I must add to Leonard Evan's "to do" list. After getting his skin
thickened, he needs courses in English comprehension and basic
epidemiology.
In my letter, I said that I gave "far more" than my litigation fees
for scholarships and a professorship, contrary to his claim that it all
came from litigation fees. I doubt that "far more" means something in
England, where Evans apparently learned...
I must add to Leonard Evan's "to do" list. After getting his skin
thickened, he needs courses in English comprehension and basic
epidemiology.
In my letter, I said that I gave "far more" than my litigation fees
for scholarships and a professorship, contrary to his claim that it all
came from litigation fees. I doubt that "far more" means something in
England, where Evans apparently learned to read poorly, than it does in
the U.S. In fact, most of the money I contributed came from investment
income enhanced by the statistical methods that Evans labels as
"unintelligible hocus pocus analyses " when I apply them to motor vehicle
fatality rates. My conscience is clear as to my motives for my gifts, my
litigation work and my statements regarding Evan's book. Anyone who knows
me and my work will laugh at Evan's allegations. Most of my scientific
work preceded any thought of being involved in litigation.
Anyone who knows the behavioral science literature will wonder about
someone who prefers to question his critic's motives rather than address
the points I made in the review. It is not unusual for someone with bad
motives to project them on others. In my review and in my articles and
books, I have praised Evans' work that I consider praiseworthy, but a
substantial part of the book under review is worthy only of condemnation.
Evans again raises the argument that litigation in the U.S. accounts
for changes in simple counts of motor vehicle deaths in the U.S. relative
to other countries. He presents no data on changes in litigation awards or
litigation activity in the various countries in correlation with changes
in death rates to support the assertion. In the book, he states that the
inference is based on his judgement (p. 389). The word “judgement” should
be preceded by “subjective”. In his most recent letter, he makes all sorts
of claims about what drivers are thinking without one shred of empirical
data to support his assertions, similar to the tone of many passages in
his book.
Although he corrects for increases in vehicle registrations in his
book, in his letters Evans relies on the 16 percent reduction in the U.S.
raw number of deaths versus more than 50 percent in other countries, such
as Canada, without specifying the years he is comparing. In the book, the
percentages are for the years 1979-2002. Litigation did not begin in the
U.S. in 1979 or therafter. The reduction in rate per vehicle given by
Evans in the book is 46% for the U.S. and 64% for Canada. Thus, simply
correcting for differential growth in number of vehicles narrows the
difference substantially. As I said in my review, other factors must be
accounted for in such comparisons: "demographic shifts, population and
vehicle density in geographic areas and changing mix of vehicles", any one
of which could close a gap between 46% and 64%. An epidemiology student
would be flunked for making the kinds of inferences that Evans makes,
without empirical analysis of the effects of such factors.
Anyone who is interested in how to reduce road-related injury should
download the recent WHO report on the subject (free on the web at
http://www.who.int/world-health-day/2004/en/) and save yourself the
outlandish $99 that Evan's wants for a book substantially full of
misinformation.
While difficult to disentangle what is getting Robertson so enraged, the following four possibilities seem likely candidates.
1. He denies my claim [1, p. 381-388] that US safety policy has been
a dramatic failure.
2. He disagrees with my explanation [1, p 389-408] that the
litigation focus of US safety policy has contributed to this dramatic
failure.
3. He dislikes my book "Traffic Safety" [1]
4. He claims that its author is incapable of clear writing and
technical understanding.
Let me respond in order.
1. The numbers speak for themselves.
2. Readers are encouraged to examine the considerable documentary and
other evidence presented [1, p 389-408] to arrive at an informed opinion.
3. With the sole exception of Robertson's review, the book has
received lavish praise by reviewers in the world's most prestigious
journals. Complete details at
http://www.scienceservingsociety.com/ts/Reviews.htm
I was concerned to see an editorial offering one opinion reduced to
poverty breeds terroism.
Suicide bombing can not be excused on any grounds; moreover, the
suicide killers of civilians are not usually from the poverty cohorts of
London, Iraq, NYC , nor Palestine. Such redutionist viewpoints give aid
to those who would have humanitarian concerns twisted. One can not equate
anything to such killings nor the...
