Home
Mission Statement
Executive Committee
Cousework
Research Publications
Community Advisory Committee
Affiliates
News and Events
Contact Us


This list includes various Center projects. For more information regarding these projects, please contact us.  To view a list of individual projects, just click on the appropriate category below.

VIOLENCE

Media Literacy as a Violence Prevention Strategy

In the fall of 2007, we began implementing the summative evaluation of the curriculum, Beyond Blame: Challenging Violence in the Media, which is currently underway in 27 schools around southern California.  The purpose of this study is to examine the impact of the curriculum on middle school students.  To test the effectiveness of the curriculum we are employing an intervention/control design, pre- and post-testing students on changes in knowledge, beliefs, attitudes and behaviors.  We are also gathering process evaluation data on integrity, delivery and utilization of the program intervention.   The final phase of the study, to begin after the summative evaluation data is analyzed, will assess the dissemination strategies of the Beyond Blame curriculum once it is digitized and a website for it is constructed.

Hide this description

Epidemiology of Intimate Partner Homicide-Suicide in Los Angeles County

This study is an extension of an earlier UCLA study, Incidence and Patterns of Intimate Partner Homicide, which assembled data from the Los Angeles County Coroner for 59 cases during the years 1994-1997.  This was formerly a seed project which is now a small project. Data have now been collected through 2004, with a total of over 200 cases. Three local agencies have collaborated with us on this study:  the Los Angeles County Department of the Coroner, the Los Angeles Police Department, and the Los Angeles Office of the Bureau of Alcohol, Tobacco and Firearms (ATF).

Initial case ascertainment was made using the California Master Mortality File and coroner data.  First, all suicides of males age 15 or older were identified in the Master file.  Each suicide was identified in the Coroners database to determine if it was associated with a homicide. Homicide records were physically examined to confirm that the death was associated with a suicide.  After case identification, corresponding records of the law enforcement agencies were identified using first and last name of decedent, and date of incident.  Where information on a weapon identified at the scene was found additional information was sought from law enforcement and ATF.  Data were abstracted from paper records by undergraduate and graduate public health students. 

Data analyses have included univariate analyses followed by multivariate statistical modeling.  The overall aim of the analyses is the elucidation of the salient characteristics of incidents of homicide-suicide.  In addition to the demographic and other personal characteristics, we are examining the nature of the perpetrator-victim relationship and other family dynamics, history of perpetrator-victim violence, protective orders, perpetrator arrests, or other law enforcement contacts prior to the fatal incident, and issues of custody and follow-up services for surviving children on the perpetrator or victim(s).  In addition, legal ownership of weapons and purchase dates are being examined.  Findings from this study will provide valuable information to guide intimate partner violence prevention and intervention activities.

Hide this description

Social and Cultural Factors Associated with Male Batterers in Mexico and Southern California

Los Angeles, with the largest Mexican population outside of Mexico City, is highly influenced by Mexican social and cultural norms.  This project will interview samples of known batterers and non-batterers in Mexico and the United States to determine the role of these factors in abuse.  The goal of this project is to describe the social factors associated with the development of violent behavior in Mexican males residing in Mexico and the United States.  The objectives are to identify risk factors which lead to violence in men, to describe the effects of this behavior on both the batterer and his partner, and to identify differences in characteristics among men attending a mandated batterer treatment program, men attending a voluntary program, and men who are not involved in treatment programs (controls).

The project will be carried out by lead investigators in Cuernavaca, Mexico and Los Angeles, California.  In the United States, only men who report Mexican descent will be included.  The projects will share elements of the same interview tool, and although each study will stand alone, results will be compared between countries.

The specific aims are:

  1. To identify the type, frequency and severity of violence (physical, emotional, sexual, verbal, and financial) predominantly committed by men in mandated and voluntary batterer treatment programs.
  2. To characterize the reported effects that the violent behavior has on the physical and emotional health of both the women victims and their male aggressors.
  3. To characterize the social and cultural variables associated with the development of violent behavior by the Mexican male.
  4. To identify the risk factors which predict the manner in which men express their violent behavior, including the initiation and escalation of violent events.

