hours of the late night driving restriction (midnight-5 a.m.) (RR=0.79 and 0.87, for 2000 vs. 1997 and 2001 vs. 1997, respectively). SUMMARY: The implementation of the California GDLS was followed by large reductions in the rate of injury-producing motor-vehicle crashes. IMPACT ON INDUSTRY: This evaluation supports previous evidence that GDLS is an effective countermeasure to adolescent motor-vehicle crashes and their associated injuries. States with a traditional licensing system may prevent adolescent driver crashes by adopting a GDLS. Future studies should examine factors that influence teenager compliance with GDLS provisions and identify approaches to improving compliance.

Accidents, Traffic↗

PubMed2004

Incidence of acute low-back injury among older workers in a cohort of material handlers.

Injuries to the low back are the most common cause for injury claims among material handlers. Previous studies have shown conflicting results about how age affects risk of low-back injury. This study describes the incidence of acute low-back injury by age, gender, length of employment, and lifting intensity measured by job classification in a cohort of material handlers. The cohort included all material handlers employed at a large home improvement retail chain in California from 1989 through 1994. The cohort accrued approximately 50,000 full time equivalents over the study period. A total of 2152 low-back injuries were reported during the study period. Compared to workers aged younger than 45, the crude rate ratio for workers aged 45 to 54 was 0.78, and for workers aged 55 and above was 0.84. However, this age difference was not apparent among length of employment strata or among jobs with low or medium lifting intensity. A higher proportion of workers over the age of 55 missed work time because of their injury, and workers over 45 had a higher average number of lost workdays per injury. This research indicates that workers over age 55 had similar injury rates to workers younger than age 55, even when considering lifting intensity and length of employment. However, their injuries may cause a longer period of disability.

Acute Disease↗

PubMed2004

Effectiveness of crime prevention through environmental design in reducing criminal activity in liquor stores: a pilot study.

Liquor store employees experience disproportionately higher rates of workplace injury death than employees in any other retail setting. However, efforts to introduce workplace violence prevention programs into liquor stores have been minimal. This study examines the effectiveness of a Crime Prevention Through Environmental Design intervention in reducing criminal activity in Santa Monica, California liquor stores. Nine stores enrolling in the study received an individualized intervention safety plan; the remaining 13 served as a comparison group. Mixed-effects Poisson regression was used to examine intervention effectiveness. The largest reductions in criminal activity occurred for robbery and shoplifting outcomes. We conclude that the Crime Prevention Through Environmental Design program reduced crime and injury in liquor stores and educated small businesses about the risks associated with retail violence and the countermeasures that can be taken.

Alcohol Drinking↗

PubMed2004

Evaluation of a falls prevention program for independent elderly.

OBJECTIVE: To evaluate the effectiveness of an older adult falls-prevention program and describe compliance with the program. METHODS: The No More Falls! program was evaluated by comparing outcomes of program participants and nonparticipants from the same health care system and by comparing outcomes in pre- and postintervention periods. RESULTS: Program participants were 20% less likely to fall than nonparticipants. Falls during the year after program participation decreased 53%, compared with a 21% decline among nonparticipants. Compliance was positively associated with program effectiveness. CONCLUSION: These findings suggest that the No More Falls! program was successful in reducing falls among older adults.

Accidental Falls↗

PubMed2003

Risks for abuse against pregnant Hispanic women: Morelos, Mexico and Los Angeles County, California.

BACKGROUND: Although violence against women is gaining international attention as a prevention priority, little is known about how risks differ across countries. METHODS: A comparative study of violence against pregnant Mexican women in Morelos, Mexico, and Latina women in Los Angeles County, California, United States. In 1998 and 1999, women in prenatal clinics were interviewed about psychological abuse and sexual and physical violence by their partner, during and the 1 year prior to the index pregnancy. The overall response rate for Morelos was 99%, with a sample size of 914; Los Angeles County had a response rate of 96.9%, with a sample size of 219. RESULTS: Women in Morelos reported a higher prevalence of violence compared to women in the California (14.8% v 11.9%, respectively). A partner aged <20 years was associated with increased violence in both countries, but the association of violence with other socioeconomic factors differed by country. For example, employed women had higher odds of violence in California but lower odds in Morelos. Women who experienced violence during both the year prior to pregnancy and as a child were more than 25 times more likely to be abused during pregnancy than women not reporting this type of abuse. CONCLUSION: The identification of factors associated with violence against women, especially as they differ by culture and ethnicity, will help clinicians to better identify victims and to design and implement culturally appropriate prevention programs.

Adult↗

PubMed2003

Facial trauma and the risk of intracranial injury in motorcycle riders.

