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Macpherson AK, Zagorski B, Saskin R, Howard AW, Harris MA, Namin S, Rothman L. Comparison of the number of pedestrian and cyclist injuries captured in police data compared with health service utilisation data in Toronto, Canada 2016-2021. Inj Prev 2024; 30:161-166. [PMID: 38195658 PMCID: PMC10958284 DOI: 10.1136/ip-2023-044974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 11/18/2023] [Indexed: 01/11/2024]
Abstract
INTRODUCTION Pedestrian and cyclist injuries represent a preventable burden to Canadians. Police-reported collision data include information on where such collisions occur but under-report the number of collisions. The primary objective of this study was to compare the number of police-reported collisions with emergency department (ED) visits and hospitalisations in Toronto, Canada. METHODS Police-reported collisions were provided by Toronto Police Services (TPS). Data included the location of the collision, approximate victim age and whether the pedestrian or cyclist was killed or seriously injured. Health services data included ED visits in the National Ambulatory Care Reporting System and hospitalisations from the Discharge Abstract Database using ICD-10 codes for pedestrian and cycling injuries. Data were compared from 2016 to 2021. RESULTS Injuries reported in the health service data were higher than those reported in the TPS for cyclists and pedestrians. The discrepancy was the largest for cyclists treated in the ED, with TPS capturing 7.9% of all cycling injuries. Cyclist injuries not involving a motor vehicle have increased since the start of the pandemic (from 3629 in 2019 to 5459 in 2020 for ED visits and from 251 in 2019 to 430 for hospital admissions). IMPLICATIONS While police-reported data are important, it under-reports the burden. There have been increases in cyclist collisions not involving motor vehicles and decreases in pedestrian injuries since the start of the pandemic. The results suggest that using police data alone when planning for road safety is inadequate, and that linkage with other health service data is essential.
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Affiliation(s)
- Alison K Macpherson
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Brandon Zagorski
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Refik Saskin
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | | | - M Anne Harris
- School of Occupational and Public Health, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Sima Namin
- Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Linda Rothman
- School of Occupational and Public Health, Toronto Metropolitan University, Toronto, Ontario, Canada
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Carsley S, Thomas S, Oei T, Smith B, Harrington D, Pike I, Macpherson AK, Richmond SA. Child abuse and neglect during the COVID-19 pandemic: An umbrella review. Child Abuse Negl 2024; 149:106645. [PMID: 38241804 DOI: 10.1016/j.chiabu.2024.106645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 12/13/2023] [Accepted: 01/10/2024] [Indexed: 01/21/2024]
Abstract
BACKGROUND During the COVID-19 pandemic, multiple child health experts postulated that the stay-at-home orders would negatively impact child abuse and neglect. OBJECTIVES We aimed to examine the impact of the COVID-19 pandemic on child abuse and neglect in children ages 18 and under; and review author recommendations for future emergency lockdown procedures. METHODS We completed a systematic search of articles across five databases. Review-level studies were included if they examined any abuse or neglect related outcomes in children and youth (e.g., injuries, case openings), and were published in English. We completed quality appraisals of each included article using the Health Evidence™ tool. We categorized the findings by data source including administrative and survey data, or other data sources. We also narratively summarized reported recommendations. RESULTS In total, 11 reviews were included. Two reviews were of strong quality, 7 moderate, and 2 were weak. Overall, studies within reviews that reported from administrative data sources demonstrated decreased child abuse and neglect outcomes compared to before the pandemic. Studies using cross-sectional data demonstrated increases. Reviews with mixed results often reported increases in emotional, neglect and psychological abuse cases and decreases physical and sexual abuse cases. CONCLUSIONS This study found consistent results across reviews; depending on the data source and study design, child abuse and neglect outcomes either increased or decreased during the COVID-19 pandemic. Future work should enhance data collection methods for surveillance and intervention of child abuse and neglect during public health emergencies when traditional mechanisms are limited, with an increased focus on the rigor of reporting.
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Affiliation(s)
- Sarah Carsley
- Department of Health Promotion Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Sera Thomas
- Department of Health Promotion Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Canada
| | - Tiffany Oei
- Department of Health Promotion Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Canada
| | - Brendan Smith
- Department of Health Promotion Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Daniel Harrington
- Department of Health Promotion Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Canada
| | - Ian Pike
- British Columbia Injury Research and Prevention Unit, BC Children's Hospital, Vancouver, BC, Canada; Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | | | - Sarah A Richmond
- Department of Health Promotion Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
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D’Souza NC, Kesibi D, Yeung C, Shakeri D, D’Souza AI, Macpherson AK, Riddell MC. The Impact of Sex, Body Mass Index, Age, Exercise Type and Exercise Duration on Interstitial Glucose Levels during Exercise. Sensors (Basel) 2023; 23:9059. [PMID: 38005447 PMCID: PMC10674905 DOI: 10.3390/s23229059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 11/03/2023] [Accepted: 11/06/2023] [Indexed: 11/26/2023]
Abstract
The impact of age, sex and body mass index on interstitial glucose levels as measured via continuous glucose monitoring (CGM) during exercise in the healthy population is largely unexplored. We conducted a multivariable generalized estimating equation (GEE) analysis on CGM data (Dexcom G6, 10 days) collected from 119 healthy exercising individuals using CGM with the following specified covariates: age; sex; BMI; exercise type and duration. Females had lower postexercise glycemia as compared with males (92 ± 18 vs. 100 ± 20 mg/dL, p = 0.04) and a greater change in glycemia during exercise from pre- to postexercise (p = 0.001) or from pre-exercise to glucose nadir during exercise (p = 0.009). Younger individuals (i.e., <20 yrs) had higher glucose during exercise as compared with all other age groups (all p < 0.05) and less CGM data in the hypoglycemic range (<70 mg/dL) as compared with those aged 20-39 yrs (p < 0.05). Those who were underweight, based on body mass index (BMI: <18.5 kg/m2), had higher pre-exercise glycemia than the healthy BMI group (104 ± 20 vs. 97 ± 17 mg/dL, p = 0.02) but similar glucose levels after exercise. Resistance exercise was associated with less of a drop in glycemia as compared with aerobic or mixed forms of exercise (p = 0.008) and resulted in a lower percent of time in the hypoglycemic (p = 0.04) or hyperglycemic (glucose > 140 mg/dL) (p = 0.03) ranges. In summary, various factors such as age, sex and exercise type appear to have subtle but potentially important influence on CGM measurements during exercise in healthy individuals.
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Affiliation(s)
- Ninoschka C. D’Souza
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, ON M3J 1P3, Canada; (N.C.D.); (D.K.); (C.Y.); (D.S.); (A.K.M.)
| | - Durmalouk Kesibi
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, ON M3J 1P3, Canada; (N.C.D.); (D.K.); (C.Y.); (D.S.); (A.K.M.)
| | - Christopher Yeung
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, ON M3J 1P3, Canada; (N.C.D.); (D.K.); (C.Y.); (D.S.); (A.K.M.)
| | - Dorsa Shakeri
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, ON M3J 1P3, Canada; (N.C.D.); (D.K.); (C.Y.); (D.S.); (A.K.M.)
| | | | - Alison K. Macpherson
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, ON M3J 1P3, Canada; (N.C.D.); (D.K.); (C.Y.); (D.S.); (A.K.M.)
| | - Michael C. Riddell
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, ON M3J 1P3, Canada; (N.C.D.); (D.K.); (C.Y.); (D.S.); (A.K.M.)
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4
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Caplan L, Lashewicz B, Pitt TM, Aucoin J, Fridman L, HubkaRao T, Pike I, Howard AW, Macpherson AK, Rothman L, Cloutier MS, Hagel BE. Blame attribution analysis of police motor vehicle collision reports involving child bicyclists. Inj Prev 2023; 29:407-411. [PMID: 37295929 DOI: 10.1136/ip-2023-044884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 05/14/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND Injuries resulting from collisions between a bicyclist and driver are preventable and have high economic, personal and societal costs. Studying the language choices used by police officers to describe factors responsible for child bicyclist-motor vehicle collisions may help shift prevention efforts away from vulnerable road users to motorists and the environment. The overall aim was to investigate how police officers attribute blame in child (≤18 years) bicycle-motor vehicle collision scenarios. METHODS A document analysis approach was used to analyse Alberta Transportation police collision reports from Calgary and Edmonton (2016-2017). Collision reports were categorised by the research team according to perceived blame (child, driver, both, neither, unsure). Content analysis was then used to examine police officer language choices. A narrative thematic analysis of the individual, behavioural, structural and environmental factors leading to collision blame was then conducted. RESULTS Of 171 police collision reports included, child bicyclists were perceived to be at fault in 78 reports (45.6%) and adult drivers were perceived at fault in 85 reports (49.7%). Child bicyclists were portrayed through language choices as being irresponsible and irrational, leading to interactions with drivers and collisions. Risk perception issues were also mentioned frequently in relation to poor decisions made by child bicyclists. Most police officer reports discussed road user behaviours, and children were frequently blamed for collisions. CONCLUSIONS This work provides an opportunity to re-examine perceptions of factors related to motor vehicle and child bicyclist collisions with a view to prevention.
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Affiliation(s)
- Lea Caplan
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Bonnie Lashewicz
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Tona Michael Pitt
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Janet Aucoin
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Liraz Fridman
- Engineering and Transportation Services, Infrastructure, Development & Enterprise, City of Guelph, Guelph, Ontario, Canada
- Department of Mechanical and Industrial Engineering, University of Toronto, Toronto, Ontario, Canada
| | - Tate HubkaRao
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Ian Pike
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
- BC Injury Research and Prevention Unit, Vancouver, British Columbia, Canada
| | - Andrew William Howard
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Alison K Macpherson
- School of Kinesiology & Health Science, Faculty of Health, York University, Toronto, Ontario, Canada
| | - Linda Rothman
- Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, Ontario, Canada
- School of Occupational and Public Health, Faculty of Community Services, Toronto Metropolitan University, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Marie-Soleil Cloutier
- Centre Urbanisation Culture Société, Institut National de la Recherche Scientifique, Montreal, Quebec, Canada
| | - Brent E Hagel
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Rothman L, Hagel BE, Howard AW, Schwartz N, Cloutier MS, Macpherson AK. Is higher school neighbourhood Walk Score associated with greater child pedestrian safety near schools? Inj Prev 2023; 29:363-366. [PMID: 37336630 DOI: 10.1136/ip-2023-044922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
Walk Score is a common index used to estimate how suitable the built environment is for walking. Although Walk Score has been extensively validated as a measure of walkability and walking, there are limited studies examining whether commonly used constructs of walkability are associated with traffic safety in children. This study examined the association between Walk Score and child pedestrian injury controlling for observed walking exposure in school zones in Calgary, Toronto and Montreal, Canada. Results indicate that a higher Walk Score was associated with more child pedestrian injuries in all three cities, even after controlling for walking exposure. School travel planning should consider established individual pedestrian collision risk and individual factors rather than assuming a highly walkable environment is also a safe pedestrian environment.
