M D Overpeck

Walter Reed Army Institute of Research, Silver Spring, Maryland, United States

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Publications (74)462.8 Total impact

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    ABSTRACT: The objective of this study is to determine prevention strategies for potentially serious injury events among children younger than 3 years of age based upon circumstances surrounding injury events. Surveillance was conducted on all injuries to District of Columbia (DC) residents less than 3 years old that resulted in an Emergency Department (ED) visit, hospitalization, or death for 1 year. Data were collected through abstraction of medical records and interviews with a subset of parents of injured children. Investigators coded injury-related events for the potential for death or disability. Potential prevention strategies were then determined for all injury events that had at least a moderate potential for death or disability and sufficient detail for coding (n = 425). Injury-related events included 10 deaths, 163 hospitalizations, and 2,868 ED visits (3,041 events in total). Of the hospitalizations, 88% were coded as moderate or high potential for disability or death, versus only 21% of the coded ED visits. For potentially serious events, environmental change strategies were identified for 47%, behavior change strategies for 77%, and policy change strategies for 24%. For 46% of the events more than one type of prevention strategy was identified. Only 8% had no identifiable prevention strategy. Prevention strategies varied by specific cause of injury. Potential prevention strategies were identifiable for nearly all potentially serious injury events, with multiple potential prevention strategies identified for a large fraction of the events. These findings support developing multifaceted prevention approaches informed by community-based injury surveillance.
    Maternal and Child Health Journal 09/2011; 15 Suppl 1:S35-41. · 2.24 Impact Factor
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    ABSTRACT: To identify trends over 12 years in the prevalence of bullying and associated victimization among adolescents in North American and European countries. Cross-sectional self-report surveys were obtained from nationally representative samples of 11-15 year old school children in 21 countries in 1993/94 and in 27 countries in each of 1997/98, 2001/02 and 2005/06. Measures included involvement in bullying as either a perpetrator and/or victim. Consistent decreases in the prevalence of bullying were reported between 1993/94 to 2005/06 in most countries. Geographic patterns show consistent decreases in bullying in Western European countries and in most Eastern European countries. An increase or no change in prevalence was evident in almost all English speaking countries participating in the study (England, Scotland, Wales, Ireland and Canada, but not in the USA). Study findings demonstrated a significant decrease in involvement in bullying behaviour in most participating countries. This is encouraging news for policy-makers and practitioners working in the field of bullying prevention.
    International Journal of Public Health 08/2009; 54 Suppl 2:225-34. · 1.99 Impact Factor
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    ABSTRACT: (1) To compare the prevalence of bullying and victimization among boys and girls and by age in 40 countries. (2) In 6 countries, to compare rates of direct physical, direct verbal, and indirect bullying by gender, age, and country. Cross-sectional self-report surveys including items on bullying and being bullied were obtained from nationally representative samples of 11, 13 and 15 year old school children in 40 countries, N = 202,056. Six countries (N = 29,127 students) included questions about specific types of bullying (e. g., direct physical, direct verbal, indirect). Exposure to bullying varied across countries, with estimates ranging from 8.6% to 45.2% among boys, and from 4.8% to 35.8% among girls. Adolescents in Baltic countries reported higher rates of bullying and victimization, whereas northern European countries reported the lowest prevalence. Boys reported higher rates of bullying in all countries. Rates of victimization were higher for girls in 29 of 40 countries. Rates of victimization decreased by age in 30 of 40 (boys) and 25 of 39 (girls) countries. There are lessons to be learned from the current research conducted in countries where the prevalence is low that could be adapted for use in countries with higher prevalence.