STUDY OBJECTIVE: We describe the associations among facial fracture, helmet use, skull fracture, and traumatic brain injury in injured motorcycle riders. METHODS: The study population consisted of 5,790 motorcycle riders who sustained an injury from a crash in 1991, 1992, or 1993 and were identified from emergency department or hospital records in 28 hospitals in 11 California counties. Diagnostic information was abstracted from ED or hospital records and coded to the 1990 Abbreviated Injury Scale. The risk of traumatic brain injury was examined by using odds ratios and 95% confidence intervals. Logistic regression analysis was used to examine the associations among helmet use, skull fracture, facial fracture, and traumatic brain injury. RESULTS: Facial injury was diagnosed in 24.4% of all injured riders, including 411 with one or more facial fractures. The odds of traumatic brain injury were 3.5 times greater with than without a facial injury and 6.5 times greater with a facial fracture than with no facial injury. Significantly increased odds of traumatic brain injury were observed for fracture of all bones of the face, but the highest odds of traumatic brain injury were found in riders with fractures to bones of the upper face. Helmet use status and the presence of skull fracture were found to be significant effect modifiers. Facial fracture with concurrent skull fracture increased the risk of traumatic brain injury dramatically. Facial fractures are more strongly associated with traumatic brain injury in helmeted riders. CONCLUSION: The presence of facial fractures increases the risk of traumatic brain injury. Riders with facial fractures should be screened for brain injury, regardless of helmet use status.

Accidents, Traffic↗

PubMed2002

Incidence, severity, and patterns of intrathoracic and intra-abdominal injuries in motorcycle crashes.

BACKGROUND: Although severe head injuries have been reduced with helmet use, little has been done to address the severity of trauma to organs of the trunk in motorcycle crashes. We detail the frequency, severity, and pattern of intrathoracic and intra-abdominal injuries that may be helpful in the recognition and medical treatment of such injuries. METHODS: Diagnostic and treatment information from emergency room, hospital, and coroner records from a cohort of motorcyclists injured from 1991 to 1992 were obtained from 28 hospitals and 11 coroners in California. RESULTS: Multiple intrathoracic and intra-abdominal injuries were common, and the number and bilaterality of rib fractures were strongly associated with chances of injuries to the thoracic and abdominal organs. CONCLUSION: Patients with severe injury in one anatomic region of the trunk are very likely to have severe injuries in the same or other anatomic regions. These patients are best treated in trauma centers, where rapid diagnosis and treatment are possible.

Abdominal Injuries↗

PubMed2002

A case-site/control-site study of workplace violent injury.

Workers in retail and service industries are at high risk for workplace violence. While studies have examined the association between environmental and community factors on robbery risk, few have examined risk factors for fatal and nonfatal employee violent injury. A matched case-site/control-site study was conducted among various retail and service establishments in seven California counties. An interview and environmental assessment was performed in each participating business. Over half of the injury events occurring in case-site were robbery-related, and nearly 13% were fatal. Businesses open 24 hours and those having a history of violent events were found to be at increased risk for employee injury.

Accidents, Occupational↗

PubMedDate not supplied

A field trial of back belts to reduce the incidence of acute low back injuries in New York City home attendants.

To determine the effect of black belt use on the incidence of low back injury in home attendants, a cluster-randomized trial involving employees of nine home attendant agencies in New York City was conducted. Nine agencies employing 12,772 home attendants between June 1997 and September 1999 were randomized into three groups-one group received back belts with use instruction, one group received lifting advice only, and one group served as a control. Low back injury rates per 100 full-time equivalents and rate ratios adjusted for potential confounders were estimated with random-effects Poisson regression. The back-belt group had a lower rate of low back injury than did those in both the advice-only and control groups, though the differences were marginally significant. Age, body mass index, history of back injury, years worked as a home attendant, and level of exercise were associated with risk of low back injury. The findings suggest that use of back belts is associated with some reduction in risk of low back injury.

Adolescent↗

PubMedDate not supplied

Suicides at work: misclassification and prevention implications.

To determine the extent of misclassification of suicides with regard to work-relatedness and the implication for intervention, a matched case-control design was used. Cases were identified from California's master mortality file using ICD 9-CM external cause codes E950-959 and a positive response to the "injury-at-work" designation on the death certificate. Two controls matched on the same external cause of death codes, age, date of death, and county of occurrence were randomly selected. Outcome measures were odds ratios and accuracy assessments. Over 11% of cases and 23% of controls were misclassified. Extrapolation to the United States suggests thousands of suicides are misclassified as to a work-related connection. The findings point to misappropriation of the work-relatedness of suicide and hence, an inaccurate understanding of underlying risk factors and their intervention potential.

California↗