Hide this description

Suicide in the Workplace

For most work-related fatal injuries, the nature of the exposure (i.e., task, activity, or duty combined with specific location) is known.  For homicides, the working relationship is also generally well understood (e.g., a shooting involving a clerk at a liquor store during the course of a robbery).  The work exposure factors associated with self-inflicted injury, however, are not well known or are poorly documented in most coroner's reports.  Based on discussions with California county coroners, self-inflicted fatal injuries are determined to be work-related on the basis only of place where injury was inflicted and not on any known duty, task or activity connected with work or employment.

The overall objective of this project is to establish and understand the multi-factorial nature of suicides that occur at work.  To address this broad question, the following specific aims will be addressed:

  1. To identify and measure the nature of work-related factors associated with suicide, classified by a coroner as an injury-at-work.
  2. To determine the degree to which these factors differentiate injury-at-work cases from those suicides not categorized by a coroner as injury-at-work.

Hide this description

An Assessment of Youth Violence Prevention Activities in USA Cities

UNITY (Urban Networks to Increase Thriving Youth through violence prevention) is a CDC-funded cooperative agreement awarded in 2005 to a partnership comprised of Prevention Institute, Dr. Deborah Prothrow-Stith of Harvard School of Public Health, and Billie Weiss from the University of California at Los Angeles – Southern California Injury Prevention Research Center. The goal of UNITY is to strengthen urban youth violence prevention, build national support for necessary resources and policies, and develop tools and framing to ensure long-term sustainability of youth violence prevention efforts.

The Southern California Injury Prevention Research Center conducted an assessment on current violence prevention activities in a sample of twelve cities. The sample was selected to be representative of the range of geographic locations and rates of fatal youth violence among the 45 largest cities in the United States. Telephone interviews were conducted with the Mayor, Police Chief, Public Health Director, and School Superintendent, or their designated representative in each city. Topics covered included city-wide plans, youth advisory councils, youth development and violence prevention programs, violence prevention coalitions, access to relevant data, and overall assessment of the city’s efforts.

Key informants identified youth violence as a serious issue in U.S.A. cities. However, very few report their city using efforts to prevent violence before it occurs; resources are addressing the aftermath of violence.

The Southern California Injury Prevention Research Center, with funding from The California Wellness Foundation, created A Guidebook to Strategy Evaluation: Evaluation Your City’s Approach to Community Safety and Youth Violence Prevention.

Documents are available for download via the citation links below:
Weiss, B.P. (June 2008). An Assessment of Youth Violence Prevention Activities in USA Cities. Los Angeles, CA: UCLA Southern California Injury Prevention Research Center.

Weiss, B.P., Berger, E., & Hatcher, B. (June 2008). A Guidebook to Strategy Evaluation: Evaluation Your City’s Approach to Community Safety and Youth Violence Prevention. Los Angeles, CA: UCLA Southern California Injury Prevention Research Center.

For more information on UNITY, go to http://www.preventioninstitute.org/UNITY.html.

Hide this description

Hide Violence project titles

SPORTS

Evaluation of Existing Sports Injury Interventions and Countermeasures in High School Varsity Football

The highest rates of injury in high school sports are reported in football.  Little is known about what schools are doing to prevent these injuries and their effectiveness.  We propose using a multilevel study design to identify primary, secondary and tertiary measures in place in local high schools; to measure whether these interventions affect the frequency and severity of injury; to compare treatment protocols across schools; and to estimate costs of medically treated injuries in selected sports clinics.  We will focus on two samples of football teams, those under medical supervision by a local sports clinic and those not.

Hide this description
Hide Sports project titles

DISASTERS

National Survey of Disaster Experiences and Preparedness  **NEW**

The Department of Homeland Security funded a Center for Excellence called the National Consortium for the Study of Terrorism and Responses to Terrorism (NC START) based at the University of Maryland, College Park. Dr. Linda Bourque received the two sub-awards through NC START as well as two additional grants from the National Science Foundation to conduct a national household telephone survey about people's experiences, preparedness and mitigation actions, and perceptions related to terrorism and disasters. A stratified sample of 3,300 households selected by random digit dialing was interviewed using computer-assisted telephone interviews. Of the total sample, 1,000 households were selected from areas considered at high risk of terrorism (Washington, D.C.; New York City; Los Angeles), and 2,300 households were selected from throughout the rest of the continental United States. The study collected information on: household and individual demographic data; past experience with disasters; respondents; definition of terrorism; cues to prepare; preparedness information received passively; trust in government organizations; terrorism-related knowledge; perceived risk; information-seeking and milling; perceived as resilience/self-efficacy; perceived response effectiveness; preparedness and mitigation actions; and behavioral intentions.