    International Journal of Public Health 08/2009; 54 Suppl 2:216-24. · 1.99 Impact Factor
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    ABSTRACT: The present study investigated the relationship between adolescents' perception of a lack of classmate support and their individual and their respective culture's daily amounts of television viewing and computer use. We tested multilevel regression models based on data from the responses of 150,552 adolescents aged 11, 13, and 15 years from 34 cultures who participated in the 2001-2002 Health Behavior in School-Aged Children (HBSC) survey. Results revealed that the average amount of television viewing in the respective adolescents' culture explained variation in their perception of a lack of classmate support in addition to their own amount of television viewing. No effect for computer use was found. It appears that, in countries in which a great deal of television is consumed, everyone is affected and not only those who watch a high amount of television. This adds to concerns about television viewing as a significant risk to the health of adolescents. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
    Swiss Journal of Psychology 05/2008; 67(2):97-106. · 0.57 Impact Factor
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    ABSTRACT: The primary objective was to present a cross-country comparison of injury rates, contexts and consequences. The research design was the analysis of data from the 1998 cross-national Health Behaviour in School-aged Children survey and 52955 schoolchildren from 11 countries, aged 11, 13 and 15 years, completed a self-administrated questionnaire. A total of 41.3% of all children were injured and needed medical treatment in the past 12 months. Injury rates among boys were higher than among girls, 13.3% reported activity loss due to injury and 6.9% reported severe injury consequences. Most injuries occurred at home and at a sport facility, mainly during sport activity. Fighting accounted for 4.1% of injuries. This paper presents the first cross-national comparison of injury rates and patterns by external cause and context. Findings present cross-country similarities in injury distribution by setting and activity. These findings emphasize the importance of the development of global prevention programmes designed to address injuries among youth.
    International Journal of Injury Control and Safety Promotion 01/2007; 13(4):205-11. · 0.67 Impact Factor
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    ABSTRACT: Based on theories suggesting that frequent television viewers act and react in hostile, malicious, malevolent, or verbally aggressive ways rather than being physically violent, the present study investigates relationships between television viewing and different forms of bullying. Multilevel regression models were estimated based on cross-sectional data from 31,177 adolescents aged 11, 13, and 15 years from Canada, Estonia, Israel, Latvia, Macedonia, Poland, Portugal, and the United States who participated in the 2001-2002 Health Behavior in School-aged Children Survey. Although all different forms of bullying were associated with television viewing in bivariate analyses, only the verbal forms (i.e. "calling mean names" and "spreading rumors") remained significant in multiple regression models. These relationships were observed consistently in all eight participating countries. However, the association between television viewing and physical forms of bullying such as kicking, pushing, or shoving around, varied across countries. In most weekend TV viewing cultures, frequent television viewers were prone to kick or push another student in addition to verbal forms of bullying, which was not the case in weekday viewing cultures. These results demonstrate the importance of limiting adolescents' time engaged in unsupervised television watching, and the need to motivate adolescents to engage in joint family activities or organized after-school activities.
    Journal of Adolescent Health 01/2007; 39(6):908-15. · 2.97 Impact Factor
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    ABSTRACT: School connectedness includes liking school and positive relations with teachers and peers. School connectedness is associated with a variety of positive health outcomes. The goal of this study was to identify characteristics of students, schools, and school neighborhoods that are related to school connectedness. In the Health Behavior in School-Aged Children (HBSC) Study, school connectedness was reported by 13,207 students (grades 6-10) in 340 schools. HBSC measured a variety of student characteristics. Characteristics of schools were culled from data maintained by Quality Education Data, and school neighborhood characteristics were derived from the 2000 decennial census. Associations between connectedness and student, school, and school neighborhood characteristics were estimated using hierarchical linear models. Characteristics of students, schools, and school neighborhoods were associated with school connectedness. Connectedness was greater among younger students, females, students with better academic performance and greater extracurricular involvement, students with greater self-rated physical attractiveness, students with more friends, students from 2-parent families, and students whose parents were more involved with school. Connectedness was greater in smaller schools, more racially homogeneous schools, and schools with more students from relatively wealthy households. School connectedness was higher in neighborhoods with a greater percentage of non-US citizens. As the percent of renters in the neighborhood increased beyond 20%, school connectedness tended to decrease. The findings point to possible strategies for fostering school connectedness.
    Journal of School Health 10/2006; 76(7):379-86. · 1.50 Impact Factor
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    ABSTRACT: The objective of this study was to examine the association between caffeine usage in U.S. adolescents and the frequency that feeling tired in the morning and having difficulty sleeping is reported. In this study we found that feeling tired in the morning and having difficulty sleeping was experienced more commonly in those adolescents that have a high intake of caffeine.
