Completed Projects
Variations in Outcomes Following Hip Fracture Injury: Understanding the Effect of Hospital and Patient Volume Levels (Mary Carter, PhD, Assistant Professor, WVU Center on Aging, Department of Community Medicine, WVU SOM).
This seed project involved secondary analysis of multiple statewide hospital discharge datasets was performed and was coupled with data from the Area Resource File. Hospital discharge data identified nearly 37,000 hip-fracture surgical procedures on patients 65 years or older. Patients undergoing hip fracture procedures at hospitals with the lowest surgery volume had a 40% greater chance of dying compared to patients treated at hospitals with the highest volume levels. Patients treated for hip fractures at hospitals with higher procedure volumes had reduced odds of being discharged to a skilled nursing facility and greater odds of being discharged to home health care. Patient outcomes appear to be affected by the regional supply of physicians including those specially trained, and skilled nursing home beds. Older patients treated at hospitals with higher concentrations of older patients have greatly reduced odds of death. Results were presented at the 2006 Annual Meeting of the Gerontology Society of America.
Human Head Response to Impact Loads and Post-traumatic Response (Victor Mucino, PhD, Professor, WVU Department of Mechanical and Aerospace Engineering).
In this biomechanics seed project, viscoelastic constitutive models for brain tissue and skull were used to simulate the stress and strain wave propagation within the brain mass after a controlled impact to the skull. Model simulation of a head under impact with a ‘padded impactor’ and a ‘control impactor’ without padding were used in order to determine the effect of head protection (e.g., helmet). A Maximum Response Loci approach described the path of the point of maximum response (strain energy, shear strain, shear stress, etc.) though the geometry of the brain mass. An advanced protocol to conduct similar simulations on animals was submitted to the Southern Consortium for Injury Biomechanics (SCIB) for possible funding. Two manuscripts have been submitted to the Journal of Applied Biomechanics.
Internet Telemedicine Follow-up in Orthopaedic Trauma Patients (Dina Jones, PhD, PT, Assistant Professor and Director of Clinical Research, Departments of Orthopaedics and Physical Therapy, WVU SOM).
In this seed project, one-hundred patients aged 18-55, who had orthopaedic surgery at WVU, were randomly assigned for standard follow-up at either WVU (control) or at 1 of 4 telemedicine sites. Data collected compared safety-related issues and complication rates between the two groups; health-related quality of life measures, economic benefits to both patients and providers, and socio-demographic and geographical factors. Finally, radiographic, impairment-based, and functional outcomes were compared over a 6-month post-surgery period. Data analysis is underway. A conceptual poster was presented at the Second North American Congress of Epidemiology meeting in 2006 (American Journal of Epidemiology 2006 163(Suppl): S146/581. Manuscript preparation in underway.
Safety Helmet Use and Rider Habits(Ron Althouse, PhD, Professor and Director, WVU Survey Research Center).
This small core project conducted a random digit-dial telephone survey of adult households in WV to ascertain the public’s knowledge of and opinions about West Virginia’s 2004 ATV Safety Law, their compliance with this regulation, and their attitudes about the use of ATVs. A poster summarizing the statewide random telephone survey of adults households in West Virginia was presented at the 2006 Congress of Epidemiology, American Journal of Epidemiology 2006 163(Suppl): S208/831. Two manuscripts are in preparation.
Descriptive Analysis of Injury-related Healthcare Resources and Services Utilization among Recipients in the WV Medicaid Program (Michael Smith, PhD, RPh, Assistant Professor, Department of Pharmaceutical Systems and Policy, WVU SOP).
This seed project determined that there were over 80,000 WV Medicaid recipients who used medical services for injury in 2003; 25% of these encounters were for falls, 12% for being struck by an object and 10% each for being cut, or in a MV crash. Recipients between ages 45 and 64 had the highest rate (361 per 1,000 recipients). Males had a slightly higher rate (199) compared to females (194). A majority of medical services use for injury occurred in the outpatient (ED and office/clinic) setting; however, hospitalizations accounted for the greatest proportion of dollars paid for injury care. The average length of stay in the hospital for any diagnosis of injury was 4.5 days. Ninety-four percent of the (adult) injuries were coded as unintentional. Results were presented at the Second North American Congress of Epidemiology meeting in 2006. American Journal of Epidemiology 2006 163(Suppl): S206/824. Manuscripts have been submitted to the Maternal and Child Health Journal and Health Care for the Poor and Underserved.
Exercise Interventions and Injuries: A Meta-analysis of Randomized Controlled Trials (George Kelley, DA, Professor and Director, Meta=Analytic Research Group, Department of Community Medicine, WVU SOM).