I was concerned to see an editorial offering one opinion reduced to
poverty breeds terroism.
Suicide bombing can not be excused on any grounds; moreover, the
suicide killers of civilians are not usually from the poverty cohorts of
London, Iraq, NYC , nor Palestine. Such redutionist viewpoints give aid
to those who would have humanitarian concerns twisted. One can not equate
anything to such killings nor the killers of civilains.
Young children of terroists are brainwashed in their schools with
hate propoganda enforced with TV hate programs. These groups abuse and
misuse international poverty funds for their own promotion of virgins
in heaven as the only right way to die by killing civilians ( "source" :
where the independent accounting of the international money sent to
Arafat , HAMAS, or the PLO, etc ? )
Better support by the UN and the world community to stop such hate
teachings would go a longer way for promoting injury control, peace and
in imiting 'suffering' .
Les Fisher M.P.H.
Safety / Management Consultant
97 Union Avenue South, Delmar NY, 12054 ,USA; 518-439-0326
Just wanted to say that I currently work as a junior orthopaedic
surgeon in a London teaching hospital. My aim is to combine a career in
surgery with one in injury prevention as many of my counterparts in low
and middle income countries do.
On July 7th this year I was working at the Royal London Hospital and
worked alongside many brilliant people in the effort to treat the patients
predomina...
Just wanted to say that I currently work as a junior orthopaedic
surgeon in a London teaching hospital. My aim is to combine a career in
surgery with one in injury prevention as many of my counterparts in low
and middle income countries do.
On July 7th this year I was working at the Royal London Hospital and
worked alongside many brilliant people in the effort to treat the patients
predominantly arriving from the Kings Cross and Aldgate bombs.
There are many things I could write about this first hand experience
but all I wanted to say to you, Editor, and the late Robin Cook is:
"Hear, hear"
Poverty and injuries go hand in hand. I see it daily in my practice.
It is preventable. People throughout the world are terrorised daily by
poverty and feelings of hopelessness and lack of educational and economic
opportunity. When people are disenfranchised it makes them more vulnerable
to manipulation and brainwashing. I say this without excusing the
individual responsibility of the perpetrators.
We do need a war on poverty. Only then will we truly have a war on
terrorism.
Shepherd and Sivarajasingam provide a range of compelling reasons why
police records of violence should not be used to measure underlying trends
in
violence. Essentially there are major threats to validity. They do not
discuss
potential means to reduce this threat. They also identify significant
similar
threats to validity of emergency department data but do not say how these
should be addressed. They then conclude: "G...
Shepherd and Sivarajasingam provide a range of compelling reasons why
police records of violence should not be used to measure underlying trends
in
violence. Essentially there are major threats to validity. They do not
discuss
potential means to reduce this threat. They also identify significant
similar
threats to validity of emergency department data but do not say how these
should be addressed. They then conclude: "Governments should use
emergency department data as an objective indicator of violence of health
related harm .." Could the authors advise readers why they prefer one poor base for an indicator over another which is equally poor?
I watched the Fifth Estate program which aired March
15, 2006 and I was saddened to hear of the parents
who lost their children but also saddened on how
naive our system is to overlook what the truth really
is. I felt compelled to call the coroner myself and
tell him about my story growing up when we called the
Choking Game, the Passing Out Game. My friends and I
didn't use objects around our necks...
I watched the Fifth Estate program which aired March
15, 2006 and I was saddened to hear of the parents
who lost their children but also saddened on how
naive our system is to overlook what the truth really
is. I felt compelled to call the coroner myself and
tell him about my story growing up when we called the
Choking Game, the Passing Out Game. My friends and I
didn't use objects around our necks we would take 10
deep breaths to hyperventilation and then a friend
would stand behing us, hold the person around the
stomach to cut off air to lungs, we would hold our
breath until we "passed out." I am 46 now back then I
was only 16 years old. This is a serious issue and
needs to be researched and not overlooked. I was
happy to know that Dr MacNab is doing the work around
this sensitive issue. I am confident that his
findings will be factual and reasuring to those
parents who need comfort, truth and understanding.