    Journal of Adolescent Health 05/2006; 38(4):451-3. · 2.97 Impact Factor
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    ABSTRACT: The cross-national consistency and variation of gender differences in subjective health complaints was examined in a sample of 125732 11- to 15-year-olds from 29 European and North American countries, participating in the WHO collaborative study 'Health behaviour in school-aged children (HBSC) 1997/98'. Health complaints were measured with the Health Behaviour in School-aged Children Symptom Checklist. Gender differences in health complaints were analysed through multilevel logistic regression analysis. The results indicated a very robust pattern of increasing gender differences across age, with 15-year-old girls as a group at increased risk for health complaints across all countries. The magnitude of gender differences varied across countries, with some countries showing a consistently strong gender difference across age group and different health complaints, and other countries showing a consistently weak gender difference. The gender difference in health complaints was stronger in countries with a low gender development index score. The findings underscore the need to incorporate socio-contextual factors in the study of gender health inequalities during adolescence.
    Social Science [?] Medicine 03/2006; 62(4):815-27. · 2.73 Impact Factor
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    ABSTRACT: We sought to (1) compare estimates of the prevalence of fighting and weapon carrying among adolescent boys and girls in North American and European countries and (2) assess in adolescents from a subgroup of these countries comparative rates of weapon carrying and characteristics of fighting and injury outcomes, with a determination of the association between these indicators of violence and the occurrence of medically treated injury. Cross-sectional self-report surveys using 120 questions were obtained from nationally representative samples of 161082 students in 35 countries. In addition, optional factors were assessed within individual countries: characteristics of fighting (9 countries); characteristics of weapon carrying (7 countries); and medically treated injury (8 countries). Participants included all consenting students in sampled classrooms (average age: 11-15 years). The primary measures assessed included involvement in physical fights and the types of people involved; frequency and types of weapon carrying; and frequency and types of medically treated injury. Involvement in fighting varied across countries, ranging from 37% to 69% of the boys and 13% to 32% of the girls. Adolescents most often reported fighting with friends or relatives. Among adolescents reporting fights, fighting with total strangers varied from 16% to 53% of the boys and 5% to 16% of the girls. Involvement in weapon carrying ranged from 10% to 21% of the boys and 2% to 5% of the girls. Among youth reporting weapon carrying, those carrying handguns or other firearms ranged from 7% to 22% of the boys and 3% to 11% of the girls. In nearly all reporting countries, both physical fighting and weapon carrying were significantly associated with elevated risks for medically treated, multiple, and hospitalized injury events. Fighting and weapon carrying are 2 common indicators of physical violence that are experienced by young people. Associations of fighting and weapon carrying with injury-related health outcomes are remarkably similar across countries. Violence is an important issue affecting the health of adolescents internationally.
    PEDIATRICS 01/2006; 116(6):e855-63. · 4.47 Impact Factor
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    ABSTRACT: Low adult supervision during the after-school hours has been associated with numerous problem behaviors among youth. We examined the extent to which this relationship pertains to the evening hours and aggressive behaviors. Cross-sectional self-report data were obtained from a nationally representative sample of 14,818 youth in grades 6-10 in the 2001-2002 Health Behaviors of School-aged Children Survey. The relationship between spending evenings out with friends and involvement in problem behaviors was examined using logistic regression analyses. One-fifth of U.S. youth surveyed reportedly spent five or more evenings out with friends each week. After adjusting for grade, race/ethnicity, parental education, parental involvement, and perception of neighborhood safety, boys and girls who reported spending five or more evenings out were 4.3 and 3.1 times, respectively, than boys and girls who spent less than two evenings out, more likely to be involved in four or more physical fights in the past year; 3.0 and 4.0 times, respectively, more likely to have bullied another at least once a week at school; 2.7 and 4.9 times, respectively, more likely to have carried a weapon 6 or more days in the past month; 3.8 and 4.8 times, respectively, more likely to consume alcohol at least once a month; and 3.3 and 7.2 times, respectively, more likely to have smoked every day. Although the majority of youth who spend most evenings out do not frequently participate in problem behaviors (69.7%), their consistently increased risk for substance use and aggressive behaviors warrants attention. Further examination of specific evening activities, extracurricular involvement, neighborhood context, adult supervision, and parental monitoring is required.