A meta-analytic approach was used to examine the risk for injury as a result of participation in exercise intervention studies among previously sedentary adults 19 years of age and older. A 10% representative sample of 1,594 randomized controlled trails (RCTs) identified through Medline were statistically integrated and the relationship between selected characteristics and the risk of injury as a result of participation in exercise intervention studies was explored. Thirty-five RCTs met selection criteria. Preliminary results in this seed project suggest that overall, there was not a statistically significant or clinically important increase in the risk for dropping out of RCT exercise intervention studies because of injuries
Suicide in the Context of Multiple Causes of Death (Ian Rockett, PhD. Professor and Associate Chair, Department of Community Medicine, WVU SOM).
In this seed project, NCHS Multiple Cause of Death public use files for 1999-2003 were used to identify decedents from the 50 states and the District of Columbia whose underlying cause of death was pre-coded under ICD-10 as intentional self harm, injury of undetermined intent or accidental injury or their sequelae of external causes. Unintentional injury decedents served as the control group owing to similarity in nature and intensity of associated death investigations. It was hypothesized that suicides manifest excess psychiatric comorbidity compared to nonsuicide decedents, including substance disorders. Also, suicides manifest excess comorbidity attributable to physical disorders compared to nonsuicide decedents. A poster was presented at the First International Conference of the Journal of Public Health (2007) and a manusc4ript is in press for Injury Prevention.
West Virginia Fatality Assessment and Control Evaluation (FACE) Program (Jim Helmkamp, PhD, Director, WVU ICRC, Research Professor, Department of Community Medicine, WVU SOM).
This NIOSH-funded cooperative grant program administered through the WV Bureau for Public Health, was designed to identify all occupational deaths in WV, investigate selected cases, and develop and disseminate appropriate interventions. From 1996 until 2006, the WV FACE program, in collaboration with the WV Department of Labor’s CFOI and OSHA Offices and law enforcement offices across WV, identified nearly 600 work-related deaths. About 10% of these were fully investigated to better understand the fatal incident and to develop interventions and recommendations to employers and workers to prevent similar deaths in the future. During the 10-years of the FACE program, twenty 1-page industry- and cause-specific safety Alerts were prepared and distributed to a variety of worker groups, labor unions and safety organizations, within WV and across the country. Eight papers have been published in peer-review journals including the Journal of Occupational and Environmental Medicine, Professional Safety, and the American Journal of Industrial Medicine. Scores of papers and posters have been presented at regional, national and international meetings.
Logger Training Intervention Study (Jim Helmkamp, PhD, Director, WVU ICRC, Research Professor, Department of Community Medicine, WVU SOM).
This 5-year project, conducted in collaboration with the WV Division of Forestry and the WVU Appalachian Hardwood Center, developed a safety training video and handbook used during required safety training for loggers. During the 3-years of the intervention portion of the study, logger’s attitudes and knowledge about safety as well as self-reported work place habits changed significantly as a result of the safety video. A paper was published in Injury Prevention (2004; 10(4):233-238) and results presented at several national conferences.
ROPS Tractor Intervention Study (Jim Helmkamp, PhD, Director, WVU ICRC, Research Professor, Department of Community Medicine, WVU SOM).
This NIOSH-funded project, administered through the GLCASH, developed a safety video to inform WV farmers about the risks associated with tractor rollovers and the effectiveness of rollover protective structures (ROPS) in reducing traumatic injuries. Nearly 6,000 videos were distributed by the WV Farm Bureau. A series of surveys were conducted to determine if the video influenced change in tractor safety and farmer behavior. Over 80% of the farmers who received the video indicated that it increased their awareness about risks associated with tractor rollovers and ways to decrease these risks. For the one-third of the farmers who typically drive non-ROPS equipped tractors, the video appears to have influenced hundreds of farmers to consider installing or take action to install ROPS. We also responded to another 43 individual farmers (who were not originally sent a video) seeking a copy of the video after learning of its existence from a statewide press release. Finally, we responded to several local and nationally-based corporations, organizations, and governmental agencies including Dupont Corporation, the Veteran’s Administration and Indiana State University who requested multiple copies of the video for internal training programs and inclusion in their lending libraries. At the GLCASH’s request, this video was adapted for national use and over 1,000 VHS and DVD versions have been distributed. The video was highlighted in Gempler’s Alert, June 2006 Volume 13(6) and posted on the National Ag Safety Data (NASD) website.
Rural Emergency Preparedness (Jim Helmkamp, PhD, Director, WVU ICRC, Research Professor, Department of Community Medicine, WVU SOM).