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Affiliation(s)
- Linda Rothman
- School of Occupational and Public Health, Toronto Metropolitan University, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Brent E Hagel
- Department of Paediatrics, Univ of Calgary, Calgary, Alberta, Canada
| | | | - Naomi Schwartz
- School of Occupational and Public Health, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Marie Soleil Cloutier
- Centre Urbanisation Culture Société, Institut national de la recherche scientifique, Quebec City, Quebec, Canada
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Hurtubise JM, Gorbet DJ, Hynes L, Macpherson AK, Sergio LE. Cortical and cerebellar structural correlates of cognitive-motor integration performance in females with and without persistent concussion symptoms. Brain Inj 2023; 37:397-411. [PMID: 36548113 DOI: 10.1080/02699052.2022.2158231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Fifteen percent of individuals who sustain a concussion develop persistent concussion symptoms (PCS). Recent literature has demonstrated atrophy of the frontal, parietal, and cerebellar regions following acute concussive injury. The frontoparietal-cerebellar network is essential for the performance of visuomotor transformation tasks requiring cognitive-motor integration (CMI), important for daily function. PURPOSE We investigated cortical and subcortical structural differences and how these differences are associated with CMI performance in those with PCS versus healthy controls. METHODS Twenty-six age-matched female participants (13 PCS, 13 healthy) completed four visuomotor tasks. Additionally, MR-images were analyzed for cortical thickness and volume, and cerebellar lobule volume. RESULTS No statistically significant group differences were found in CMI performance. However, those with PCS demonstrated a significantly thicker and larger precuneus, and significantly smaller cerebellar lobules (VIIIa, VIIIb, X) compared to controls. When groups were combined, volumes of both the cerebellar lobules and cortical regions were associated with CMI task performance. CONCLUSION The lack of behavioral differences combined with the structural differences may reflect a compensatory mechanism for those with PCS. In addition, this study highlights the effectiveness of CMI tasks in estimating the structural integrity of the frontoparietal-cerebellar network and is among the first to demonstrate structural correlates of PCS.
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Affiliation(s)
- Johanna M Hurtubise
- School of Kinesiology and Health Science, York University, Toronto, Canada
- Centre for Sport and Exercise Education, Camosun College, Victoria, Canada
| | - Diana J Gorbet
- School of Kinesiology and Health Science, York University, Toronto, Canada
| | - Loriann Hynes
- School of Kinesiology and Health Science, York University, Toronto, Canada
| | | | - Lauren E Sergio
- School of Kinesiology and Health Science, York University, Toronto, Canada
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7
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Migotto BDJ, Gill S, Sem M, Macpherson AK, Hynes LM. Sex-related differences in sternocleidomastoid muscle morphology in healthy young adults: A cross-sectional magnetic resonance imaging measurement study. Musculoskelet Sci Pract 2022; 61:102590. [PMID: 35667320 DOI: 10.1016/j.msksp.2022.102590] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 05/19/2022] [Accepted: 05/22/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Changes in sternocleidomastoid (SCM) muscle cross-sectional area (CSA) and volume may contribute to neck-related concussion symptoms and whiplash-associated disorders. Magnetic resonance imaging (MRI) data on healthy SCM morphology can provide information that may lead to targeted treatment protocols. OBJECTIVES To examine sex-related differences in MRI-based SCM CSA, SCM volume and neck area in healthy young adults, to analyze associations between measurements and participant variables and to assess inter-rater reliability for measurement quantification. DESIGN Cross-sectional study. METHODS 13 males and 14 females underwent MRI scans. Slices obtained from C3-C7 were analyzed by three raters. SCM CSA at C4, total SCM volume from C3-C7 and neck area at C4 were quantified. Measurements were calculated as absolute and normalized values by body mass. Multivariable regression was used to analyze associations between normalized measurement values and participant variables. Inter-rater reliability was determined using intraclass correlation coefficients (ICC). RESULTS Females had significantly lower normalized overall average SCM CSA (mean difference 1.3 mm2/kg (95% CI 0.4-2.2, p = 0.006) and total SCM volume (mean difference 140.8 mm3/kg (95% CI 66.1-215.5, p < 0.001) than males. Regression models indicated female sex was associated with lower normalized overall average SCM CSA (p = 0.004) and total SCM volume (p < 0.001). Inter-rater reliability was excellent for SCM CSA (ICC3,3 = 0.909), SCM volume (ICC3,3 = 0.910) and neck area (ICC3,3 = 0.995). CONCLUSIONS These results enhance our understanding of sex-related differences in SCM morphology and will inform future research and clinical practice related to cervical muscle injury.
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Affiliation(s)
- Ben D J Migotto
- Whiplash and Head Injury Prevention/Rehabilitation (WHIPR) Lab, York University, 4700, Keele Street, Toronto, ON, M3J 1P3, Canada; School of Kinesiology & Health Science, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
| | - Sandeep Gill
- Whiplash and Head Injury Prevention/Rehabilitation (WHIPR) Lab, York University, 4700, Keele Street, Toronto, ON, M3J 1P3, Canada; School of Kinesiology & Health Science, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
| | - Matthew Sem
- Whiplash and Head Injury Prevention/Rehabilitation (WHIPR) Lab, York University, 4700, Keele Street, Toronto, ON, M3J 1P3, Canada; School of Kinesiology & Health Science, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
| | - Alison K Macpherson
- School of Kinesiology & Health Science, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada; York University Sport Medicine Team, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
| | - Loriann M Hynes
- Whiplash and Head Injury Prevention/Rehabilitation (WHIPR) Lab, York University, 4700, Keele Street, Toronto, ON, M3J 1P3, Canada; School of Kinesiology & Health Science, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada; York University Sport Medicine Team, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada.
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Douglas AS, Rotondi MA, Baker J, Jamnik VK, Macpherson AK. A Comparison of On-Ice External Load Measures Between Subelite and Elite Female Ice Hockey Players. J Strength Cond Res 2022; 36:1978-1983. [DOI: 10.1519/jsc.0000000000003771] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Rothman L, Schwartz N, Cloutier MS, Winters M, Macarthur C, Hagel BE, Macpherson AK, El Amiri N, Fuselli P, Howard AW. Child pedestrian and cyclist injuries, and the built and social environment across Canadian cities: the Child Active Transportation Safety and the Environment Study (CHASE). Inj Prev 2022; 28:311-317. [PMID: 35058306 PMCID: PMC9340017 DOI: 10.1136/injuryprev-2021-044459] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 12/31/2021] [Indexed: 12/02/2022]
Abstract
Introduction Traffic injury is a leading and preventable cause of child death and disability, with child pedestrians and cyclists particularly vulnerable. Examining built environment correlates of child pedestrian and cyclist motor vehicle collisions (PCMVC) in different settings is needed to promote an evidence-based approach to road safety. Methods We conducted a cross-sectional study across multiple urban/suburban environments in Canada (Calgary, Toronto, Montreal, Laval, Peel Region). All public elementary schools were included (n=1030). We examined the role of land use/social environments, road environments and traffic safety interventions on the rates of child PCMVC within 1000 m of schools. Multivariable negative binomial regression was conducted for all cities and by individual city. In a subset of schools (n=389), we examined associations when controlling for active school transportation (AST). Results Mean PCMVC rate per school ranged from 0.13 collisions/year in Peel to 0.35 in Montreal. Child PCMVC were correlated with land use, social and road environments and traffic safety interventions. In fully adjusted models, social and land use features remained the most important correlates. New immigrant population had the largest positive association with child PCMVC (incidence rate ratio (IRR): 1.26, 95% CI 1.06 to 1.50), while old housing (pre-1960) density was most protective (IRR: 0.83, 95% CI 0.77 to 0.90). AST was associated with PCMVC, but it had no effect on the relationships between PCMVC and other social/environmental correlates. Conclusion The built environment and social factors influence rates of child PCMVC. Opportunities to reduce child PCMVC exist through modifications to city design and road environments and implementing traffic safety interventions.
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Affiliation(s)
- Linda Rothman
- School of Occupational and Public Health, Ryerson University, Toronto, Ontario, Canada
- Child Health Evaluative Sciences, The Hospital for Sick Children, SickKids Research Institute, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Naomi Schwartz
- School of Occupational and Public Health, Ryerson University, Toronto, Ontario, Canada
| | - Marie-Soleil Cloutier
- Centre Urbanisation Culture Société, Institut National de la Recherche Scientifique, Montreal, Québec, Canada
| | - Meghan Winters
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Colin Macarthur
- Child Health Evaluative Sciences, The Hospital for Sick Children, SickKids Research Institute, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Brent E Hagel
- Department of Paediatrics, University of Calgary, Calgary, Alberta, Canada
| | - Alison K Macpherson
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
| | - Nisrine El Amiri
- Child Health Evaluative Sciences, The Hospital for Sick Children, SickKids Research Institute, Toronto, Ontario, Canada
| | | | - Andrew William Howard
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Orthopaedic Surgery, Child Health and Evaluative Sciences, Hospital for Sick Children, Toronto, Ontario, Canada
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Rothman L, Ling R, Hagel BE, Macarthur C, Macpherson AK, Buliung R, Fuselli P, Howard AW. Pilot study to evaluate school safety zone built environment interventions. Inj Prev 2021; 28:243-248. [PMID: 34462331 PMCID: PMC9132849 DOI: 10.1136/injuryprev-2021-044299] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 08/10/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND School safety zones were created in 2017 under the City of Toronto's Vision Zero Road Safety Plan. This pilot study examined the effect of built environment interventions on driver speeds, active school transportation (AST) and dangerous driving. METHODS Interventions were implemented at 34 schools and 45 matched controls (2017-2019). Drivers travelling over the speed limit of >30 km/hour and 85th percentile speeds were measured using pneumatic speed tubes at school frontages. Observers examined AST and dangerous driving at school arrival times. Repeated measures beta and multiple regression analyses were used to study the intervention effects. RESULTS Most schools had posted speed limits of 40 km/hour (58%) or ≥50 km/hour (23%). A decrease in drivers travelling over the speed limit was observed at intervention schools post-intervention (from 44% to 40%; OR 0.79, 95% CI 0.66 to 0.96). Seventy-one per cent of drivers travelled >30 km/hour and the 85th percentile speed was 47 km/hour at intervention schools, with no change in either postintervention. There were no changes in speed metrics in the controls. AST increased by 5% (OR 1.22, 95% CI 0.97 to 1.54) at intervention schools. Reductions in dangerous driving were observed at all schools. CONCLUSIONS Posted speed limits were >30 km/hour at most schools and high proportions of drivers were travelling above the speed limits. There were reductions in drivers exceeding the speed limit and in dangerous driving, and modest increased AST post intervention. Bolder interventions to slow traffic are required to effectively reduce speeding around schools, which may increase safe AST.
