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October 27, 1989, Vol 262, No. 16 >
ARTICLE | October 27, 1989

Epidemiology and Prevention of Adolescent Injury: Title and subTitle BreakA Review and Research Agenda FREE

Carol W. Runyan, MPH, PhD; Elizabeth A. Gerken, MSPH
[+] Author Affiliations

Reprint requests to Department of Health Behavior and Health Education, School of Public Health, Rosenau Hall, CB# 7400, University of North Carolina, Chapel Hill, NC 27599 (Dr Runyan).


JAMA. 1989;262(16):2273-2279. doi:10.1001/jama.1989.03430160095038
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Article
References

INJURY, only recently recognized as a public health problem, is a major source of morbidity and mortality among adolescents. Prevention has been hampered by inadequacies in record keeping, research, and conceptualization of the problem.1 Published reviews have relied primarily on mortality data and given meager attention to intentional injury or methodological concerns.2-4 This article reviews the epidemiology of injury for youths aged 10 through 19 years, discusses selected interventions, and suggests a research agenda.

GENERAL EPIDEMIOLOGIC PATTERNS Mortality  Injuries are the leading cause of death for persons between the ages of 1 and 44 years. They account for 40% of all years of potential life lost before age 65 years, far exceeding the figures for cancer and heart disease.1 Among adolescents aged 10 through 14 and 15 through 19 years, injuries are responsible for 57% and 79% of all deaths, respectively, and the death rates have increased in

REFERENCES

1 +
National Academy of Sciences. Injury in America . Washington, DC: National Academy Press; 1985;.
2 +
Halpern SF, Bass JL, Mehta KA.  Unintentional injuries among adolescents and young adults: a review and analysis . J Adolesc Health Care. 1983;; 4:175-181.
3 +
Bass JL, Gallagher SS, Mehta KA.  Injuries to adolescents and young adults . Pediatr Clin North Am. 1985;;32:31-39.
4 +
Paulson JA.  The epidemiology of injuries in adolescents . Pediatr Ann . (February) 1988;;17:84-96.
5 +
Last J, ed. Maxcy-Rosenau: Public Health and Preventive Medicine. 11th ed. East Norwalk, Conn: Appleton-Century-Crofts; 1980;.
6 +
National Center for Health Statistics. Vital Statistics of the US: Mortality. Washington, DC: US Government Printing Office; 1980;2:pt A.
7 +
National Center for Health Statistics. Vital Statistics of the US: Mortality. Washington, DC: US Government Printing Office; 1981;2:pt A.
8 +
National Center for Health Statistics. Vital Statistics of the US: Mortality. Washington, DC: US Government Printing Office; 1982;2:pt A.
9 +
US Bureau of the Census. Current Population Reports, Series P-25, No. 1000: Estimates of the Population of the United States by Age, Sex, and Race: 1980-1986. Washington, DC: US Government Printing Office; 1987.
10 +
National Center for Health Statistics. Vital Statistics of the US: Mortality Data. Washington, DC: US Government Printing Office; 1950;3.
11 +
National Center for Health Statistics. Vital Statistics Rates in the US, 1940-1960. Washington, DC: US Government Printing Office; 1968.
12 +
Hoekelman RA, Pless IP.  Decline in mortality among young Americans during the 20th century: prospects for reaching national mortality reduction goals for 1990 . Pediatrics. 1988;;82:582-595.
13 +
Gallagher SS, Finison K, Guyer B, Goodenough S.  The incidence of injuries among 87,000 Massachusetts children and adolescents: results of the 1980-81 statewide childhood injury prevention program surveillance system . Am J Public Health. 1984;;74:1340-1347.
14 +
Kraus JF.  Epidemiologic features of injuries to the central nervous system . In: Neuroepidemiology . Boca Raton, Fla: CRC Press Inc. In press.
15 +
Frankowski RF.  Descriptive epidemiologic studies of head injury in the United States: 1974-1984 . Adv Psychosom Med. 1986;;16:153-172.
