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P Roeper

Publications and source records attributed to P Roeper.

13 recordsLinked to original sources

Effect of community-based interventions on high-risk drinking and alcohol-related injuries.

CONTEXT: High-risk alcohol consumption patterns, such as binge drinking and drinking before driving, and underage drinking may be linked to traffic crashes and violent assaults in community settings. OBJECTIVES: To determine the effect of community-based environmental interventions in reducing the rate of high-risk drinking and alcohol-related motor vehicle injuries and assaults. DESIGN AND SETTING: A longitudinal multiple time series of 3 matched intervention communities (northern California, southern California, and South Carolina) conducted from April 1992 to December 1996. Outcomes were assessed by 120 general population telephone surveys per month of randomly selected individuals in the intervention and comparison sites, traffic data on motor vehicle crashes, and emergency department surveys in 1 intervention-comparison pair and 1 additional intervention site. INTERVENTIONS: Mobilize the community; encourage responsible beverage service; reduce underage drinking by limiting access to alcohol; increase local enforcement of drinking and driving laws; and limit access to alcohol by using zoning. MAIN OUTCOME MEASURES: Self-reported alcohol consumption and driving after drinking; rates of alcohol-related crashes and assault injuries observed in emergency departments and admitted to hospitals. RESULTS: Population surveys revealed that the self-reported amount of alcohol consumed per drinking occasion declined 6% from 1.37 to 1. 29 drinks. Self-reported rate of "having had too much to drink" declined 49% from 0.43 to 0.22 times per 6-month period. Self-reported driving when "over the legal limit" was 51% lower (0. 77 vs 0.38 times) per 6-month period in the intervention communities relative to the comparison communities. Traffic data revealed that, in the intervention vs comparison communities, nighttime injury crashes declined by 10% and crashes in which the driver had been drinking declined by 6%. Assault injuries observed in emergency departments declined by 43% in the intervention communities vs the comparison communities, and all hospitalized assault injuries declined by 2%. CONCLUSION: A coordinated, comprehensive, community-based intervention can reduce high-risk alcohol consumption and alcohol-related injuries resulting from motor vehicle crashes and assaults. JAMA. 2000;284:2341-2347.

Accidents, Traffic↗

Alcohol consumption measured at roadside surveys and variations in traffic injury crashes.

This analysis examines whether roadside surveys that measure changes in the prevalence of driving after drinking can be used to evaluate the impact of interventions designed to reduce alcohol-related traffic crashes. Using data collected at a roadside survey over a 4-year period in two California communities (N = 33,614), this analysis examines the relationship of BAC and drinks since 5 P.M., aggregated on a monthly basis, with nighttime injury crash data from the California Highway Patrol aggregated on a monthly basis. A regression analysis was used in which daytime injury and drinking style were covariates. The data demonstrate that temporal changes in drinking and driving collected at a roadside survey reflect temporal changes in nighttime injury rates. Hence, this study substantiates the use of roadside surveys as an appropriate methodology to evaluate drinking and driving interventions.

Accidents, Traffic↗

The geography of availability and driving after drinking.

This paper reports on an analysis of geographically based data from four communities conducted to evaluate relationships between measures of the physical availability of alcohol and rates of driving after drinking. From a review of the literature, it was expected that rates of driving after drinking would be directly related to the availability of alcohol at on-premise establishments. Based on theoretical arguments regarding the life activities which underlie drinking and driving it was expected that the effects of availability upon these outcomes would extend significantly beyond the local areas of outlets. Taking into account the geographic variations in environmental characteristics (road network density, traffic flow, population density), and socioeconomic (age, gender, race, marital status, income, employment) and drinking characteristics (rates of abstention, frequency and quantity of use) of resident populations, a spatial analysis of drinking driving and alcohol-related crashes was conducted. The results of the analysis showed that physical availability was unrelated to self-reports of driving after drinking and driving while intoxicated and significantly related to rates of single vehicle night-time crashes. In the latter case, physical availability affected both local and adjacent area rates of crashing.

