Do reminder signs promote use of safety belts?

STUDY OBJECTIVE: To determine whether reminder signs placed at the exits to parking decks increase the rate of safety belt use. METHODS: The subjects in this study were drivers of automobiles with permits to park in campus decks at a major university. Volunteer observers were positioned near the exits of 5 parking decks around the campus. Rates of safety belt use were noted before and at 2 intervals after reminder signs were installed. RESULTS: A total of 6, 780 observations were collected. The baseline rate of safety belt use was 83%. Female drivers were significantly more likely to wear a safety belt than male drivers (85.3% versus 79.6%, P <.001). Safety belt use did not increase after the signs were installed (83.3% before versus 83.5% after, P =.86). CONCLUSION: Placing reminder signs at the exits to parking decks did not boost the rate of safety belt use at our institution. Other strategies are needed to achieve the National Highway Traffic Safety Administration's goal of increasing the overall rate of safety belt usage to 90% by the year 2005.

Bilateral vocal cord paralysis after meningitis due to Streptococcus pneumoniae.

We report the clinical course of a 15-month-old boy who had fever, decreased activity, and weakness, with severe respiratory distress during transport to the hospital. Laboratory evaluation confirmed the diagnosis of meningitis due to Streptococcus pneumoniae. He was intubated on arrival and required 4 days of ventilatory support. Soon after extubation, he had marked stridor and dyspnea that were unresponsive to standard therapy with nebulized racemic epinephrine and intravenous dexamethasone. Magnetic resonance imaging of the brain revealed nonspecific findings, and airway endoscopy showed bilateral vocal cord paralysis. Repeated endoscopy showed no improvement in vocal cord function and a deficient swallowing mechanism. Tracheostomy was done to facilitate airway management before discharge from the pediatric intensive care unit. We propose that the diagnosis of vocal cord paralysis must be considered in patients with meningitis and respiratory compromise.

Measurement of self-esteem in repeat assault victims.

Background characterization of assault-related injuries have demonstrated that lifestyle, substance abuse, education, employment, mental illness, and high-risk behavior contribute to low self-esteem in repeat assault victims. Recurrent-assault patients have never been studied with respect to self-esteem. This study evaluated self-esteem and assault-related injury in 28 consecutive male assault patients (11 first-assault and 17 recurrent-assault patients) and 19 controls with no previous assault history. Study participants were administered the Walmyr Assessment Scales Index of Self-Esteem (WASISE) as part of a three-item survey to determine the relationship between self-esteem and assault-related injury. No demographic differences were found between the groups. The mean (+/- standard error) WASISE score for recurrent-assault patients (34.9 +/- 3.4) was significantly higher than mean scores for no-assault and first-time assault-injured patients (14.7 +/- 1.4 and 15.0 +/- 2.3, respectively). The recurrent-assault patients had a lower mean education level than both no-assault and first-time assault-injured patients (2.1 +/- 0.26 and 1.9 +/- 0.57, respectively). Eighteen (2%) first-time assault-injured and 11 (7%) recurrent-assault patients were employed. These data suggest that self-esteem, education, and employment history need to be considered when evaluating and developing interventions for repeat-assault patients.