16 +
Klauber MR, Barrett-Conner E, Marshall LF, Bowers S.  The epidemiology of head injury . Am J Epidemiol. 1981;;113:500-509.
17 +
Baker SP, O'Neill B, Karpf R. The Injury Fact Book . Lexington (Mass) Books; 1984;.
18 +
Wise PH, Kotelchuck M, Wilson ML, Mills M.  Racial and socioeconomic disparities in childhood mortality in Boston . N Engl J Med. 1985;;313:360-366.
19 +
Spivak H, Prothrow-Stith D, Hausman AJ.  Dying is no accident: adolescents, violence, and intentional injury . Pediatr Clin North Am. 1988;; 35:1339-1347.
20 +
Klein D.  Some social characteristics of accident victims . Presented at the 101st Annual Meeting of the American Public Health Association; November 6, 1973; San Francisco, Calif .
21 +
Insurance Institute for Highway Safety.  Teens and autos: a deadly combination . Status Report . (September 23) , 1981;;16:1-11.
22 +
Williams AF.  Fatal motor vehicle crashes involving teenagers . Pediatrician. 1985;;12:37-40.
23 +
Williams AF, Wells JK, Lund AK.  Voluntary belt use among high school students . Accid Anal Prev. 1983;;15:161-165.
24 +
Waller PF, Runyan CW, Perry PE. Assessing the Impact of Increasing the Drinking Age on Motor Vehicle Injuries: An Injury Control Case Study . Atlanta, Ga: Centers for Disease Control; 1986;.
25 +
Wagenaar AC. Alcohol, Young Drivers, and Traffic Accidents . Lexington (Mass) Books; 1983;.
26 +
Fell JC.  Alcohol in fatal accidents for various driver age groups . In: Research Notes . Washington, DC; National Highway Traffic Safety Administration; 1984;:1-2.
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Campbell BJ, Hunter WW, Stewart JR, Stutts JC. Increasing Safety Belt Use Through an Incentive Program . Chapel Hill, NC: Highway Safety Research Center; 1982;.
28 +
Campbell BJ, Stewart JR, Campbell FA. 1985-1986 Experience With Belt Laws in the United States . Chapel Hill, NC: Highway Safety Research Center; 1987;.
29 +
Robertson L.  The seat belt use law in Ontario: effects on actual use . Can J Public Health. 1978;;69:154-157.
30 +
Preusser DF, William AF, Lund AK.  The effect of New York's seat belt use law on teenage drivers . Accid Anal Prev. 1987;;19:73-80.
31 +
National Highway Traffic Safety Administration. Fatal Accident Reporting System . Washington, DC: US Dept of Transportation; 1987;.
32 +
Williams AF.  Nighttime driving and fatal crash involvement of teenagers . Accid Anal Prev. 1985;;17:1-5.
33 +
DuMouchel W, Williams AF, Zador P.  Raising the alcohol purchase age: its effects on fatal motor vehicle crashes in 26 states . Legal Studies. 1987;; 16:249-266.
34 +
Hingson R, Merrigan D, Heeren T.  Effects of Massachusetts raising the legal drinking age from 18 to 20 on deaths from teenage homicide, suicide and nontraffic accidents . Pediatr Clin North Am. 1985;;32:221-232.
35 +
Garber S.  Minimum legal drinking ages and highway safety: a methodologic critique . In: Graham JD, ed. Preventing Automobile Injury: New Findings From Evaluation Research . Boston, Mass: Auburn House Publishing Co; 1988;.
36 +
Womble K. The Impact of Minimum Drinking Age Laws on Fatal Crash Involvements: An Update of the NHTSA Analyses . Washington, DC: National Highway Traffic Safety Administration; 1989;.
37 +
Phelps CE.  Alcohol taxes and highway safety . In: Graham JD, ed. Preventing Automobile Injury: New Findings From Evaluation Research . Boston, Mass: Auburn House Publishing Co; 1988;.
