( A P u b l i c a t i o n o f t h e u a B I n j u r y C o n t r o l r e s e a r c h C e n t e r ]

informer

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Vol. 17 no. 2 Fall 2006

( U p c o m i n g e v e n t s ]

uaB injury control research centerch19 401 • 933 19th street south1530 3rd aVe sBirMinghaM al 35294-2041

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The University of Alabama at Birmingham administers its educational programs and activities, including admission, without regard to race, color, religion, sex, national origin, age, handicap, or Vietnam era or disabled veteran status.

[ )

aFter a decade of declining homicide rates in the city of Birmingham,

statistics appear to be on the rise again, with 65 homicides counted in

2002, 85 in 2003, 59 in 2004, and 104 in 2005. While some UAB

researchers believe the 2004 figure to be a statistical blip, a rising trend

may emerge if 2006 projections exceed homicide figures from last year.

“There’s something going on in Birmingham,” said Dr. John

Bolland, an associate professor in the UAB School of Public Health

and the principal investigator of a youth violence intervention program

(see page 3).

According to Dr. Bolland, Birmingham’s situation is similar to those

of increasingly abandoned urban centers across the country, where

abject poverty is becoming a heritable trait. U.S. Census Bureau data in

2004 showed that 16.9 percent of Alabamians live in poverty, up from

13.3 percent in 2000.

The numbers paint a bleak picture. The most economically disadvan-

taged tend to remain in the city and become isolated from the rest of

society. Often, clinically depressed parents struggle to manage their own

lives and fail to act as stable, confident role models for their children. Dr.

Bolland said that youth who live in a world of chaos, poverty, and violent

Learn More about the UAB ICRCThe UAB ICRC is breaking new ground every day, conducting practical research that protects and saves lives. Find out how the ICRC’s discoveries—including the projects described in this newsletter—can benefit you. Learn how you can get involved. And be part of the solution to the injury problem.

205.934.7845

Fax: 205.975.8143

www.uab.edu/icrc

Mailing Address:CH19 4011530 3RD AVE SBIRMINGHAM AL 35294-2041

Street Address:401 Community Health Services Building-19th Street933 19th Street SouthBirmingham, Alabama

Katherine S. Terry, M.P.H., Editor

November 4-8, 2006American Public Health Association 134th Annual Meeting & ExpositionBoston, MAWeb: www.apha.org/meetings/

December 13-14, 2006Southern Consortium for Injury Biomechanics 4th Annual Scientific SymposiumBirmingham, ALE-mail: jonathan.tidwell@ccc.uab.edu

February 27, 2007Alabama State of the State in Traumatic Brain Injury ConferenceBirmingham, ALWeb: www.ahif.org

March 16-17, 20074th Biennial National Conference on Health and Domestic ViolenceSan Francisco, CAWeb: www.endabuse.org/health/conference

dysfunction find little refuge and often lose hope for the future.

“The kids’ attitudes about violence include a strong sense of inevita-

bility,” he said. “They don’t feel they have a ‘long term.’”

Dr. Bolland believes that the involvement of society as a whole is

necessary for change.

“Violence is a public issue,” he said. “To address a major public

health issue, you need more than the local communities.”

Dr. Tom Kovandzic, an associate professor in the UAB Department

of Justice Sciences, agrees that something is going on in Birmingham,

but he has a different take on the recent increase in homicide rates.

“It’s prison re-entry,” he said. “We’ll release up to 600,000 from

prisons nationwide this year. The ones we’re releasing are worse than

the ones we’re putting in.”

Many of those released from prison have few marketable skills and

few opportunities to earn money legitimately. Many also have histories

of drug use and mental health problems. Increased prison populations

translate into less available funding for rehabilitation programs, with

the predictable result that many felons return to a life of crime after

their release from prison. “We must help them find non-criminal ways

of meeting their needs,” said Dr. Kovandzic.

Both professors see opportunities for change. Dr. Bolland posits that

renewed levels of connectedness in communities could lead to reduced

violence. “And we need to have people working full-time to facilitate

that,” he said.

According to Dr. Kovandzic, “we need to give felons released from

prison a helping hand, and then jobs.”

