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This study presents the results of an efficacy evaluation of a web-based brief motivational alcohol prevention/intervention program called "Michigan Prevention and Alcohol Safety for Students" (M-PASS). Four on-line sessions providing individually-tailored feedback were delivered to first-year college students over 9 weeks. Non- and low-risk drinking participants received risk prevention, while high-risk drinking participants received a risk-reduction intervention. Both intervention and control groups were surveyed at baseline and at a 3-month follow-up. Analysis showed positive effects for both men and women on stage of change, drinking behavior, drinking motivation and attitudes, and use of risk-reduction strategies. These results provided evidence of efficacy and found that M-PASS had both intervention and prevention effects, making it unique among currently developed brief alcohol interventions for college students. (Contains 1 figure and 2 tables.)

Objective: Reduce college student at-risk drinking (ARD) using a Web-based brief motivational alcohol prevention/intervention called "Michigan Prevention and Alcohol Safety for Students" (M-PASS). Participants: Participants included 1,137 randomly sampled first-year college students, including 59% female, 80% white, and averaged age 18.1 years. Methods: Intervention group participants (n = 616) attended 4 online M-PASS sessions, receiving feedback tailored to individual drinking patterns and concepts from 4 behavior change theories. Control group participants (n = 521) completed a mid-phase survey, and both groups were surveyed at baseline and posttest. Results: Evidence of M-PASS's efficacy was found. The intervention was associated with advanced stage of change, lower tolerance of drinking and drink/driving, fewer reasons to drink, and use of more strategies to avoid ARD. Preliminary evidence of behavioral change was also found. Efficacy was greater for women than men. Conclusions: Web-based programs may be useful in reducing alcohol-related risk among college students. Further evaluation is needed. (Contains 2 tables.)

Objectives. To evaluate the impact of the partial repeal of Michigan’s universal motorcycle helmet law on helmet use, fatalities, and head injuries. Methods. We compared helmet use rates and motorcycle crash fatality risk for the 12 months before and after the April 13, 2012, repeal with a statewide police-reported crash data set. We linked police-reported crashes to injured riders in a statewide trauma registry.We compared head injury before and after the repeal. Regression examined the effect of helmet use on fatality and head injury risk. Results. Helmet use decreased in crash (93.2% vs 70.8%; P < .001) and trauma data (91.1% vs 66.2%; P < .001) after the repeal. Although fatalities did not change overall (3.3% vs 3.2%; P = .87), head injuries (43.4% vs 49.6%; P < .05) and neurosurgical intervention increased (3.7% vs 6.5%; P < .05). Male gender (adjusted odds ratio [AOR] = 1.65), helmet nonuse (AOR = 1.84), alcohol intoxication (AOR = 11.31), intersection crashes (AOR = 1.62), and crashes at higher speed limits (AOR = 1.04) increased fatality risk. Helmet nonuse (AOR = 2.31) and alcohol intoxication (AOR = 2.81) increased odds of head injury. Conclusions. Michigan’s helmet law repeal resulted in a 24% to 27% helmet use decline among riders in crashes and a 14% increase in head injury. [ABSTRACT FROM AUTHOR]

Background:Seat belts are the most effective method of decreasing fatal and nonfatal motor vehicle crash injury. Advocacy groups have recently been successful in enacting repeals of mandatory motorcycle helmet laws in several states. In some states, this has prompted renewed efforts aimed at repealing mandatory seat belt laws. Purpose:To evaluate and quantify the potential impact of rescinding seat belt laws on annual crash-related fatalities, nonfatal injuries, and associated economic costs, using Michigan as a model, to inform the national debate. Methods:Proportional injury rates were calculated utilizing police-reported statewide passenger vehicle crash data from 1999 and 2002, where belt use rates approximate estimates associated with repeal of primary and secondary seat belt laws. Proportional rates were applied to the most recent year of crash data (2011) to estimate changes in statewide fatalities and nonfatal injuries. National cost estimates were applied to injury data to calculate associated economic costs. Results:Full repeal of the seat belt law is estimated to result in an additional 163 fatalities, 13,722 nonfatal injuries, and an associated societal cost of $1.6 billion annually. Repeal of the primary seat belt law only is estimated to result in an additional 95 fatalities, 9156 nonfatal injuries, and an associated societal cost of $1.0 billion annually. Conclusions:This analysis suggests that repealing the either the primary or full seat belt law would have a substantial and negative impact on public health, increasing motor vehicle crash related fatality, nonfatal injury, and associated economic costs. [ABSTRACT FROM AUTHOR]