    Journal of Adolescent Health 01/2006; 37(6):517. · 2.97 Impact Factor
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    ABSTRACT: To determine factors associated with variation in bicycle helmet use by youth of different industrialized countries. A multinational cross sectional nationally representative survey of health behaviors including symptoms, risk taking, school setting, and family context. School based survey of 26 countries. School students, ages 11, 13, and 15 years totaling 112,843. Reported frequency of bicycle helmet use among bicycle riders. Reported helmet use varied greatly by country from 39.2% to 1.9%, with 12 countries reporting less than 10% of the bicycle riders as frequent helmet users and 14 countries more than 10%. Reported helmet use was highest at 11 years and decreased as children's age increased. Use was positively associated with other healthy behaviors, with parental involvement, and with per capita gross domestic product of the country. It is negatively associated with risk taking behaviors. Countries reported to have interventions promoting helmet use, exemplified by helmet giveaway programmes, had greater frequency of reported helmet use than those without programmes. Bicycle helmet use among young adolescents varies greatly between countries; however, helmet use does not reach 50% in any country. Age is the most significant individual factor associated with helmet for helmet using countries. The observation that some helmet promotion programmes are reported for countries with relatively higher student helmet use and no programmes reported for the lowest helmet use countries, suggests the possibility of a relation and the need for objective evaluation of programme effectiveness.
    Injury Prevention 11/2005; 11(5):288-93. · 1.76 Impact Factor
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    ABSTRACT: To determine whether the relationship between bullying and psychosocial adjustment is consistent across countries by standard measures and methods. Cross-sectional self-report surveys were obtained from nationally representative samples of students in 25 countries. Involvement in bullying, as bully, victim, or both bully and victim, was assessed. Surveys were conducted at public and private schools throughout the participating countries. Participants included all consenting students in sampled classrooms, for a total of 113 200 students at average ages of 11.5, 13.5, and 15.5 years. Psychosocial adjustment dimensions assessed included health problems, emotional adjustment, school adjustment, relationships with classmates, alcohol use, and weapon carrying. Involvement in bullying varied dramatically across countries, ranging from 9% to 54% of youth. However, across all countries, involvement in bullying was associated with poorer psychosocial adjustment (P<.05). In all or nearly all countries, bullies, victims, and bully-victims reported greater health problems and poorer emotional and social adjustment. Victims and bully-victims consistently reported poorer relationships with classmates, whereas bullies and bully-victims reported greater alcohol use and weapon carrying. The association of bullying with poorer psychosocial adjustment is remarkably similar across countries. Bullying is a critical issue for the health of youth internationally.
    Archives of Pediatrics and Adolescent Medicine 09/2004; 158(8):730-6. · 4.28 Impact Factor
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    ABSTRACT: To determine the prevalence, risk factors, and risk behaviors associated with depressive symptoms in a nationally representative, cross-sectional sample of young adolescents. A school-based survey collected through self-administered questionnaires in grades 6, 8, and 10 in 1996. Schools in the United States. 9863 students in grades 6, 8, and 10 (average ages, 11, 13, and 15). Depressive symptoms, substance use, somatic symptoms, scholastic behaviors, and involvement in bullying. Eighteen percent of youths reported symptoms of depression. A higher proportion of females (25%) reported depressive symptoms than males (10%). Prevalence of depressive symptoms increased by age for both males and females. Among American Indian youths, 29% reported depressive symptoms, as compared with 22% of Hispanic, 18% of white, 17% of Asian American, and 15% of African American youths. Youths who were frequently involved in bullying, either as perpetrators or as victims, were more than twice as likely to report depressive symptoms than those who were not involved in bullying. A significantly higher percentage of youths who reported using substances reported depressive symptoms as compared with other youths. Similarly, youths who reported experiencing somatic symptoms also reported significantly higher proportions of depressive symptoms than other youths. Depression is a substantial and largely unrecognized problem among young adolescents that warrants an increased need and opportunity for identification and intervention at the middle school level. Understanding differences in prevalence between males and females and among racial/ethnic groups may be important to the recognition and treatment of depression among youths.