38 +
Waller PF.  A graduated licensing system for beginning drivers . Presented at the Provisional Driver License Workshop; October 21, 1986; Amsterdam, the Netherlands .
39 +
Lund AK, Williams AF, Zador P.  High school driver education: further evaluation of the Dekalb County study . Accid Anal Prev. 1986;;18:349-357.
40 +
Robertson LS.  Crash involvement of teenaged drivers when driver education is eliminated from high school . Am J Public Health. 1980;;70:599-603.
41 +
Wilson DC. The Effectiveness of Motorcycle Helmet Use in Reducing Fatalities . Washington, DC: National Highway Traffic Safety Administration; 1989;.
42 +
Evans L, Frick MC.  Helmet effectiveness in preventing motorcycle driver and passenger fatalities . Accid Anal Prev. 1988;;20:447-458.
43 +
IIHS Facts 1989: Motorcycles . Washington, DC: Insurance Institute for Highway Safety; 1989;.
44 +
McSwain NE, Willey J.  The impact of re-enactment of the motorcycle helmet law in Louisiana . Proc Am Assoc Automotive Med. 1985;:425-446.
45 +
Walk Alert: National Pedestrian Safety Program . Chicago, Ill: National Safety Council; 1987;.
46 +
Jonah BA, Engel GR.  Measuring the relative risk of pedestrian accidents . Accid Anal Prev. 1983;;15:193-206.
47 +
Homicide Surveillance: High Risk Racial and Ethnic Groups—Blacks and Hispanics, 1970-1983 . Atlanta, Ga: Centers for Disease Control; 1986;.
48 +
Christoffel KK, Christoffel T.  Handguns as a pediatric problem . Pediatr Emerg Care. 1986;;2: 75-81.
49 +
Grand Jury Report on Juveniles and Firearms . Grand Jury of Baltimore (Md) City; 1987;.
50 +
Sadowski LS, Cairns RB, Earp JA.  Firearm ownership among nonurban adolescents . AJDC . In press.
51 +
Berkelman RL, Callaway JL, Howard LB, Sikes RK.  Fatal injuries and alcohol . Am J Prev Med. 1985;;116:21-28.
52 +
Wintemute GJ.  Firearms as a cause of death in the United States, 1920-1982 . J Trauma. 1987;;27: 532-536.
53 +
Pierce GL, Bowers WJ.  The Bartley-Fox gun law's short-term impact on crime in Boston . Ann Am Acad Political Soc Sci. 1981;;455:121-137.
54 +
Loftin C, McDowall D.  The deterrent effects of the Florida felony firearm law . J Criminal Law Criminology. 1984;;75:250-259.
55 +
Loftin C, McDowall D.  'One with a gun gets you two': mandatory sentencing and firearms violence in Detroit, 1981 . Ann Am Academy Political Soc Sci. 1981;;455:151-167.
56 +
Sloan JH, Kellerman AL, Reay DT, et al.  Handgun regulations, crime, assaults, and homicide . N Engl J Med. 1988;;319:1256-1261.
57 +
Prothrow-Stith D, Spivak H, Hausman AJ.  The violence prevention project: a public health approach . Sci Tech Human Values. 1987;;12:67-69.
58 +
Zuckerman D, Zuckerman B.  Television's impact on children . Pediatrics. 1985;;75:233-240.
59 +
Stringham P, Neitzman M.  Violence counseling in the routine health care of adolescents . J Adolesc Health Care. 1988;;9:389-393.
60 +
Youth Suicide in the United States, 1970-1980 . Atlanta, Ga: Centers for Disease Control; 1986;.
61 +
Wintemute GJ, Teret SP, Kraus JF, Wright M.  The choice of weapons in firearm suicides . Am J Public Health. 1988;;78:824-825.
62 +
Rosenberg ML, Smith JC, Davidson LE, Conn JM.  The emergence of youth suicide: an epidemiologic analysis and public health perspective . Annu Rev Public Health. 1987;;8:417-440.