Background: Evidence is mixed on the effects of graduated driver licensing (GDL) on motor vehicle crashes involving drivers aged 18 years. Purpose: This study examined the effects of GDL on crashes involving drivers aged 18 years in three states: Maryland, where GDL applies to novice drivers of all ages, and Florida and Michigan, where GDL applies only to new drivers aged <18 years. In addition, this study sought to confirm positive effects of GDL among drivers aged 16 and 17 years. Methods: Monthly rates for three levels of crash severity (fatal/disabling injury, nondisabling injury, and possible injury/property damage only [PDO]) for drivers aged 16, 17, and 18 years were calculated using crash records and census data. Data for Maryland spanned 1998 to 2009, for Florida 1990 to 2009, and Michigan 1992 to 2009. GDL’s effects on teen driver crashes by age were estimated using time-series analyses, conducted in 2012. Results: Crash rates for drivers aged 16 and 17 years declined in all three states following implementation or revision of GDL. For drivers aged 18 years, revision of an existing GDL law in Maryland was followed by a 6.9% decrease in possible-injury/PDO crashes; in Michigan, GDL implementation was followed by a 3.6% increase in possible-injury/PDO crashes; and in Florida, GDL had no effect. Conclusions: GDL led to expected declines in crash rates for drivers aged 16 and 17 years. However, the findings suggest that when GDL applies only to novice drivers aged <18 years, rather than to all novice drivers, crash rates among drivers aged 18 years may increase. In order to potentially extend the safety benefits of GDL, the age at which GDL for new drivers should be applied requires further attention. [Copyright &y& Elsevier]

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The article discusses a study which investigated the efficacy of brief interventions aimed at addressing violence and alcohol use among adolescents presenting to an urban emergency department. The randomized controlled trial involved adolescents who reported past-year alcohol use and aggression at a level I ED in Flint, Michigan between September 2006 and 2009. They undertook combined motivational interviewing with skills training and a brief intervention, which resulted in a drop in the prevalence of self-reported aggression and alcohol consequences.

Background: Alcohol consumption and drink/driving are positively correlated and many predictors of alcohol use also predict drink/driving. Past research has not fully distinguished the contributions of personal risk factors from the level of alcohol use in the prediction of drink/driving. As a result, the extent to which predictors are specific to drink/driving, versus due to a mutual association to alcohol use, is unclear. Methods: This study examined the unique and shared risk factors for drink/driving and alcohol use, and examined the attributable risk (AR) associated with predictors of drink/driving while adjusting for alcohol use. Study data were from a telephone survey of 3,480 Michigan-licensed young adults who were drinkers. Four groups of drink/drivers were formed based on the prior 12-month maximum severity of drink/driving: (1) never drink/driving; (2) driving at least once within an hour of 1 or 2 drinks; (3) driving within an hour of 3 or more drinks or while feeling the effects of alcohol; and (4) drinking while driving. Results: Lower perceived risk of drink/driving, greater social support for drinking and drink/driving, greater aggression and delinquency, more cigarette smoking, and more risky driving behaviors uniquely predicted drink/driving severity in models adjusted for alcohol use. The largest ARs were associated with social support for drinking and drink/driving and perceived risk of drink/driving. Conclusions: These results confirm that alcohol use and drink/driving share risk factors, but also indicate that part of the variation in these factors is specific to drink/driving. Implications for interventions to reduce drink/driving are discussed. [ABSTRACT FROM AUTHOR]