    Archives of Pediatrics and Adolescent Medicine 09/2004; 158(8):760-5. · 4.28 Impact Factor
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    ABSTRACT: Data on the prevalence and co-occurrence of multiple somatic symptoms among US adolescent females as they are influenced by sociodemographic, behavioral, and environmental factors is limited. To describe the health status of adolescent US females measured by the prevalence, frequency, and co-occurrence of headache, stomachache, backache, and morning fatigue and to investigate associations between selected risk and protective factors. School-based, cross-sectional, nationally representative survey of adolescents in the 6th through 10th grades in the US. Data collected between 1997 and 1998. Prevalence of headache, stomachache, backache, and morning fatigue. Among US adolescent girls, 29.1% experience headaches, 20.7% report stomachaches, 23.6% experience back pain, and 30.6% report morning fatigue at the rate of more than once a week. Co-occurrence of somatic complaints is common. Among girls who experienced headaches more than once a week, 3.2 million (53.3%) also reported stomach pain more than once a week and 4.1 million (74.3%) reported morning fatigue more than once a week. Heavy alcohol use, high caffeine intake, and smoking cigarettes every day were strongly associated with all symptoms, while parent and teacher support served as protective factors. Somatic complaints of headache, stomachache, backache, and morning fatigue are common among US adolescent girls and co-occur often. Effective clinical treatment of this population requires comprehensive assessment of all female adolescents presenting with seemingly isolated somatic complaints.
    Archives of Pediatrics and Adolescent Medicine 09/2004; 158(8):797-803. · 4.28 Impact Factor
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    ABSTRACT: This cross-sectional study examined the combined and interactive effects of material deprivation and area deprivation on adolescent self-rated health, using data from the World Health Organization collaborative study 'Health Behaviour in School-aged Children 1997/1998'. Included in the present study were 94,915 11-15-year-old students from a total of 22 European and North American countries. Multilevel logistic regression analyses revealed significant additive main effects of individual material deprivation and area deprivation, but not interactive effects. The most deprived students had an odds ratio for self-rated poor health almost three times higher than the least deprived students. Area deprivation effects were stronger at the country level than at the school level, and stronger among 11-year-olds than among 13- and 15-year-olds. A combined 'individual and area deprivation' model predicted that the most disadvantaged 11-year-old students were eight times more likely to have poor self-rated health compared to the least disadvantaged student (OR (95% CI) = 7.96 (3.38, 18.75)). The findings highlight the multilevel effects of deprivation at the individual, local, and national level.
    Social Science [?] Medicine 08/2004; 59(1):1-12. · 2.73 Impact Factor
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    ABSTRACT: Violent behavior among adolescents is a significant problem worldwide, and a cross-national comparison of adolescent violent behaviors can provide information about the development and pattern of physical violence in young adolescents. To determine and compare frequencies of adolescent violence-related behaviors in 5 countries and to examine associations between violence-related behaviors and potential explanatory characteristics.Design, Setting, and Cross-sectional, school-based nationally representative survey at ages 11.5, 13.5, and 15.5 years in 5 countries (Ireland, Israel, Portugal, Sweden, and the United States). Frequency of physical fighting, bullying, weapon carrying, and fighting injuries in relation to other risk behaviors and characteristics in home and school settings. Fighting frequency among US youth was similar to that of all 5 countries (nonfighters: US, 60.2%; mean frequency of 5 countries, 60.2%), as were the frequencies of weapon carrying (noncarriers: US, 89.6%; mean frequency of 5 countries, 89.6%) and fighting injury (noninjured: US, 84.5%; mean frequency of 5 countries, 84.6%). Bullying frequency varied widely cross-nationally (nonbullies: from 57.0% for Israel to 85.2% for Sweden). Fighting was most highly associated with smoking, drinking, feeling irritable or bad tempered, and having been bullied. Adolescents in 5 countries behaved similarly in their expression of violence-related behaviors. Occasional fighting and bullying were common, whereas frequent fighting, frequent bullying, any weapon carrying, or any fighting injury were infrequent behaviors. These findings were consistent across countries, with little cross-national variation except for bullying rates. Traditional risk-taking behaviors (smoking and drinking) and being bullied were highly associated with the expression of violence-related behavior.