Accidents, Traffic↗

Evaluation of media advocacy efforts within a community trial to reduce alcohol-involved injury. Preliminary newspaper results.

This article examines coverage of alcohol-related topics in local newspapers as applied to a conceptual model of media advocacy being tested in a five-component community trial to reduce alcohol-involved injuries. Based on a literature review of determinants of exposure of newspaper articles, it uses a composite measure that takes into account the likelihood that given articles will be read. This measure is evaluated in terms of the timing of media advocacy training, technical consultation, and resulting media advocacy efforts. Three hypotheses find support. First, postintervention levels of coverage across experimental communities appear generally higher than similar preintervention coverage. Second, although postintervention local and county coverage appears higher across experimental communities, no equivalent effect is present across comparison communities. Third, increases in local and county coverage in experimental communities were not matched by increases in state and national coverage in these communities.

Accident Prevention↗

Estimating alcohol involvement in trauma patients: search for a surrogate.

This study explores the potential for the development of a surrogate for alcohol-involved traumatic injury. It presents a bivariate probit analysis that simultaneously models likelihoods of patients being tested for blood alcohol content (BAC) and having positive BACs given testing using 17,356 adult trauma cases selected from the California Regional Trauma Registry. It concludes that patient and injury characteristics predict both testing and BAC, and that a weighting scheme may be profitably used to determine changes in levels of alcohol-involved trauma in populations over time in the absence of empirical measurement of BAC.

Accidents, Traffic↗

Birth prevalence study of the Apert syndrome.

Estimates of the Apert syndrome birth prevalence and the mutation rate are reported for Washington State, Nebraska, Denmark, Italy, Spain, Atlanta, and Northern California. Data were pooled to increase the number of Apert births (n = 57) and produce a more stable birth prevalence estimate. Birth prevalence of the Apert syndrome was calculated to be approximately 15.5/1,000,000 births, which is twice the rate determined in earlier studies. The major reason appears to be incomplete ascertainment in the earlier studies. The similarity of the point estimates and the narrow bounds of the confidence limits in the present study suggest that the birth prevalence of the Apert syndrome over different populations is fairly uniform. The mutation rate was calculated to be 7.8 x 10(-6) per gene per generation. Apert syndrome accounts for about 4.5% of all cases of craniosynostosis. The mortality rate appears to be increased compared to that experienced in the general population; however, further study of the problem is necessary.

Acrocephalosyndactylia↗

Gastroschisis.

Explore the source record for details and available documents.

Abdominal Muscles↗

Using the Short Michigan Alcoholism Screening Test to study social drinkers: Tecumseh, Michigan.

The Short Michigan Alcoholism Screening Test (SMAST), often given to clinical samples to detect alcoholics, was used in a survey of a randomly selected sample (N = 1,266) in a small midwestern town, with a population of about 10,000. The specific aims were: (1) to test if scores on the SMAST would be related to these normal subject's levels of drinking; (2) to test if the SMAST could identify a drinking group who had never sought treatment for alcohol-related problems, thus defining a potential subset for help; and (3) to appraise the SMAST as a research tool for use in a general population. Results show that the number of SMAST items endorsed is significantly but modestly correlated to drinking levels, with higher volume drinkers having higher scores. This prediction was improved by removing two items reporting "not normal" drinking that had caused SMAST scores to be spuriously high. Factor analysis of test items allowed construction of five rank-ordered groups: those (1) reporting no alcohol-related SMAST problems; (2) described by two items, self-reported "not normal" drinking; (3) with one problem: "can't stop" drinking; (4) reporting problems but had not received treatment for them (the predicted group); and (5) reporting both problems and attempts at help with them (e.g., Alcoholics Anonymous). These latter two groups had significantly higher scores on several other measures of alcohol-related behavior, as well as tests measuring emotional adjustment, notably Eysenck's Neuroticism Scale and Buss and Plomin's measure of Impulsivity. The SMAST demonstrates potential usefulness in selecting problem, no-problem and patterns of use in drinkers from a normal drinking population when clusters of items are constructed to be exclusive in a Guttman-like rank order, rather than by sheer number of items endorsed or use of simple factor scores.