BACKGROUND AND OBJECTIVES: Emergency department (ED) visits present an opportunity to deliver brief interventions (Bis) to reduce violence and alcohol misuse among urban adolescents at risk for future injury. Previous analyses demonstrated that a BI resulted in reductions in violence and alcohol consequences up to 6 months. This article describes findings examining the efficacy of Bis on peer violence and alcohol misuse at 12 months. METHODS: Patients (14-18 years of age) at an ED reporting past year alcohol use and aggression were enrolled in the randomized control trial, which included computerized assessment, random assignment to control group or BI delivered by a computer or therapist assisted by a computer. The main outcome measures (at baseline and 12 months) included violence (peer aggression, peer victimization, violence-related consequences) and alcohol (alcohol misuse, binge drinking, alcohol- related consequences). RESULTS: A total of 3338 adolescents were screened (88% participation). Of those, 726 screened positive for violence and alcohol use and were randomly selected; 84% completed 12-month follow-up. In comparison with the control group, the therapist assisted by a computer group showed significant reductions in peer aggression (P < .01) and peer victimization (P < .05) at 12 months. BI and control groups did not differ on alcohol-related variables at 12 months. CONCLUSIONS: Evaluation of the SafERteens intervention 1 year after an ED visit provides support for the efficacy of computer-assisted therapist brief intervention for reducing peer violence. [ABSTRACT FROM AUTHOR]

The β+ decay of very neutron-deficient 43Cr was studied by means of an imaging time projection chamber that allowed recording tracks of charged particles. Events of β-delayed emission of one, two, and three protons were clearly identified. The absolute branching ratios for these channels were determined to be (81±4)%, (7.1±0.4)%, and (0.08±0.03)%, respectively. 43Cr is thus established as the second case in which the β-3p decay occurs. Although the feeding to the proton-bound states in 43V is expected to be negligible, the large branching ratio of (12±4)% for decays without proton emission is found. [ABSTRACT FROM AUTHOR]

Objectives: In this study, we sought to accomplish the following objectives: to (1) calculate the percentage of children considered appropriately restrained across 8 criteria of increasing restrictiveness; (2) examine agreement between age- and size-based appropriateness criteria; (3) assess for changes in the percentage of children considered appropriately restrained by the 8 criteria between 2011 (shortly after updates to U.S. guidelines) and 2015., Methods: Data from 2 cross-sectional surveys of 928 parents of children younger than 12 years old (n = 591 in 2011, n = 337 in 2015) were analyzed in 2017. Child age, weight, and height were measured at an emergency department visit and used to determine whether the parent-reported child passenger restraint was considered appropriate according to 8 criteria. Age-based criteria were derived from Michigan law and U.S., Guidelines: Weight, height, and size-based criteria were derived from typical restraints available in the United States in 2007 and 2011. The percentage appropriate restraint use was calculated for each criterion. The kappa statistic was used to measure agreement between criteria. Change in appropriateness from 2011 to 2015 was assessed with chi-square statistics., Results: Percentage appropriate restraint use varied from a low of 19% for higher weight limits in 2011 to a high of 91% for Michigan law in 2015. Agreement between criteria was slight to moderate. The lowest kappa was for Michigan law and higher weight limits in 2011 (κ = 0.06) and highest for U.S. guidelines and lower weight limits in 2011 (κ = 0.60). Percentage appropriate restraint use was higher in 2015 than 2011 for the following criteria: U.S. guidelines (74 vs. 58%, P < .001), lower weight (57 vs. 47%, P = .005), higher weight (25 vs. 19%, P = .03), greater height (39 vs. 26%, P < .001), and greater size (42 vs. 30%, P = .001)., Conclusions: The percentage of children considered to be using an appropriate restraint varied substantially across criteria. Aligning the definition of appropriate restraint use with current U.S. guidelines would increase consistency in reporting results from studies of child passenger safety in the United States. Potential explanations for the increased percentage of children considered appropriately restrained between 2011 and 2015 include adoption of the updated U.S. guidelines and the use of child passenger restraints with higher weight and height limits.