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Affiliation(s)
- Linda Rothman
- School of Occupational and Public Health, Faculty of Community Services, Ryerson University, Toronto, Ontario, Canada .,Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Rebecca Ling
- Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Brent E Hagel
- Department of Paediatrics, University of Calgary, Calgary, Alberta, Canada
| | - Colin Macarthur
- Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Alison K Macpherson
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, Ontario, Canada
| | - Ron Buliung
- Department of Geography, Geomatics and Environment, University of Toronto-Mississauga, Toronto, Ontario, Canada
| | | | - Andrew William Howard
- Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Orthopaedic Surgery, Hospital for Sick Children, Toronto, Ontario, Canada
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Cloutier MS, Beaulieu E, Fridman L, Macpherson AK, Hagel BE, Howard AW, Churchill T, Fuselli P, Macarthur C, Rothman L. State-of-the-art review: preventing child and youth pedestrian motor vehicle collisions: critical issues and future directions. Inj Prev 2020; 27:77-84. [PMID: 33148798 PMCID: PMC7848053 DOI: 10.1136/injuryprev-2020-043829] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 09/10/2020] [Accepted: 09/12/2020] [Indexed: 11/08/2022]
Abstract
Aim To undertake a comprehensive review of the best available evidence related to risk factors for child pedestrian motor vehicle collision (PMVC), as well as identification of established and emerging prevention strategies. Methods Articles on risk factors were identified through a search of English language publications listed in Medline, Embase, Transport, SafetyLit, Web of Science, CINHAL, Scopus and PsycINFO within the last 30 years (~1989 onwards). Results This state-of-the-art review uses the road safety Safe System approach as a new lens to examine three risk factor domains affecting child pedestrian safety (built environment, drivers and vehicles) and four cross-cutting critical issues (reliable collision and exposure data, evaluation of interventions, evidence-based policy and intersectoral collaboration). Conclusions Research conducted over the past 30 years has reported extensively on child PMVC risk factors. The challenge facing us now is how to move these findings into action and intervene to reduce the child PMVC injury and fatality rates worldwide.
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Affiliation(s)
- Marie-Soleil Cloutier
- Centre Urbanisation Culture Société, Institut National de la Recherche Scientifique, Montreal, Quebec, Canada
| | - Emilie Beaulieu
- Département de pédiatrie, Faculté de médecine, Centre Hospitalier Universitaire de Québec-Université Laval, Quebec City, Quebec, Canada
| | - Liraz Fridman
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
| | | | - Brent E Hagel
- Department of Paediatrics and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Alberta Children' Hospital Research Institute and O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada.,Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Andrew William Howard
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada.,Orthopaedic Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
| | | | | | - Colin Macarthur
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Linda Rothman
- School of Occupational and Public Health, Ryerson University, Toronto, Ontario, Canada
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12
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Audet O, Hagel BE, Hamel D, Tremblay B, Macpherson AK, Goulet C. The association between removing and reintroducing man-made jumps in terrain parks and severe alpine skiing and snowboarding injuries. J Sci Med Sport 2020; 24:212-217. [PMID: 32868202 DOI: 10.1016/j.jsams.2020.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 07/14/2020] [Accepted: 08/03/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To explore the effect of removing and reintroducing man-made jumps in terrain parks (TPs), on the proportion of severe injuries among alpine skiers and snowboarders in Québec, Canada. DESIGN Quasi-experimental study. METHODS Injuries were identified via injury report forms completed by ski patrollers during seasons 2000-2001 to 2016-2017 in Québec ski areas. Severe injuries were defined based on the type of injury or ambulance evacuation. Logistic regression analysis was used to provide adjusted odds ratios (AOR) for the comparison of the time periods before jump removal (PRE) and after jump reintroduction (POST) with the jump removal interval (INT). RESULTS Compared with INT, the proportion of severe injuries in PRE was not significantly different (AOR: 1.05; 95% CI: 0.85-1.30), but was higher in POST (AOR: 1.76; 95% CI: 1.24-2.51) for ski areas with jump removal. In ski areas without jump removal, there was no change in PRE (AOR: 0.96; 95% CI: 0.87-1.07) and increased odds of severe injuries in POST (AOR: 1.20; 95% CI: 1.07-1.35). A supplementary analysis suggested that removing jumps from TPs has contributed significantly to a reduction in the proportion of severe injuries. This protective effect appears to decline over time. CONCLUSIONS These results do not suggest that removing jumps from TPs as an effective long-term injury prevention strategy in skiing and snowboarding. Collecting data on exposure could improve our understanding of how removing, introducing or reintroducing man-made jumps in TPs is associated with the risk of minor and severe injuries in TPs and on regular trails.
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Affiliation(s)
| | - Brent E Hagel
- Department of Pediatrics, University of Calgary, Canada; Department of Community Health Sciences, University of Calgary, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Canada; O'Brien Institute for Public Health, University of Calgary, Canada; Sport Injury Prevention Research Centre, University of Calgary, Canada
| | - Denis Hamel
- Bureau d'information et d'études en santé des populations, Québec Public Health Institute, Canada
| | - Benoit Tremblay
- Ministère de l'Éducation et de l'Enseignement supérieur (Québec Ministry of Education and Higher Education), Canada
| | - Alison K Macpherson
- Department of Kinesiology, Université Laval, Canada; School of Kinesiology & Health Science, York University, Canada
| | - Claude Goulet
- Department of Physical Education, Université Laval, Canada.
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13
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Hurtubise JM, Gorbet DJ, Hynes LM, Macpherson AK, Sergio LE. White Matter Integrity and Its Relationship to Cognitive-Motor Integration in Females with and without Post-Concussion Syndrome. J Neurotrauma 2020; 37:1528-1536. [PMID: 31928154 DOI: 10.1089/neu.2019.6765] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Fifteen percent of individuals who sustain a concussion go on to develop post-concussion syndrome (PCS). These persistent symptoms are believed to be attributed to damage to white matter tracts and impaired neurotransmission. Specifically, declines in white matter integrity after concussion have been found along the long-coursing axons underlying the frontoparietal network. This network is essential for the performance of visuomotor transformation tasks requiring cognitive-motor integration (CMI). We have previously observed deficits in performance on CMI-based tasks in those who have a history of concussion, but were asymptomatic. The aim of this study was to investigate performance on a CMI task, as well as white matter integrity differences along frontoparietal-cerebellar white matter tracts, in those with PCS compared to healthy controls. We hypothesized an association between the behavioral and brain structural measures. Twenty-six female participants (13 with PCS for ≥6 months and 13 healthy controls) completed four computer-based visuomotor CMI tasks. In addition, diffusion tensor images (DTIs) were acquired. No statistically significant differences were found in CMI performance between groups (p > 0.05). Further, there were no statistically significant differences between groups on any DTI metrics (p > 0.05). However, examination of the data collapsed across participants revealed significant associations between performance on a CMI task and white matter integrity. Further investigation into additional causes of symptoms in those with PCS (including psychological and cervicogenic factors) will strengthen our understanding of this diverse group. Nonetheless, this study demonstrates that white matter integrity is related to levels of performance in tasks that require rule-based movement control.
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Affiliation(s)
- Johanna M Hurtubise
- Centre for Sport and Exercise Education, Camosun College, Victoria, British Columbia, Canada
| | - Diana J Gorbet
- School of Kinesiology and Health Science, York University, Sherman Health Science Research Centre, Toronto, Ontario, Canada.,Centre for Vision Research, York University, Sherman Health Science Research Centre, Toronto, Ontario, Canada
| | - Loriann M Hynes
- School of Kinesiology and Health Science, York University, Sherman Health Science Research Centre, Toronto, Ontario, Canada
| | - Alison K Macpherson
- School of Kinesiology and Health Science, York University, Sherman Health Science Research Centre, Toronto, Ontario, Canada
| | - Lauren E Sergio
- School of Kinesiology and Health Science, York University, Sherman Health Science Research Centre, Toronto, Ontario, Canada.,Centre for Vision Research, York University, Sherman Health Science Research Centre, Toronto, Ontario, Canada
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14
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Audet O, Macpherson AK, Valois P, Hagel BE, Tremblay B, Goulet C. Terrain park feature compliance with Québec ski area safety recommendations. Inj Prev 2020; 27:injuryprev-2019-043629. [PMID: 32299838 DOI: 10.1136/injuryprev-2019-043629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 03/10/2020] [Accepted: 03/14/2020] [Indexed: 11/04/2022]
Abstract
OBJECTIVES The primary objective of this paper is to examine terrain park (TP) feature compliance with recommendations from a ski area industry guide (are TP features compliant with the guide?) and determine factors that could be associated with TP feature compliance in Québec ski areas (do factors influence TP feature compliance?), Canada. These recommendations on the design, construction and maintenance are provided by the Québec Ski Areas Association Guide. METHODS A group of two to four trained research assistants visited seven ski areas. They used an evaluation tool to assess the compliance of 59 TP features. The evaluation tool, originally developed to assess the quality of TP features based on the guide, was validated in a previous study. Compliance was calculated by the percentage of compliant measures within a given feature. The potential influence of four factors on compliance (size of the TP, size of the feature, snow conditions and type of feature) were examined using a mixed-effects logistic regression model. RESULTS The average TP feature compliance percentage was 93% (95% CI 88% to 99%) for boxes, 91% (95% CI 89% to 94%) for rails and 89% (95% CI 86% to 92%) for jumps. The logistic regression showed that none of the four factors examined were associated with TP feature compliance with the guide. CONCLUSION Our results suggest that TP features are highly compliant with the guide in Québec ski areas.
