Objective: To measure the effect of motor vehicle crash (MVC) involvement and readiness to change drinking and driving behaviors on subsequent driving and drinking behaviors among injured emergency department (ED) patients who use alcohol at harmful levels.
Methods: This was a secondary analysis of a randomized controlled trial of injured ED patients who screened positive for harmful alcohol use, who at recruitment reported driving in the past 12 months and received at least one of the intended intervention sessions (brief behavioral intervention versus attention placebo control; N = 407). Outcome variables were as follows: (1) change in 6 impaired driving behaviors and (2) report of MVCs and traffic violations in the 12 months following recruitment; predictor variables were as follows: (1) treatment assignment, (2) MVC involvement at recruitment, and (3) baseline readiness to change alcohol use and drinking and driving.
Results: Modeling of change in the 6 impaired driving variables indicated that neither the recruitment visits being MVC related nor baseline readiness to change alcohol use and drinking and driving behaviors predicted greater changes in impaired driving over time. Baseline reports of past moving traffic violations and the ED visit being MVC related predicted a greater likelihood of each behavior at 12 months following study recruitment.
Conclusions: This study and others have demonstrated that ED patients with harmful alcohol use are willing to engage in behavioral interventions directed at changing risky behaviors. However, this study did not demonstrate that patients considered having the potential to be more engaged with the intervention because their ED visit was MVC related and/or they had expressed intent to change their risky alcohol use and drinking and driving behaviors were more likely to change these risky behaviors. 相似文献
ABSTRACT: The responses of the spotfin shiner (Notropis spilopterus) and bluntnose minnow (Pimephales notatus) to intermittent chlorine discharges from a fossil fuel power plant in the New River were investigated by seine collections in the chlorinated discharge channel, and chlorine avoidances were obtained in a field laboratory at the power plant in Glen Lyn, Virginia. No fish were captured by seine during chlorination periods when the total chlorine (TCR) and free chlorine (FCR) residuals were, respectively, 0.46 and 0.27 mg/1 or higher at river water temperatures of 12 C or less. For collections made between eight-hour chlorination periods, the number of fish was reduced by approximately 50% at 0.20 and 0.06 mg/1 TCR and FCR, respectively. Significant (0.05 level) laboratory avoidances occurred at 0.10 to 0.20 mg/1 TCR (0.03 to 0.14 mg/1 FCR) for both species when exposed to increasing TCR concentrations of 0.10, 0.20, 0.30 and 0.40 mg/1. Responses varied with acclimation temperature (6, 12, 18 and 24 C) with no consisteent trends between species. When exposed to a constant TCR concentration during any one test (0.14, 0.18 and 0.26 mg/1 for the spotfin shiner, and 0.11 and 0.17 mg/1 for the bluntnose minnow), significant avoidances were observed at 0.26 and 0.17 mg/1 for each species, respectively. In all laboratory trials, occurrence or residence times decreased with increasing chlorine concentration, with residence times as high as 64.7% at 0.10 mg/1 TCR and as low as 8.3% at 0.40 mg/1 being observed. 相似文献
Flood forecasts and warnings are intended to reduce flood‐related property damages and loss of human life. Considerable research has improved flood forecasting accuracy (e.g., more accurate prediction of the occurrence of flood events) and lead time. However, the delivery of improved forecast information alone is not necessarily sufficient to reduce flood damage and loss of life, as people have varying responses and reactions to flood warnings. This study develops an agent‐based modeling framework that evaluates the impacts of heterogeneity in human behaviors (i.e., variation in behaviors in response to flood warnings), as well as residential density, on the benefits of flood warnings. The framework is coupled with a traffic model to simulate evacuation processes within a road network under various flood warning scenarios. The results show the marginal benefit associated with providing better flood warnings is significantly constrained if people behave in a more risk‐tolerant manner, especially in high‐density residential areas. The results also show significant impacts of human behavioral heterogeneity on the benefits of flood warnings, and thus stress the importance of considering human behavioral heterogeneity in simulating flood warning‐response systems. Further study is suggested to more accurately model human responses and behavioral heterogeneity, as well as to include more attributes of residential areas to estimate and improve the benefits of flood warnings. 相似文献