Dr. John A Staples
MD, FRCPC, MPH
Scientist, Centre for Health Evaluation and Outcome Sciences
Clinical Assistant Professor
University of British Columbia
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Around 64 million Americans live in states that have legalized recreational marijuana. Many policymakers are trying to figure out what that means for traffic safety.
On April 20th, some Americans participate in an annual "4/20" counterculture holiday that celebrates and promotes the use of cannabis. Some 4/20 events such as those in Denver and San Francisco involve thousands of participants. Much like celebrations at midnight on New Year's eve, public 4/20 events sometimes mark 4:20 p.m. by a countdown followed by synchronized mass consumption of cannabis. We thought this was a perfect natural experiment to evaluate the influence that cannabis intoxication has on the risk of motor vehicle crash.
To examine this question, we analyzed 25 years of data on all fatal traffic crashes in the United States. We compared the number of drivers in crashes between 4:20 p.m. and midnight on April 20th to the number of drivers in crashes during the same time interval on control days one week earlier and one week later.
We found that the risk of crash involvement was 12% higher on April 20th than on control days. In the subgroups of drivers younger than 21 years of age, the risk of crash involvement was 38% higher on April 20th than on control days.
Assuming fewer than 12% of Americans celebrate 4/20, our results suggest that substance use at April 20th celebrations more than doubles the risk of fatal crash.
Dr. Jarman[/caption]
Dr. Molly Jarman PhD
Postdoctoral Research Fellow at
Brigham and Womens Hospital
MedicalResearch.com: What is the background for this study?
Response: Injuries are a leading cause of death and disability in the US, and there are well documented disparities in injury incidence and outcomes. Certain populations (i.e. rural, low income, people of color) experience more injury than others, and are more likely to die following and injury.
Past studies focused on individual health and socioeconomic characteristics as the primary driving force behind these disparities, along with variation in the time required to transport an injured patient to the hospital. We wondered if geographic features of an injury incident location contributed to variation in injury mortality that was not explained by differences in individual patient characteristics.
In other words, we know that who you are contributes to injury mortality, and we wanted to know if it also matters where you are when an injury occurs.
Dr. Brett D Owens, MD
Dr. Owens is currently Team Physician for the US Lacrosse National Men’s Team, and
Team Physician for Brown University
Professor at Uniformed Services University and Professor at Brown University
Alpert School of Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: This study is a review of the literature on ski and snowboarding injuries. We summarize findings by our group and others on the injuries seen with these snow sports and report an overall increase in injuries as participation continues to increase.
Snowboarders have a higher injury rate and there are different injury patterns with skiers experiencing more lower extremity injuries (knee) and snowboarders experiencing more upper extremity injuries (wrist, shoulder, etc.).
MedicalResearch.com Interview with:
Eric T. Carniol, MD, MBA
Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology–Head and Neck Surgery, University of Toronto
Toronto, Ontario, Canada
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Tympanic membrane perforations (aka "popped" or "burst" ear drum) is a common complaint of patients presenting to the emergency room, primary care offices, and otolaryngologist (ENT doctors) offices. These may be caused by trauma, infections, or other causes. As well, many patients will use qtips (cotton-tipped applicators) to clean ears and remove ear wax and are unaware of the potential harms of doing so.
This study was designed to examine the cause of ear drum perforations as diagnosed in emergency departments in the United States.
Foreign body instrumentation of the ear (qtips, hair combs, hair pins, needles, etc) were the cause of 61.2% of perforations. Cotton tip applicators are the single leading cause of traumatic tympanic membrane perforation in all age groups except young adults (13-18) and 19-36 year olds, in which it is the second largest cause (behind water trauma).
Children less than 18 years old constitute nearly 2/3 of all ear drum perforations in the emergency department.
Tara Kelley-Baker PhD
Data and Information Group Leader
AAA Foundation for Traffic Safety
MedicalResearch.com: What is the background for this study?