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Affiliation(s)
- Olivier Audet
- Department of Kinesiology, Université Laval, Québec, Québec, Canada
| | - Alison K Macpherson
- Department of Kinesiology, Université Laval, Québec, Québec, Canada
- School of Kinesiology & Health Science, York University, Toronto, Ontario, Canada
| | - Pierre Valois
- Department of Educational Fundamentals and Practices, Université Laval, Québec, Québec, Canada
| | - Brent E Hagel
- Departments of Paediatrics and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Benoit Tremblay
- Québec Network of Regional Units of Leisure and Sport, Trois-Rivières, Québec, Canada
| | - Claude Goulet
- Department of Physical Education, Université Laval, Québec, Québec, Canada
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15
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Mahboob A, Richmond SA, Harkins JP, Macpherson AK. Childhood unintentional injury: The impact of family income, education level, occupation status, and other measures of socioeconomic status. A systematic review. Paediatr Child Health 2019; 26:e39-e45. [PMID: 33542777 DOI: 10.1093/pch/pxz145] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 08/05/2019] [Indexed: 11/13/2022] Open
Abstract
Introduction Unintentional injuries represent a substantial public health burden among children and adolescents, and previous evidence suggests that there are disparities in injury by socioeconomic status (SES). This paper reports on a systematic review of literature on injury rates among children and adolescents by measures of SES. Methods A systematic literature search was conducted using six electronic databases: MEDLINE, PsycINFO, CINAHL, HealthSTAR, EMBASE, and SportsDiscus. This review considered children ages 19 years and under and publications between 1997 and 2017-representing an update since the last systematic review examined this specific question. Fifty-four articles were summarized based on study and participant descriptions, outcome and exposure, statistical tests used, effect estimates, and overall significance. Results Most articles addressed risk factors across all injury mechanisms; however, some focused particularly on burns/scalds, road traffic injuries, falls/drowning cases, and playground/sports injuries. Other studies reported on specific injury types including traumatic dental injuries, traumatic brain injuries, and fractures. The studies were of moderate quality, with a median of 15.5 (95% confidence interval [CI]: 15.34 to 15.66) out of 19. Thirty-two studies found an inverse association between SES and childhood unintentional injury, three found a positive association while twenty were not significant or failed to report effect measures. Conclusion Given the variability in definition of the exposure (SES) and outcome (injury), the results of this review were mixed; however, the majority of studies supported a relationship between low SES and increased injury risk. Public health practice must consider SES, and other measures of health equity, in childhood injury prevention programming, and policy.
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Affiliation(s)
- Afifa Mahboob
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, Ontario
| | - Sarah A Richmond
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Ontario.,Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario
| | - Joshua P Harkins
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, Ontario
| | - Alison K Macpherson
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, Ontario
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16
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Douglas A, Rotondi MA, Baker J, Jamnik VK, Macpherson AK. On-Ice Physical Demands of World-Class Women's Ice Hockey: From Training to Competition. Int J Sports Physiol Perform 2019; 14:1227-1232. [PMID: 30859859 DOI: 10.1123/ijspp.2018-0571] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 01/18/2019] [Accepted: 02/13/2019] [Indexed: 10/27/2023]
Abstract
PURPOSE To compare on-ice external and internal training loads in world-class women's ice hockey during training and competition. METHODS On-ice training loads were collected during 1 season from 25 world-class ice hockey players via wearable technology. A total of 105 on-ice sessions were recorded, which consisted of 61 training sessions and 44 matches. Paired and unpaired t tests compared training and competition data between and across playing positions. RESULTS For training data, there was a difference between positions for PlayerLoad (P < .001, effect size [ES] = 0.32), PlayerLoad·minute-1 (P < .001, ES = 0.55), explosive efforts (P < .001, ES = 0.63), and training impulse (P < .001, ES = 0.48). For the competition data, there were also differences between positions for PlayerLoad (P < .001, ES = 0.26), PlayerLoad·minute-1 (P < .001, ES = 0.38), explosive efforts (P < .001, ES = 0.64), and training impulse (P < .001, ES = 1.47). Similar results were found when positions were viewed independently; competition had greater load and intensity across both positions for PlayerLoad, training impulse, and explosive efforts (P < .001, ES = 1.59-2.98) and with PlayerLoad·minute-1 (P = .016, ES = 0.25) for the defense. CONCLUSIONS There are clear differences in the volume and intensity of external and internal workloads between training and competition sessions. These differences were also evident when comparing the playing positions, with defense having lower outputs than forwards. These initial results can be used to design position-specific drills that replicate match demands for ice hockey athletes.
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17
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Rothman L, Macarthur C, Wilton A, Howard AW, Macpherson AK. Recent trends in child and youth emergency department visits because of pedestrian motor vehicle collisions by socioeconomic status in Ontario, Canada. Inj Prev 2019; 25:570-573. [PMID: 30975762 DOI: 10.1136/injuryprev-2018-043090] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 02/01/2019] [Accepted: 02/11/2019] [Indexed: 11/03/2022]
Abstract
BACKGROUND Children in lower-income households have higher injury rates. Trends in emergency department (ED) visits by children 0-19 years because of pedestrian motor vehicle collisions (PMVCs) in Ontario, Canada (2008-2015) by socioeconomic status were examined. METHODS PMVC ED data were obtained from the Institute for Clinical Evaluative Sciences for children age 0-19 years over the period 2008-2015. Age-adjusted rates were calculated using Ontario census data. Household income quintiles were determined from the Registered Persons Database. Poisson regression was used to model ED visit rates by year, age and income quintile. RESULTS The frequency of child PMVC ED visits in Ontario decreased from 1562 in 2008 to 1281 in 2015. Age-adjusted rates were unchanged over time (IRR 1.00, 95% CI 0.99 to 1.00); however, rate disparities by income status persisted with an IRR of 0.52 (0.50 to 0.55) comparing the highest with the lowest income level. CONCLUSIONS Exposure to traffic may play a role in rate disparities by income status in child PMVC; however, less safe traffic environments in lower income areas may also be strong contributors. These findings highlight the potential impact of roadway safety modifications in lower income areas to mitigate disparities in injury rates by socioeconomic status.
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Affiliation(s)
- Linda Rothman
- CHES, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Colin Macarthur
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Andrew Wilton
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | | | - Alison K Macpherson
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
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18
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Rothman L, Cloutier MS, Manaugh K, Howard AW, Macpherson AK, Macarthur C. Spatial distribution of roadway environment features related to child pedestrian safety by census tract income in Toronto, Canada. Inj Prev 2019; 26:229-233. [PMID: 30936120 DOI: 10.1136/injuryprev-2018-043125] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 03/04/2019] [Accepted: 03/08/2019] [Indexed: 11/04/2022]
Abstract
BACKGROUND Investments in traffic calming infrastructure and other street design features can enhance pedestrian safety as well as contribute to the 'walkability' of neighbourhoods. Pedestrian-motor vehicle collisions (PMVCs) in urban areas, however, remain common and occur more frequently in lower income neighbourhoods. While risk and protective features of roadways related to PMVC have been identified, little research exists examining the distribution of roadway environment features. This study examined the relationship between roadway environment features related to child pedestrian safety and census tract income status in Toronto. METHODS Spatial cluster detection based on 2006 census tract data identified low-income and high-income census tract clusters in Toronto. Police-reported PMVC data involving children between the ages of 5 and 14 years were mapped using geographical information system. Also mapped were roadway environment features (densities of speed humps, crossing guards, local roads, one-way streets and missing sidewalks). Multivariate logistic regression was used to examine the relationship between roadway environment features (independent variables) and cluster income status (dependent variable), controlling for child census tract population. RESULTS There were significantly fewer speed humps and local roads in low-income versus high-income clusters. Child PMVC rates were 5.4 times higher in low-income versus high-income clusters. CONCLUSION Socioeconomic inequities in the distribution of roadway environment features related to child pedestrian safety have policy and process implications related to the safety of child pedestrians in urban neighbourhoods.
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Affiliation(s)
- Linda Rothman
- Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Marie-Soleil Cloutier
- Centre Urbanisation Culture Société, Institut National de la Recherche Scientifique, Montreal, Québec, Canada
| | | | | | | | - Colin Macarthur
- Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, Ontario, Canada
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19
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Matveev R, Sergio L, Fraser-Thomas J, Macpherson AK. Trends in concussions at Ontario schools prior to and subsequent to the introduction of a concussion policy - an analysis of the Canadian hospitals injury reporting and prevention program from 2009 to 2016. BMC Public Health 2018; 18:1324. [PMID: 30497446 PMCID: PMC6267048 DOI: 10.1186/s12889-018-6232-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 11/20/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Concussion is a preventable injury that can have long-term health consequences for children and youth. In Ontario, the Policy/Program Memorandum # 158 (PPM) was introduced by the Ministry of Education of Ontario in March 2014. The PPM's main purpose is to require each school board in the province to create and implement a concussion policy. The purpose of this paper is to examine trends in school-based concussions prior to and subsequent to the introduction of the PPM. METHODS This report examined emergency department (ED) visits in 5 Ontario hospitals that are part of the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP), and compared trends over time in diagnosed concussions, and suspected concussions identified as "other head injury" in children and youth aged 4-18. RESULTS From 2009 to 2016 study years, there were 21,094 suspected concussions, including 8934 diagnosed concussions in youth aged 4-18. The average number of diagnosed concussions in the 5 years before the PPM was 89 concussions/month, compared to approximately 117 concussions per month after; a 30% increase in the monthly rate of concussions presenting to the ED. The total number of concussion or head injury-related ED visits remained relatively unchanged but the proportion of diagnosed concussions rose from 31% in 2009 to 53% in 2016. The proportion of diagnosed concussions in females also increased from 38% in 2013 to 46% in 2016. The percent of all diagnosed concussions occurring at schools increased throughout the study reaching almost 50% in 2016 with most injuries taking place at the playground (24%), gymnasium (22%) or sports field (20%). CONCLUSIONS The introduction of the PPM may have contributed to a general increase in concussion awareness and an improvement in concussion identification at the school level in children and youth aged 4-18.