I had also spoken to my sixteen year old daughter who
is aware of this game. She shared with me that when
she was in grade school, girls and boys played this
game and she witnessed two girls in the school
washroom using their hands to choke themselves. I had
also spoken to a co-worker who is now 21 years old.
When she was in high school, she too witnessed her
peers playing this game, hands around the neck,
choking each other until they lost Conscientious.
My heart goes out to Amanda Bryant, my prayers are
with you and I hope you will find the truth and that
the systems works with you and opens up their mind to
this possibility. God Bless you all.
Like Ann L., I tried this 'game' when I was in grade school. This
would have been 1990 in New Brunswick. It was something I learned from
other schoolmates, and was relatively common among students of grades 5-6.
We used a self strangulation technique where we would grab our neck with
palms on either side of the trachea restricting blood flow causing us to
pass out. We were eventually caught doing this...
Like Ann L., I tried this 'game' when I was in grade school. This
would have been 1990 in New Brunswick. It was something I learned from
other schoolmates, and was relatively common among students of grades 5-6.
We used a self strangulation technique where we would grab our neck with
palms on either side of the trachea restricting blood flow causing us to
pass out. We were eventually caught doing this on the playground and
reprimanded enough to prevent us from doing it any longer.
I'm glad this is getting recognized as a problem and is something we need
to create more awarness of in parents and teachers alike.
My thoughts are with those who've lost to this lethal game.
Hi my name is Lyndsey, I am 16 and my Mother Cindy
recently told me about the choking game. I have had
some experiences with this game. The only difference
is that my friends and I would call it Black Out.
How we would start out playing this game is, we
would sit on the ground with our knees up and leaning
over with our elbows on our knees. We would then take
really hard breaths in and out until we couldn't
h...
Hi my name is Lyndsey, I am 16 and my Mother Cindy
recently told me about the choking game. I have had
some experiences with this game. The only difference
is that my friends and I would call it Black Out.
How we would start out playing this game is, we
would sit on the ground with our knees up and leaning
over with our elbows on our knees. We would then take
really hard breaths in and out until we couldn't
handle it any more. Almost like hyperventilation. We
would take one last breath in really hard and lean
back on a chair or lay on the ground. Then someone would press with all
their body weight on our neck but not to close to our bronchial tube.
While they are doing this, our breath is leaving our lungs but they
wouldn't let go
until our body state was totally relaxed. At that
time we felt like we were in a dream and didn't know
what we were doing but our friends could see what was
happening. Some people when they are passed out, they would laugh, feel a
tingling body sensation when waking up. When they wake up they feel
refreshed and ask what they did. My friends would then tell them what
happened. One time I witnessed this girl, she was laughing and having a
good time,while passed out and then my friend actually punched her in her
face. She stopped laughing for
a second and then kept on laughing after she got
punched. After wards she asked why her face hurt, so then we told her what
happened. She laughed and then the next girl was up to try the game black
out. Another time one of my really good friends decided to try the game. I
was there with her and one of my other good friends was going
to preform the game on her. She did what she was told
to do and she blacked out. She laughed for a good 10
seconds and just when she started waking up she
urinated. This game obviously makes the brain very
confused and she lost control of her bodily functions.
I remember this game got introduced when I was in
grade school. It got more popular when I was in
Junior High School but didn't last long.
I have played this game before also and at first I was
scared, not knowing if I would wake up or not. As
a young child of course you want to try things not
knowing the dangers of the game. We just thought it
was "fun" but more and more kids are hearing about
this. There is a possibility that if more kids find out about this game,
we may hear of more deaths. We as a society, need to do something about
it. I find it very
offensive how the system seems to be overlooking this game. We need to
know the truth and consider the fact that suicide may not be suicide. I
would be just devastated if my younger cousins, that are in grade school
now, knew of this game; morevover, tried it or even think of trying it.
I just can't say how appaulled I am at age 16 how
the system is handling this situation. As I said
before, we as a society NEED to do something about
this new up coming "fun" game for kids to play. Let's
not have anymore accidental deaths happen to our childern of the future.
