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International Collaborative Effort on Injury

International Collaborative Effort on Injury. June 1-3, 2005 Cuernevaca, Mexico Yvette Holder, Consultant Biostatistician/Epidemiologist. An Overview of ICE-related work. ICECI (Violence Module) WHO’s Injury Surveillance Guidelines Violence Indicators. INTENT. Unintentional.

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International Collaborative Effort on Injury

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  1. International Collaborative Effort on Injury June 1-3, 2005 Cuernevaca, Mexico Yvette Holder, Consultant Biostatistician/Epidemiologist

  2. An Overview of ICE-related work • ICECI (Violence Module) • WHO’s Injury Surveillance Guidelines • Violence Indicators

  3. INTENT Unintentional Proximal Risk Factors Perpetrator/Victim Relationship Self-directed Violence Sub-module Interpersonal Violence Sub-module INTENTIONAL Intentional Self-harm No. of previous attempts Interpersonal Context of Assault War/ Civil Conflict Type of conflict War/Civil Conflict Sub-Module Adverse Effects Undetermined Violence Module - ICECI

  4. WHO Injury Surveillance Guidelines

  5. Purpose of Guidelines • Provide surveillance officers/researchers with the basic tools for collecting information on injury • Facilitate capture of injury data in a standardised but flexible format • Hence, contribute to the building of an internationally comparable body of injury data

  6. Layout of the Guidelines - Introduction • Injury - definition; types; epidemiology • Surveillance - definition; purpose • Need for injury surveillance • Steps of the surveillance process • Attributes of a good surveillance system

  7. Identify Stakeholders Define/ Redefine Objectives Identify Data Sources & Systems Assess available resources Sensitise/Orient Stakeholders State Data Needs Draft Form & Formulate Data Collection System Process Data Monitor & Evaluate Design Output for Dissemination Implement & Train Designing an Injury Surveillance System

  8. Occupation Assaults Transport Sport Suicides Injury Surveillance Information System Overview Optional Data Set Optional Data Set MDS CORE

  9. Minimum Data Set (MDS) Residence, Date, Time, Alcohol Use, Drug Use, Object, Severity, Disposition Core Data Set - for All Injuries Optional Data Set Age, Sex, Intent, Place Activity, Nature of Injury, Mechanism/External Cause Text Summary

  10. CORE INJURY SURVEILLANCE INSTRUMENT- MDS

  11. Expanded Data Set – All Injuries

  12. Modules for Specific Injury Typese.g. Assaults Optional Data Set Minimum Data Set Circumstances, Perpetrator/Victim Relationship Object

  13. Building a Data Set Core Minimum Data Set with basic categories + modules + data elements + detailed categories = ICECI

  14. Way Forward • Application • Surveillance Guidelines • Validation • Comparison with Injury Matrix (60% of specifically defined cells) • excludes non-traffic, machinery, overexertion and natural/environment • includes sexual assault • % of unspecified injuries according to the ICECI MDS • ?Further editing

  15. Evaluation • Retrospective review of surveillance system data • Prospective System Evaluation • System Environment Evaluation

  16. Indicators for Monitoring Violence • Purpose: To monitor violence in the Americas in a standardised way • Types: • Basic: minimal, readily available • Developmental: desirable but collection would require a system to be put in place • Research: best collected via surveys Note: All rates are per 100,000 population

  17. Basic Indicators • Age-adjusted suicide rate • Age-adjusted homicide rate in males aged 15-44 yrs • Age-adjusted homicide rate in females aged 15-44 yrs • Homicide rate in children aged 0-4 yrs. • Reports of assault per 1000 pop. • Reports of robbery per 1000 pop. • Reports of kidnappings per 100,000 pop.

  18. Developmental Indicators – I • Age-adjusted death rate due to intimate partner violence (IPV) • Death rate due to child abuse • Death rate due to elder abuse • Age-adjusted robbery-related homicide rate • Age-adjusted hospital discharge rate due to suicide attempts • Age-adjusted hospital discharge rate due to assault in males aged 15-44 yrs

  19. Developmental Indicators – I ct’d • Age-adjusted hospital discharge rate due to assault in females aged 15-44 yrs • Hospital discharge rate due to assault in children aged less than 5 yrs • Hospital discharge rate for assault in elderly • Reported civil rights violations per 1,000 pop. • Reported cases of child maltreatment per 1,000 pop • Reported cases of school fights per 100,000 pop of school-aged children per yr

  20. Developmental Indicators – II • Age-adjusted hospital discharge rate for assault resulting from IPV • Hospital discharge rate resulting from child abuse • Hospital discharge rate for assault due to elder abuse

  21. Developmental Indicators – III • Age-adjusted Emergency Room (ER) visit rate due to suicide attempts • Age-adjusted ER visit rate in males aged 15-44 yrs. due to assaults • Age-adjusted ER visit rate due to assaults resulting from IPV • ER visit rate due to assaults resulting from child abuse • ER visit rate due to assaults resulting from elder abuse

  22. Research Indicators • Rate of suicide ideation • Rate of suicide attempts in past 12 months • Self-reported weapon carrying among youth at school, per 100 school children • Self-reported fighting rate among youth at school per 100 school children • Self-reported rate of IPV per 1,000 respondents

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