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Affiliation(s)
- Roman Matveev
- School of Kinesiology & Health Science, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada.
| | - Lauren Sergio
- School of Kinesiology & Health Science, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
| | - Jessica Fraser-Thomas
- School of Kinesiology & Health Science, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
| | - Alison K Macpherson
- School of Kinesiology & Health Science, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
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20
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Fridman L, Fraser-Thomas J, Pike I, Macpherson AK. An interprovincial comparison of unintentional childhood injury rates in Canada for the period 2006-2012. Can J Public Health 2018; 109:573-580. [PMID: 30073552 PMCID: PMC6964635 DOI: 10.17269/s41997-018-0112-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 07/04/2018] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To perform an interprovincial comparison of unintentional population-based injury hospitalization and death rates for Canadian children ages 0-19 years and compare trends between 2006 and 2012. METHODS Annual population-based hospitalization rates per 100,000 from unintentional injuries were calculated for children/youth (< 19 years) using data from the Discharge Abstract Database between 2006 and 2012. Annual mortality rates were analyzed using provincial coronial data. The mean annual change in the rate of hospitalizations due to unintentional injuries was reported for each province. RESULTS The average annual rate of hospital admissions for unintentional injuries was 305.10 per 100,000 population between 2006 and 2012, and this decreased by - 11.91 over time (p < 0.01, - 15.85; - 7.77). Saskatchewan had the highest average annual morbidity rate (550.76 per 100,000) from all unintentional causes, and Ontario had the lowest average annual rate (238.89 per 100,000). Saskatchewan had the highest average annual rate for all subcauses except for drowning. Ontario was the only province with an average annual injury morbidity rate that was consistently below the Canadian average. The average annual mortality rate from all unintentional injury was highest in Saskatchewan (17.51 per 100,000) and lowest in Ontario (5.99 per 100,000) when compared to Canada (7.97 per 100,000). CONCLUSION Injury prevention policies vary considerably among provinces. Although the unintentional injury hospitalization rate is decreasing over time, some subcauses such as choking/suffocation have shown an increase in certain provinces. Evidence-based childhood injury prevention policies, such as playground equipment safety and four-sided pool fencing among others, should be standardized across Canada.
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Affiliation(s)
- Liraz Fridman
- School of Kinesiology and Health Science, York University, 4700 Keele Street, Toronto, ON, Canada.
| | - Jessica Fraser-Thomas
- School of Kinesiology and Health Science, York University, 4700 Keele Street, Toronto, ON, Canada
| | - Ian Pike
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, V6H3V4, Canada
| | - Alison K Macpherson
- School of Kinesiology and Health Science, York University, 4700 Keele Street, Toronto, ON, Canada
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21
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Rothman L, Macpherson AK, Ross T, Buliung RN. The decline in active school transportation (AST): A systematic review of the factors related to AST and changes in school transport over time in North America. Prev Med 2018; 111:314-322. [PMID: 29155222 DOI: 10.1016/j.ypmed.2017.11.018] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 10/18/2017] [Accepted: 11/13/2017] [Indexed: 12/31/2022]
Abstract
Active travel to school has declined during the last 50years in North America. During the last decade, the children's active school transportation (AST) literature has grown. This systematic review provides an updated examination of AST correlates, and discusses why school travel mode (STM) share may have changed over time. AST trends are described and a systematic literature review of AST correlates in North America for the period 1990-2016 was conducted. Strength of association between correlates and AST, and relationship direction are assessed and reported. Graphical presentation of correlates included in ≥5 studies were included. Sixty-three studies were identified and reviewed. Distance to school was most strongly associated with AST. Individual, parental and societal correlates had moderate positive associations with AST including: child age, lower parental education, income and other income related factors, race and positive perceptions of AST. Longitudinal studies were few in number, as were studies about exceptional populations, policy, and interventions. AST intervention should focus on key AST correlates. Social and environmental diversity calls for local solutions to school travel challenges. Changes in AST correlates over time should be considered for evaluating existing policy approaches, and to support development of new policy, regulation, design, and program interventions.
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Affiliation(s)
- Linda Rothman
- Child Health Evaluative Sciences, The Hospital for Sick Children, 555 University Ave, Toronto M5G 1X8, Canada.
| | | | - Timothy Ross
- Department of Geography & Planning, University of Toronto St. George, 100 St. George Street, Toronto, ON M5S 3G3, Canada
| | - Ron N Buliung
- Department of Geography, University of Toronto Mississauga, 3359 Mississauga Road N, South Building, Mississauga, ON L5L 1C6, Canada
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22
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Fridman L, Fraser-Thomas JL, Pike I, Macpherson AK. Canadian Child Safety Report Card: a comparison of injury prevention practices across provinces. Inj Prev 2018; 25:252-257. [DOI: 10.1136/injuryprev-2018-042745] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 03/05/2018] [Accepted: 03/06/2018] [Indexed: 11/03/2022]
Abstract
BackgroundInjury prevention report cards that raise awareness about the preventability of childhood injuries have been published by the European Child Safety Alliance and the WHO. These report cards highlight the variance in injury prevention practices around the world. Policymakers and stakeholders have identified research evidence as an important enabler to the enactment of injury legislation. In Canada, there is currently no childhood injury report card that ranks provinces on injury rates or evidence-based prevention policies.MethodsThree key measures, with five metrics, were used to compare provinces on childhood injury prevention rates and strategies, including morbidity, mortality and policy indicators over time (2006–2012). Nine provinces were ranked on five metrics: (1) population-based hospitalisation rate/100 000; (2) per cent change in hospitalisation rate/100 000; (3) population-based mortality rate/100 000; (4) per cent change in mortality rate/100 000; (5) evidence-based policy assessment.ResultsOf the nine provinces analysed, British Columbia ranked highest in Canada and Saskatchewan lowest. British Columbia had a morbidity and mortality rate that was close to the Canadian average and decreased over the study period. British Columbia also had a number of injury prevention policies and legislation in place that followed best practice guidelines. Saskatchewan had a higher rate of injury hospitalisation and death; however, Saskatchewan’s rate decreased over time. Saskatchewan had a number of prevention policies in place but had not enacted bicycle helmet legislation.ConclusionsFuture preventative efforts should focus on harmonising policies across all provinces in Canada that reflect evidence-based best practices.
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Hurtubise JM, Hughes CE, Sergio LE, Macpherson AK. Comparison of baseline and postconcussion SCAT3 scores and symptoms in varsity athletes: an investigation into differences by sex and history of concussion. BMJ Open Sport Exerc Med 2018; 4:e000312. [PMID: 29629181 PMCID: PMC5884362 DOI: 10.1136/bmjsem-2017-000312] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2018] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE To investigate the use of the Sport Concussion Assessment Tool 3 (SCAT3) as an assessment tool in the varsity population, as well as the effects of sex and concussion history on both baseline and postconcussion scores. METHODS A comparison between baseline and postconcussion SCAT3 scores of varsity level athletes was conducted through retrospective chart review. Differences in both baseline and postconcussion scores were further analysed by sex and history of concussion. RESULTS The only clinically significant change on the SCAT3 elicited by a concussion was that of self-reported symptoms. There were no clinically significant differences based on sex or history of concussion. CONCLUSION The SCAT3 in its entirety may not be useful in this population. Additional research on sociocultural and sport aspects that may be affecting symptom reporting in this population is needed.
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Affiliation(s)
- Johanna M Hurtubise
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
- York University Sport Medicine Team, York University, Toronto, Ontario, Canada
| | - Cindy E Hughes
- York University Sport Medicine Team, York University, Toronto, Ontario, Canada
- Department of Sport and Recreation, York University, Toronto, Ontario, Canada
| | - Lauren E Sergio
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
- York University Sport Medicine Team, York University, Toronto, Ontario, Canada
- Centre for Vision Research, York University, Toronto, Ontario, Canada
| | - Alison K Macpherson
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
- York University Sport Medicine Team, York University, Toronto, Ontario, Canada
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Rothman L, Cloutier MS, Macpherson AK, Richmond SA, Howard AW. Spatial distribution of pedestrian-motor vehicle collisions before and after pedestrian countdown signal installation in Toronto, Canada. Inj Prev 2017; 25:110-115. [PMID: 28988199 DOI: 10.1136/injuryprev-2017-042378] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 09/15/2017] [Accepted: 09/18/2017] [Indexed: 11/03/2022]
Abstract
BACKGROUND Pedestrian countdown signals (PCS) have been installed in many cities over the last 15 years. Few studies have evaluated the effectiveness of PCS on pedestrian motor vehicle collisions (PMVC). This exploratory study compared the spatial patterns of collisions pre and post PCS installation at PCS intersections and intersections or roadways without PCS in Toronto, and examined differences by age. METHODS PCS were installed at the majority of Toronto intersections from 2007 to 2009. Spatial patterns were compared between 4 years of police-reported PMVC prior to PCS installation to 4 years post installation at 1864 intersections. The spatial distribution of PMVC was estimated using kernel density estimates and simple point patterns examined changes in spatial patterns overall and stratified by age. Areas of higher or lower point density pre to post installation were identified. RESULTS There were 14 911 PMVC included in the analysis. There was an overall reduction in PMVC post PCS installation at both PCS locations and non-PCS locations, with a greater reduction at non-PCS locations (22% vs 1%). There was an increase in PMVC involving adults (5%) and older adults (9%) at PCS locations after installation, with increased adult PMVC concentrated downtown, and older adult increases occurring throughout the city following no spatial pattern. There was a reduction in children's PMVC at both PCS and non-PCS locations, with greater reductions at non-PCS locations (35% vs 48%). CONCLUSIONS Results suggest that the effects of PCS on PMVC may vary by age and location, illustrating the usefulness of exploratory spatial data analysis approaches in road safety. The age and location effects need to be understood in order to consistently improve pedestrian mobility and safety using PCS.