Birmingham

AddressingViolencein

Homicides in birmingham, aL (2002-2005)

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according to icrc scientist and motor

vehicle crash expert Dr. David Brown,

• nearly 144,000 vehicle crashes occurred on

Alabama’s roadways in 2005,

• more than 44,000 people were injured, and

• more than 1,100 people died.

In response to this enormous public health

and transportation problem, Alabama is putting

into play an aggressive plan to markedly reduce

those numbers by 2008.

The Alabama Strategic Highway Safety Plan,

or SHSP, was developed by federal, state, and

local traffic and safety professionals who ana-

[ ) [ )

Making Alabama’s roads safer together

2 3

lyzed vehicle crash data to deter-

mine the highest risk factors for

fatal collisions on Alabama road-

ways. Factors included failure to

use seat belts, speeding, delay

of emergency medical services

(EMS), alcohol and drug use,

young drivers (16-20 years old),

failure to obey signs or traffic

signals, and mature drivers (more

than 64 years old). These and

other factors were condensed and combined

into five major areas of emphasis for the

Alabama SHSP: run-off-road crashes, risky

driving, EMS, older drivers, and

legislation.

The second Safe Home

Alabama Summit was held in

Montgomery on June 29, 2006.

More than 225 government offi-

cials, law enforcement officers,

transportation researchers, and

others from across the state and

nation came together to discuss

implementation of the plan.

The gathering was sponsored by the Federal

Highway Administration and the Alabama

Department of Transportation in partnership

with eight other state- and federally-funded

entities, including the ICRC.

The summit focused on implementation of

the Alabama SHSP, and numerous presenta-

tions included words of encouragement from

federal partners, updates about work accom-

plished, and discussions about future efforts to

make Alabama’s roads safer for travel. All summit

attendees were encouraged to participate in an

area of emphasis.

ICRC staff members helped to plan the

summit and now continue their involvement in

SHSP implementation.

dr. david Brown

L at e - b r e a k i n g n e w s :

ICRC Research in Progress seminar series

want to know the inside scoop

on important injury control research

being conducted at UAB? Need to

find out how it’s going long before

it hits the journals? The Research

in Progress seminars sponsored by

the UAB Injury Control Research

Center are just the thing.

So far in 2006, the noon seminars

have covered advances in minority

youth violence prevention, child pas-

senger safety, and eye injury research.

Topics scheduled for fall include

transportation safety research, tissue

biomechanics, and bicycle safety.

Contact the ICRC at (205) 934-

7845 or e-mail Katherine Terry at

katherine.terry@ccc.uab.edu to be

notified about upcoming seminars—

and don’t forget to bring your lunch!

Internet connections facilitate ICRC Journal Club

Is it Working?Inner-city intervention:the good news is that the violent crime rate

in the United States reached the lowest point on

record in 2004, according to the U.S. Bureau of

Justice Statistics. The bad news is that the rate

remains unacceptably high, particularly among

minority youth living in the inner city.

Finding ways to reduce violent crime is

the focus of Dr. John Bolland’s ICRC-funded

evaluation of the Mobile Police Department’s

Family Intervention (FIT) Program. The FIT

Program brings social workers into Mobile’s

inner-city neighborhoods where they work

with at-risk youth to help reduce high-risk

behaviors. The research team observes the

work and interviews the social workers and

community residents to determine what is

working and why.

The goal of the process evaluation is to

determine how the FIT Program is put into

practice in the hope that it can be implement-

ed in other locations. The outcome evaluation

examines the intervention’s impact on violent

behavior by analyzing data from the ongoing

Mobile Youth Survey (MYS), a longitudinal

study of 12-to-18-year-olds living in high-pov-

erty neighborhoods in southwest Alabama.

Through years of research, Dr. Bolland has

found support for the theory that violence cor-

responds with poverty and disconnection from

society. Those who can leave the inner city do

so; those who remain are at an increasing risk

of depression and hopelessness. Young people

in those communities see little prospect for

a promising future, so little impact is gained

from interventions that hope to modify violent

behavior by emphasizing possible negative

outcomes later in life.

