In Saudi Arabia, road traffic crashes are becoming a serious public health problem and there are no recent, large-scale, published reports discussing maternal and fetal injuries. We aimed to explore the predictors of fetal death/abortion after maternal trauma. A retrospective case-control study was performed exploring cases of maternal trauma. The study group included 118 women with pregnancy loss while 308 women without loss represented the control group. All data were compared using univariate analysis followed by multivariate regression analysis. Only 3 predictors were associated with significant effect on pregnancy loss after trauma (P < 0.05): second trimester of pregnancy (OR 2.77, 95% CI: 1.66-4.63, placental abruption (OR 3.69, 95% CI: 2.01-6.79) and severe injury score (OR 6.78, 95% CI: 4.04-11.37).

Objective: To evaluate the robustness of an appearance-focused intervention to prevent skin cancer in individuals reporting seasonal affective disorder (SAD) symptoms and pathological tanning motives. Design: Randomized, controlled clinical trial. Setting: College campus. Participants: Four hundred thirty adult female indoor tanners (200 in the intervention group and 230 control participants). Intervention: A booklet discussing the history of tanning, current tanning norms, UV radiation's effects on skin, recommendations for indoor tanning use focusing on abstinence and harm reduction recommendations, and information on healthier, appearance-enhancing alternatives to tanning. Main Outcome Measures: Self-reported attitudes, intentions, and tanning behaviors; pathological tanning motives assessed by a questionnaire developed for this study; and SAD symptoms assessed by the Seasonal Pattern Assessment Questionnaire. Results: Two of the 4 pathological tanning scales, opiatelike reactions to tanning and dissatisfaction with natural skin tone, were significant moderators demonstrating stronger treatment effects for individuals scoring higher on these scales. Treatment effects were equivalently positive (ie, no significant moderator effects) for all levels of SAD symptoms and all levels of the other 2 pathological tanning motive scales (ie, perceiving tanning as a problem and tolerance to the effects of tanning). Conclusions: The appearance-focused skin cancer prevention intervention is robust enough to reduce indoor tanning among tanners who exhibit SAD symptoms or pathological tanning motives. Tailored interventions may address individuals' motivations for tanning and their relation to maladaptive behavior, such as dissatisfaction with appearance or the need for relaxation because of anxiety.

No description available.

Objective: To determine the efficacy of a 2-year obesity prevention program in African American girls. Design: Memphis GEMS (Girls' health Enrichment Multi-site Studies) was a controlled trial in which girls were randomly assigned to an obesity prevention program or alternative intervention. Setting: Local community centers and YWCAs (Young Women's Christian Associations) in Memphis, Tennessee. Participants: Girls aged 8 to 10 years (N=303) who were identified by a parent or guardian as African American and who had a body mass index (BMI) at or higher than the 25th percentile for age or 1 parent with a BMI of 25 or higher. Interventions: Group behavioral counseling to promote healthy eating and increased physical activity (obesity prevention program) or self-esteem and social efficacy (alternative intervention). Main Outcome Measure: The BMI at 2 years. Results: The BMI increased in all girls with no treatment effect (obesity prevention minus alternative intervention) at 2 years (mean, 0.09; 95% confidence interval [CI], -0.40 to 0.58). Two-year treatment effects in the expected direction were observed for servings per day of sweetened beverages (mean, -0.19; 95% CI, -0.39 to 0.09), water (mean, 0.21; 95% CI, 0.03 to 0.40), and vegetables (mean, 0.15; 95% CI,-0.02 to 0.30), but there were no effects on physical activity. Post hoc analyses suggested a treatment effect in younger girls (P for interaction=.08). The mean BMI difference at 2 years was -2.41 (95% CI, -4.83 to 0.02) in girls initially aged 8 years and -1.02 (95% CI, -2.31 to 0.27) in those initially aged 10 years. Conclusions: The lack of significant BMI change at 2 years indicates that this intervention alone is insufficient for obesity prevention. Effectiveness may require more explicit behavior change goals and a stronger physical activity component as well as supportive changes in environmental contexts. Trial Registration: Clinicaltrials.gov Identifier: NCT00000615