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Affiliation(s)
- Linda Rothman
- Child Health Evaluative Science, Hospital for Sick Children, Toronto, Ontario, Canada.,Faculty of Health-School of Kinesiology & Health Science, York University, Norman Bethune College, Toronto, Ontario, Canada
| | - Marie-Soleil Cloutier
- Centre Urbanisation Culture Société, Institut National de la Recherche Scientifique, Montreal, Quebec, Canada
| | - Alison K Macpherson
- Faculty of Health-School of Kinesiology & Health Science, York University, Norman Bethune College, Toronto, Ontario, Canada
| | - Sarah A Richmond
- Faculty of Health-School of Kinesiology & Health Science, York University, Norman Bethune College, Toronto, Ontario, Canada
| | - Andrew William Howard
- Child Health Evaluative Science, Hospital for Sick Children, Toronto, Ontario, Canada
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25
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Cryer C, Davie GS, Gulliver PJ, Petridou ET, Dessypris N, Lauritsen J, Macpherson AK, Miller TR, de Graaf B. Empirical validation of the New Zealand serious non-fatal injury outcome indicator for 'all injury'. Inj Prev 2017; 24:300-304. [PMID: 28956758 DOI: 10.1136/injuryprev-2017-042463] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 08/19/2017] [Accepted: 08/25/2017] [Indexed: 11/03/2022]
Abstract
Our purpose was to empirically validate the official New Zealand (NZ) serious non-fatal 'all injury' indicator. To that end, we aimed to investigate the assumption that cases selected by the indicator have a high probability of admission. Using NZ hospital in-patient records, we identified serious injury diagnoses, captured by the indicator, if their diagnosis-specific survival probability was ≤0.941 based on at least 100 admissions. Corresponding diagnosis-specific admission probabilities from regions in Canada, Denmark and Greece were estimated. Aggregate admission probabilities across those injury diagnoses were calculated and inference made to New Zealand. The admission probabilities were 0.82, 0.89 and 0.90 for the regions of Canada, Denmark and Greece, respectively. This work provides evidence that the threshold set for the official New Zealand serious non-fatal injury indicator for 'all injury' captures injuries with high aggregate admission probability. If so, it is valid for monitoring the incidence of serious injuries.
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Affiliation(s)
- Colin Cryer
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Gabrielle S Davie
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Pauline J Gulliver
- Social and Community Health, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Eleni Th Petridou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.,Unit of Clinical Epidemiology, Medical School, Karolinska Institute, Stockholm, Sweden
| | - Nick Dessypris
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Jens Lauritsen
- Accident Analysis Group, Department of Orthopedics, Odense University Hospital, Odense, Denmark.,Department of Clinical Medicine, University of Southern Denmark, Odense, Denmark
| | - Alison K Macpherson
- Kinesiology and Health Science, Faculty of Health, York University, Toronto, Ontario, Canada
| | - Ted R Miller
- Calverton Center, Pacific Institute for Research and Evaluation, Calverton, Maryland, USA.,Health Science Research and Graduate Studies, Curtin University Centre for Health Policy Research, Perth, Western Australia, Australia
| | - Brandon de Graaf
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
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26
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Gauthier LR, Dworkin RH, Warr D, Pillai Riddell R, Macpherson AK, Rodin G, Zimmermann C, Lawrence Librach S, Moore M, Shepherd FA, Gagliese L. Age-Related Patterns in Cancer Pain and Its Psychosocial Impact: Investigating the Role of Variability in Physical and Mental Health Quality of Life. Pain Medicine 2017; 19:658-676. [DOI: 10.1093/pm/pnx002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Lynn R Gauthier
- School of Kinesiology and Health Science
- Department of Supportive Care
- School of Kinesiology and Health Science
| | - Robert H Dworkin
- Departments of Anesthesiology and Neurology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - David Warr
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre
- Department of Medicine
| | - Rebecca Pillai Riddell
- Department of Psychology, York University, Toronto, Ontario, Canada
- Department of Psychiatry
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
| | | | - Gary Rodin
- Department of Supportive Care
- Department of Medicine
- Department of Psychiatry
| | - Camilla Zimmermann
- Department of Supportive Care
- Department of Medicine
- Department of Psychiatry
| | - S Lawrence Librach
- Family and Community Medicine, Division of Palliative Care, University of Toronto, Toronto, Ontario, Canada
- Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Malcolm Moore
- British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Frances A Shepherd
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre
- Department of Medicine
| | - Lucia Gagliese
- School of Kinesiology and Health Science
- Department of Anesthesia, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
- Department of Supportive Care
- Department of Psychiatry
- Mount Sinai Hospital, Toronto, Ontario, Canada
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27
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Zemek RL, Grool AM, Rodriguez Duque D, DeMatteo C, Rothman L, Benchimol EI, Guttmann A, Macpherson AK. Annual and Seasonal Trends in Ambulatory Visits for Pediatric Concussion in Ontario between 2003 and 2013. J Pediatr 2017; 181:222-228.e2. [PMID: 27843008 DOI: 10.1016/j.jpeds.2016.10.067] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 09/14/2016] [Accepted: 10/19/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To investigate annual and seasonal trends in physician office and emergency department (ED) visit rates for pediatric concussion in Ontario between 2003 and 2013. STUDY DESIGN A retrospective, population-based study was conducted using linked health administrative data from all concussion-related visits to ED and physician office by children aged 5 through 18 years. Time series analysis was used to assess whether periodic components exist in the monthly number of concussion-related visits. RESULTS Over the 11-year study period, there were 176 685 pediatric visits for concussion in EDs and physician offices in Ontario. Standardized concussion-related visits showed a 4.4-fold (95% CI 4.37-4.45) increase per 100 000 from 2003 to 2013, with nearly 35 000 total visits in 2013. Concussion-related visits demonstrated a steep increase from 2010 onward. The greatest increases in standardized visits were in females (6.3-fold, 95% CI 6.23-6.46 vs 3.6-fold, 95% CI 3.56-3.64 in males) and 13-18.99 year olds (5.0-fold, 95% CI 4.93-5.08 vs 4.1-fold, 95% CI 3.99-4.27 in 9-12 years and 2.3-fold, 95% CI 2.23-2.42 in 5-8 years). A strong seasonal variability (R2autoreg = 0.87, P < .01) in the number of concussion-related visits was present, with most occurring in fall and winter. CONCLUSIONS Pediatric concussion-related ED and physician office visit rates have greatly increased in the last decade, particularly since 2010. Prevention strategies may be targeted at those most at risk and at seasonal-related activities carrying the greatest risk of concussion.
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Affiliation(s)
- Roger L Zemek
- Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.
| | - Anne M Grool
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | | | - Carol DeMatteo
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Linda Rothman
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, Ontario, Canada
| | - Eric I Benchimol
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Astrid Guttmann
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Hospital for Sick Children, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Alison K Macpherson
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, Ontario, Canada
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28
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Brown RE, Canning KL, Fung M, Jiandani D, Riddell MC, Macpherson AK, Kuk JL. Calorie Estimation in Adults Differing in Body Weight Class and Weight Loss Status. Med Sci Sports Exerc 2017; 48:521-6. [PMID: 26469988 DOI: 10.1249/mss.0000000000000796] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
PURPOSE Ability to accurately estimate calories is important for weight management, yet few studies have investigated whether individuals can accurately estimate calories during exercise or in a meal. The objective of this study was to determine if accuracy of estimation of moderate or vigorous exercise energy expenditure and calories in food is associated with body weight class or weight loss status. METHODS Fifty-eight adults who were either normal weight (NW) or overweight (OW), and either attempting (WL) or not attempting weight loss (noWL), exercised on a treadmill at a moderate (60% HRmax) and a vigorous intensity (75% HRmax) for 25 min. Subsequently, participants estimated the number of calories they expended through exercise and created a meal that they believed to be calorically equivalent to the exercise energy expenditure. RESULTS The mean difference between estimated and measured calories in exercise and food did not differ within or between groups after moderate exercise. After vigorous exercise, OW-noWL overestimated energy expenditure by 72% and overestimated the calories in their food by 37% (P < 0.05). OW-noWL also significantly overestimated exercise energy expenditure compared with all other groups (P < 0.05) and significantly overestimated calories in food compared with both WL groups (P < 0.05). However, among all groups, there was a considerable range of overestimation and underestimation (-280 to +702 kcal), as reflected by the large and statistically significant absolute error in calorie estimation of exercise and food. CONCLUSIONS There was a wide range of underestimation and overestimation of calories during exercise and in a meal. Error in calorie estimation may be greater in overweight adults who are not attempting weight loss.
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Affiliation(s)
- Ruth E Brown
- School of Kinesiology and Health Science, York University, Toronto, Ontario, CANADA
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29
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Christensen RAG, Raiber L, Macpherson AK, Kuk JL. The association between obesity and self-reported sinus infection in non-smoking adults: a cross-sectional study. Clin Obes 2016; 6:389-394. [PMID: 27860347 DOI: 10.1111/cob.12164] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 09/07/2016] [Accepted: 09/26/2016] [Indexed: 11/29/2022]
Abstract
The aim of this article was to examine the associations between having had a sinus infection (SI) and BMI and physical activity (PA), diet quality, stress and/or sleep. A total of 2915 adults from the National Health and Nutrition Examination Survey 2005-2006 were examined. Logistic regression analysis was used to examine the association between having had an SI with BMI and PA, diet quality, stress or sleep. As these factors are known to influence one another, a fully adjusted model with PA, diet quality, stress and sleep was also constructed to examine their independent associations with having had an SI. Overall, 15.5 ± 1.2% of the population report having had an SI in the past year. In all models, individuals with obesity were approximately twice as likely to have had an SI compared to those of normal weight (P < 0.05). While PA and diet quality were not significantly associated with having had an SI (P > 0.05), individuals with stress and sleep troubles were also twice as likely to have had an SI (P < 0.05) independent of BMI. In the fully adjusted model, only the associations for BMI and sleep troubles remained significant (P < 0.05). Results from this study suggest that obesity and sleep troubles, but not PA, quality of diet and stress, are associated with having had an SI. As interactions exist between obesity, immune system factors and exposure to infectious disease(s), more research is necessary to understand the directionality of these relationships.