Background on LongROAD
The AAA Foundation for Traffic Safety (AAAFTS) launched the Senior Driver Initiative in 2012 in an effort to better understand and meet the safe mobility needs of older adult drivers. A multidisciplinary research team from six institutions was formed to design and implement the Longitudinal Research on Aging Drivers (LongROAD) study.
The aims of the study are to better understand:
Elizabeth George, MD
PGY-4 Radiology Resident
Brigham and Women’s Hospital
Dr. Bharti Khurana MD
Clinical Fellow, Harvard Medical School and
Assistant Director, Emergency Radiology
Director, Emergency Musculoskeletal Radiology
Program Director, Emergency Radiology Fellowship
Assistant Professor, Harvard Medical School
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: According to the CDC, 1 in 3 women in the United States are victims of abuse by their intimate partner. Despite the US Preventive Services Task Force recommendations, intimate partner violence (IPV) screening is still not widely implemented and IPV remains very prevalent and often under-recognized.
The goals of this study are to increase the awareness among physicians about this public health problem and to elucidate the potential role of imaging in the identification of these patients. In fact, there is a striking disparity in the literature on the role of imaging in identifying non-accidental trauma in children compared to intimate partner violence.
The common patterns of injury we identified in this population were soft tissue injuries (swelling, hematoma or contusion) followed by extremity fractures, which often involve the distal upper extremities, suggesting injury from defensive attempts. Other common injuries were facial fractures, which represent an easily accessible site for inflicting trauma, and pregnancy failure. Since radiologists have access to both current and prior radiological studies of these patients, they could play a critical role by putting the pieces together in identifying victims of IPV.
Dr. Mercado[/caption]
Dr. Melissa C. Mercado PhD, MSc, MA Behavioral scientist Division of Violence Prevention National Center for Injury Prevention and Control CDC
MedicalResearch.com: What is the background for this study? What are the main findings? Response: Suicide ranks as the 10th leading cause of death for all age groups combined and has been among the top 12 leading causes of death since 1975 in the U.S. In 2015, across all age groups, suicide was responsible for 44,193 deaths in the U.S., which is approximately one suicide every 12 minutes. Suicide was the second leading cause of death among U.S. youth aged 10-24 years in 2015. Self-inflicted injury is one of the strongest risk factors for suicide. This study examined trends in non-fatal self-inflicted injuries treated in hospital emergency departments (EDs) among youth aged 10 to 24 years in the United States from 2001-2015. The overall weighted age-adjusted rate for this group increased by 5.7% annually during the 2008 to 2015 period. Age-adjusted trends for males overall and across age groups remained stable throughout 2001-2015. However, rates among females increased significantly, by 8.4% annually. The largest increase among females was observed among those aged 10-14 years, with an increase of 18.8% annually from 2009 to 2015.
Ole J. Johansson
Junior researcher
Master’s in social psychology
Institute of Transport Economics
MedicalResearch.com: What is the background for this study?
Response: Many countries have bans on driving while distracted and would fine drivers for texting while driving. Furthermore, people mostly know about the dangers of not paying attention to the traffic. Still, many people do engage in distracting behaviors. Thus, in this study, I wanted to examine:
a) Who are more likely to engage with distractors?
b) Is there an easy way to help people avoid distractions?
From these two points, we developed the study to engage with distracted driving from a psychological and scientific point of view.
Specifically using the theory of planned behavior and the big five to answer point a) and implementation intentions to answer point b).
Dr. Tricco[/caption]
Andrea C. Tricco PhD, MSc
Scientist and Lead of the Knowledge Synthesis Team
Associate Professor Dalla Lana School of Public Health, University of Toronto
Associate Editor Journal of Clinical Epidemiology, BMC Medical Research Methodology, Systematic Reviews
MedicalResearch.com: What is the background for this study?
Response: Falls are the leading cause of injury among older adults and account for $2 billion in direct health-care costs annually ($31 billion in costs to Medicare in the United States in 2012). We aimed to determine which types of fall-prevention programs may be effective for reducing falls in older people.
MedicalResearch.com: What are the main findings?