Thank you for an innovative and practical editorial illustrating applications of the Web of Science for historical research on peer reviewed journal archives (1).
Several years ago, I went to a medical library and manually reviewed all the annual indices between 1900 and 1975 of the American Journal of Public Health and of Public Health Reports for
citations on home or child a...
Thank you for an innovative and practical editorial illustrating applications of the Web of Science for historical research on peer reviewed journal archives (1).
Several years ago, I went to a medical library and manually reviewed all the annual indices between 1900 and 1975 of the American Journal of Public Health and of Public Health Reports for
citations on home or child accident and injury. My search found only three before 1946 (2-4). These peer reviewed articles were usually descriptive reviews of needs, unlike much currently analytical
research.
My conclusion confirms your findings of little interest in injury or accident control during the early period. My favorite was written by Edward Godfrey in 1937 (4). Godfrey was the commissioner of the New York State Department of Health which later become the first full time accident control program in the United States. Godrey's article remains a pioneering description and a basis for subsequent injury prevention program planning and development. It was a forerunner of several important publications on
accident and injury prevention in the United States (5-6).
At the October 23, 1936, Annual American Public Health Meetings, Vital Statistics Section, in New Orleans, Godfey, subsequently APHA President, stated his belief that health departments study of 'accidents' required an epidemiological approach. He stated,: "few, if any health officers or health
departments are displaying any interest in prevention of injury and deathfrom accidents. They are content that statistics shall be tabulated and published, leaving prevention entirely to other agencies or the will of God... It is the field of home and public accidents, however, that Ibelieve the health department has the greatest responsibility and opportunity."
The 1946 Armstrong and Cole article that your editorial describes (7) as possibly "the first such paper to be published in the peer review literature" was preceded by other publications by these authors in the early 1940's (8), By 1949 (9-10) they evolved into one of the first effective medical and public health advocacy coalitions in our field.: T.M. Brown and I republished an excerpt of that 1949 article along with a brief biosketch of the authors (11).
In preparing our article, we found other 1940s-1950s journal articles of interest (12-27) and noticed that many were based on studies funded by the Kellogg Foundation. These studies were largely state and local demonstration projects which, while limited in scientific design, helped establish formal links between public health agencies and injury contral activities in the U.S.
Readers may be further interested in two historical assessments of the field. One is Tarr J and Tebeau M, Housewives as home safety managers: The changing perception of the home as a place of hazard and risk, 1870-1940. In ACCIDENTS AND HISTORY: INJURIES, FATALITIES, AND SOCIAL RELATIONS. The Wellcome Institute Series in the History of Medicine. Amsterdam, 1996, 197-233. The other is available seriatim in the monthly newsletters and at members only (28) of the Injury Control and Emergency Health Services Section of the American Public Health Association (http://www.icehs.org).
Thank you again for citing our field's earlier historical challenges as a help in guiding studies of injury control needs world wide. I hope students of modern injury control will turn to history for possible lessons, especially regarding programming efficacy in a world of limited fiscal resources and injury control leadership memories.
Les Fisher M.P.H.
Safety / Management Consultant
(Archivist, American Public Health Association, ICEHS Section (see my
leadership in injury prevention history commentaries in newsletters and
at member's only http://www.icehs.org)
97 Union Avenue South, Delmar NY, 12054
USA
518-439-0326
Theodore Brown Professor of History and of Community and Preventive Medicine
University of Rochester
Rochester
NY 14627
Theodore_Brown@URMC.Rochester.edu
These comments are those of the authors alone and do not represent any organization.
References
1. A brief history of injury and accident prevention publications
IB Pless Inj Prev 2006;12:65-66.
2. Public Health Notes: Accidents Among Children: Am J Public
Health1922;12:634-635.
3. Scott CB. Our nation's accident problem. Am J Public
Health:1929;19:141-144.
4. Godfrey E. Role of health departments in the prevention of
accidents. Am J Public Health 1937;27:152-155.
5. Brightman IJ. The New York State home accident prevention
program.Am J Public Health1949;39:504.