    Archives of Pediatrics and Adolescent Medicine 07/2004; 158(6):539-44. · 4.28 Impact Factor
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    ABSTRACT: To compare the body mass index (BMI) (calculated as weight in kilograms divided by the square of height in meters) and the prevalence of BMI at or above the 85th centile and 95th centile (overweight) in adolescents. Cross-sectional, nationally representative school-based surveys in 1997-1998 by means of identical data collection methods. Austria, Czech Republic, Denmark, Flemish Belgium, Finland, France, Germany, Greece, Lithuania, Ireland, Israel, Portugal, Slovakia, Sweden, and the United States. A total of 29 242 boys and girls, aged 13 and 15 years. The BMI, BMI at or above the 85th centile, and BMI at or above the 95th centile (overweight) from self-reported height and weight. The highest prevalence of overweight was found in the United States and the lowest in Lithuania. On the basis of the study reference standard, the prevalence of overweight (percentage) in the United States was 12.6% in 13-year-old boys, 10.8% in 13-year-old girls, 13.9% in 15-year-old boys, and 15.1% in 15-year-old girls, all significantly increased. Prevalence of overweight in Lithuania was significantly below the expected 5%, with 1.8% in 13-year-old boys, 2.6% in 13-year-old girls, 0.8% in 15-year-old boys, and 2.1% in 15-year-old girls. Relative rankings among countries were similar for BMI at or above the 85th centile, although there were less dramatic differences at this level. The highest prevalences of overweight were found in the United States, Ireland, Greece, and Portugal.
    Archives of Pediatrics and Adolescent Medicine 02/2004; 158(1):27-33. · 4.28 Impact Factor
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    ABSTRACT: To examine the association of acculturation, as measured by language spoken at home, with the health, psychosocial, school, and parental risk factors of adolescents of various racial/ethnic groups. Using the U.S. component of the 1997-98 World Health Organization Study of Health Behavior in School Children, bivariate and multiple logistic regression analyses were conducted of records for adolescents in four racial/ethnic groups to explore the relationship between the language spoken at home and outcome variables regarding health status and risks, psychosocial and school risk factors, and parental factors. Data were analyzed using Software for the Statistical Analysis of Correlated Data (SUDAAN). Adolescents of all racial and ethnic groups who primarily speak a language other than English at home are at elevated risk for psychosocial risk factors such as alienation from classmates and being bullied, and parental risk factors such as feeling that their parents are not able or willing to help them. Those who speak a combination of languages are also at risk for being bullied and for high parental expectations. Language spoken at home is generally not associated with health and safety measures for adolescents across racial/ethnic groups. Adolescents whose primary language at home is not English experience higher psychosocial, school, and parental risks than non-Hispanic white English-speakers. New immigrant youths of all races and ethnic groups would potentially benefit from preventive and risk-reduction services.
    Journal of Adolescent Health 01/2004; 33(6):479-88. · 2.97 Impact Factor
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    Tonja R Nansel, Mary D Overpeck
    JAMA Pediatrics 11/2003; 157(11):1135. · 4.28 Impact Factor

Publication Stats

4k Citations
462.80 Total Impact Points

Institutions

  • 2011
    • Walter Reed Army Institute of Research
      • Center for Military Psychiatry and Neuroscience Research
      Silver Spring, Maryland, United States
  • 2007–2009
    • National University of Ireland, Galway
      • • School of Health Sciences
      • • Department of Health Promotion
      Galway, C, Ireland
  • 2006
    • University of Bergen
      Bergen, Hordaland, Norway
    • Johns Hopkins Bloomberg School of Public Health
      Baltimore, Maryland, United States
  • 1998–2003
    • National Institutes of Health
      • Division of Epidemiology, Statistics and Prevention Research (DESPR)
      Bethesda, MD, United States
  • 1992–2002
    • National Institute of Child Health and Human Development
      Maryland, United States
  • 2000–2001
    • Centers for Disease Control and Prevention
      • • National Center for Health Statistics
      • • Division of Reproductive Health
      Druid Hills, GA, United States
  • 1999
    • Bar Ilan University
      Gan, Tel Aviv, Israel