Accidental sharp force injury fatalities.

The authors review all accidental sharp force injury deaths investigated at the Southwestern Institute of Forensic Sciences from 1990 to 1999. Twenty-two cases of accidental sharp force injury were identified, accounting for 0.29% of all accidental deaths (9,562) during the 10-year study period. Included in this series are 5 incised wounds, 11 stab wounds, 4 chop wounds, and 2 deaths caused by dog attacks. About half of the cases involved some type of motorized machinery. The victims' ages ranged from 2 years to 71 years, with most deaths occurring in older teenagers and younger adults. Male subjects (17) were involved much more frequently than female subjects (5). In 50% of the cases, ethanol or other drug use was a possible underlying contributing factor in the accident. The cases are briefly reviewed, and the importance of detailed investigation in manner-of-death certification is emphasized.

Older boyfriends and girlfriends increase risk of sexual initiation in young adolescents.

PURPOSE: To explore the prevalence and impact of older boyfriends or girlfriends on sexual behavior in sixth graders (mean age 11.5 years). METHODS: Students in 19 ethnically diverse middle schools in an urban area were surveyed (n = 2829, response rate 68%). Instrument measured demographics, age of oldest boyfriend or girlfriend, unwanted sexual advances, peer norms, and sexual behavior. Students with older, same-age, or no boyfriend or girlfriend were compared on demographic and psychosocial variables using analysis of variance. Separate multivariate logistic regressions for both boys and girls were used to predict sexual behavior from demographics, psychosocial variables, and age categories of boyfriend or girlfriend. RESULTS: One-half of the respondents (56%) had never had a serious boyfriend or girlfriend, 35% reported that their oldest boyfriend or girlfriend was <2 years older than they, and 8.5% reported a partner > or =2 years older. Those reporting an older boyfriend or girlfriend were more likely to be Hispanic, were less acculturated, reported more unwanted sexual advances and more friends who were sexually active, and, among girls, were more likely to have experienced menarche. Overall, 4% of students reported ever having had sex. Students with an older boyfriend or girlfriend were over 30 times more likely than those with no boyfriend or girlfriend ever to have had sex (odds ratio = 33.8 for boys and 44.2 for girls). In the multivariate logistic regressions, peer norms about sexual behavior, having experienced unwanted sexual advances, and having a boyfriend or girlfriend were strongly associated with having had sex. CONCLUSIONS: Having an older boyfriend or girlfriend, although rare, is associated with early sexual onset and unwanted sexual activity in this population of sixth graders.

Condom availability programs in U.S. schools.

School condom availability programs have been promoted as a promising approach for increasing condom use among students, for reducing the risk of infections with the human immunodeficiency virus and with other sexually transmitted diseases and for preventing unintended pregnancy. Data from a telephone survey of key individuals at school condom programs across the United States suggest that as of January 1995, at least 431 public schools in 50 U.S. school district made condoms available-2.2% of all public high schools and 0.3% of high school districts. In about half of the schools that were surveyed, students obtained more than one condom per student per year, on average, and in 14% students obtained more than six. Students in alternative schools, in smaller schools, in schools that made condoms available in baskets and in schools with health clinics obtained more condoms per student per year than did students in other schools.

PIP: Despite emerging consensus that school-based programs have the potential to create an environment that promotes and facilitates adolescent condom use, the availability of such programs has not been documented. Thus, four data sources were utilized in an effort to identify all school-based condom distribution programs in the US: state departments of education, lists from institutions knowledgeable about such programs, networking with professionals in the field, and interviews with staff members at known programs. This process resulted in the identification of 431 schools (92% high schools) in 50 school districts in 21 states with condom availability programs as of January 1995. This represents only 2.2% of all US high schools and 0.3% of high school districts. 24% of these schools had school health centers as well. 81% of programs were implemented in 1991-92 in Los Angeles and New York City as a result of mandates aimed at reducing human immunodeficiency virus transmission among young people. In most schools, the condom distribution program was part of a more comprehensive program aimed at preventing unprotected intercourse and its consequences. Parental consent and counseling are common requirements for condom acquisition. Also common are restrictions on the hours condoms are distributed and the number that can be taken at one time. The median number of condoms obtained per school year was 1.1 per student. Three program variables were highly related to this number: making condoms available in bowls or baskets (4.8 more condoms per student compared to schools lacking this anonymous distribution technique), the presence of a school health clinic (1.5 more condoms per student), and condom vending machines (3.1 fewer condoms per student). Condom acquisition was also greater in smaller schools and alternative schools.