6. Brightman IJ, McCaffrey I, Cook LC. Morbidity statistics as a
direction finder in home accident prevention. Am J Public Health
1952;24:842.
7. Armstrong DB and Cole WG. Accident Prevention. Am J. Public
Health 1946; 36: 869-74.
8. Armstrong DB and Cole WG. Study of home accidents: Their public
health significance. Am J Public Health 1941;31:1135-1142.
9. Wheatley G. Child accident reduction: the challenge to the
pediatrician. Pediatrics 1948;2:367-368.
10. Armstrong DB and Cole WG. Can child accidents be prevented in
your community? Am J Public Health1949;39:585-592.
11. Brown T and Fisher L. Voices from the past: Donald Budd
Armstrong and W. Graton Cole, Early Injury Control Advocates. Am J Public
Health 2004; 94:940-42
12. Illness and accidents among persons living under different
housing conditions. PHR 1941; 56: 609-639.
13. Gordon JL. Epidemiology of accidents. Am J Public Health.
1949;39:504.
14. Weinerman ER. Accident proness: a critique. PHR 1949:64:1527.
15. Beelman FC. Accident prevention - a state health department's
responsibility. PHR 1949;64:363-372.
16. King BG. Accident prevention research. PHR 1949;64:373-382.
17. Roberts H. A community surveys its home accidents. Am J Public
Health 1951;41:1118-1121.
18. Roberts H, Gordon J, Fiore A. Epidemiological techniques in home
accident prevention. PHR 1952; 67;547.
19. Kent F and Pershing M. Home accident prevention activities. PHR
1952; 67; 541-551
20. Cavender C, Blum HL, and Fletcher E. Neighbor to neighbor safety
education. PHR 1952;77:511-517.
21. Sullivan A. Tennessee Accidents, 1946-50. PHR 1953;68:301-303
22. Wain H, Samuelson H, and Hemphill FM. An experience in home
injury prevention. PHR. 1955;70:554.
24. Wain H, Samuelson H, and Hemphill FM. An experience in home
injury prevention. PHR 1955;70:554.
25. Bissel D. Home safety in San Jose. PHR 1958:73:53
26. Gray TH and Truss G. Growth of an accident prevention
program.PHR 1958;73:493-498.
27. Goddard JL. Accident Prevention in Childhood. PHR 1959;71:523-
534.
28. Fisher L. Shaping the Millennium. From the History of Child Home
Injury in the United States, in public health journals (1900 - 1975), to
Applications of Leadership Systems. At http://www.icehs.org at members only and
related commentaries at that web site's monthly newsletters.
Cummings, et al, in their June, 2006 paper, "Changes in traffic crash
mortality rates attributed to use of alcohol, or lack of a seat belt, air
bag, motorcycle helmet, or bicycle helmet, United States, 1982-2001" [1]
apparently assume that the data on bicycle helmet use among fatally
injured bicyclists contained within the Fatality Analysis Reporting System
(FARS) database is at least as valid as that...
Cummings, et al, in their June, 2006 paper, "Changes in traffic crash
mortality rates attributed to use of alcohol, or lack of a seat belt, air
bag, motorcycle helmet, or bicycle helmet, United States, 1982-2001" [1]
apparently assume that the data on bicycle helmet use among fatally
injured bicyclists contained within the Fatality Analysis Reporting System
(FARS) database is at least as valid as that for motorcycle helmet use and
seat belt use. However, even a cursory examination of the data indicates
FARS was underestimating actual helmet use among fatally injured
bicyclists by up to an order of magnitude or more during the period 1994-
98, when FARS first began recording such data; and though the situation
has improved considerably since then, FARS continues to underestimate
overall bicycle helmet use in the US by a factor of two or more as of 2004
(the most recent data available) [2].
