Completed CIRCL Research Projects

The purpose of the grant, "Why Some Generations Are More Violent Than Others": A Contextual Model for Understanding Crime Trends, was to study trends in youth violence and to determine the role of social influence on violence in adolescents over time.

Using data from the Pittsburgh Youth Study, a study of 1,517 inner-city boys from Pittsburgh, between the ages of 7 and 25 to better understand how and why boys get involved in delinquent behaviors. Dr. Fabio looked at two age groups from the study: those 7 years old at the beginning of the study in 1987, and those aged 13 years at the beginning of the study.

The older group reported higher rates of violence than the younger group throughout the study. The primary question that Dr. Fabio and his colleagues planned to answer was whether this difference is due to some inherent distinction between the groups, or to some special or cultural factor such as poor economy, increased gang participation or drug dealing that played a greater risk during the time that the older group was growing up. Understanding these differences may help to predict future increase in violence.

Fabio A, Loeber R, et al. (2006). "Why some generations are more violent than others: assessment of age, period, and cohort effects." Am J Epidemiol 164(2):151-60, 2006.

Managing Return-to-Play Decisions Following Mild Traumatic Brain Injury

Mark Stevenson, MD (Principal Investigator)
Director, Injury Prevention and Trauma Care Division
The George Institute for International Health
Affiliated with The University of Sydney, Australia

Michael Collins, PhD (Co-Investigator)
Assistant Professor Orthopedic Surgery
Assistant Director, UPMC Sports Medicine Concussion Program
University of Pittsburgh

Mark Lovell, PhD (Co-Investigator)
Assistant Professor Orthopedic Surgery
Director, UPMC Sports Medicine Concussion Program
University of Pittsburgh

Caroline Finch, PhD (Co-Investigator)
University of Sydney, Australia

Contact sports, such as football, carry a high risk of mild traumatic brain injury (mTBI). These injuries have the potential for adverse long-term effects. Despite the potential to significantly reduce the adverse outcomes of mTBI, there are conflicting guidelines about when a player should return to play. The aim of this study was to estimate the incidence of mTBI among high school and non-elite Australian football players and to develop guidelines to manage return-to-play decisions following mTBI.

Stevenson, M. (2003). "Developing return-to-play guidelines following mild traumatic brain injury." J Sci Med Sport 6(4): 519-20.

Survey of Injury Prevention Activities in PA ED: Successes, Barriers and Opportunities

Hank Weiss, MPH, PhD (Principal Investigator)
Center for Injury Research and Control;
Associate Professor, Department of Neurological Surgery, University of Pittsburgh

The purpose of this survey was 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 asked Emergency Physicians to complete a brief (20 minute) online survey.

This study was conducted by Dr. Harold Weiss at the University of Pittsburgh in cooperation with the Pennsylvania Chapter of the American College of Emergency Physicians.

Garrettson, M., H. B. Weiss, et al. (2008). "A survey of ED injury prevention activities." J Emerg Nurs 34(1):61-8.

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

Mary Clyde Pierce, MD (Co-Investigator)
Children's Memorial Hospital Chicago

The purpose of this project was to develop and validate computer simulation models to investigate head injury risk associated with common pediatric falls in one-year-old children. This was 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.

Bertocci GE, Pierce MC, et al. "Influence of fall height and impact surface on biomechanics of feet-first free falls in children." Injury 35(4):417-24, 2004.

Bertocci GE, Pierce MC, et al. "Using test dummy experiments to investigate pediatric injury risk in simulated short-distance falls." Archives of Pediatrics & Adolescent Medicine 157(5):480-6, 2003.

Improving Biofidelity of the Hybrid III Three-Year-Old for Long-bone Fracture Prediction

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.

Deemer E, Bertocci G, et al. "Influence of wet surfaces and fall height on pediatric injury risk in feet-first freefalls as predicted using a test dummy. [erratum appears in Med Eng Phy 27(5):435-7]." Med Eng Phys 27(1):31-9.

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. This study tested the hypothesis that the hospitalization rate for assault would be higher among pregnant women than all women of reproductive age. E-coded (cause of injury) hospital discharge data was obtained from selected state hospital discharge databases. The combined data set covered 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 was 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 were 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 also resulted in the creation of a large population based sample of injuries and assaults against women useful for other summary reports and researchers.

Final Report

Pregnancy Exemption Survey of International Seat Belt Laws

Hank Weiss, Principal Investigator

Substantial evidence of seatbelt efficacy has been shown by several studies, and it is widely recommended that motor vehicle occupants use properly fitted seat belts. However, some (but a heretofore unknown number of) countries with national seat belt laws permit various exemptions which may lower use rates. The aim of this study was to survey the variety of exemptions to national seat belt laws. METHODS: This investigation relied on identifying respondents from national traffic safety agencies, other governmental and non-governmental organizations, Internet searches, personal contacts, and other sources. Questionnaires were deployed through a web based survey supplemented by email and postal versions. RESULTS: Responses were received from 30 countries of which 28 (93.7%) had a national seat belt law. About two thirds (63.7%) of the 28 national laws applied to both front and back seat passengers. The leading exemption types included vehicles made before a certain year (n = 13), antique vehicles (n = 12), military vehicles (n = 11), buses (n = 9), and emergency vehicles (n = 8). Most responding countries reported one or more specific categories of individuals as exempt including those with medical exemptions (n = 20), taxi drivers (n = 11), police (n = 9), emergency medical personnel (n = 8), physically disabled people (n = 6), and pregnant women (n = 6). Out of 26 responses to the question regarding current level of enforcement, 42.3% felt enforcement was "very good or good" and 57.7% characterized it as "fair or poor". CONCLUSIONS: This study represents one of the largest international traffic law surveys reported. Most national seatbelt laws offer perilous exemptions to a broad array of vehicle types and road user groups. These findings, coupled with concern over the level of enforcement in the majority of countries surveyed, suggest that international road safety efforts have a long way to go to improve coverage and enforcement of national seat belt laws.

Weiss H, Sirin H, et al. "International survey of seat belt use exemptions." Inj Prev 12(4):258-61, 2006.