Comparison of recidivism rates for a teenage trauma prevention program after the addition of high-fidelity patient simulation

Objectives: We evaluated the benefits of adding high-fidelity simulation to a teenage trauma prevention program to decrease recidivism rates and encourage teens to discuss actionable steps toward safe driving.

Methods: A simulated pediatric trauma scenario was integrated into an established trauma prevention program. Participants were recruited because they were court-ordered to attend this program after misdemeanor convictions for moving violations. The teenage participants viewed this simulation from the emergency medical services (EMS) handoff to complete trauma care. Participants completed a postsimulation knowledge assessment and care evaluation, which included narrative data about the experience. Qualitative analysis of color-coded responses identified common themes and experiences in participants' answers. Court records were reviewed 6 years after course completion to determine short- and long-term recidivism rates, which were then compared to our program's historical rate.

Results: One hundred twenty-four students aged 16–20 years participated over a 2-year study period. Narrative responses included general reflection, impressions, and thoughts about what they might change as a result of the course. Participants reported that they would decrease speed (30%), wear seat belts (15%), decrease cell phone use (11%), and increase caution (28%). The recidivism rate was 55% within 6 years. At 6 months it was 8.4%, at 1 year it was 20%, and it increased approximately 5–8% per year after the first year. Compared with our programs, for historical 6-month and 2-year recidivism rates, no significant difference was seen with or without simulation.

Conclusions: Adding simulation is well received by participants and leads to positive reflections regarding changes in risk-taking behaviors but resulted in no changes to the high recidivism rates This may be due to the often ineffectiveness of fear appeals.     

A contemporary assessment of polybrominated diphenyl ethers (PBDE) in the ambient air and soil of Azerbaijan

PBDEs were measured in air and soil across Azerbaijan to establish contemporary concentrations at 13 urban and rural sites. Polyurethane foam passive air samplers (PUF-PAS) were deployed for a period of a month with surface soil samples collected at the same sites. Unlike organochlorine pesticides previously surveyed by our group, PBDE concentrations in both contemporary air and soil were low in comparison to recent European and Asian studies. For example, mean ∑₉PBDE concentrations in air and soil were 7.13 ± 1.66 pg m^?3 and 168 ± 57 pg g^?1, respectively. The fully brominated BDE-209 was the most abundant congener observed in soil (174.8 ± 58.5 pg g^?1), comprising ~ 96% of ∑₁₀PBDE. However, the PAS-derived air concentrations for highly brominated congeners must be viewed with caution as there is uncertainty over the uptake rates of particle-bound chemicals using these devices. Some of the highest concentrations in air were observed at sites with the highest wind speeds and at several remote locations in the north of the country and this requires further research. Levels of BDE-47 and 99 (the two most abundant congeners in the widely used penta-formulation) were lower than levels reported elsewhere suggesting limited use/import of the penta-BDE formulation in Azerbaijan.     

The toxicology of climate change: Environmental contaminants in a warming world

Climate change induced by anthropogenic warming of the earth's atmosphere is a daunting problem. This review examines one of the consequences of climate change that has only recently attracted attention: namely, the effects of climate change on the environmental distribution and toxicity of chemical pollutants. A review was undertaken of the scientific literature (original research articles, reviews, government and intergovernmental reports) focusing on the interactions of toxicants with the environmental parameters, temperature, precipitation, and salinity, as altered by climate change. Three broad classes of chemical toxicants of global significance were the focus: air pollutants, persistent organic pollutants (POPs), including some organochlorine pesticides, and other classes of pesticides. Generally, increases in temperature will enhance the toxicity of contaminants and increase concentrations of tropospheric ozone regionally, but will also likely increase rates of chemical degradation. While further research is needed, climate change coupled with air pollutant exposures may have potentially serious adverse consequences for human health in urban and polluted regions. Climate change producing alterations in: food webs, lipid dynamics, ice and snow melt, and organic carbon cycling could result in increased POP levels in water, soil, and biota. There is also compelling evidence that increasing temperatures could be deleterious to pollutant-exposed wildlife. For example, elevated water temperatures may alter the biotransformation of contaminants to more bioactive metabolites and impair homeostasis. The complex interactions between climate change and pollutants may be particularly problematic for species living at the edge of their physiological tolerance range where acclimation capacity may be limited. In addition to temperature increases, regional precipitation patterns are projected to be altered with climate change. Regions subject to decreases in precipitation may experience enhanced volatilization of POPs and pesticides to the atmosphere. Reduced precipitation will also increase air pollution in urbanized regions resulting in negative health effects, which may be exacerbated by temperature increases. Regions subject to increased precipitation will have lower levels of air pollution, but will likely experience enhanced surface deposition of airborne POPs and increased run-off of pesticides. Moreover, increases in the intensity and frequency of storm events linked to climate change could lead to more severe episodes of chemical contamination of water bodies and surrounding watersheds. Changes in salinity may affect aquatic organisms as an independent stressor as well as by altering the bioavailability and in some instances increasing the toxicity of chemicals. A paramount issue will be to identify species and populations especially vulnerable to climate–pollutant interactions, in the context of the many other physical, chemical, and biological stressors that will be altered with climate change. Moreover, it will be important to predict tipping points that might trigger or accelerate synergistic interactions between climate change and contaminant exposures.     