63 +
Buescher PA, Patetta MJ. Alcohol-Related Morbidity and Mortality in North Carolina . Raleigh, NC: State Center for Health Statistics; 1986;.
64 +
Brent DA, Perper JA, Allman CJ.  Alcohol, firearms, and suicide among youth: temporal trends in Allegheny County, Pennsylvania, 1960 to 1983 . JAMA. 1987;;257:3369-3372.
65 +
Patetta MJ, Biddinger PN.  Characteristics of drowning deaths in North Carolina . Public Health Rep. 1988;;103:406-411.
66 +
Wintemute GJ, Kraus JF, Teret SP, Wright M.  Drowning in childhood and adolescence: a population-based study . Am JPublic Health. 1987;;77:830-832.
67 +
Orlowski JP.  Adolescent drownings: swimming, boating, diving and scuba accidents . Pediatric Ann. 1988;;17:125-132.
68 +
Howland J, Hingson R.  Alcohol as a risk factor for drownings: a review of the literature (1950-1985) . Accid Anal Prev. 1988;;20:19-25.
69 +
Millner N, Pearn J, Guard R.  Will fenced pools save lives? A 10 year study from Mulgrave Shire, Queensland . Med J Aust. 1980;;2:510-511.
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Pearn J, Nixon J.  Are swimming pools becoming more dangerous? Med J Aust. 1977;;2:702-704.
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Pearn J, Wong R, Brown J, Ching Y, Bart R, Hammar S.  Drowning and near-drowning involving children: a five year total population study from the city and county of Honolulu . Am J Public Health. 1979;;69:450-454.
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Wintemute GJ, Kraus JF, Teret SP, Wright M.  Drowning in childhood and adolescence: a population-based study . Am J Public Health. 1987;;77:830-832.
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Dietz PE, Baker SP.  Drowning epidemiology and prevention . Am J Public Health. 1974;;64:303-312.
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MacLachlan J.  Drowning, other aquatic injuries and young Canadians . Can J Public Health. 1984;;75:218-222.
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Torg JS, Vegso JJ, Sennett B.  The National Football Head and Neck Injury Registry: 14-year report on cervical quadriplegia (1971-1984) . Clin Sports Med. 1987;;6:61-73.
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Runyan D.  The preparticipation examination of the young athlete . Clin Pediatr. 1983;;22:674-679.
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93 +
Jacobsson B, Schelp L.  One year incidence of occupational injuries among teenagers in a Swedish rural municipality . Scand J Soc Med. 1988;;16:21-25.
94 +
Kraus JF.  Homicide while at work: persons, industries and occupations at high risk . Am J Public Health. 1987;;77:1285-1289.
95 +
Centers for Disease Control.  Fatal occupational injuries, Texas, 1982 . MMWR. 1985;;34:130-134.
96 +
Rossignol AM, Locke JA, Boyle CM, Burke JF.  Epidemiology of work-related burn injuries in Massachusetts requiring hospitalization . J Trauma. 1986;;26:1097-1101.
97 +
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98 +
Rivara FP.  Fatal and nonfatal farm injuries to children and adolescents in the United States . Pediatrics. 1985;;76:567-573.
99 +
Waller JA.  Methodologic issues in hospital based injury research . In: Proceedings of the 31st annual meeting of the American Association for Automotive Medicine ; (September 28) -30, 1987;; New Orleans, La. Pages 95-108.
100 +
Payne SR, Waller JA.  Trauma registry and trauma center biases in injury research . J Trauma. 1989;;29:424-429.
101 +
Haddon W.  Options for the prevention of motor vehicle crash injury . Isr J Med. 1980;;16:45-68.
102 +
Nelson GD, Moffit PB.  Safety belt promotion: theory and practice . Accid Anal Prev. 1988;;20:27-38.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
National Academy of Sciences. Injury in America . Washington, DC: National Academy Press; 1985;.
