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INJURY EPIDEMIOLOGY AND CONTROL

FALL 1995

PRMD 6637

Course Directors

William Marine, MD MPH Office: 270 6850 1 832C (SOM) Home: 444-6970 E Mail: William.Marine@UCHSC.edu

Steve Lowenstein, MD MPH Office: 270-6439 (Research Bridge, Rm. 5440) E Mail: Lowenste@rachel.hsc.colorado.edu

Teaching Assistant

Skip Tinnell, RN MSPH Of fice: 670 3331 Home: 670 8511

Class Meetings

Monday and Wednesday 1:00 pm - 2:20 pm. Room: MS1601

Objectives

1. Define and assess the impact of injury on the health status of the population as an acute condition and as a chronic condition.

2. Identify the major causes of injury, pre-event, event, and post-event risk factors and major forms of prevention for each phase of risk factors.

3. Identify the role of education, engineering, enforcement(legislation & regulation), and economics in the control and prevention of injuries.

4. Specify the role of acute care treatment, prevention, epidemiology and surveillance, and rehabilitation and biomechanics in the control and prevention of inJuries.

5. Identify and interpret the data sources for investigating injury.

6. Identify and critique the epidemiologic and statistical methods especially relevant to the study of injuries.

7. Assess the effectiveness of various measures used to control and prevent injury.

8. Demonstrate the ability to critically analyze the literature suppporting an injury prevention/reduction intervention.

9. Present a summary of your comprehensive review orally to your peers.

Evaluation

Evaluation of students will be based on a midterm examination, a final examination and a written and orally presented paper .

a. 25% Midterrn (take home on 9/27 to return 10/2)

b. 25% Paper and Oral Presentation

c. 50% Final Examination (in class)

Examinations

The midterm examination will be distributed on September 27 (Wednesday) and is due on October 2 (Monday). The final examination will be given in class on November 13 (during final exam week).

Paper

Select an existing or proposed intervention, control measure, regulation, or law to control an injury, and review the literature supporting its effectiveness. ( Hint: Healthy People 2000 Risk Reduction and Services and Protection Objectives is a good place to start)

Topics should be selected and reported to Dr. Marine or Dr. Lowenstein no later than September 18 for review and comment. Papers should be ten or twelve pages in length (double-spaced, typed/word processed). Papers are due on November 6 or November 8, depending on when you give your in-class presentation.

Optional Text

Colorado Department of Public Health and Environment. Violence in Colorado: Trends and Resources. 1994. Available from Course Director. Cost. $10.

Required Texts

Baker SP, O'Neill B, Ginsburg MJ, Li G. The Injury Fact Book, 2nd Ed. Oxford University Press. 1992. Available in UCHSC Bookstore.

Centers for Disease Control. Position Papers from the Third National Injury Control Conference, Setting the National Agenda for Injury Control in the 1990's. US Department of Health and Human Services. 1992. Available from Course Director for no charge.

Additional Bibliography

Commitee of Trauma Research, Commission on Life Sciences, National Research Council and the Institute of Medicine. Injury in America: a continuing public health problem. National Academy Press. 1985.

Centers for Disease Control. Injury Control. A Review of the Status and Progress of the Injury Control Program at the Centers for Disease Control. National Academy Press. 1988.

National Committee for Injury Prevention and Control. Injury Prevention: Meeting the Challenge. Oxford University Press. 1989.

Rice DP, MacKenzie EJ and Associates. Cost of Injury in the United States: A Report to Cogress.

Institute for Health and Aging, University of California (San Francisco) and Injury Prevention Center, The Johns Hopkins University. 1989.

Department of Health and Human Services. Healthy People, National Health Promotion and Disease Prevention Objectives. DHHS Publication No. (PHS) 91- 50212.1991.

Rosenberg ML, Fenley MA (Eds). Violence in America: a public health approach. Oxford University Press. 1991.

Robertson LS. Injury Epidemiology. Oxford University Press. 1992.

Additional Faculty Lecturers

Lorann Stallones, Ph.D., Associate Professor, Dept. Env. Hlth., CSU

Thomas Christoffel, J.D., SPH, Medical Epidemiologist, Colo. Dept. PH & Envir.

Deborah Haack, Injury Prevention Program, Colo. Dept. PH & Envir.

Ben Honigman, MD, Head, Emergency Medicine, UCHSC

Ernest Moore, MD, Chief, Trauma Surgery, Denver General Hospital

Tony Suruda, MD, MPH, Assoc. Dir. Rocky Mtn. Ctr. Occ.&Env. Hlth.,U.Utah

Gail Whiteneck, Ph.D, Director of Research, Craig Hospital, Englewood, CO.

Richard Hoffman, MD,MPH, State Epidemiologist, Colo. Dept. PH & Envir.

Robert Meier, MD, Chair, Department of Rehabilitation Med., UCHSC

Lane Wake,MSPH, Injury Prevention, Colo. Dept. PH & Envir.

John Fluke, American Humane Association

Kim Feldhaus , Denver General Hospital

Course Outline

Date/Topic/Reading

8/28 (M) Overview, History, Concepts, Mechanics [Marine] Baker: Ch 1-3

8/30 (W) Unintentional Injury - MVT [Lowenstein] Baker: Ch 16-21 CDC: pp 77-139

9/4 (M) Labor Day (No Class)

9/6 (W) Unintentional Injury - MVT [Lowenstein] Baker: Ch 16-21 CDC: pp 77-139

9/11 (M) Other Unintentional Injuries Farm Injuries [Stallomes] Baker: Ch 4,7,8,10,12-15 CDC: pp 261 - 313

9/13 (W) Injury Risk Factors - Alcohol and Drugs [Marine]

9/18 (M) Legal Aspects of Unintentional Injuries [Christoffel]

Deadline for paper topic

9/20 (W) Intentional Injuries I: Homicide, Use of Firearms [Hedegaard] Baker: Ch 6-11

CDC: pp 163-224

9/25 (M) Intentional Injuries II: Child Abuse, Child Fatality Review [Fluke, Haak] CDC: pp 163-224

9/27 (W) Acute Care - EMS [Honigman] CDC: pp 441-476

10/2 (M) Acute Care - Trauma Surgery [Moore] CDC: pp 377-420

10/4 (W) Intentional Injuries III: Domestic Violence, Suicide [Feldhaus, Wake] Baker: Ch 5 CDC: pp 163-224

10/9 (M) Acute Care - Evaluation, Registries [Tinnell, Lowenstein, Marine] CDC: pp 377-420

10/11 (W) Regulation and Prevention of Work-Related Injuries [Sundra] Baker: Ch 9 CDC: pp 329-368

10/16 (M) Legal Aspects of Intentional Injuries [Christoffel]

10/18 (W) Quantifying Rehabilitation Outcomes [Whiteneck] CDC: pp 497-526

10/23 (M) Injury Surveillance [Hoffman]

10/25 (W) Injury Contol Policy and Legislation [Lowenstein]

10/30 (M) Injury Prevention and Control [Haack]

11/1 (W) Role of Rehabilitation in Injury Control and Burn Injuries [Meier] CDC: pp 497-526

11/6 (M) Student Reports

11/8 (W) Student Reports

11/13 (M) Final Exarnination Week

Text Assignments will be supplemented with articles given out in class, usually a week ahead.

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