Purpose: The purpose of this study was to determine the effects of Michigan's universal text messaging restriction (effective July 2010) across different age groups of drivers and crash severities., Methods: Changes in monthly crash rates and crash trends per 10,000 licensed drivers aged 16, 17, 18, 19, 20-24, and 25-50 years were estimated using time series analysis for three levels of crash severity: (1) fatal/disabling injury; (2) nondisabling injury; and (3) possible injury/property damage only (PDO) crashes for the period 2005-2012. Analyses were adjusted for crash rates of drivers' aged 65-99 years, Michigan's unemployment rate, and gasoline prices., Results: After the introduction of the texting restriction, significant increases were observed in crash rates and monthly trends in fatal/disabling injury crashes and nondisabling injury crashes, and significant decreases in possible injury/PDO crashes. The magnitude of the effects where significant changes were observed was small., Conclusions: The introduction of the texting restriction was not associated with a reduction in crash rates or trends in severe crash types. On the contrary, small increases in the most severe crash types (fatal/disabling and nondisabling injury) and small decreases in the least severe crash types (possible injury/PDO) were observed. These findings extend the literature on the effects of cell phone restrictions by examining the effects of the restriction on newly licensed adolescent drivers and adult drivers separately by crash severity., (Published by Elsevier Inc.)