Documents are available for download via the citation links below:
Kano, M., Wood, M.M., Mileti, D.S., & Bourque, L.B. (2008). Public Response to Terrorism: Findings from the National Survey of Disaster Experiences and Preparedness. Los Angeles, CA: Southern California Injury Prevention Research Center.

Wood, M.M., Kano, M., Mileti, D.S., & Bourque, L.B. (2008). Questionnaire Specifications: Documentation of the National Survey of Disaster Experiences and Preparedness (NSDEP). Los Angeles, CA: Southern California Injury Prevention Research Center.

Bourque, L.B., Kano, M., Mileti, D.S., & Wood, M.M. (2008). English, Spanish, and Annotated Questionnaires: Questionnaires Used in the National Survey of Disaster Experiences and Preparedness (NSDEP). Los Angeles, CA: Southern California Injury Prevention Research Center.

Video coverage of the presentation of research findings at the National Press Club provided by C-SPAN can be viewed via the link below:
Bourque, L.B. & Milet, D.S. (December 15, 2008). Public Response to Terrorism in America. A Research Briefing at the National Press Club, Washington, D.C.

The PowerPoint slides presented at the National Press Club can be downloaded via the link below:
Bourque, L.B. & Milet, D.S. (December 15, 2008). Public Response to Terrorism in America. A Research Briefing at the National Press Club, Washington, D.C.

 

Hide this description

Needs Assessment of Emergency Preparedness and Response Activities in California Schools

School emergency preparedness is essential to prevent and minimize the health and social impact of hazards on the school community, including children, teachers, staff, their families and those who live or work near schools.  Between September 2005 and February 2006, a mail survey was administered to representatives of 200 public school districts and 470 public schools, grades K through 12, located in 34 of the 58 counties in California.  Responses were obtained from 98 school districts and 157 schools.  Data from the survey were analyzed to describe the schools’ prior experiences with emergencies and disasters, the available resources for preparedness, their current levels of preparedness, and their needs for improving preparedness.

Documents are available for download via the citation links below:
Kano, M. & Bourque, L.B. (January 2007). School Emergency Preparedness Survey Report: Improving Coordination Is Vital for School Districts. Los Angeles, CA: UCLA Southern California Injury Prevention Research Center.

Kano, M. & Bourque, L.B. (March 2007). School Emergency Preparedness Survey Report: A Written Plan is a Good Start, But Only a Start. Los Angeles, CA: Southern California Injury Prevention Research Center. 

Kano, M. & Bourque, L.B. (July 2007). School Emergency Preparedness Survey Report: It Takes A Village To Prepare Schools for Emergencies. Los Angeles, CA: Southern California Injury Prevention Research Center.

Hide this description

Evaluation of Wildfire Evacuation Plans in California Counties

Timely evacuation of populations threatened by wildfires is essential to prevent fatal and non-fatal injuries from exposure to fire, smoke, and other secondary hazards.  There has been a paucity of studies that examine the characteristics of official community evacuation plans and their potential to minimize damage in wildfire disasters, especially in densely populated areas where wildfire may spread to residential areas.  This study will describe and evaluate official evacuation plans for California counties at high risk of wildfires.  A content analysis will be performed on evacuation plans obtained from 58 California county offices of emergency management using 20 criteria developed by the U.S. Department of Transportation and the Department of Homeland Security for an evaluation of catastrophic hurricane evacuation plans.  The evaluation of plans will be augmented by key informant interviews with emergency management officials in the respective counties to identify the strengths and weaknesses of their current evacuation plans and their expectations regarding the public’s response to evacuation orders.  Findings from this study will be translated into a model template and guidelines that can be used by emergency management officials to create or improve their wildfire evacuation plans.   It is anticipated that this study will provide the basis for developing a large project involving a broader household survey on evacuations and the health and social impact of wildfires in Southern California communities repeatedly affected by wildfires.