2 +
Halpern SF, Bass JL, Mehta KA.  Unintentional injuries among adolescents and young adults: a review and analysis . J Adolesc Health Care. 1983;; 4:175-181.
3 +
Bass JL, Gallagher SS, Mehta KA.  Injuries to adolescents and young adults . Pediatr Clin North Am. 1985;;32:31-39.
4 +
Paulson JA.  The epidemiology of injuries in adolescents . Pediatr Ann . (February) 1988;;17:84-96.
5 +
Last J, ed. Maxcy-Rosenau: Public Health and Preventive Medicine. 11th ed. East Norwalk, Conn: Appleton-Century-Crofts; 1980;.
6 +
National Center for Health Statistics. Vital Statistics of the US: Mortality. Washington, DC: US Government Printing Office; 1980;2:pt A.
7 +
National Center for Health Statistics. Vital Statistics of the US: Mortality. Washington, DC: US Government Printing Office; 1981;2:pt A.
8 +
National Center for Health Statistics. Vital Statistics of the US: Mortality. Washington, DC: US Government Printing Office; 1982;2:pt A.
9 +
US Bureau of the Census. Current Population Reports, Series P-25, No. 1000: Estimates of the Population of the United States by Age, Sex, and Race: 1980-1986. Washington, DC: US Government Printing Office; 1987.
10 +
National Center for Health Statistics. Vital Statistics of the US: Mortality Data. Washington, DC: US Government Printing Office; 1950;3.
11 +
National Center for Health Statistics. Vital Statistics Rates in the US, 1940-1960. Washington, DC: US Government Printing Office; 1968.
12 +
Hoekelman RA, Pless IP.  Decline in mortality among young Americans during the 20th century: prospects for reaching national mortality reduction goals for 1990 . Pediatrics. 1988;;82:582-595.
13 +
Gallagher SS, Finison K, Guyer B, Goodenough S.  The incidence of injuries among 87,000 Massachusetts children and adolescents: results of the 1980-81 statewide childhood injury prevention program surveillance system . Am J Public Health. 1984;;74:1340-1347.
14 +
Kraus JF.  Epidemiologic features of injuries to the central nervous system . In: Neuroepidemiology . Boca Raton, Fla: CRC Press Inc. In press.
15 +
Frankowski RF.  Descriptive epidemiologic studies of head injury in the United States: 1974-1984 . Adv Psychosom Med. 1986;;16:153-172.
16 +
Klauber MR, Barrett-Conner E, Marshall LF, Bowers S.  The epidemiology of head injury . Am J Epidemiol. 1981;;113:500-509.
17 +
Baker SP, O'Neill B, Karpf R. The Injury Fact Book . Lexington (Mass) Books; 1984;.
18 +
Wise PH, Kotelchuck M, Wilson ML, Mills M.  Racial and socioeconomic disparities in childhood mortality in Boston . N Engl J Med. 1985;;313:360-366.
19 +
Spivak H, Prothrow-Stith D, Hausman AJ.  Dying is no accident: adolescents, violence, and intentional injury . Pediatr Clin North Am. 1988;; 35:1339-1347.
20 +
Klein D.  Some social characteristics of accident victims . Presented at the 101st Annual Meeting of the American Public Health Association; November 6, 1973; San Francisco, Calif .
21 +
Insurance Institute for Highway Safety.  Teens and autos: a deadly combination . Status Report . (September 23) , 1981;;16:1-11.
22 +
Williams AF.  Fatal motor vehicle crashes involving teenagers . Pediatrician. 1985;;12:37-40.
23 +
Williams AF, Wells JK, Lund AK.  Voluntary belt use among high school students . Accid Anal Prev. 1983;;15:161-165.
24 +
Waller PF, Runyan CW, Perry PE. Assessing the Impact of Increasing the Drinking Age on Motor Vehicle Injuries: An Injury Control Case Study . Atlanta, Ga: Centers for Disease Control; 1986;.
