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16 July 2001



Research Methods
  • The Barell Injury Diagnosis Matrix: A Framework for Classifying Injuries by Body Region and Nature of the Injury

    Barell V, Hashomer T, MacKenzie E, Aharonson-Daniel L, Fingerhut L and the International Collaborative Effort on Injury Statistics; 2001. Hyattsville, MD: US National Center for Health Statistics.

    Available online:
    http://www.cdc.gov/nchs/about/otheract/ice/barellmatrix.htm

    Correspondence: Lois A. Fingerhut, US National Center for Health Statistics, Division of Data Services, 6525 Belcrest Road, Hyattsville, MD 20782-2003, USA laf4@cdc.gov

    This injury diagnosis-by-site matrix is a product of the International Collaborative Effort on Injury Statistics. The matrix as presented on the Web should be considered version 1. Future plans include a version of the matrix based on 3-digit ICD-9 CM codes that can be used for multiple cause of death analyses (when detailed 5-digit codes are often not available). In addition, once ICD-10 CM is adopted for use, the matrix will be ‘translated’ into those appropriate codes. It is anticipated that a complete discussion of the matrix including guidelines for use and data analysis will be in a forthcoming article in the journal Injury Prevention.

  • Preliminary ICD-10 external cause of injury framework by cause and intent.

    Fingerhut LA. Preliminary ICD-10 Matrix; 2001. Hyattsville, MD: US National Center for Health Statistics. Available online:
    http://www.cdc.gov/nchs/about/otheract/ice/matrix10.htm

    Correspondence: Lois A. Fingerhut, US National Center for Health Statistics, Division of Data Services, 6525 Belcrest Road, Hyattsville, MD 20782-2003, USA laf4@cdc.gov

    The International Classification of Diseases Revision 10 is now used for classifying the cause of death in most of the world. The ICD-10 injury mortality framework was developed to be as consistent as possible with the recommended framework developed based on the ICD-9 external cause of injury codes as published in www.cdc.gov/mmwr/PDF/rr/rr4614.pdf. Colleagues in the ICE (International Collaborative Effort) on Injury Statistics as well as in the Injury Control and Emergency Health Services (ICEHS) section of APHA participated in its development. This matrix should not be considered to be the final ICD-10 matrix until NCHS completes the final comparability study of ICD-9 and ICD-10.

Suicide
  • Is Suicide Contagious? A Study of the Relation between Exposure to the Suicidal Behavior of Others and Nearly Lethal Suicide Attempts

    Mercy JA, Kresnow1 M, O'Carroll PW, Lee RK, Powell KE, Potter LB, Swann AC, Frankowski RF, Bayer TL. Am J Epidemiol 2001; 154(2): 120-127.

    Correspondence: James A. Mercy, Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Mailstop K60, 4770 Buford Highway NE, Atlanta, GA 0341-3724, USA jam2@cdc.gov

    This study sought to determine the association between nearly lethal suicide attempts and exposure to the suicidal behavior of parents, relatives, friends, or acquaintances and to accounts of suicide in the media. The authors conducted a population-based case-control study in Houston, Texas, from November 1992 through July 1995. They interviewed 153 victims of attempted suicide aged 13–34 years who had been treated at emergency departments in Houston and a random sample of 513 control subjects. After controlling for potentially confounding variables, the authors found that exposure to the suicidal behavior of a parent (adjusted OR = 1.5; 95% CI: 0.6, 3.6; p = 0.42) or a nonparent relative (adjusted OR = 1.2; 95% CI: 0.7, 2.0; p = 0.55) was not significantly associated with nearly lethal suicide attempts. Both exposure to the suicidal behavior of a friend or acquaintance (adjusted OR = 0.6; 95% CI: 0.4, 1.0; p = 0.05) and exposure to accounts of suicidal behavior in the media (adjusted OR = 0.2; 95% CI: 0.1, 0.3; p = 0.00) were associated with a lower risk of nearly lethal suicide attempts. Exposure to accounts of suicidal behavior in the media and, to a lesser extent, exposure to the suicidal behavior of friends or acquaintances may be protective for nearly lethal suicide attempts, but further research is needed to better understand the mechanisms underlying these findings.

Transportation
  • Do speed bumps really decrease traffic speed? An Italian experience

    Pau M, Angius S. Accid Anal Prev 2001; 33(5): 585-597.

    Correspondence: Massimiliano Pau, Department of Territorial Engineering, Transportation Section, University of Cagliari, Piazza d'Armi, 09123 Cagliari, ITALY pau@doctorsun.unica.it

    Italy introduced the extensive use of speed bumps only in 1990, in an attempt to limit the high number of fatalities involving pedestrians in urban streets caused by the high speed of vehicles. In many countries, such devices have been the subject of careful investigations (in order to assess their effectiveness and disadvantages for the traffic circulation) and this has resulted in a number of modifications in the design to improve their performance. On the contrary, no systematic and scientific studies have been carried out on Italian installations: moreover, the type of undulation adopted is known to produce a series of problems for some categories of users and is not so effective in reducing speed as larger devices such as `speed humps' or `speed cushions'. This paper proposes a study of the effectiveness of 23 speed bumps installed in the city of Cagliari; to this aim, a speed analysis was performed at speed bump locations, at the crosswalks protected by the devices and at sections of the streets where bumps are installed but far from them. The results show that in one third of the cases the 85th percentile of speed measured at the speed bumps is higher than the posted speed limit (50 km/h) and an equal percentage of vehicles travel at a speed in the range of 45-50 km/h. No statistically significant differences were found from the comparison of speed values observed in free, bump or crosswalk sections of the same streets, while speed profiles calculated at four sites, where a high percentage of braking vehicles was observed, showed a common trend from which it clearly emerges that the effect of the device on driver's behavior is restricted to a short spatial range (about 20-30 m before and after the bump). The current situation thus suggests the use of more effective devices such as humps or cushions, or the integration of speed bumps with other traffic calming techniques.



  • Adolescent antecedents of high-risk driving behavior into young adulthood: substance use and parental influences

    Shope JT, Waller PF, Raghunathan, Patil SM.Accid Anal Prev 2001; 33(5): 649-658.

    Correspondence: Jean T. Shope, Transportation Research Institute, University of Michigan, 2901 Baxter Road, Ann Arbor, MI 48109-2150, USA jshope@umich.edu

    Driver history data, in combination with previously collected tenth-grade questionnaire data, for 4403 subjects were analyzed by Poisson regression models to identify the significant substance use and parental characteristics predicting subsequent high-risk driving of new drivers (starting at age 16) through age 23-24 years. Substance use (cigarettes, marijuana, and alcohol) reported at age 15 was shown to be an important predictor of subsequent excess risk of serious offenses and serious crashes for both men and women. In addition, negative parental influences (lenient attitudes toward young people's drinking; low monitoring, nurturance, family connectedness), were also demonstrated to increase the risk of serious offenses and serious crashes for both men and women.



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