Hide this description

Exploratory Study of Disaster Preparedness in Southern California Immigrant Communities

This study will explore issues related to disaster preparedness among underserved, Latino and Asian immigrant and limited-English proficient (LEP) communities in Southern California using a multi-lingual survey.  This study builds upon a qualitative research study conducted in 2007 by the Asian Pacific American Legal Center (APALC) in collaboration with the Tomás Rivera Policy Institute (TPRI) at the University of Southern California.  This study involved key informant interviews with government and non-government organizations and focus groups with Asian and Latino immigrant community members residing in four Southern California cities.  The study identified formal and informal disaster-preparedness and -response networks and resources and how they are prepared to serve immigrant and LEP populations.  It also identified barriers to disaster preparedness for these minority communities.  The significance of the qualitative study could be bolstered by a survey of the same population that replicates and quantifies its findings.  Results from the survey can be translated into recommended policies and practices for government and emergency response organizations to eliminate disparities in disaster preparedness, response, relief and recovery, not only in Southern California but also in areas with similar demographics throughout the nation.  Some of the project activities will be performed under a subcontract to APALC, as specified in a separate project report.

Hide this description

California Survey of Household Earthquake Preparedness and Mitigation  **NEW**

This study, funded by the California Governor's Office of Emergency Services, the California Seismic Safety Commission, the Institute for Business and Home Safety, and the Southern California Association of Governments, will document the current state of household mitigation and preparedness for disasters in the State of California with an emphasis on earthquakes. The study will determine the current state of household mitigation and preparedness for the state as a whole, select racial and ethnic minorities, and different geographical areas at high risk of earthquakes. The research will also identify the key processes that lead households to take mitigation and preparedness actions. Computer-assisted telephone interviews will be conducted with a total of 2,000 households selected by random-digit-dialing. The sample is equally divided across three strata: 10 northern counties at high risk of earthquakes, 6 southern counties at high risk of earthquakes, and the rest of the state.

Hide this description

UCLA Social Science Data Archive of Earthquake Research  **NEW**

Dr. Linda Bourque led an effort to create an electronic data archive of social science research on earthquakes. The archive was made available to the public in 2005 by data archivist, Elizabeth Stephenson, through the UCLA Institute for Social Science Research (ISSR). The collection, which currently includes 18 data sets, 4 of which are products of Dr. Bourque's own research, represents research conducted since 1971 through the present. Most of the archived survey data were collected from statistically representative samples of northern, central and southern California populations. A range of events was studied, including actual earthquakes, earthquake predictions, and earthquake education and public information campaigns. Key variables include knowledge, perceptions, preparedness actions, responses to earthquakes and earthquake predictions, and demographic characteristics. The archive provides free access to the data sets and their accompanying codebook, questionnaire and specifications. A bibliography of published and unpublished writings associated with the archived data is also available. In addition, there is an option for performing on-line analyses of most of the data. This special collection is a permanent feature of the ISSR Data Archive and will be updated as more data become available. Its purpose is to preserve data, promote research and education, and inform public policy.

The data archive can be accessed at the link below:
UCLA Institute for Social Science Research (ISSR), Social Science Data Archive Earthquake Survey Data at UCLA

Hide this description

First Aid in Disaster

Two studies were conducted to examine the ability of citizens to perform basic first aid with the notion that these skills can be critical in preventing and reducing morbidity and mortality in the aftermath of disasters.  Data from a population-based household survey (N=506) of Los Angeles County conducted after the 1994 Northridge earthquake were analyzed to test a causal path model predicting self-reported first aid abilities.  Factors that predicted greater ability to perform first aid included taking a course in first aid, being white, being younger, speaking English in the home (as opposed to other languages), and having lower income.  A related study examined panel data (N=414) collected from households that were interviewed as part of the 1994 Northridge earthquake survey and then re-interviewed three years later after the El Nino winter of 1997-98.  Findings included that 24% of the interviewees had received first aid training since the first interview.  Those who had recently received training reported greater first aid skills and were more likely to report actual and expected utilization of those skills compared to those who were not recently trained or never trained.  These studies highlighted the importance of first aid training, skill evaluation and skill retention among members of the public.

Hide this description
Hide Disasters project titles

TRAFFIC AND TRANSPORTATION

The Effectiveness of Rumble Strips in Reducing Motor Vehicle Crashes on Rural Highways and Freeways

This study was designed to estimate the effectiveness of both centerline and shoulder rumble strips in reducing the incidence of motor vehicle injury crashes.  This would be accomplished by assembling a multi-state database that is large enough to allow detailed analyses and precise estimation of effects.  Data would be obtained from police crash report databases and state highway department records, and collected from study sites by research staff.  The results of this study would allow state and federal policymakers to better anticipate benefits of the incorporation of rumble strips into highway construction and reconditioning projects, and would enable valid cost-benefit analyses to be conducted.