Adult↗

Skin color, ethnicity, and blood pressure I: Detroit blacks.

Census areas in Detroit were ranked for their stress scores based on instability (e.g., crime, marital break up) and socioeconomic status. Four areas were selected for detailed study: 1) high stress, population predominantly black, 2) white, 3) low stress, population predominantly black, 4) white. A sample was drawn from each area of persons of the predominant race, 25-60 years old, married and living with spouse, and having relatives in the Detroit Area. Nurses interviewed such persons; three blood pressure readings were taken during the first half-hour of medical history, and skin color was rated. Results show that darker skin color, for black males especially, is related to higher pressure, independently of nine control variables (e.g., age, weight, socioeconomic status, etc.). However, younger black males (25-39 years of age) in high stress areas had higher pressure than counterparts in low stress areas, regardless of skin color and relative weight; for older black males (40-59 years of age) darker skin color was correlated with higher pressure, regardless of relative weight or stress area. For 35 blacks whose fathers were from the West Indies, pressures were higher than those with American-born fathers. These findings suggest that varied gene mixtures may be related to blood pressure levels and that skin color, an indicator of possible metabolic significance, combines with socially induced stress to induce higher blood pressures in lower class American blacks.

Adult↗

Skin color, ethnicity, and blood pressure II: Detroit whites.

Census areas in Detroit were ranked for their stress scores based on instability (e.g., crime, marital break up) and socioeconomic status. Four areas were selected for detailed study: 1) high stress, population predominantly black and 2) white, and 3) low stress, population predominantly black and 4) white. A sample was drawn from each area of persons of the predominant race, 25-60 years old, married and living with spouse, and having relatives in the Detroit Area. Nurses interviewed such persons; three blood pressure readings were taken during the first half-hour of medical history, and skin color was rated. While lighter skin color showed a negligible relation to higher blood pressure, a four-category division of European national background based on a skin color cline in Europe from Northern areas to the Mediterranean was significantly associated with a nurse-rating of skin color. The rank order of this four category variable, white ethnicity, was related linearly to both systolic and diastolic blood pressure means. Respondents with parents from Mediterranean countries had the lowest pressures and those from Northern Europe had the highest. The relationship is stronger for women than men. The relationship was independent of nine other control variables including age, overweight, smoking etc., and high and low stress areas, although of greater magnitude for the high than low stress groups. In this article, findings in whites are compared with prior results in blacks. Findings suggest that physiological and biological correlates exist that can be explored profitably by future research.

Adult↗

Evaluation of the hospital discharge diagnoses index and the birth certificate as sources of information on birth defects.

The hospital discharge diagnoses index (DI) for newborns and the birth certificate were evaluated as sources of information about birth defects by comparing them with the same births in the case registry of the California Birth Defects Monitoring Program (CBDMP). The CBDMP is an active surveillance system; the staff visit hospitals to identify children with birth defects diagnosed in the first year of life. The study population comprised 66,481 live births to residents of five counties in the San Francisco Bay area in 1983. Of these infants, 2,543 had at least one birth defect noted on the DI, and 1,623 were in the CBDMP registry; 1,020 with defects noted on the DI were also in the CBDMP registry. For this same population, 399 infants had one or more defects noted on the birth certificate; 304 of these were also in the CBDMP registry. Reporting of birth defects on the birth certificate was poor for every condition. Reporting on the DI was most reliable for oral clefts and chromosomal defects; for these defects, the DI omitted one-third of the cases but had identified only about 10 percent false-positive (that is, unverified) cases. Major central nervous system malformations were less well reported, with about one-third of them false-positive. For all other birth defects, the DI either omitted more than half of the cases, or more than half of the cases reported were false-positive cases. These findings raise questions about the validity of analytic studies of birth defects if the data are obtained only from the DI or the birth certificate.

Birth Certificates↗