Response: Exercise, along with vision assessment and treatment, as well as an assessment and possible modification of a person’s living environment, reduced the risk of injurious falls by 23% compared to usual care.
Yi Zuo[/caption]
Yi Zuo
Lead Biostatistician
Center for Clinical Translational Epidemiology and Comparative Effectiveness Research
Preventive Medicine & Epidemiology
Department of Medicine
Boston University School of Medicine
Boston, MA 02118
MedicalResearch.com: What is the background for this study?
Response: Non-fatal firearm injuries constitute approximately 70% of all firearm trauma injuries in the United States. However, patterns of severity of those injuries are poorly understood.
Ali Rowhani-Rahbar, MD, MPH, PhD
Associate Professor, Department of Epidemiology
Adjunct Associate Professor, Department of Pediatrics
University of Washington
Seattle, WA 98195
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The impact of firearm carrying on public health and public safety is a topic of considerable interest in the US. Nonetheless, contemporary national data on some of the most fundamental questions about the scope of firearm carrying among adults in the US do not exist. We used data collected through a nationally representative survey designed by investigators at Harvard University and Northeastern University and conducted in 2015 to understand why, how frequently, or in what manner (i.e., concealed or openly) US adults carry loaded handguns on their person. We also examined the prevalence of handgun carrying among this group by the stringency of state laws regulating concealed carry permits.
Prof. Siegel[/caption]
Michael Siegel, MD, MPH
Professor, Department of Community Health Sciences
Boston University School of Public Health
Boston, MA 02118
MedicalResearch.com: What is the background for this study?
Response: A central question in the debate about public policies to reduce firearm violence is whether easier access to concealed handguns increases or decreases the rate of firearm-related homicides. Previous studies on the impact of concealed carry permitting laws have yielded inconsistent results. Most of these studies were conducted more than a decade ago. This study provided a reexamination of this research question with more recent data, up to and including the year 2015.
While all states allow certain persons to carry concealed handguns, there are 3 major variations in permitting policy. In 9 states, law enforcement officials have wide discretion over whether to issue concealed carry permits; these are referred to as “may issue” states because police chiefs can deny a permit if they deem the applicant to be at risk of committing violence, even if there is not a criminal history. In 29 states, there is little or no discretion; these are referred to as “shall-issue” states because permits must be issued if requisite criteria are met. In an additional 12 states, no permit is necessary to carry a concealed handgun.
Dr. Smith[/caption]
Gary Smith, MD, DrPH
Director, Center for Injury Research and Policy
Nationwide Children’s Hospital
Columbus, OH
MedicalResearch.com: What is the background for this study?
Response: Previous studies have documented the frequency and characteristics of stair-related injuries among children and older adults. Numerous studies have examined gait characteristics of different age groups and their relationship to falls. In addition, it is estimated that the direct medical and indirect costs of non-fatal stair-related injuries are $92 billion annually in the US.
The current study investigates the epidemiological characteristics of stair-related injuries among all ages using a nationally representative sample over a multi-year period. Our study also expands upon prior research on this topic to investigate the mechanisms of stair-related injuries and examine trends.
Dr. Siegel[/caption]
Professor Michael Siegel, MD, MPH
Department of Community Health Sciences
Boston University School of Public Health
Boston, MA 02118
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Each year, more than 1,800 people in the U.S. are killed by their intimate partners. Approximately half of these homicides are committed using firearms. While federal law prohibits people subject to domestic violence restraining orders from possessing firearms, there is no requirement that they surrender guns already in their possession.
To close this loophole, several states have enacted laws that not only prohibit gun possession by people subject to restraining orders, but which also explicitly require that they relinquish weapons that they already have. If you are unclear as to the laws of your state, then you should contact a local law firm, such as this nyc lawyer, to discuss your current circumstances.
In this study, we investigated the impact of state domestic violence-related firearm laws and rates of intimate partner homicide, using data from all 50 states over a 25-year period, 1991-2015.