25 +
Wagenaar AC. Alcohol, Young Drivers, and Traffic Accidents . Lexington (Mass) Books; 1983;.
26 +
Fell JC.  Alcohol in fatal accidents for various driver age groups . In: Research Notes . Washington, DC; National Highway Traffic Safety Administration; 1984;:1-2.
27 +
Campbell BJ, Hunter WW, Stewart JR, Stutts JC. Increasing Safety Belt Use Through an Incentive Program . Chapel Hill, NC: Highway Safety Research Center; 1982;.
28 +
Campbell BJ, Stewart JR, Campbell FA. 1985-1986 Experience With Belt Laws in the United States . Chapel Hill, NC: Highway Safety Research Center; 1987;.
29 +
Robertson L.  The seat belt use law in Ontario: effects on actual use . Can J Public Health. 1978;;69:154-157.
30 +
Preusser DF, William AF, Lund AK.  The effect of New York's seat belt use law on teenage drivers . Accid Anal Prev. 1987;;19:73-80.
31 +
National Highway Traffic Safety Administration. Fatal Accident Reporting System . Washington, DC: US Dept of Transportation; 1987;.
32 +
Williams AF.  Nighttime driving and fatal crash involvement of teenagers . Accid Anal Prev. 1985;;17:1-5.
33 +
DuMouchel W, Williams AF, Zador P.  Raising the alcohol purchase age: its effects on fatal motor vehicle crashes in 26 states . Legal Studies. 1987;; 16:249-266.
34 +
Hingson R, Merrigan D, Heeren T.  Effects of Massachusetts raising the legal drinking age from 18 to 20 on deaths from teenage homicide, suicide and nontraffic accidents . Pediatr Clin North Am. 1985;;32:221-232.
35 +
Garber S.  Minimum legal drinking ages and highway safety: a methodologic critique . In: Graham JD, ed. Preventing Automobile Injury: New Findings From Evaluation Research . Boston, Mass: Auburn House Publishing Co; 1988;.
36 +
Womble K. The Impact of Minimum Drinking Age Laws on Fatal Crash Involvements: An Update of the NHTSA Analyses . Washington, DC: National Highway Traffic Safety Administration; 1989;.
37 +
Phelps CE.  Alcohol taxes and highway safety . In: Graham JD, ed. Preventing Automobile Injury: New Findings From Evaluation Research . Boston, Mass: Auburn House Publishing Co; 1988;.
38 +
Waller PF.  A graduated licensing system for beginning drivers . Presented at the Provisional Driver License Workshop; October 21, 1986; Amsterdam, the Netherlands .
39 +
Lund AK, Williams AF, Zador P.  High school driver education: further evaluation of the Dekalb County study . Accid Anal Prev. 1986;;18:349-357.
40 +
Robertson LS.  Crash involvement of teenaged drivers when driver education is eliminated from high school . Am J Public Health. 1980;;70:599-603.
41 +
Wilson DC. The Effectiveness of Motorcycle Helmet Use in Reducing Fatalities . Washington, DC: National Highway Traffic Safety Administration; 1989;.
42 +
Evans L, Frick MC.  Helmet effectiveness in preventing motorcycle driver and passenger fatalities . Accid Anal Prev. 1988;;20:447-458.
43 +
IIHS Facts 1989: Motorcycles . Washington, DC: Insurance Institute for Highway Safety; 1989;.
44 +
McSwain NE, Willey J.  The impact of re-enactment of the motorcycle helmet law in Louisiana . Proc Am Assoc Automotive Med. 1985;:425-446.
45 +
Walk Alert: National Pedestrian Safety Program . Chicago, Ill: National Safety Council; 1987;.
46 +
Jonah BA, Engel GR.  Measuring the relative risk of pedestrian accidents . Accid Anal Prev. 1983;;15:193-206.