Horizon scanning for South African biodiversity: A need for social engagement as well as science

Ambio - A horizon scan was conducted to identify emerging and intensifying issues for biodiversity conservation in South Africa over the next 5–10 years. South African biodiversity...     

Soilaluminum, Iron, and Phosphorus Dynamics in Response to Long-Term Experimental Nitrogen and Sulfur Additions at the Bear Brook Watershed in Maine, USA

Atmospheric deposition of nitrogen (N) and sulfur (S) containing compounds affects soil chemistry in forested ecosystems through (1) acidification and the depletion of base cations, (2) metal mobilization, particularly aluminum (Al), and iron (Fe), (3) phosphorus (P) mobilization, and (4) N accumulation. The Bear Brook Watershed in Maine (BBWM) is a long-term paired whole-watershed experimental acidification study demonstrating evidence of each of these acidification characteristics in a northeastern U.S. forested ecosystem. In 2003, BBWM soils were studied using the Hedley fractionation procedure to better understand mechanisms of response in soil Al, Fe, and P chemistry. Soil P fractionation showed that recalcitrant P was the dominant fraction in these watersheds (49%), followed by Al and Fe associated P (24%), indicating that a majority of the soil P was biologically unavailable. Acidification induced mobilization of Al and Fe in these soils holds the potential for significant P mobilization. Forest type appears to exert important influences on metal and P dynamics. Soils supporting softwoods showed evidence of lower Al and Fe in the treated watershed, accompanied by lower soil P. Hardwood soils had higher P concentrations in surface soils as a result of increased biocycling in response to N additions in treatments. Accelerated P uptake and return in litterfall overshadowed acidification induced P mobilization and depletion mechanisms in hardwoods.     

Effects of energy consumption and ecological footprint on CO2 emissions: an empirical evidence from Pakistan

Environment, Development and Sustainability - This study aims twofold; first, to analyze the effects of traditional energy, renewable energy, ecological footprint, urbanization, transportation on...     

Social vulnerability to climate change: a review of concepts and evidence

Regional Environmental Change - This article provides a review of recent scientific literature on social vulnerability to climate change, aiming to determine which social and demographic groups,...     

What’s Wrong with the Tap? Examining Perceptions of Tap Water and Bottled Water at Purdue University

The environmental impacts of bottled water prompted us to explore drinking water choices at Purdue University, located in West Lafayette, IN. A random sample of 2,045 Purdue University students, staff, and faculty was invited to participate in an online survey. The survey assessed current behaviors as well as perceived barriers and benefits to drinking tap water versus bottled water. 677 surveys were completed for a response rate of 33.1%. We then conducted qualitative interviews with a purposive sample of university undergraduates (n = 21) to obtain contextual insights into the survey results and the beliefs of individuals with a variety of drinking water preferences. This study revealed that women drink disproportionately more bottled water then men while undergraduate students drink more than graduate students, staff and faculty. The study also uncovered a widespread belief that recycling eliminates the environmental impacts of bottled water. Important barriers to drinking tap water at Purdue include: perceived risks from tap water and the perceived safety of bottled water, preferring the taste of bottled water, and the convenience of drinking bottled water. The qualitative interviews revealed that drinking water choices can be influenced by several factors—especially whether individuals trust tap water to be clean—but involve varying levels of complexity. The implications of these results for social marketing strategies to promote tap water are discussed.     

Antecedents of work–family conflict: A meta‐analytic review

This study provides and meta‐analytically examines an organizing framework and theoretical model of work–family conflict. Results, based on 1080 correlations from 178 samples, indicate that work role stressors (job stressors, role conflict, role ambiguity, role overload, time demands), work role involvement (job involvement, work interest/centrality), work social support (organizational support, supervisor support, coworker support), work characteristics (task variety, job autonomy, family friendly organization), and personality (internal locus of control, negative affect/neuroticism) are antecedents of work‐to‐family conflict (WFC); while family role stressors (family stressors, role conflict, role ambiguity, role overload, time demands, parental demands, number of children/dependents), family social support (family support, spousal support), family characteristics (family climate), and personality (internal locus of control, negative affect/neuroticism) are antecedents of family‐to‐work conflict (FWC). In addition to hypothesized results, a revised model based on study findings indicates that work role stressors (job stressors, role conflict, role ambiguity, role overload) and work social support (organizational support, supervisor support, coworker support) are predictors of FWC; while family role stressors (family stressors, role conflict, role ambiguity, role overload), family involvement (family interest/centrality), family social support (family support, spousal support), and family characteristics (family climate) are predictors of WFC. Copyright © 2010 John Wiley & Sons, Ltd.