Injury resulting from motor vehicle crashes is the leading cause of death among teenagers in the US. Few programs or policies have been found to be effective in reducing the risk of fatal car crashes for young novice drivers. One effective policy that has been widely implemented is Graduated Driver Licensing (GDL). Published articles have mostly reported on the temporal effectiveness of GDL in the US. This article reports on the development of spatial statistical modeling approaches to evaluate and compare the effectiveness of GDL policy across eighty-three counties in the state of Michigan. Data were gathered from several publicly available databases, including the US Fatality Analysis Reporting System (FARS), US Census Bureau, US Bureau of Labor Statistics, and US Department of Agriculture. To account for spatial dependence among crash counts from adjacent counties we invoke spatial random effects, which we provide with a Conditionally AutoRegressive (CAR) prior. Our analysis confirms previous findings that GDL in Michigan is an effective policy that significantly reduces the risk of fatal car crashes among novice teenage drivers. In addition, it indicates that rurality is an important contextual variable associated with spatial differences in GDL effectiveness across the state of Michigan. Finally, our findings provide information that can be used to strengthen GDL policy and its implementation to further enhance teenage-driver safety., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Unlabelled: An inner-city emergency department (ED) visit provides an opportunity for contact with high-risk adolescents to promote injury prevention., Objectives: To identify the prevalence of injuries sustained over the past year by teens presenting to an inner-city ED, and to identify factors associated with recent injury to inform future ED-based injury prevention initiatives., Methods: Over 1 year, 7 days a week, from 1:00-11:00 p.m., patients aged 14-18 years presenting to the ED participated in a survey regarding past-year risk behaviors and injuries., Results: Of the entire group of teens presenting to the ED (n = 1128) who completed the survey (83.8% response rate), 46% were male, and 58% were African-American. Past-year injuries were reported by 768 (68.1%) of the teens; 475 (61.8%) of those reported an unintentional injury and 293 (38.1%) reported an intentional injury. One-third of all youth seeking care reported a past-year sports-related injury (34.5%) or an injury related to driving or riding in a car (12.3%), and 8.2% reported a gun-related injury. Logistic regression found that binge drinking (adjusted odds ratio [AOR] 1.95) and illicit weapon carrying (AOR 2.31) predicted a past-year intentional injury. African-American youth (AOR 0.56) and those receiving public assistance (AOR 0.73) were less likely to report past-year unintentional injuries., Conclusions: Adolescents seeking care in an inner-city ED, regardless of the reason for seeking care, report an elevated prevalence of recent injury, including violence. Future injury screening and prevention efforts should consider universal screening of all youth seeking ED care., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Background: This study compared driving exposure between two high-crash-risk groups (16-17 and 18-24-year-olds), with a low-crash-risk group (35-64-year-olds). In addition, patterns of association between driving exposure measures and demographic and driving behavior variables were examined., Methods: Respondent's total miles, minutes, and trips driven were calculated within a 48-hour period, using state-wide survey data collected in 2004 and 2005., Results: The youngest drivers drove fewer miles and minutes, but a comparable number of trips as the two older groups. Employment and high vehicle access were associated with greater driving exposure for 16-17-year-olds and 18-24-year-olds. Employment, high household income, large household size, and low vehicle access were associated with greater driving exposure for 35-64-year-olds. More driving was done alone than with passengers present and during the day than at night across all ages. There was a positive association between two driving exposure measures (miles and minutes driven) and demographic and driving behavior variables, which did not extend to trips driven., Discussion: Driving exposure is directly related to stage of life. The entire sample of 16-17-year-old respondents were in high school, which directly influenced their driving times, destinations, and purpose. Those aged 18-24years displayed driving behavior patterns that were closer to the older drivers, while retaining some differences. The oldest drivers were likely to be shouldering the greatest household responsibilities, and their greater driving exposure may reflect this reality., Impact on Industry: These findings provide new information about driving exposure for two high-risk and one low-risk group of drivers. They also raise concern over potential workplace safety issues related to teens' higher driving exposure, and concomitant crash risk, related to being employed. Future research should examine this issue more carefully so that evidence based recommendations can be made to enhance the safety of teens who are employed, especially those who are employed as drivers., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Researchers recognize that the connection between alcohol and peer violence may relate to community level ecological factors, such as the location of businesses that sell alcohol. Building on previous research among adults, this study examines the relationship between alcohol outlet density and violent behaviors among adolescents, taking into account demographic characteristics, individual alcohol use, and neighborhood level socioeconomic indicators. Data drawn from a diverse Emergency Department based sample of 1,050 urban adolescents, combined with tract level data from the state liquor control commission and U.S. Census, were analyzed. Results of multivariate multi-level regression analysis indicate that alcohol outlet density is significantly related to adolescents' violent behaviors, controlling for demographic characteristics and individual alcohol use. Census tract level socioeconomic indicators were not significantly associated with youth violence. Findings suggest that alcohol outlet density regulation should be considered as part of broader violence prevention strategies for urban adolescents.

Motor vehicle crashes are the leading cause of death and a leading cause of non-fatal injury for teenagers in the United States. Understanding teen crashes requires a good measure of crash risk. The measure of exposure that is used in the calculation of risk estimates determines what information the resulting rates and rate ratios provide and the conclusions that can be drawn about teen driver crash risk. The purpose of this study is to provide an initial description of three measures of individual-level exposure to driving for 16-17-year-olds in the state of Michigan, using data from the state-wide Michigan Travel Counts survey conducted in 2004 and 2005. The total miles, minutes, and trips driven within the 48-h survey period were calculated for each respondent using self-reported measures and geo-spatial mapping. Young drivers who worked and those with greater access to a vehicle drove significantly more than their peers who did not work and those who had less access to a vehicle. Those from urban residences spent more time driving than those from rural residences. All 16-17-year-olds drove substantially more during the day than at night, and on their own than with passengers. There was little difference in overall driving exposure and driving behavior between young men and young women. This study provides an initial description of driving exposure and behavior for a population for which there is very little specific information about amounts and patterns of individual driving exposure. The relationship between individual driving exposure and risk of motor vehicle crash, injury or fatality requires further investigation., (Copyright 2010 Elsevier Ltd. All rights reserved.)