The rigorous evaluation of the Mobile

project will offer insight into the types of

programs most likely to be effective with

inner-city youth. The MYS will also help guide

the design of other programs to address and

reduce injury and death due to violence by

examining trends in the ways violence devel-

ops among that population.

a journal club that meets 24/7/365? Spirited dis-

cussions about the most recent injury prevention and

control research are now just a mouse-click away.

The ICRC continues its commitment to help

interested scientists and students stay atop the lit-

erature by establishing an Electronic Journal Club.

Participants are able to join in exchanges any time,

day or night, from anywhere in the world. Authors

of articles under discussion are even encouraged to

come online and participate in the exchange.

The ICRC’s EJC enables anyone with interests

in specific topics to take full advantage of today’s

Internet technology. Anyone interested in being con-

nected to the latest discussions should contact Jeff

Foster at jeffrey.foster@ccc.uab.edu.

[ ) [ )4 5

Emerging Research: Glucose intolerance and commercial truck crashes

when an 18-wheeler swings out onto

the road and begins closing distance,

few drivers think, “I wonder if he needs

a doughnut?”

That’s just the questions the UAB

ICRC is asking—in a more scientific

way—in its ongoing pilot study of dia-

betes and glucose intolerance among

long-haul truck drivers. The study

seeks to determine the existence of a

meaningful link between undiagnosed,

poorly managed diabetes or glucose

intolerance and crash history in com-

mercial truck drivers.

“Historically, studies have shown

that people with poorly controlled dia-

betes can become hypoglycemic, thus

more likely to crash,” said Jeff Foster,

who manages the study for the ICRC.

“Hypoglycemia can suddenly cause

extreme fatigue, dizziness, shakiness,

nausea, vomiting, and disorientation.

Any of these factors could play a huge

role in a driver crashing a vehicle.”

Long-haul truck drivers sit for hours

and often find it difficult to eat healthy

meals. Irregular activity, poor eating

habits, and the resulting excess body

weight are all markers of elevated risk

for diabetes. Few rigorous studies have

looked at the connection between dia-

betes, glucose intolerance, and truck

crashes.

The ICRC is recruiting 100 drivers

for the study. A painless finger puncture

will provide a small blood specimen

from which will be measured hemoglo-

bin A1C, a compound indicating the

subject’s blood sugar level over the past

90 days. Study personnel will analyze

the crash data records and blood sugar

levels of participating truck drivers to

determine any significant relationship

between poor blood sugar management

and collision history.

Those drivers who may have

untreated or poorly managed glu-

cose intolerance or diabetes will be

notified and encouraged to see a

physician. Currently, the ICRC is seek-

ing additional funding to expand the

pilot study.

UAB UTC Associate Directors Named

dr. russ Fine, director of the UAB ICRC, SCIB, and

the newly established University Transportation Center

(UTC), has named two associate directors for the UAB

UTC.

Dr. Jay Goldman will take on the position of Associate

Director for Research and Scientific Oversight in addi-

tion to his current duties within the ICRC and SCIB. Dr.

Goldman is a Distinguished Service Professor and dean

emeritus of the UAB School of Engineering, among

other accolades. In his capacity with the UTC, his prima-

ry responsibility will be coordinating and managing the

research project selection process, as well as the ongo-

ing monitoring of project quality and progress through-

out the grant cycle. He will also serve as the UTC’s liaison

with the UAB School of Engineering, the SCIB, and the

University Transportation Center of Alabama.

Andrea Underhill will assume the position of Associate

Director for Administration and Finance. She will be

responsible for managing and coordinating all day-to-day

operations and support activities of the UTC, ranging

from financial management to assistance with the selec-

tion and monitoring of research project quality and

progress.

Currently, the UTC leadership is developing a manda-

tory strategic plan, which must be approved by the over-

sight agency, the U.S. Department of Transportation’s

Research and Innovative Technology Administration

(RITA), before the center can become fully operational.

To maximize research potential in the UAB UTC,

which is the only university transportation center in the

country associated with a medical school, the center has

joined forces with Dr. Loring Rue, Professor of Surgery,

Chief of Trauma and Burns, and Director of the Center for

Injury Science. Together they are establishing the UAB

Transportation Safety and Injury Research Institute. The

UTC strategic plan will reflect this partnership, as well

as the breadth of resources available through established

ICRC and SCIB research relationships.

