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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 l.jpg

International Collaborative Effort on Injury

June 1-3, 2005

Cuernevaca, Mexico

Yvette Holder,

Consultant Biostatistician/Epidemiologist


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An Overview of ICE-related work

  • ICECI (Violence Module)

  • WHO’s Injury Surveillance Guidelines

  • Violence Indicators


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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



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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


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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


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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


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Occupation

Assaults

Transport

Sport

Suicides

Injury Surveillance Information System Overview

Optional Data Set

Optional Data Set

MDS

CORE


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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




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Modules for Specific Injury Typese.g. Assaults

Optional Data Set

Minimum Data Set

Circumstances,

Perpetrator/Victim Relationship

Object


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Building a Data Set

Core Minimum Data Set with basic categories

+ modules

+ data elements

+ detailed categories

= ICECI


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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


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Evaluation

  • Retrospective review of surveillance system data

  • Prospective System Evaluation

  • System Environment Evaluation


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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


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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.


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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


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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


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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


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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


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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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