Dr. McAlister[/caption]
Dr. Vivian Mcalister, M.B., CCFP(C), FRCSC, FRCS(I), FACS
Professor - Department of Surgery
London Health Sciences Centre
University Hospital
London, Ontario, Canada
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: This study was performed by medical and nursing officers who were all deployed to the war zone. We were deeply concerned about the type of injuries we were seeing. They were more awful than any we had seen before. We were familiar with reviews of antipersonnel landmine injuries that were reported by Red Cross surgeons in the 1990s. The injuries that we were dealing with were from antipersonnel IEDs more than landmines. We decided to do a formal prospective study for two reasons: first was to carefully describe the pattern of injury so we could develop new medical strategies, if possible, to help victims. The second reason was to catalogue these injuries so we could impartially and scientifically report what we were witnessing.
Dr. Rosellini[/caption]
Anthony J. Rosellini, Ph.D.
Research Assistant Professor
Center for Anxiety and Related Disorders
Department of Psychological & Brain Sciences
Boston University
Boston, MA 02215
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Sexual assault among service members is a significant concern of the Department of Defense (DoD) and U.S. Army. Although the annual rate of sexual assault among soldiers is believed to be decreasing, there have also been increases in the number of victims coming forward to report their experiences. The DoD and Army have responded by creating a framework of universal prevention in which all soldiers are required to participate in relatively brief programs aimed at decreasing rates of sexual assault. More intensive preventive interventions could be required, but would only be cost-effective if targeted at a subset of soldiers who are most likely to perpetrate sexual assault.
The goal of this study was to use DoD and U.S. Army administrative records that are available for all soldiers to develop prediction models for sexual assault perpetration. We used the records from all 821,807 male soldiers who served between 2004 and 2009 to develop separate models to predict assaults directed against within-family and non-family adults and minors.
Dr. Taipale[/caption]
Heidi Taipale, PhD Pharm
Senior Researcher
School of Pharmacy, University of Eastern Finland; and
Department of Clinical Neuroscience
Karolinska Institutet
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Antidepressant use among older persons has been associated with an increased risk of falling and fall-related events, such as hip fractures, in previous studies. Our previous study identified risk of hip fractures in antidepressant among persons with Alzheimer’s disease. As falling is the main causal factor for head traumas and traumatic brain injuries among older persons, we hypothesized that antidepressant use could also be associated with these injuries.
We utilized a nationwide cohort of 70,718 persons newly diagnosed with Alzheimer’s disease, identified from the Finnish registers. The risk of head injuries and traumatic brain injuries was compared between persons initiating antidepressant use and comparison persons of the same age, gender and time since they received diagnoses of Alzheimer’s disease but not using antidepressants. We found a 40-percent increased risk of head injuries and 30-percent increased risk of traumatic brain injuries associated with antidepressant use. Antidepressant use was associated with a higher risk of head injuries especially at the beginning of use – during the first 30 days – but the risk persisted even longer, up to two years. The association was also confirmed in a study design comparing time periods within the same person, thus eliminating selective factors.
Stanford Chihuri[/caption]
Stanford Chihuri, MPH
Staff Associate/Data Analyst
Department of Anesthesiology, College of Physicians and Surgeons
Columbia University Medical Center
NY, NY 10032
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: In the past 2 decades, consumption of prescription opioids has substantially increased in the U.S. Prescription drugs may cause drowsiness and impaired cognition which may interfere with psychomotor functioning necessary during the operation of a motor vehicle. The current study assessed time trends in prescription opioids detected in drivers killed in motor vehicle crashes from 1995 to 2015 in 6 states in the U.S.
Results of the study showed that the prevalence of prescription opioids detected in fatally injured drivers has increased 700% in the past 2 decades.
Dr. Petrosky[/caption]
EmikoPetrosky MD M.P.H
Science Officer, National Violent Death Reporting System at Centers for Disease Control and Prevention
Centers for Disease Control and Prevention
Emory University Rollins School of Public Health
MedicalResearch.com: What is the background for this study?
Response: Homicide is one of the leading causes of death for women aged 44 years and younger. In 2015, 3,519 girls and women died by homicide in the United States. It is the 5th leading cause of death for women under 45 years age (defining women as 18-44 years of age).