ICRC cultivates researcher through Minority Enrichment Program

Freelance writer, teacher, children’s author, filmmaker, and now,

researcher.

Demetrius Paschel has worn many hats, but his goal in life is

singular—to help children live better lives. When he learned about

the ICRC-funded evaluation research being done by John Bolland in

Mobile, Paschel wanted to be a part of it. Through the ICRC Minority

Enrichment Program, he got that chance.

This past summer, Paschel worked with Dr. Bolland’s team

to evaluate the effectiveness of a minority youth violence pre-

vention program (see page 3). His involvement doesn’t stop

there; Paschel took notes on his experiences and interviewed

program providers, program participants, and his own fellow

researchers in order to publish a magazine article about the

Mobile project and, ultimately, produce a film about it.

“What Dr. Bolland is doing is very unique and needed. It

provides hope for the children and their families,” Paschel said.

“I want to be a vehicle to shed some light on the situation.”demetrius Paschel

ICRC seed grant helps reduce time, cost of pressure ulcer treatmentskin is the most frequently injured organ in

the body, and pressure ulcers are among the most

common injuries to the skin. New treatments

for pressure ulcers may reduce the time patients

spend in bed from six months to six weeks, with-

out requiring surgery.

Pressure ulcers form when soft tissue is com-

pressed over a bony prominence for a prolonged

period of time. People who spend extended time

in one position, such as those confined to a wheel-

chair due to spinal cord injury, are most at risk.

Dr. Dale Feldman, an associate professor in

biomedical engineering at UAB, is studying the

assessment and treatment of pressure ulcers in

a home environment through an ICRC intramu-

ral seed grant. Currently, treatment options are

limited; patients face bed rest for three to six

months without surgery, or surgery followed

by six weeks of bed rest and an increased risk

of recurring sores around the surgery scar. Dr.

Feldman hopes to provide another option by

developing treatments that would, through the

use of innovative wound dressings and electrical

stimulation, allow patients to recover at home in

about six weeks without undergoing surgery.

The goal is “to get these patients out of bed

and performing their normal activities without the

cost of surgery,” Dr. Feldman said, and to “give the

clinicians more flexibility in medical care.”

This approach could reduce health care costs

by millions of dollars nation-

wide. The ongoing research

has already yielded one treat-

ment that helps heal pressure

ulcers in patients with spinal

cord injuries, and others are

under development.

dr. dale Feldman

[ ) [ )6 7

SCIB Research Into Action: Konigsberg Instruments

traFFic on the freeway is backed up.

Suddenly, a vehicle rear-ends you. Your head

snaps forward and back. A bad day just got

worse.

As you climb from your car to check the

damage, you probably don’t think about the

complex body mechanics that enabled you to

absorb the hit and still move your body nor-

mally. Those mechanics are precisely what the

SCIB wants to know more about.

Konigsberg Instruments Inc. in Pasadena,

Calif. recently completed SCIB-sponsored

work on a nine-accelerometer mouth-

piece that will interface with pre-existing

National Highway Transportation Safety

Administration software. The assembly will

measure the accelerations of the head in simu-

lated crash environments or circumstances

like a boxing arena.

Using information gathered by the mouth-

piece, models can be refined to examine the

movements of the head and neck in a vehicle

crash. The models can help researchers learn

more about the specific parts of the head and

neck that undergo stress or damage in injury

scenarios. They can also help medical pro-

fessionals provide more accurate diagnoses

and treatment with the help of the models

and help engineers create safer vehicles and

roadways.

The design is currently in the prototype

stage. The NHTSA will test the accelerom-

eter and determine its future use.

konigsberg industries nine-accelerometer array

toP scientists in the field of injury

biomechanics will share their latest research

findings at the Southern Consortium of

Injury Biomechanics Fourth Annual Scientific

Symposium in Birmingham on Wednesday,

December 13 and Thursday, December 14,

2006.

SCIB-funded scientists from some of

America’s most prestigious research univer-

sities will present their latest findings at the

event, highlighted by the participation of

Mr. Tomiji Sugimoto, vice president of the

Automobile Technology Research Division

of Honda R&D Americas, Inc.