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Affiliation(s)
- R A G Christensen
- Department of Kinesiology and Health Science, York University, Toronto, Canada
| | - L Raiber
- Department of Kinesiology and Health Science, York University, Toronto, Canada
| | - A K Macpherson
- Department of Kinesiology and Health Science, York University, Toronto, Canada
| | - J L Kuk
- Department of Kinesiology and Health Science, York University, Toronto, Canada
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Rothman L, Macpherson AK, Howard A, Parkin PC, Richmond SA, Birken CS. Direct observations of active school transportation and stroller use in kindergarten children. Prev Med Rep 2016; 4:558-562. [PMID: 27818914 PMCID: PMC5094266 DOI: 10.1016/j.pmedr.2016.10.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Revised: 10/19/2016] [Accepted: 10/23/2016] [Indexed: 11/17/2022] Open
Abstract
Little is known about kindergarten students' active school transportation (AST) and stroller/wagon use as sedentary travel devices. The primary objective of this cross-sectional study was to determine the prevalence of kindergarten children arriving to school by active and sedentary modes, including strollers, in Toronto elementary schools and compare to students in kindergarten to grade 6 (K–6). The secondary objective was to examine factors associated with AST in kindergarten and K–6 students. School travel mode was counted using direct observations at elementary schools in the City of Toronto in 2015. Two samples were observed: 1) Kindergarten sample: a random sample of schools with separate kindergarten entrances (n = 26 schools, 1069 children); 2) Kindergarten to grade 6 sample: observations were conducted at arrival locations at 50% of eligible elementary schools for students of all ages (n = 88 schools, 17,224 children). Proportions arriving by different travel modes were compared using Chi-square analysis. Negative binomial regression was conducted to examine the association between school characteristics and AST. AST was lower in the kindergarten compared to the K–6 sample (60% versus 74%, χ2 = 91.37, p < 0.001). The predominant sedentary mode for kindergarten students was by vehicle (38%), with < 2% using strollers/wagons. Recent immigrant status was related to higher AST in kindergarten students; higher social disadvantage, crossing guards, school population and collision rates were related to higher AST in the K–6 sample. Factors influencing AST in young students require further investigation to influence the development of healthy active lifestyles at an early age. Observational counts of school transportation mode and stroller use was conducted. Active school transportation (AST) was less in kindergarten versus all age students. < 2% of kindergarten students use strollers for transportation to school. School proportion of recent immigrants was related to AST in kindergarten students. Higher social disadvantage was most strongly related to AST in all age students.
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Affiliation(s)
- Linda Rothman
- Child Health Evaluative Sciences, The Hospital for Sick Children, 555 University Ave, Toronto M5G 1X8, Canada; Faculty of Health, School of Kinesiology & Health Science, York University, Norman Bethune College, 4700 Keele St., Room 339, Toronto M3J 1P3, Canada
| | - Alison K Macpherson
- Faculty of Health, School of Kinesiology & Health Science, York University, Norman Bethune College, 4700 Keele St., Room 339, Toronto M3J 1P3, Canada
| | - Andrew Howard
- Child Health Evaluative Sciences, The Hospital for Sick Children, 555 University Ave, Toronto M5G 1X8, Canada; Orthopaedic Surgery, The Hospital for Sick Children, 555 University Ave, Toronto M5G 1X8, Canada
| | - Patricia C Parkin
- Child Health Evaluative Sciences, The Hospital for Sick Children, 555 University Ave, Toronto M5G 1X8, Canada; Pediatrics, The Hospital for Sick Children, 555 University Ave, Toronto M5G 1X8, Canada
| | - Sarah A Richmond
- Child Health Evaluative Sciences, The Hospital for Sick Children, 555 University Ave, Toronto M5G 1X8, Canada; Faculty of Health, School of Kinesiology & Health Science, York University, Norman Bethune College, 4700 Keele St., Room 339, Toronto M3J 1P3, Canada
| | - Catherine S Birken
- Child Health Evaluative Sciences, The Hospital for Sick Children, 555 University Ave, Toronto M5G 1X8, Canada; Pediatrics, The Hospital for Sick Children, 555 University Ave, Toronto M5G 1X8, Canada
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Cryer C, Miller TR, Lyons RA, Macpherson AK, Pérez K, Petridou ET, Dessypris N, Davie GS, Gulliver PJ, Lauritsen J, Boufous S, Lawrence B, de Graaf B, Steiner CA. Towards valid 'serious non-fatal injury' indicators for international comparisons based on probability of admission estimates. Inj Prev 2016; 23:47-57. [PMID: 27501735 DOI: 10.1136/injuryprev-2016-042020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 05/25/2016] [Accepted: 06/24/2016] [Indexed: 11/04/2022]
Abstract
BACKGROUND Governments wish to compare their performance in preventing serious injury. International comparisons based on hospital inpatient records are typically contaminated by variations in health services utilisation. To reduce these effects, a serious injury case definition has been proposed based on diagnoses with a high probability of inpatient admission (PrA). The aim of this paper was to identify diagnoses with estimated high PrA for selected developed countries. METHODS The study population was injured persons of all ages who attended emergency department (ED) for their injury in regions of Canada, Denmark, Greece, Spain and the USA. International Classification of Diseases (ICD)-9 or ICD-10 4-digit/character injury diagnosis-specific ED attendance and inpatient admission counts were provided, based on a common protocol. Diagnosis-specific and region-specific PrAs with 95% CIs were calculated. RESULTS The results confirmed that femoral fractures have high PrA across all countries studied. Strong evidence for high PrA also exists for fracture of base of skull with cerebral laceration and contusion; intracranial haemorrhage; open fracture of radius, ulna, tibia and fibula; pneumohaemothorax and injury to the liver and spleen. Slightly weaker evidence exists for cerebellar or brain stem laceration; closed fracture of the tibia and fibula; open and closed fracture of the ankle; haemothorax and injury to the heart and lung. CONCLUSIONS Using a large study size, we identified injury diagnoses with high estimated PrAs. These diagnoses can be used as the basis for more valid international comparisons of life-threatening injury, based on hospital discharge data, for countries with well-developed healthcare and data collection systems.
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Affiliation(s)
- Colin Cryer
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Ted R Miller
- Pacific Institute for Research and Evaluation, Calverton, Maryland, USA.,Curtin University Centre for Health Policy Research, Perth, Australia
| | - Ronan A Lyons
- Farr Institute, Swansea University Medical School, Swansea, UK
| | - Alison K Macpherson
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
| | - Katherine Pérez
- Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain.,CIBER Epidemiología y Salud Pública, Institute of Biomedical Research (IIBSP), Barcelona, Spain
| | - Eleni Th Petridou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Nick Dessypris
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Gabrielle S Davie
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Pauline J Gulliver
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Jens Lauritsen
- Injury Prevention Group, Odense University Hospital, Odense, Denmark.,Department of Clinical Medicine, University of Southern Denmark, Odense, Denmark
| | - Soufiane Boufous
- Transport and Road Safety Research, University of New South Wales, Sydney, New South Wales, Australia
| | - Bruce Lawrence
- Pacific Institute for Research and Evaluation, Calverton, Maryland, USA
| | - Brandon de Graaf
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Claudia A Steiner
- Division of Healthcare Delivery Data, Measures and Research, Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality (AHRQ), Rockville, Maryland, USA
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32
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Pike I, Khalil M, Yanchar NL, Tamim H, Nathens AB, Macpherson AK. Establishing an injury indicator for severe paediatric injury. Inj Prev 2016; 23:118-123. [PMID: 27512110 DOI: 10.1136/injuryprev-2016-042028] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 06/17/2016] [Accepted: 06/24/2016] [Indexed: 11/03/2022]
Abstract
BACKGROUND Routinely gathered injury data, such as hospitalisations, may be subject to variation from sources other than injury incidence. There is a need for an indicator that defines severe injury, which may be less vulnerable to fluctuations due to changes in care policies. The purpose of this study was to identify International Classification of Diseases-10 codes associated with severe paediatric injuries and to specify and validate a severe paediatric injury indicator. METHODS Two data sets that included the ISS and the survival risk ratio were used to produce a list of diagnoses to define severe paediatric injury. The list was sent to trauma surgeons who classified each code as severe enough or not severe enough to require care in a trauma centre. The indicator was fully specified, then validated by using a different data set to validate the codes in a real-world situation. RESULTS Sixty diagnoses were identified as representing severe paediatric injury. Following specification, the indicator was applied to an existing comprehensive data set of paediatric injuries. The decline in hospitalisation of paediatric injuries was significantly steeper for severe than non-severe injuries, suggesting that factors related to the decline in this trauma subset are unlikely to be related to changes in access or other components of trauma care delivery. CONCLUSIONS This indicator can be used for the evaluation of trends in severe paediatric trauma and will help identify populations at risk. This research may inform policies and procedures for referrals of severe childhood injury to appropriate levels of care.
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Affiliation(s)
- Ian Pike
- Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,BC Injury Research and Prevention Unit, BC Children's Hospital, Vancouver, British Columbia, Canada
| | - Mina Khalil
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
| | - Natalie L Yanchar
- Division of Pediatric General Surgery, IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Hala Tamim
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
| | - Avery B Nathens
- Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Alison K Macpherson
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
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Abstract
Background Although water-related fatality rates have changed over time, the epidemiology of drowning in Canada has not recently been examined. In spite of the evidence supporting varying drowning death rates by age, information on how characteristics of drowning incidents differ by age group remains limited. The primary objective of this study was to examine the epidemiology of drowning in Canada. A secondary objective was to describe the characteristics of these drowning incidents as they vary by age group. Methods A retrospective descriptive analysis was conducted using data that were collected for incidents occurring in Canada between January 1, 2008 and December 31, 2012. The main outcome variable was a water-related fatality, in the majority of cases (94 %) the primary cause of death was drowning. Age specific frequencies, proportions and rates per 100,000 population were calculated and compared among six age groups. Results There were 2392 unintentional water-related fatalities identified in Canada between 2008 and 2012. Death rates (per 100,000) varied by age group 0–4 (1.05), 5–14 (0.57), 15–19 (1.27), 20–34 (1.70), 35–64 (1.44), 65+ (1.74). The male to female ratio was 5:1. Differences in the characteristics of drowning by age group were identified across: sex, body of water, urban versus rural location, time of year, activity type, purpose of activity, alcohol involvement, personal flotation device use, accompaniment, and whether a rescue was attempted. Conclusions The study results suggest that there may be a need for drowning prevention strategies that are tailored to specific age groups. Rural areas in Canada may also benefit from targeted drowning prevention.