Objective: To develop items to measure indoor tanning and sunless tanning that can be used to monitor trends in population surveys or to assess changes in behavior in intervention studies. Design: A group of experts on indoor tanning convened in December 2005, as part of a national workshop to review the state of the evidence, define measurement issues, and develop items for ever tanned indoors, lifetime frequency, and past-year frequency for both indoor tanning and sunless tanning. Each item was subsequently assessed via in-person interviews for clarity, specificity, recall, and appropriateness of wording. Setting: Universities in Tennessee and Virginia, a medical center in Massachusetts, and a high school in New Hampshire. Participants: The study population comprised 24 adults and 7 adolescents. Results: Participants understood indoor tanning to represent tanning from beds, booths, and lamps that emit artificial UV radiation, rather than sunless tanning, even though both can be obtained from a booth. Two items were required to distinguish manually applied from booth-applied sunless tanning products. Frequency of use was easier for participants to recall in the past year than for a lifetime. Conclusions: While indoor tanning items may be recommended with confidence for clarity, sunless tanning items require additional testing. Memory aids may be necessary to facilitate recall of lifetime use of nonsolar tanning. In addition, studies that assess reliability and validity of these measures are needed. Since study participants were primarily young and female, testing in other populations should also be considered.

Objective: To identify indoor tanning patterns with relevance for health screening and prevention efforts. Design: We collected data on indoor tanning patterns from January 17, 2006, through April 14, 2006. By cluster analysis, 4 patterns of indoor tanning were identified: special event, spontaneous or mood, mixed, and regular year-round tanning. These 4 types of indoor tanning were compared by demographic, behavioral, and psychosocial variables for clinically significant differences. Setting: Midsized (ie, approximately 12 000 students) southeastern university. Participants: A total of 168 women who tanned indoors. Main Outcome Measures: Self-reported attitudes, intentions and tanning behaviors, and tanning dependence. Results: Event tanners tanned the least, started tanning the latest, and scored lowest on measures of attitudes, social norms, and tanning dependence measures. Regular year-round tanners started the earliest, tanned at the highest levels, and scored the highest on the attitude, social norms, and tanning dependence measures. Spontaneous or mood tanners were similar to event tanners but with a mood component to their tanning. Mixed tanners, as the name implies, exhibited behavior that appeared to be a mixture of the regular and event tanning types. Conclusions: The results of this study emphasize the fact that "one size fits all" does not apply when it comes to indoor tanning. Tanning behavioral types, which can be clinically assessed, can serve as a guide to physicians so that they can tailor their skin cancer prevention messages to be more effective.

College provides a context for experimentation with alcohol and drugs, the consequences of which range from mild to severe. One purpose of this study involved testing the usefulness of the Shortened Inventory of Problems - Alcohol and Drugs (SIP-AD) to assess negative consequences associated with substance use. A random sample of students (n = 421) was drawn from a medium-sized, public university. Subjects reported patterns of use for alcohol, marijuana, and cocaine over both the last 30 days and the past year. Reliability and factor analyses illustrated the internal consistency and validity of the SIP-AD. Multiple linear regression was also used to show how demographic characteristics and substance use behaviors can predict problems associated with using alcohol and/or drugs.

Objective: To identify familial characteristics that may have influenced the effectiveness of a parent-based intervention to reduce unsafe sun practices in children aged 9 to 12 years (fourth through sixth grades). Design: Randomized control design with a 30-day follow-up. Setting: Participants were recruited from 2 distinct regions in the United States: southern Idaho and eastern Tennessee. Participants: Three hundred forty children were assigned to the experimental group in which the parents received the intervention materials. One hundred twenty-nine respondents were assigned to the control group. Intervention: The intervention provided materials that encouraged parents to communicate skin cancer risks, promote sun-safe behaviors, and discourage high-risk sun-related behaviors. Main Outcome Measures: Outcome measures included sunburn frequencies, sunburn severity, and sunbathing tendencies. The moderator variables were positive characteristics of the parent-child relationship, levels of negative communication, parental monitoring, and child compliance. Results: Sunburn frequency, sunburn severity, and sunbathing tendencies were most effectively reduced when the quality of the parent-child relationship was high, the child exhibited high levels of compliance, and there were low levels of negative communication. Conclusion: The findings of this study provide evidence that parents can be viable change agents for child behaviors and that the quality of the family relationship is critical to the success of such interventions.

No description available.

No description available.