Completed Projects
- Survey of Injury Prevention Activities in PA ED: Successes, Barriers and Opportunities
- Infant Head Injury Risk in Falls Using Experimental and Computational Models
- Pilot Project
- A Population-Based Comparison of Assault Injury Patterns Among Hospitalized Pregnant Women Compared to all Women of Reproductive Age
Survey of Injury Prevention Activities in PA ED: Successes, Barriers and Opportunities
Hank
Weiss, MPH, PhD - Principal Investigator
Director, Center for Injury Research and Control;
Associate Professor, Department
of Neurological Surgery, University of Pittsburgh
The purpose of this survey is to identify and describe the breadth and depth of injury prevention programs currently in use and to delineate important implementation barriers. For that reason, we are asking you to complete a brief (20 minute) online survey.
There are no foreseeable risks associated with this project. Your name and contact information is requested if we need to clarify or verify your responses. All responses are confidential and results will be kept under lock and key. Your participation is voluntary, and you don't have to answer these questions if you don't want to.
This study is being conducted by Dr. Harold Weiss at the University of Pittsburgh in cooperation with the Pennsylvania Chapter of the American College of Emergency Physicians; he can be reached at 412.648.2600 if you have any questions.
Also see attached: A Survey of Injury Prevention Activities in Pennsylvania Emergency Departments.
Infant Head Injury Risk in Falls Using Experimental and Computational Models
Gina Bertocci, PhD
- Principal Investigator
J.B. Speed School of Engineering
University of Louisville
Louisville KY 40292
Mary Clyde Pierce, MD - Co-Investigator
University of Louisville
The purpose of this project is to develop and validate computer simulation models to investigate head injury risk associated with common pediatric falls in one-year-old children. This will be accomplished by modeling common fall scenarios involving a one-year-old child using computer simulation techniques; conducting experiments to validate a computer simulation models using an anthropomorphic test dummy representing the one-year-old child; and conducting analyses to determine the influence of various fall environment factors and initial conditions on head injury risk.
Pilot Project
In addition to these projects, Ernest Deemer, MS, PE, was the principal investigator on a pilot study titled "Improving Biofidelity of the Hybrid III Three-Year-Old for Long-bone Fracture Prediction." The goal was to better understand the types of pediatric injuries associated with common household falls. These same falls are often falsely reported scenarios in child abuse. By using a biomechanical approach to investigate falls, we may provide the first step in aiding in the diagnosis of child abuse.
A Population-Based Comparison of Assault Injury Patterns Among Hospitalized Pregnant Women Compared to all Women of Reproductive Age
Injuries are a major cause of morbidity and mortality in women of reproductive age. Injuries to pregnant women increase the risk of fetal loss and pre-term labor. However, little population-based work has been conducted quantifying the incidence of hospitalized assaults among pregnant women and research has not confirmed whether pregnant women are at greater risk for serious violence. The study tests the hypothesis that the hospitalization rate for assault will be higher among pregnant women than all women of reproductive age. E-coded (cause of injury) hospital discharge data will be obtained from selected state hospital discharge databases. The combined data set will cover at least 20 percent of the U.S. population for 1997, representing ascertainment of hospitalized injury for over 15 million person-years of exposure, half-a-million pregnancies, and approximately 4,000 injuries. Data will be solicited from those states that have mandated E-coding for 2 years or more, an E-code completeness rate of 90% or better, expected charge information, and at least 5 diagnosis fields to search for pregnancy related ICD-9-CM codes. Using a modified ICD-9-CM code selection criteria, combined with injury identification through diagnosis and E-codes, all women ages 15-44 discharged with both a pregnancy and an injury related diagnosis will be identified for descriptive and comparative analyses using rate calculations based on estimated person years of exposure. This research will promote the use of a standard technique to measure the burden of the most severe non-fatal violence against pregnant women, on a state-by-state basis. These measures can be used for generating hypotheses, prioritizing control programs and targeting specific demographic and geographic populations for preventive efforts. It will also result in creation of a large population based sample of injuries and assaults against women useful for other summary reports and researchers.
Prevention Core
The goal of the Prevention Core is the development and implementation of research, education, and programming to address intentional and unintentional injuries.
The core is led by Dr. Harold Weiss, Ph.D.
- Pregnancy Exemption Survey of International Seat Belt Laws
- Feasibility of a study linking longitudinal survey data to trauma center data to study relationships between alcohol use and violence
- Analysis of the age, period and cohort effects on violence trends
Pregnancy Exemption Survey of International Seat Belt Laws
Hank Weiss, Principal Investigator
Background: It is recommended by medical and transportation safety authorities in many countries that pregnant women traveling in motor-vehicles should wear properly fitted seat belts for the well-being of both mother and fetus. While a better understanding of the nature of fetal risks from severe crashes among belted occupants and long term outcomes of fetal trauma exposure remains to be elucidated, it is clear that lack of restraint use results in increased risk of fetal death and adverse birth outcomes. Despite this knowledge, several, but an uncertain number of countries, continue to have dangerous and outdated seat belt use exemptions or medical exclusions for pregnant women.