Hide this description

Helmets and Spinal Injuries: Dispelling the Myth and Enhancing Helmet Laws

Although helmets on motorcyclists and scooter operators have been shown to be effective in reducing mortality and severe head injury in crashes, some researchers and a vocal minority of anti-helmet groups have persisted in claims that wearing a helmet in a motorcycle crash increases the risk of physical injury to the neck. The basis for their claim has been anecdotal observations and biomechanical speculation.  The objective of this project was to examine analytically new information from a large database on the hypothesis of increased risk of physical injury to the neck, trunk and spine from wearing helmets in crashes.

Hide this description

Adult Skateboard Injuries: A New Emerging Problem in Recreation

This project was a cooperative study by investigators from UCLA and Scripps Memorial Hospital, La Jolla.  Little is known about skateboard related injuries in adults despite an extensive medical literature on these injuries in children and adolescents dating to the 1970’s.  Although most of the injuries described in earlier research were non-life threatening, health and safety professionals began the call for restrictions on use of skateboards including requirements for protective equipment.  The findings of the CPSC show over 281,900 medically treated injuries based on a national surveillance network.  The literature on skateboarding injuries over the past 10 years has continued to emphasize the pediatric population, yet recent observations in one large trauma center has suggested that the injury problem is no longer confined to children or adolescents but to adults as well.  The purpose of this project was to fill the void in critical epidemiological and clinical information on a new and growing subgroup of injured skateboarders.  To this end, we obtained information from the U.S. National Trauma Data Bank and compared these data to that derived from the Scripps Memorial Hospital Trauma Service for 2000-2006 to describe and compare analytically details of the demographic, exposure, injury features and severity as well as clinical treatment parameters for adult injured skateboarders.

Hide this description

Pedestrian Collision Injuries

As a response to the Southern California Injury Prevention Research Center’s call for new researchers to become involved in injury research, this project used geographic information systems (GIS) and spatial data analyses to evaluate socio-geographic inequalities in pedestrian-motor vehicle (PMV) collisions across the city of Los Angeles. It was hypothesized that low-income and non-white groups are at higher risk of being involved in PMV collisions than are white and high-income groups because urban-environmental hazards (e.g., traffic congested intersections, poorly maintained and enforced crosswalks, etc.) are often located in neighborhoods where disadvantaged groups reside. This project addressed items identified on the CDC’s Injury Research Agenda (i.e., transportation-related injury prevention and control) with an innovative analytical framework and methodology, and provided insights into the risks of injury that underrepresented and disadvantaged groups face in urban environments.

Hide this description
Hide Traffic and Transportation project titles

COMMUNITY OUTREACH

Violence Prevention Coalition of Greater Los Angeles (VPC) - A Project of Community Partners

The Violence Prevention Coalition of Greater Los Angeles (VPC) is a public/private network of individuals and organizations dedicated to addressing violence as a public health issue. Coalition members are located throughout Los Angeles County and Southern California and represent community based organizations, academic institutions, schools, neighborhood groups, youth development groups, mental health providers, law enforcement agencies, government groups, domestic violence programs, child maltreatment prevention organizations, arts and recreation programs, gang violence prevention and intervention programs, schools, the media and many other groups.  Members join as individuals or for their organizations.   

The SCIPRC has been a partner of the VPC since it’s inception in 1991, and is currently providing program evaluation workshops, media advocacy training, and in-kind staff support to the VPC.  The VPC is open to all who are interested in preventing violence in the home, in the schools, the streets, the neighborhoods and in the community.

Some of the past accomplishments of the VPC include:

  • The VPC in partnership with others has launched the Youth Violence Prevention Peace Coalition; a countywide coalition of youth dedicated to working together to find peaceful solutions to violence in their communities.
  • The National Campaign Against Youth Violence selected the VPC as the Los Angeles representative for the campaign.
  • Forty-one challenge grants have been provided to community-based organizations for youth focused violence prevention activities. More than 8,000 youth have participated in at least one community violence prevention activity as a result of the $1,000 challenge grants. This amounts to an average cost of $ 2.62 for each youth participating.
  • Activities have included: events for Asian Pacific youth to participate in theater, music, and arts; A summer youth festival for Korean and Latino youth in the Westlake/Korea town area; A candlelight vigil and a resource fair in East Los Angeles focusing on relationships and domestic violence; A tour of the Museum of Tolerance and workshops at the Skirball Cultural Center for youths in grades 6 to 8; Establishment of a youth support group at the Loved Ones of Homicide Victims Counseling Center; In the Harbor Area, Samoan and Latino youth have organized an annual forum to address multi-cultural concerns; Low income and homeless youth are working together to address violence for youth in Affordable Housing developments across the County; Inglewood youth held a neighborhood clean-up day and coupled that activity with a Day of Dialogue to explore racial violence.
  • This year the VPC is providing seminars and courses for our members on evaluation and using data to assess the effectiveness of the work being done.
  • The VPC was instrumental in the passage of the first ban on .50 Caliber Sniper Rifles in the City of Los Angeles.

The VPC receives funding from The California Endowment, The California Wellness Foundation, and the Jewish Family Foundation.  SCIPRC staff  serve on the VPC Steering Committee.

Documents are available for download via the citation links below:
Violence Prevention Coalition of Greater Los Angeles. (June 2007).  Fact Sheet: Alcohol and Violence. Los Angeles, CA: Violence Prevention Coalition of Greater Los Angeles.

Violence Prevention Coalition of Greater Los Angeles. (June 2007).  Fact Sheet: Child Abuse. Los Angeles, CA: Violence Prevention Coalition of Greater Los Angeles.

 

Violence Prevention Coalition of Greater Los Angeles. (June 2007).  Fact Sheet: Intimate Partner Violence (IPV). Los Angeles, CA: Violence Prevention Coalition of Greater Los Angeles.

 

Violence Prevention Coalition of Greater Los Angeles. (June 2007).  Fact Sheet: Firearms and Firearm-related Violence. Los Angeles, CA: Violence Prevention Coalition of Greater Los Angeles.

 

Violence Prevention Coalition of Greater Los Angeles. (June 2007).  Fact Sheet: Gang Violence. Los Angeles, CA: Violence Prevention Coalition of Greater Los Angeles.

 

Violence Prevention Coalition of Greater Los Angeles. (June 2007).  Fact Sheet: School Violence. Los Angeles, CA: Violence Prevention Coalition of Greater Los Angeles.

 

Violence Prevention Coalition of Greater Los Angeles. (June 2007).  Fact Sheet: Sexual Violence. Los Angeles, CA: Violence Prevention Coalition of Greater Los Angeles.

 

Violence Prevention Coalition of Greater Los Angeles. (June 2007).  Fact Sheet: Suicide. Los Angeles, CA: Violence Prevention Coalition of Greater Los Angeles.

 

Violence Prevention Coalition of Greater Los Angeles. (June 2007).  Fact Sheet: Violence and Emergency Medical Services (EMS). Los Angeles, CA: Violence Prevention Coalition of Greater Los Angeles.

 

Violence Prevention Coalition of Greater Los Angeles. (June 2007).  Fact Sheet: Violence in Los Angeles. Los Angeles, CA: Violence Prevention Coalition of Greater Los Angeles.

 

Violence Prevention Coalition of Greater Los Angeles. (June 2007).  Fact Sheet: Violence in the Workplace. Los Angeles, CA: Violence Prevention Coalition of Greater Los Angeles.

Hide this description

Evaluation Training Workshop Series for Violence Prevention Providers

With funding from the California Wellness Foundation, SCIPRC offers a four-session workshop series on program evaluation for providers of violence prevention services. SCIPRC plays an active role in the Violence Prevention Coalition of Greater Los Angeles; Associate Director, Billie Weiss, MPH, has served as the Executive Director of the Coalition. Coalition members are invited to participate in this hands-on series of training workshops designed to address the particular barriers and challenges they face in evaluating their violence prevention programs. Trainings are offered several times per year.

Hide this description
Hide Community project titles

TRAUMATIC BRAIN INJURY (TBI)

Mild Traumatic Brain Injury Outcomes

Few studies have provided detailed information on the demographic characteristics, external causes and outcomes of representative groups of persons hospitalized with mild traumatic brain injury (MTBI).  A longitudinal multi-cohort study in San Diego, California is examining the epidemiology of MTBI to address interrelated questions about outcome, occurrence, risk prediction and treatment needs for mild brain injured adults.  Analyses will identify specific sequelae of mild brain injury, show the relation between particular precursors and predictors and the outcomes of MTBI and ascertain risk factors for mild brain injury.  These finding in turn are necessary to assemble a composite index of key factors related to outcomes and to improve prediction, intervention strategies and treatment parking for patients and their families.

