R J Glass | PubMed Health

PubMed2000

Cognitive impairment screening in second offense DUI programs.

Patients enrolled in alcohol treatment programs for driving under the influence (DUI) offenders are at elevated risk of cognitive impairment, but are not systematically screened. We developed a 30-min screening battery that can be administered in a group setting to test patients' ability to handle the cognitive demands of psychoeducational treatment. Testing of 134 volunteers identified 73% as having one or more clinically significant cognitive deficits. A majority of subjects scored below the 50th percentile on tests of word fluency, vocabulary, sustained attention, memory, executive functioning, and impulse control. The prevalence of cognitive impairment in the repeat DUI offender population is extremely high, making DUI treatment programs an ideal venue for screening and referral. Treatment programs should be responsive to the special needs of this population, incorporating teaching techniques that address short attention span, poor memory, lack of verbal fluency, and lack of impulse control.

Adult↗

PubMed2000

Child passenger safety: decisions about seating location, airbag exposure, and restraint use.

The installation of passenger-side airbags in new vehicles complicates efforts to maximize child safety in motor vehicle crashes. It has been recommended by both public and private organizations that children sit in the rear seat with proper restraint to achieve maximum safety. Drivers now need to decide whether a child should be restrained, where the child should be seated (front versus rear), and whether the child should be seated in front of a passenger-side airbag. This research was undertaken to determine which choice minimizes the risk of fatality to children. Using data from the U.S. Fatality Analysis Reporting System for calendar years 1989 to 1998, fatal vehicle crashes with child passengers younger than 13 years were analyzed. The effectiveness of passenger-side airbags and rear seating for children, by age category and restraint use, was estimated using the double-pair comparison method. For each of four age categories, the fatality risk of each possible combination of restraint use, seating location, and airbag presence was also estimated using logistic regression. Passenger airbags were associated with an increase in child fatality risk of 31% for restrained children, and 84% for unrestrained children. Passenger airbags did appear to offer protection to restrained 9- to 12-year-old children. Restraint use and rear seating were associated with statistically significant reductions in the odds of a child dying in a crash. In order to minimize child fatality risk, parents should seat children in the rear of the vehicle while using the proper child restraint system, especially in vehicles with passenger airbags. These findings support current public education efforts in the United States.

Accidents, Traffic↗

PubMed1996

Osteosarcoma metastatic to the pancreas in young patients.

Two rare cases of pancreatic metastases from osteosarcoma are reported. Metastatic spread occurred after treatment with chemotherapy. This unusual phenomenon represents an alternation in the natural history of osteosarcoma with increased long-term survival of patients who are successfully treated with chemotherapy.

Adolescent↗