This project, funded by the Health Resources and Services Administration, involved multiple sub-projects all designed to improve emergency preparedness and medical care in rural environments through research, education and training, and technical assistance. Two of the sub-projects involved a national survey of rural hospital preparedness and a regional survey of rural EMS preparedness. Another sub-project used systems modeling as a foundation for evidence-based disaster planning. Three peer-review papers resulted from this project: Manley, WG et al, Disaster Management and Response 2006; 4(3):80-87; Furbee PM, et al, Prehospital and Disaster Medicine 2006; 21(2):64-70; and Hoard M, et al, International Journal of Hygiene and Environmental health 2005; 208:117-125. Additionally, a video and accompanying manual to assist WV’s senior citizens to better prepare for emergencies were developed and distributed to senior centers across WV.
Use of Administrative Data Sources for Injury Research (Jeffrey Coben, MD, Director WVU Center for Rural Emergency Medicine and Professor, Department of Emergency Medicine, WVU SOM).
In collaboration with intramural staff of the Agency for Healthcare Research and Quality (AHRQ), this project examined the completeness of external cause of injury coding in the Healthcare Cost and Utilization Project (HCUP) databases. Successful completion of the project resulted in a comprehensive final report (posted on the HCUP website), presentations at national injury control conferences. A peer-review manuscript appeared in Injury Prevention 2006; 12:199-201. .
Motorcycle-related Hospitalizations in the United States (Jeffrey Coben, MD, Director WVU Center for Rural Emergency Medicine and Professor, Department of Emergency Medicine, WVU SOM).
Utilizing the AHRQ HCUP data, this project examined the characteristics of motorcycle-related hospitalizations in the United States and compared hospitalizations across states with different helmet use laws. A manuscript reporting nationwide hospitalization estimates and the costs associated with these cases was published in the American Journal of Preventive Medicine (2004; 27(5):355-362) and another paper summarizing motorcycle injuries in relation to helmet laws appeared in Accident Analysis and Prevention 2007; 39:190-196.
Co-occurring Child Maltreatment and Intimate Partner Violence (Jeffrey Coben, MD, Director WVU Center for Rural Emergency Medicine and Professor, Department of Emergency Medicine, WVU SOM).
This National Institute of Justice funded project collected contextual data from a national sample of child welfare agencies and domestic violence service agencies to examine the policies and procedures of these agencies when dealing with the issue of co-occurring child maltreatment and intimate partner violence. Led by investigators at Columbus Children’s Research Institute, WVU was a subcontracted collaborating organization. This project has produced multiple peer-review manuscripts including: Journal of Interpersonal Violence 2006; 21(6):774-797; Family Violence Prevention and Practice 2005; 1(2): 1-11; Children and Youth Services Review 2005; 27:1243-1258; Child and Youth Services Review 2007; 29:490-500; and Journal of Contemporary Social Services 2007; 88(1):35-41.
Physicians Reporting Unsafe Drivers (Jeffrey Coben, MD, Director WVU Center for Rural Emergency Medicine and Professor, Department of Emergency Medicine, WVU SOM).
This Pennsylvania Department of Transportation supported project determined the attitudes, beliefs, and behaviors of physicians regarding the required reporting of potentially unsafe drivers in the state of Pennsylvania. Methods included focus groups with practicing physicians representing different specialties and a statewide survey of physicians. A poster was presented at the 2007 meeting of the Society for Academic Emergency Medicine.
Evaluation of Injuries among Young Workers in West Virginia, 1996-2005 (Priscah Mujuru, DrPH, RN, Assistant Professor, Department of Community Medicine and Institute of This study, funded through the Johns Hopkins NIOSH Education Research Center, used Worker’s Compensation data to summarize the trend of work-related injuries sustained by young workers in West Virginia during the 10-year period, 1996-2005. Sixteen percent of the total WC claims for injury (566,546) were filed by young workers 14-24 years of age. The overall rate of occupational injury was highest among workers 19-21 (10.3 injuries per 100 employees) and significantly higher in male workers compared to female workers. Injuries were most common in services (32%), manufacturing (17%), and the wholesale/retail trade (17%) industries. Males accounted for the majority of the 74 young workers who died on the job. Results were presented at the 2006 meeting of the American Public Health Association.
Public Health Workforce Assessment (Ian Rockett, PhD, Professor and Associate Chair, Department of Community Medicine, WVU SOM).
This 2-year project funded by the WV Bureau for Public Health analyzed a survey of the states’ public health workforce to assess training needs. An official report, ‘Accounting for Population Health: A Profile of West Virginia’s Public Health Workforce and Its Training Needs,” was released in September 2007.