Hide this description

Frequency, Types of Outcomes and Rehabilitation Needs Assessment for Mild Traumatic Brain Injury

It is well established that older persons recover more slowing from brain injuries than their younger counterparts, even when the injury is of similar severity.  Although there have been thousands of reports in the research literature on mild traumatic brain injury (MTBI), few have addressed this problem in the elderly and almost none have been concerned with specific outcomes following MTBI.  Epidemiological evidence shows that persons aged 15-24 and over age 65 have the highest incidence of MTBI; yet follow-up studies of the consequences of injuries in older persons are almost nonexistent.  The few reports that are available have had very small sample sizes, large losses to follow up, and lacked specificity of outcome to the elderly differential from normal aging.  hence, this project has, as its main objective, the determination of age-specific consequences of MTBI, especially those related to physical complaints, memory and cognitive deficits, impairments or disabilities (including social factors such as work or leisure activities), and indicators of unfilled rehabilitation treatment needs.  In addition, the cost of these consequences is unknown and therefore, secondary objectives of this project will be to measure it and the quality of life following MTBI.

Hide this description

Outcomes of Mild Traumatic Brain Injury

The current state of epidemiologic research in mild traumatic brain injury (MTBI) demonstrates uncertainty about essential characteristics of the injury and the path to recovery.  Few studies have provided detailed information on the demographic characteristics, external causes, and outcomes of representative groups of persons with MTBI.  Little epidemiologic data are available on risk factors or other circumstances pertaining to exposure by individuals with MTBI.  This project will evaluate important neurological, cognitive, behavioral, social, or adjustment impairments that may occur after MTBI, comparing outcomes from a brain-injured cohort admitted to the hospital to those from an other-injury cohort and a non-hospitalized slight head-injured cohort gathered at the same time.  Also to be examined are the contributions to long-term recovery from MTBI due to pre-injury factors such as socioeconomic status, pre-injury behaviors, social characteristics, and potential confounders such as alcohol use.  Results of this study will be used to design individual and family post-injury counseling as well as general community education efforts.

Three specific aims to be evaluated by this study are:

  1. To identify, describe and measure neurological and behavioral sequelae six months post-injury in a well-defined medically diagnosed MTBI cohort and to compare these findings in another cohort of persons with slight head injury.
  2. To identify, describe and measure economic and social risk factors in the occurrence of mild brain injuries.
  3. To identify patterns of service and rehabilitation needs after discharge between the cohort of MTBI, a cohort of persons with injuries of comparable severity to regions other than the brain, and a cohort of persons with slight head injury who are seen but not admitted to a hospital.

Hide this description

Gender and Traumatic Brain Injury

It has long been observed that some patients with moderate or severe brain injury survive and are discharged with "good" recovery.  But, the factors related to good recovery are largely still unknown.  The U.S. Brain Injury Association and Brain Trauma Foundation published Guidelines for the Management of Severe Head Injury.  One section dealt with prognosis and evaluated carefully the published literature on the subject of prognostic factors and TBI.  Age, Glasgow Coma Scale score, papillary diameter and light reflex, hypotension, and CT scan features were identified as factors related to outcome following injury.  These factors allow for probabilistic estimates of survival yet in aggregate they are not deterministic.  In fact, no single study has examined all factors simultaneously and many factors are acknowledged confounders with one another.  The overall objective of this project is to address the role of an additional factor in prognostic outcome of TBI, namely gender.  Hence this project has two specific aims; one methodological and one evaluative:
  1. To develop and pilot test a protocol for the collection of gender specific TBI data across multiple international medical centers
  2. Using pooling data, to determine if gender is differentially related to poor outcomes following TBI, controlling for several known factors.

Hide this description

Biomechanical/Forensic Study of Fatal Head Trauma

The Los Angeles County Office of the Coroner (LACCO) must routinely assess injury diagnoses to determine the cause of death.  In this project, we will review five years of fatalities among children aged five and under in which severe head and intracranial injury was present.  Using the head injury diagnoses, we will reconstruct the biomechanical pathway for cranial injuries and compare this pathway to the stated histories.  With the input of biomechanical and forensic professionals, we will identify inconsistencies between diagnoses, biomechanical mechanism of these injuries, and the stated histories to determine if any of these cases present the potential for child abuse.