The unique gathering will provide par-

ticipants with opportunities to exchange

ideas about ways in which their individual

areas of research expertise can be integrated

to advance the field of injury biomechanics

and, ultimately, save lives.

SCIB Fourth Annual Symposium, December 2006

crash test dummies have become

cultural icons, featured in witty televi-

sion commercials and the name of a rock

band. But in the laboratory, they are

being replaced with new digital models

of the human body.

The SCIB is at the forefront of

digital modeling with its Digital Child

Project, or DCP. Drawing top scien-

tists into a collaborative effort, the

SCIB is developing digital models to

represent children at various stages of

development. The DCP will provide

scientists with a means to examine the

effects of vehicle crashes on the young,

improving children’s safety in automo-

biles and treatment for children injured

in crashes.

Drs. Albert King and King Yang from

Wayne State University in Michigan

plan to use MRI scans of actual children

to obtain precise structural dimensions

for males and females at ages three, six,

and 10. They will also review common

injuries sustained by children in vehicle

crashes and make recommendations to

the computer modeling team as to spe-

cific details of the Digital Children.

Dr. Bharat Soni, professor and

chairman of the UAB Department of

Mechanical Engineering, and his team

will build computer models, known

as finite element (FE) mesh modeling,

from the data supplied by the WSU

team. The finer the detail of the data,

and therefore the FE mesh, the closer

simulated injuries will be to actual inju-

ries likely to arise from a crash.

The UAB team will conduct trial

simulations of the mesh models and

compare the results with known data

from impact biomechanics research.

The computer models will be adjusted

and retested until they produce the

expected responses. Once the DCP

FE models are developed, refined

versions can be used effectively in

research and design to make vehicles

safer for children during crashes.

SCIB Digital Child Project underway

Exciting Prospects:

Honda VP ICRC, Lauds Injury Biomechanics Research

On August 16th, UAB’s Southern Consortium for

Injury Biomechanics and The School of Medicine wel-

comed Mr. Tomiji Sugimoto, Vice President of Honda

R&D Americas, Inc., Automobile Technology Research

Division, as he visited the campus.

Drs. Russ Fine, Jay Goldman, and Bharat Soni of

UAB and Dr. Jeff Crandall of the University of Virginia

represented the SCIB Executive Leadership Group. The

School of Medicine’s Senior Associate Deans Allen

Bolton and Dr. Bob Kimberly participated in this land-

mark meeting, and hosted a luncheon honoring Mr.

Sugimoto.

Dr. Crandall, also Director of the UVA Center for

Applied Biomechanics and a leading expert on impact

injury mechanisms, presented an overview of SCIB

research on behalf of its executive council.

Others present included Chuck Ernst, Plant Manager

of Honda Manufacturing of Alabama, Don Erwin, Vice

President of Corporate Development for The Barber

Companies, Tom Acheson, Chairman and CEO of

Tameron Honda and Dr. Ken Burke, UAB’s Associate

Vice President of Development.

Mr. Sugimoto is scheduled to participate in the SCIB

4th Annual Scientific Symposium (see page 6) and con-

tinue discussions regarding Honda’s possible collabora-

tion with the SCIB.

(From l to r) tom acheson, tomiji sugimoto and chuck ernst

jonathan Tidwell is excited about

the Southern Consortium for Injury

Biomechanics (SCIB).

“It’s pretty amazing that I have an

opportunity to associate with some of

the most highly regarded injury bio-

mechanists in the world,” said Tidwell,

manager of the SCIB since October

2005. “They are brilliant people, and

their research really does save lives.”

Tidwell began working with the SCIB

while still a student at UAB. After receiv-

ing an undergraduate degree in finance

from the School of Business two years

ago, he joined the consortium full-time.

“It’s more interesting and challenging

than the usual, everyday choices avail-

able for most business school graduates,”

he said.

In addition to maintaining the signif-

icant day-to-day financial aspects of the

consortium, Mr. Tidwell communicates

with funding agencies, submits quar-

terly reports on all research projects,

and coordinates annual events such

as the upcoming SCIB symposium (see

page 6).

Jonathan Tidwell,

Manager of the SCIB