This study identified casualty crash types for which teen drivers experience excess risk relative to adults. Michigan State Police crash records were used to examine casualty crashes in two statewide populations of drivers who experienced at least one crash from 1989-1996 (pre-graduated driver licensing in Michigan): teens (ages 16-19) and adults (ages 45-65). Rates and rate ratios (RR) based on crash occurrence per 100,000 person miles driven (PMD) compared teens and adults from the two statewide populations. Excess risk was defined as a RR for a specific type of crash that was significantly greater than the RR for all crashes combined. The RRs for all crashes combined for teenage males was 2.41 and 1.75 for teenage females. RRs for teenage males ranged from a low of 2.16 for casualty crashes attributed to alcohol to 8.98 for casualty road departure crashes at night. Among teenage females, RRs ranged from 2.06 for casualty crashes on the weekend to 7.86 for casualty crashes at night with passengers. Casualty crash rates for teenage males ranged from 0.21 per 100,000 PMD for rollover crashes to 1.95 per 100,000 PMD for crashes with passengers. Among teen females, casualty crash rates ranged from 0.21 per 100,000 PMD for drink/driving with passengers to 3.31 per 100,000 PMD for crashes with passengers. Implications for graduated driver licensing, teen driver supervision, and policy are discussed. This study was funded by the National Institute on Alcohol Abuse and Alcoholism and the Centers for Disease Control and Prevention's National Center for Injury Prevention and Control.

Background: Motor vehicle injury is the major cause of mortality among young adults. Information about the individual characteristics of those who drive dangerously could enhance traffic safety programs. The goal of this research was to examine the association between various personality-related characteristics and risky driving behaviors., Methods: Young adults in Michigan, USA (n = 5,362) were surveyed by telephone regarding several personality factors (risk-taking, hostility, aggression, tolerance of deviance, achievement expectations) and driving behaviors (competitive driving, risk-taking driving, high-risk driving, aggressive driving, and drink/driving). Michigan driver records were obtained to examine offenses, serious offenses, driving offense points, crashes and serious crashes in the three pre-interview years. Multivariate regression analyses, adjusting for age, race, and marital status were conducted separately by sex to identify personality factors related to driving., Results: For men and women, greater risk-taking propensity, physical/verbal hostility, aggression, and tolerance of deviance were significant predictors of a competitive attitude toward driving, risk-taking driving, high-risk driving, driving aggression, and drink/driving. Greater risk-taking propensity, physical/verbal hostility, aggression, and to a small degree, expectations for achievement predicted higher numbers of offenses, serious offenses, and points., Conclusion: Traffic safety policies and programs could be enhanced through recognition of the role personality factors play in driving behavior and the incorporation of this knowledge into the design and implementation of interventions that modify the behaviors associated with them.

Objective: Patients with serious mental illnesses, such as schizophrenia, bipolar disorder, and other psychoses, may be less likely to receive adequate care for chronic medical conditions than patients without serious mental illness. The quality and outcomes of diabetes care were compared in an observational study among patients with and without serious mental illness., Methods: National data were studied for 36,546 individuals receiving care within the U.S. Department of Veterans Affairs (VA) health care system. Widely used diabetes quality-of-care measures and intermediate outcomes were compared for patients with diabetes and serious mental illness and age-matched patients with diabetes who did not have a serious mental illness. Patients' use of health services was also examined., Results: During fiscal year 1998, patients with diabetes and serious mental illness were as likely as patients with diabetes alone to have their hemoglobin A1c, low-density lipoproteins (LDL), and cholesterol measured; both groups had comparable A1c, LDL, and cholesterol values. Patients with diabetes and serious mental illness had more outpatient visits, both primary care and specialty visits, and made more multiclinic visits, including visits to both primary care and mental health services on the same day., Conclusions: In the VA, patients with diabetes and serious mental illness appear to receive diabetes care that is comparable with the care that other patients with diabetes receive, possibly because of increased levels of contact with the health system and the VA's integration of medical and mental health services.