The ultimate goal of this project is to identify patterns of cranial injury and reported history, both fatal and non-fatal, that may indicate the need for further investigation of abuse.  This information will be of great value to agencies which examine causes of death or that must quickly assess the correlation between caretaker's reports and the injuries diagnosed.  Infant Death Review committees, which routinely examine circumstances surrounding pediatric deaths, are an example.  These teams are usually well equipped to examine agency response to deaths, but rarely have the biomechanical expertise to determine inconsistencies between forensic findings and reported histories.  Healthy People 2010 has identified increased activity of Infant Death Review teams as a priority, and this study will provide a demonstrated protocol to introduce biomechanical forces into the investigation of intracranial injuries.

This project will review the case series of fatalities to children under the age of five in Los Angeles County who had intracranial trauma among their diagnoses.  The specific aims of this project are:

  1. To identify the forensic pathology of cranial injuries.
  2. To describe the biomechanical circumstances of cranial impact necessary to create the injuries.
  3. To determine if the recorded history of the cause and/or activities surrounding the death are consistent with the injuries sustained.
  4. To determine if there are patterns of cranial injury which are inconsistent with reported non-contact injury (which suggest the potential for abusive injury).

Hide this description

Hide Traumatic Brain Injury (TBI) project titles

PEDIATRICS

Co-Sleeping and Sudden Unexpected Deaths in Infancy (SUDI)

Co-sleeping is one of the most debated risk factors for Sudden Infant Death Syndrome (SIDS) and may lead to other injury deaths, such as suffocation. Although organizations such as the American Academy of Pediatrics (AAP) recommend against co-sleeping, other health organizations and practitioners are advocates, arguing that if practiced safely, co-sleeping has important health benefits for mothers and their infants.  Few studies on the benefits and risks associated with co-sleeping have been conducted in the United States.

Most studies on co-sleeping have examined risk of SIDS, the leading contributor to post-neonatal death. However, many infants die from suffocation and undetermined causes each year. A complete understanding of the risks associated with co-sleeping requires examining these outcomes. Furthermore, it is suspected that a diagnostic shift began in the late 1990’s, such that deaths once classified as SIDS are increasingly categorized to other causes. Yet few studies have documented how coroners classify the manner and cause of infant deaths and the effects of diagnostic shifts on case-control study results are not well known. Anecdotally, it is apparent that diagnoses vary between and even within coroners offices because of differences between agencies’ protocols and the degree to which protocols are carried out by medical examiners. For instance, even without clear evidence of suffocation, co-sleeping may lead some investigators to call a death accidental suffocation rather than SIDS.

The goal of this study is to examine the relationship between co-sleeping and Sudden Unexpected Deaths in Infancy (SUDI) using a population-based case-control in California. The term Sudden Unexpected Deaths in Infancy (SUDI) was developed to encompass all sudden deaths to infants, including deaths classified as SIDS, undetermined, accidental suffocation, and homicide.

Hide this description

Hide Pediatrics project titles

OTHER

Morbidity and Mortality Associated with Acute Injuries Following Chiropractic Manipulation of the Cervical Spine

Chiropractic manipulation frequently causes transient minor side effects, and, less commonly, serious events resulting in neurological sequelae and stroke.  Valid estimates of the frequency of such acute events and the morbidity and mortality associated with them are currently lacking, however.  This project will use diagnostic and E-code data from hospital discharge and death certificate records from California to identify acute injuries, including posterior cervical artery circulation stroke and deaths associated with health-care delivery.  These data will then be linked to subjects’ hospital records and medical examiners’/coroners’ reports to specifically identify acute injuries associated with chiropractic procedures.  These data, coupled with population-based chiropractic utilization data, will be used to estimate the risk of acute injuries and death associated with chiropractic manipulation of the cervical spine.  Findings may be used by patients and health-care providers and policymakers in aiding informed decision-making and in the development of evidence-based guidelines for chiropractic care.

Hide this description
Hide Other project titles

 

Home > Mission Statement > Executive Committee > Projects > Course Work
Publications / Presentations > Community Advisory Committee > Affiliates
News and Events > Support Injury Prevention > Contact Us
UCLA Home Page