47 +
Homicide Surveillance: High Risk Racial and Ethnic Groups—Blacks and Hispanics, 1970-1983 . Atlanta, Ga: Centers for Disease Control; 1986;.
48 +
Christoffel KK, Christoffel T.  Handguns as a pediatric problem . Pediatr Emerg Care. 1986;;2: 75-81.
49 +
Grand Jury Report on Juveniles and Firearms . Grand Jury of Baltimore (Md) City; 1987;.
50 +
Sadowski LS, Cairns RB, Earp JA.  Firearm ownership among nonurban adolescents . AJDC . In press.
51 +
Berkelman RL, Callaway JL, Howard LB, Sikes RK.  Fatal injuries and alcohol . Am J Prev Med. 1985;;116:21-28.
52 +
Wintemute GJ.  Firearms as a cause of death in the United States, 1920-1982 . J Trauma. 1987;;27: 532-536.
53 +
Pierce GL, Bowers WJ.  The Bartley-Fox gun law's short-term impact on crime in Boston . Ann Am Acad Political Soc Sci. 1981;;455:121-137.
54 +
Loftin C, McDowall D.  The deterrent effects of the Florida felony firearm law . J Criminal Law Criminology. 1984;;75:250-259.
55 +
Loftin C, McDowall D.  'One with a gun gets you two': mandatory sentencing and firearms violence in Detroit, 1981 . Ann Am Academy Political Soc Sci. 1981;;455:151-167.
56 +
Sloan JH, Kellerman AL, Reay DT, et al.  Handgun regulations, crime, assaults, and homicide . N Engl J Med. 1988;;319:1256-1261.
57 +
Prothrow-Stith D, Spivak H, Hausman AJ.  The violence prevention project: a public health approach . Sci Tech Human Values. 1987;;12:67-69.
58 +
Zuckerman D, Zuckerman B.  Television's impact on children . Pediatrics. 1985;;75:233-240.
59 +
Stringham P, Neitzman M.  Violence counseling in the routine health care of adolescents . J Adolesc Health Care. 1988;;9:389-393.
60 +
Youth Suicide in the United States, 1970-1980 . Atlanta, Ga: Centers for Disease Control; 1986;.
61 +
Wintemute GJ, Teret SP, Kraus JF, Wright M.  The choice of weapons in firearm suicides . Am J Public Health. 1988;;78:824-825.
62 +
Rosenberg ML, Smith JC, Davidson LE, Conn JM.  The emergence of youth suicide: an epidemiologic analysis and public health perspective . Annu Rev Public Health. 1987;;8:417-440.
63 +
Buescher PA, Patetta MJ. Alcohol-Related Morbidity and Mortality in North Carolina . Raleigh, NC: State Center for Health Statistics; 1986;.
64 +
Brent DA, Perper JA, Allman CJ.  Alcohol, firearms, and suicide among youth: temporal trends in Allegheny County, Pennsylvania, 1960 to 1983 . JAMA. 1987;;257:3369-3372.
65 +
Patetta MJ, Biddinger PN.  Characteristics of drowning deaths in North Carolina . Public Health Rep. 1988;;103:406-411.
66 +
Wintemute GJ, Kraus JF, Teret SP, Wright M.  Drowning in childhood and adolescence: a population-based study . Am JPublic Health. 1987;;77:830-832.
67 +
Orlowski JP.  Adolescent drownings: swimming, boating, diving and scuba accidents . Pediatric Ann. 1988;;17:125-132.
68 +
Howland J, Hingson R.  Alcohol as a risk factor for drownings: a review of the literature (1950-1985) . Accid Anal Prev. 1988;;20:19-25.
69 +
Millner N, Pearn J, Guard R.  Will fenced pools save lives? A 10 year study from Mulgrave Shire, Queensland . Med J Aust. 1980;;2:510-511.
70 +
Pearn J, Nixon J.  Are swimming pools becoming more dangerous? Med J Aust. 1977;;2:702-704.
71 +
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To understand the clinical management of acute heart failure syndromes.
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