Suicide ideation among US college students. Associations with other injury risk behaviors

Suicide, the endpoint of a continuum that begins with suicide ideation, is the third leading cause of death among the US college-aged population. The first and second leading causes of death among this age group, unintentional injury and homicide, may also be linked to suicide ideation. We used data from the National College Health Risk Behavior Survey to examine the association between suicide ideation and injury-related behaviors among 18- to 24-year-old college students. Students who reported suicide ideation were significantly more likely than students who did not report considering suicide to carry a weapon, engage in a physical fight, boat or swim after drinking alcohol, ride with a driver who had been drinking alcohol, drive after drinking alcohol, and rarely or never used seat belts. Given this clustering of injury-related risk behaviors, college prevention programs should aim to reduce risks for injuries comprehensively, rather than addressing each risk behavior separately.     

Chemical and Radiation Environmental Risk Management: Differences, Commonalities, and Challenges

Driven by differing statutory mandates and programmatic separation of regulatory responsibilities between federal, state, and tribal agencies, distinct chemical and radiation risk management strategies have evolved. In the field this separation poses real challenges since many of the major environmental risk management decisions we face today require the evaluation of both types of risks. Over the last decade, federal, state, and tribal agencies have continued to discuss their different approaches and explore areas where their activities could be harmonized. The current framework for managing public exposures to chemical carcinogens has been referred to as a "bottom up approach." Risk between 10(-4) and 10(-6) is established as an upper bound goal. In contrast, a "top down" approach that sets an upper bound dose limit and couples with site specific As Low As Reasonably Achievable Principle (ALARA), is in place to manage individual exposure to radiation. While radiation risk are typically managed on a cumulative basis, exposure to chemicals is generally managed on a chemical-by-chemical, medium-by-medium basis. There are also differences in the nature and size of sites where chemical and radiation contamination is found. Such differences result in divergent management concerns. In spite of these differences, there are several common and practical concerns among radiation and chemical risk managers. They include 1) the issue of cost for site redevelopment and long-term stewardship, 2) public acceptance and involvement, and 3) the need for flexible risk management framework to address the first two issues. This article attempts to synthesize key differences, opportunities for harmonization, and challenges ahead.     

IntroductionExposing Misinformation Concerning Child Sexual Abuse and Adult Survivors

This article introduces a special volume on misinformation about child sexual abuse. Despite extensive research findings on the long-term effects and consequences of child sexual abuse, misinformation on this topic is widespread. Several forces have worked to support and disseminate this erroneous information. Because it is difficult to comprehend the horror of sexual crimes against children, society's denial and disbelief have often unwittingly supported the agendas of those who want to discount or minimize the impact of these crimes. The media has also contributed to the aura of skepticism surrounding claims of sexual abuse and its mental health impact, and has reported favorably on controversial and unproven claims such as the “false memory syndrome.” In the hope of countering misinformation and thus raising the level of discourse to the engagement of real scientific issues, a number of well known and respected researchers and clinicians examine various facets of the problem.     

The industrial athlete?

Many similarities can be drawn between the athletic and industrial population. It is time for a shift in the approach toward injured workers utilizing a sports medicine perspective. We must think of workers as industrial athletes and recognize that the sports medicine model can be appropriately adapted to the injured worker. This model includes prevention, early intervention/identification, training and conditioning, and progressive treatment. Sports medicine rehabilitation concepts include treating the entire kinetic chain that is associated with a specific injury and the SAID principle (Specific Adaptations to Imposed Demands).     

Importance of job analysis with functional capacity matching in medical case management: A physician's perspective

Medical case management of musculoskeletal injuries can be facilitated when objective testing of the physical demands of the job can be compared to the functional capabilities of the individual. When the job analysis is appropriately sectioned into the separate physical demands, the physician can use information about specific job demands to maximize the likelihood of a safe return to regular duties. The response in the physical abilities in the worker can then be again functionally evaluated, leading to increased confidence in the process.     

Adolescents with Gambling Problems: From Research to Treatment

Considerable interest in the area of youth gambling has prompted an increase in empirical investigations examining the correlates associated with youth experiencing severe gambling problems. Based upon the current state of knowledge and our clinical experience, the development of the treatment program for youth with serious gambling problems employed at the McGill University Youth Gambling Research and Treatment Clinic is described. The major tenets, underlying philosophy, and therapeutic processes are presented. A case study is included to illustrate the therapeutic approach. The authors present the need for greater funding for more basic and applied research and the necessity for further scientifically validated treatment and prevention programs.     

Dependence Estimation Over a Finite Bivariate Failure Time Region

This articleconcerns nonparametric estimation of association between bivariatefailure times. In the presence of independent right censoring,the support for failure time variates may be restricted and measuresof dependence over a finite failure time region may be of particularinterest. To this end, the reciprocal cross ratio function, weightedby the bivariate failure time density, is proposed as a summarymeasure of dependence over a failure time region. This `relativerisk' estimator is shown to be consistent and asymptoticallynormally distributed, with consistent bootstrap variance estimator.A finite-region version of Kendall's tau, which is suitable forcensored failure time data, is also proposed, and correspondingasymptotic distribution theory is noted. The accuracy of theseasymptotic approximations is studied in simulations and an illustrationis provided.     

Who Holds the Stakes? A Case Study of Stakeholder Identification at Two Nuclear Weapons Production Sites

Traditional risk assessments, including those involving the United States Department of Energy (USDOE), are often criticized for producing useless or noncredible management responses because they did not meaningfully involve the public. The first step to involve the public is to identify appropriate active participants (stakeholders). This study was done to understand the processes used to identify stakeholders to serve on advisory boards established at the two largest remediation sites in the United States: the Hanford Nuclear Reservation in Washington state and the Savannah River Site in South Carolina. The Hanford stakeholder identification process produced an interest-based board whereas the Savannah River Site strategy produced population-based representation. The basic goals of the stakeholder advisory groups were similar. However, different processes were used to identify the participants for the groups in part because of distinctly different social and cultural conditions in the areas affected by the operations of the two facilities, and in part because of the different level of trust of the USDOE and their contractors at Hanford compared with Savannah River. The discussion analyzes their different needs and potential for successful citizen participation.