The National Violent Death Reporting System (NVDRS) links together data from death certificates, coroner/medical examiner reports, and law enforcement reports, resulting in more information about the circumstances of death than what is available elsewhere.
Dr. Li[/caption]
Guohua Li DrPH, MD
Professor and Director
Center for Injury Epidemiology and Prevention
Department of Epidemiology
Mailman School of Public Health
Columbia University
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Drugged driving has become a serious problem in the United States in the recent years due to increased consumption of marijuana and opioids. About 20% of fatally injured drivers used two or more substances, with alcohol-marijuana being the most commonly detected polydrug combination.
Our study of over 14000 fatal 2-car crashes indicates that drivers testing positive for alcohol, marijuana, or both are significantly more likely to be responsible for initiating these crashes than those using neither of the substances. Specifically, compared to drivers not using alcohol and marijuana, the risk of being responsible for initiating fatal crashes increases 62% for those testing positive for marijuana and negative for alcohol, 437% for those testing positive for alcohol and negative for marijuana, and 539% for those testing positive for both alcohol and marijuana. These results suggest that when used in combination, alcohol and marijuana have a positive interaction on the risk of fatal crash initiation.
The most common driver error leading to fatal 2-car crashes is failure to keep in proper lane, followed by failure to yield right of way and speeding.
Mitchell Doucette[/caption]
Mitchell L. Doucette, MS
PhD Candidate
The William Haddon Jr Fellowship in Injury Prevention 2017 Co-Fellow
Center for Injury Research and Policy
Department of Health Management and Policy
Johns Hopkins Bloomberg School of Public Health
Baltimore, MD 21205
MedicalResearch.com: What is the background for this study?
Response: Currently in the U.S., 8 states have legalized marijuana for recreational use and an additional 28 states permit marijuana for medical use. Some states have instituted a legal driving limit for marijuana intoxication, 5 ng/mL, and for Colorado specifically, research indicates the average time from law enforcement dispatch to blood sample collection was 2.32 hours—a period of time outside the window of legal sample collection under state law and peak THC detectability. Countries with similar marijuana driving limits perform roadside oral fluid testing for establishing intoxication at point of arrest.
Dr. Gaither[/caption]
Tom Gaither, MD, MAS
Department of Urology
San Francisco, CA 94143
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Admission to the hospital because of bicycle crashes has increased over the past 15 years. We aimed to estimate the costs due to these bicycle crashes.
From 1999 to 2013, the total costs due to these injuries (direct medical costs, work loss costs, and pain and suffering) were $209 billion dollars. Costs due to non-fatal injuries have increased by 137% over the study period. In 2013, the total direct and indirect costs were $24 billion dollars, which is approximately doubling the costs due to occupational injuries in the US.
Dr. Smith[/caption]
Gary Smith, MD, DrPH
Director, Center for Injury Research and Policy
Nationwide Children’s Hospital
Columbus, OH
MedicalResearch.com: What is the background for this study?
Response: Lawn mowers continue to be an important source of serious pediatric morbidity in the United States (US) with initial treatment of pediatric lawn mower-related injuries costing about $90 million annually. The long-term physical, psychological, and financial effects of these traumatic injuries can be devastating for those injured and for their families.
This study comprehensively analyzes data over a 25-year period using a nationally representative database to evaluate the epidemiologic characteristics, including mechanism of injury, of lawn mower-related injuries to children in the US. It also provides a discussion of relevant injury prevention strategies.
Dr. Smith[/caption]
Gary Smith, MD, DrPH
Director, Center for Injury Research and Policy
Nationwide Children’s Hospital
Columbus, OH
MedicalResearch.com: What is the background for this study?
Response: Golf is enjoyed worldwide as a leisure activity and competitive sport. While golf is viewed as a low-risk sport, acute traumatic and overuse injuries do occur. Previous studies have generally focused on the clinical aspects of golf-related injuries. Few studies examine injuries that occurred during practice at home or school, or due to conditions or hazards on a golf course.