Specific Aims: The aims of this project are to survey the specific number and characteristics of occupant exemptions to national seat belt laws in different countries around the globe, with a particular focus on pregnancy-related clauses. Another goal is to estimate the number of pregnancies potentially impacted by these exemptions.
Methods: The lack of a complete and accurate international census of national and local agencies responsible for developing and enforcing seat belt laws makes it very difficult to target agencies and individuals for a survey. This international investigation will rely on multiple means of identifying credible compilations of exemption regulations from national and international traffic-safety agencies and other governmental organizations, non-governmental organizations, search engine reports of the World-wide web, personal contacts, related internet list servers, and conference registration lists. Data will be collected through a web-based survey instrument supplemented by electronic mail and hard copy (postal) distribution of the 16 question two-page survey instrument. Results will be made available online, at international traffic safety and injury control meetings and in published reports.
Significance: The findings from this survey will be useful for bringing the issue of unwarranted and dangerous pregnancy-related seat belt exemptions to the international medical community and the traffic and safety agencies of the respective countries examined. By singling out those countries with such exemptions it is hoped that advocates, agencies and the legislative bodies of each country will be made aware of the need to remove these exemptions, thereby leading to safer mothers and healthier babies across the globe.
Feasibility of a study linking longitudinal survey data to trauma center data to study relationships between alcohol use and violence
Anthony Fabio, Principal Investigator
There is a large body of evidence linking alcohol use to violence; however, the exact connection has not been clarified beyond a simple relationship. Prior research has been based on population surveys, experimental laboratory studies on aggression, and studies of violent victimization in trauma centers. In surveys, the association between alcohol and violence found to date have been correlational in nature, the measure of alcohol intake is often subjective, and the measurements between violence and alcohol intake often span months rather than being proximal. Although cross-sectional surveys assess socially important, "real world" situations, they utilize limited data of prior history of alcohol use and aggression, and often do not adjust for important confounders, such as age and race. Experimental studies have assessed the proximal link between alcohol use and simulated aggression, but not in "real world" situations, and almost always lack data on individuals' history of alcohol use and aggression. Studies that have used data from trauma centers also lack adequate information on individual history. Also, laboratory studies and trauma center studies have failed to distinguish between victims of violence, perpetrators of violence and those who fall in both categories. The distinction is important - in violent encounters, chance often plays a role in determining who becomes a victim or perpetrator of violence.
In order to overcome past limitations, we are developing a study that combines the best elements of survey and trauma center studies. Currently we are developing the methods and collecting pilot data for the development of an NIAAA grant application. The application will propose to link longitudinal survey data to data from trauma centers on the same individuals treated for injury. Specifically, we will propose to link data from the Pittsburgh Youth Study (PYS) with data from trauma centers in and around Pittsburgh. The PYS contains 14 years of longitudinal information on the developmental pathways of delinquency. Trauma registry data contain information on the intentionality of injuries along with an objective measure of blood alcohol content (BAC) for a large majority of serious injuries in the city of Pittsburgh. This linkage has three major benefits: First, the survey data will provide information of detailed longitudinal data on the history of alcohol use and aggression, along with a significant number of other variables that can be used to control confounding. Second, trauma center data provides a proximal and objective measure of alcohol, as well as socially relevant circumstances. Third, better knowledge about the characteristics of individuals with a prior history of violent offending and/or violent victimization will help to design and improve screening measures that can be used in trauma centers to identify those who are at highest risk for revictimization in the future. We see this as a first step in improving prevention interventions based in trauma centers.
Analysis of the age, period and cohort effects on violence trends
Anthony Fabio, Principal Investigator
The Pittsburgh Youth Study is a longitudinal study of three cohorts of Pittsburgh children who have been followed from 1987 to 2001. The PYS database tracks increases and decreases in juvenile crime trends as well as risk factors, protective factors, and behavior. The youngest and oldest cohorts aged from 7 to 20 and from 13 to 25 respectively. These data provide a valuable opportunity to develop a predictive model for offending based on a large amount of individual data of separate cohorts collected over many years. We plan to use these data to develop a predictive model of juvenile offending (age 7-17 years) utilizing as predictors risk factors both publicly available at the county level and specific to the PYS. This approach allows us to test whether Pittsburgh juveniles' offending behavior is best explained by trends in the prevalence of risk factors (period effects), changes in children's behavioral responses to risk factors (cohort effects), or both. It will also allow us to test the utility of this model in predicting county level offending. This will provide important information to aid in public policy decisions on whether currently available data at the community level is sufficient to predict offending, or whether it will be necessary to collect new data. We will also be able to improve the power to predict turning points in juvenile offending by improving estimates of the lags between the emergence of risk factors and precursor behaviors on the one hand, and offending behavior on the other.