Like most other data elements reported under FARS, data on helmet use
is derived from individual Police Accident Reports (PARs) collected by the
various state agencies that deal with traffic crashes. Since data on
bicycle helmet use is not considered a particularly high priority in most
jurisdictions, relatively few state PAR forms have the type of simple
check-off box commonly associated with seat belts or motorcycle helmets
(e.g. "used", "not used", or "unknown") that allow for easy transcription
into the FARS database. In these cases (i.e. the vast majority involving
bicyclists), any information on bicycle helmet use must be obtained from
the narrative of the crash prepared by the attending police officer; and
if no definite mention is made as to whether a bicycle helmet was used or
not (which is still all too common given the relatively low priority in
determining actual helmet use among involved bicyclists), such cases
should be recorded as "unknown" according to the FARS coding protocols.
Unfortunately, it appears that nearly all of these cases that should have
been coded as "unknown" (including a considerable number where the
bicyclist actually was using a helmet, but such usage was either never
noted or overlooked in the narrative) were instead coded as "not
used"—particularly in the initial period of 1994-98.
One strong indicator that the FARS bicycle helmet use data should not
be fully trusted is the fact that the "unknowns" are so few in number in
the first place. It is simply not credible that a low priority data
element such as bicycle helmet use would have a precision associated with
it that is a factor of 20 better than that seen for much higher priority
data elements such as seat belt or motorcycle helmet use (0.5% "unknowns"
vs. 11% or 10%). Even more persuasive is a direct comparison of FARS data
with equivalent state data. Though very few states make any real effort
to determine bicycle helmet use in their annual traffic crash summary
reports, two that have done so for at least a decade, California and
Florida, together account for ~30% of all US bicycle fatalities.
California data from the StateWide Integrated Traffic Records System
(SWITRS) indicates that 13.2% of fatally injured bicyclists were using a
helmet during the period 1994-98 [3], but only 3.4% supposedly were doing
so according to FARS [2]. Likewise, Florida data from the Department of
Highway Safety and Motor Vehicles (DHSMV) indicates that 6.5% of their
fatally injured bicyclists were using a helmet during the same period [4],
but only 0.2% (i.e. just 1 out of nearly 600) according to FARS [2]. And
while the reliability of bicycle helmet use data in FARS has clearly
improved in recent years (15.0% vs. 17.6% CA SWITRS data for the period
2001-03, and 5.5% vs. 6.8% FL DHSMV data for the period 1999-2004), it is
clear that FARS continues to undercount such use in too many cases.
Indeed, while overall bicycle helmet use in FARS has reached 11% for the
period 2001-04, a number of states within FARS now routinely record
bicycle helmet use rates in excess of 20% (CO, GA, HI, ID, NV, OK, TN,
WA), and a few actually record use rates in excess of 40% (MA, NE, VT, WY)
[2].
It should be obvious by this point that the overall 2% bicycle helmet
use figure FARS indicated in 1994 (and as recently as 1998) has no basis
in reality, and the assumption by the authors that helmet use among
fatally injured bicyclists was essentially nil before 1994 is
fundamentally flawed. Since SWITRS bicycle helmet use data extends back
fairly reliably to 1990, it is noteworthy that even in the earlier 1990-93
period, helmet use had already reached 8.4% among fatally injured CA
bicyclists, and that perhaps a dozen other states may have had helmet use
rates at least similar to or greater than that of CA.
It is also worth pointing out that during this earlier period, SWITRS
data indicates that helmet use among non-fatally injured CA bicyclists
grew steadily from 6.3% in 1990 to 9.0% in 1993, before jumping to 13.5%
in 1994 and 16.7% in 1995 (at least partially in response to the passage
of a mandatory helmet law in1994 covering all CA bicyclists under the age
of 18), and eventually reached a plateau level of 20-22% from 1999 on.
Since the overall helmet use rate averaged just 7.5% among non-fatally
injured CA bicyclists during 1990-93, it could actually be argued that
bicycle helmets had no beneficial effect at all in preventing fatalities,
though later data suggests this more likely was just an artifact of non-
fatal helmet use being less reliably recorded during the earlier period.
Over the next 10 years (1994-2003), non-fatal helmet use averaged
18.76%, compared to 15.52% among fatally injured CA bicyclists, which
suggests that bicycle helmets have at best only been ~17% effective in
preventing fatalities statewide (selective recruitment effects have almost
certainly resulted in a positive bias, so it remains quite possible there
is no net safety benefit associated with bicycle helmets at the whole
population level). Since this result is far lower than the ~65%
effectiveness the authors assumed for bicycle helmets based on a single
case control study [5], it seems clear that either the assumed
effectiveness of bicycle helmets has been wildly inflated relative to real
world data, and/or risk compensation effects have essentially negated any
safety benefits bicycle helmets may have to offer in the event of a crash-
-by apparently "encouraging" helmeted cyclists to crash more often and/or
get into more serious crashes.
[5] Thompson DC, Rivara FP, Thompson RS. Effectiveness of bicycle
helmets in preventing head injuries: a case-control study. JAMA
1996;276:1968–73.[Abstract]
Dear Editor,
I must add to Leonard Evan's "to do" list. After getting his skin thickened, he needs courses in English comprehension and basic epidemiology.
In my letter, I said that I gave "far more" than my litigation fees for scholarships and a professorship, contrary to his claim that it all came from litigation fees. I doubt that "far more" means something in England, where Evans apparently learned...
Dear Editor
While difficult to disentangle what is getting Robertson so enraged, the following four possibilities seem likely candidates.
1. He denies my claim [1, p. 381-388] that US safety policy has been a dramatic failure.
2. He disagrees with my explanation [1, p 389-408] that the litigation focus of US safety policy has contributed to this dramatic failure.
3. He di...
I was concerned to see an editorial offering one opinion reduced to poverty breeds terroism.
Suicide bombing can not be excused on any grounds; moreover, the suicide killers of civilians are not usually from the poverty cohorts of London, Iraq, NYC , nor Palestine. Such redutionist viewpoints give aid to those who would have humanitarian concerns twisted. One can not equate anything to such killings nor the...
Dear Editor
Just wanted to say that I currently work as a junior orthopaedic surgeon in a London teaching hospital. My aim is to combine a career in surgery with one in injury prevention as many of my counterparts in low and middle income countries do.
On July 7th this year I was working at the Royal London Hospital and worked alongside many brilliant people in the effort to treat the patients predomina...
Shepherd and Sivarajasingam provide a range of compelling reasons why police records of violence should not be used to measure underlying trends in violence. Essentially there are major threats to validity. They do not discuss potential means to reduce this threat. They also identify significant similar threats to validity of emergency department data but do not say how these should be addressed. They then conclude: "G...
Dear Editor,
I watched the Fifth Estate program which aired March 15, 2006 and I was saddened to hear of the parents who lost their children but also saddened on how naive our system is to overlook what the truth really is. I felt compelled to call the coroner myself and tell him about my story growing up when we called the Choking Game, the Passing Out Game. My friends and I didn't use objects around our necks...
Dear Editor,
Like Ann L., I tried this 'game' when I was in grade school. This would have been 1990 in New Brunswick. It was something I learned from other schoolmates, and was relatively common among students of grades 5-6. We used a self strangulation technique where we would grab our neck with palms on either side of the trachea restricting blood flow causing us to pass out. We were eventually caught doing this...
Hi my name is Lyndsey, I am 16 and my Mother Cindy recently told me about the choking game. I have had some experiences with this game. The only difference is that my friends and I would call it Black Out.
How we would start out playing this game is, we would sit on the ground with our knees up and leaning over with our elbows on our knees. We would then take really hard breaths in and out until we couldn't h...
Dear Editor,
Thank you for an innovative and practical editorial illustrating applications of the Web of Science for historical research on peer reviewed journal archives (1).
Several years ago, I went to a medical library and manually reviewed all the annual indices between 1900 and 1975 of the American Journal of Public Health and of Public Health Reports for citations on home or child a...
Dear Editor,
Cummings, et al, in their June, 2006 paper, "Changes in traffic crash mortality rates attributed to use of alcohol, or lack of a seat belt, air bag, motorcycle helmet, or bicycle helmet, United States, 1982-2001" [1] apparently assume that the data on bicycle helmet use among fatally injured bicyclists contained within the Fatality Analysis Reporting System (FARS) database is at least as valid as that...
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