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Affiliation(s)
- Tessa Clemens
- School of Kinesiology & Health Science, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada.
| | - Hala Tamim
- School of Kinesiology & Health Science, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
| | - Michael Rotondi
- School of Kinesiology & Health Science, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
| | - Alison K Macpherson
- School of Kinesiology & Health Science, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
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Costanian C, Macpherson AK, Tamim H. Inadequate prenatal care use and breastfeeding practices in Canada: a national survey of women. BMC Pregnancy Childbirth 2016; 16:100. [PMID: 27150027 PMCID: PMC4858884 DOI: 10.1186/s12884-016-0889-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 04/29/2016] [Indexed: 11/25/2022] Open
Abstract
Background Previous studies have demonstrated that prenatal care (PNC) has an effect on women’s breastfeeding practices. This study aims to examine the influence of adequacy of PNC initiation and services use on breastfeeding practices in Canada. Methods Data for this secondary analysis was drawn from the Maternity Experiences Survey (MES), a cross sectional, nationally representative study that investigated the peri-and post-natal experiences of mothers, aged 15 and above, with singleton live births between 2005 and 2006 in the Canadian provinces and territories. Adequacy of PNC initiation and services use were measured by the Adequacy of Prenatal Care Utilization Index. The main outcomes were mother’s intent to breastfeed, initiate breastfeeding, exclusively breastfeed, and terminate breastfeeding at 6 months. Multivariate logistic regression analysis assessed the adequacy of PNC initiation and service use on breastfeeding practices, while adjusting for socioeconomic, demographic, maternal, pregnancy and delivery related variables. Bootstrapping was performed to account for the complex sampling design. Results Around 75.0 % of women intended to only breastfeed their child, with 90.0 % initiating breastfeeding, while 6 month termination and exclusive breastfeeding rates were at 52.0 % and 14.3 %, respectively. Regression analysis showed no association between adequate PNC initiation or services use, and any breastfeeding practice. Mothers with either a family doctor or a midwife as PNC provider were significantly more likely to have better breastfeeding practices compared to an obstetrician. Conclusions In Canada, provider type impacts a mother’s breastfeeding decision and behavior rather than quantity and timing of PNC. Electronic supplementary material The online version of this article (doi:10.1186/s12884-016-0889-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Christy Costanian
- School of Kinesiology & Health Science, Bethune College, York University, 4700 Keele Street, M3J 1P3, Toronto, ON, Canada.
| | - Alison K Macpherson
- School of Kinesiology & Health Science, Bethune College, York University, 4700 Keele Street, M3J 1P3, Toronto, ON, Canada
| | - Hala Tamim
- School of Kinesiology & Health Science, Bethune College, York University, 4700 Keele Street, M3J 1P3, Toronto, ON, Canada
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Black AM, Macpherson AK, Hagel BE, Romiti MA, Palacios-Derflingher L, Kang J, Meeuwisse WH, Emery CA. Policy change eliminating body checking in non-elite ice hockey leads to a threefold reduction in injury and concussion risk in 11- and 12-year-old players. Br J Sports Med 2015; 50:55-61. [DOI: 10.1136/bjsports-2015-095103] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Pike I, Piedt S, Davison CM, Russell K, Macpherson AK, Pickett W. Youth injury prevention in Canada: use of the Delphi method to develop recommendations. BMC Public Health 2015; 15:1274. [PMID: 26689806 PMCID: PMC4687288 DOI: 10.1186/s12889-015-2600-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Accepted: 12/11/2015] [Indexed: 11/15/2022] Open
Abstract
Background The Health Behaviour in School-aged Children Survey is one of very few cross-national health surveys that includes information on injury occurrence and prevention within adolescent populations. A collaboration to develop a Canadian youth injury report using these data resulted in, Injury among Young Canadians: A national study of contextual determinants. The objective of this study was to develop specific evidence-based, policy-oriented recommendations arising from the national report, using a modified-Delphi process with a panel of expert stakeholders. Method Eight injury prevention experts and a 3-person youth advisory team associated with a Canadian injury prevention organization (Parachute Canada) reviewed, edited and commented on report recommendations through a three-stage iterative modified-Delphi process. Results From an initial list of 27 draft recommendations, the modified-Delphi process resulted in a final list of 19 specific recommendations, worded to resonate with the group(s) responsible to lead or take the recommended action. Two recommendations were rated as “extremely important” or “very important” by 100 % of the expert panel, two were deleted, a further two recommendations were deleted but the content included as text in the report, and four were merged with other existing recommendations. Conclusions The modified-Delphi process was an appropriate method to achieve agreement on 19 specific evidence-based, policy-oriented recommendations to complement the national youth injury report. In providing their input, it is noted that the injury stakeholders each acted as individual experts, unattached to any organizational position or policy. These recommendations will require multidisciplinary collaborations in order to support the proposed policy development, additional research, programming and clear decision-making for youth injury prevention. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-2600-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ian Pike
- University of British Columbia, F508-4480 Oak Street, Vancouver, BC, V6H 3V4, Canada.
| | - Shannon Piedt
- British Columbia Injury Research and Prevention Unit, F508-4480 Oak Street, Vancouver, BC, V6H 3V4, Canada.
| | - Colleen M Davison
- Queens University, Carruthers Hall, Office 203, 62 Fifth Field Company Lane, Kingston, ON, K7L 3N6, Canada.
| | - Kelly Russell
- University of Manitoba, 656-715 McDermot Ave., Winnipeg, MB, R3E 3P4, Canada.
| | - Alison K Macpherson
- York University, 337 Bethune College, 4700 Keele St, Toronto, ON, M3J 1P3, Canada.
| | - William Pickett
- Queens University, Carruthers Hall, Office 203, 62 Fifth Field Company Lane, Kingston, ON, K7L 3N6, Canada.
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Brown JA, Dalecki M, Hughes C, Macpherson AK, Sergio LE. Cognitive-motor integration deficits in young adult athletes following concussion. BMC Sports Sci Med Rehabil 2015; 7:25. [PMID: 26491541 PMCID: PMC4612424 DOI: 10.1186/s13102-015-0019-4] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 10/09/2015] [Indexed: 01/05/2023]
Abstract
BACKGROUND The ability to perform visually-guided motor tasks requires the transformation of visual information into programmed motor outputs. When the guiding visual information does not align spatially with the motor output, the brain processes rules to integrate the information for an appropriate motor response. Here, we look at how performance on such tasks is affected in young adult athletes with concussion history. METHODS Participants displaced a cursor from a central to peripheral targets on a vertical display by sliding their finger along a touch sensitive screen in one of two spatial planes. The addition of a memory component, along with variations in cursor feedback increased task complexity across conditions. RESULTS Significant main effects between participants with concussion history and healthy controls without concussion history were observed in timing and accuracy measures. Importantly, the deficits were distinctly more pronounced for participants with concussion history compared to healthy controls, especially when the brain had to control movements having two levels of decoupling between vision and action. A discriminant analysis correctly classified athletes with a history of concussion based on task performance with an accuracy of 94 %, despite the majority of these athletes being rated asymptomatic by current standards. CONCLUSIONS These findings correspond to our previous work with adults at risk of developing dementia, and support the use of cognitive motor integration as an enhanced assessment tool for those who may have mild brain dysfunction. Such a task may provide a more sensitive metric of performance relevant to daily function than what is currently in use, to assist in return to play/work/learn decisions.
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Affiliation(s)
- Jeffrey A Brown
- School of Kinesiology and Health Science, York University, 357 Bethune College, 4700 Keele Street, Toronto, M3J 1P3 ON Canada
| | - Marc Dalecki
- School of Kinesiology and Health Science, York University, 357 Bethune College, 4700 Keele Street, Toronto, M3J 1P3 ON Canada ; Centre for Vision Research, York University, Toronto, Canada
| | - Cindy Hughes
- School of Kinesiology and Health Science, York University, 357 Bethune College, 4700 Keele Street, Toronto, M3J 1P3 ON Canada ; York University Sport Medicine Team, York University, Toronto, Canada
| | - Alison K Macpherson
- School of Kinesiology and Health Science, York University, 357 Bethune College, 4700 Keele Street, Toronto, M3J 1P3 ON Canada ; York University Sport Medicine Team, York University, Toronto, Canada
| | - Lauren E Sergio
- School of Kinesiology and Health Science, York University, 357 Bethune College, 4700 Keele Street, Toronto, M3J 1P3 ON Canada ; Centre for Vision Research, York University, Toronto, Canada ; York University Sport Medicine Team, York University, Toronto, Canada ; Southlake Regional Health Centre, Newmarket, ON Canada
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Pike I, Khalil M, Yanchar N, Tamim H, Nathens A, Macpherson AK. Establishing an injury indicator for severe pediatric injury. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv172.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Macpherson AK, Brussoni M, Fuselli P, Middaugh-Bonney T, Piedt S, Pike I. An evaluation of evidence-based paediatric injury prevention policies across Canada. BMC Public Health 2015. [PMID: 26208854 PMCID: PMC4514983 DOI: 10.1186/s12889-015-1986-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Policies to reduce injury among Canadians can be controversial and there is variability in the enactment of injury prevention laws across the country. In general, laws are most effective when they are based on good research evidence, supported by widespread public awareness and education, and maintained by consistent enforcement strategies. The purpose of this study was to document and compare key informants' perceptions of the quality, awareness, and enforcement of three evidence-based paediatric injury prevention policies (bicycle helmet legislation, child booster seat legislation, graduated driver licensing) among Canadian provinces and territories. METHODS We identified best practices related to each policy, then developed an online survey to ascertain the extent to which each jurisdiction's policy aligned with best practices, whether experts believed that the public was aware of the policy and whether it was enforced. The survey was distributed using a snowball sampling strategy to key informants across Canada. RESULTS Thirty-eight key informants responded to the bicycle helmet survey, with 73 and 35 key informants for the booster seat and graduated driver licensing surveys, respectively. Respondent's perceptions of the policies varied substantially. Key informants indicated that residents are not always aware of legislation, and legislation is not consistently enforced. These results suggest that child health policy is not always guided by evidence. CONCLUSIONS There was variation between evidence and the policies related to paediatric injury prevention among Canadian provinces and territories. Experts generally rate their policies more highly when they align with evidence and best practice. There is room for improvement and harmonization of injury prevention policies.
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Affiliation(s)
- Alison K Macpherson
- 337 Bethune College, York University, 4700 Keele St, Toronto, ON, M3J 1P3, Canada.
| | - Mariana Brussoni
- Department of Pediatrics, University of British Columbia, F508-4480 Oak Street, Vancouver, BC, V6H 3 V4, Canada.
| | - Pamela Fuselli
- Parachute Canada, 150 Eglinton Avenue East, Suite 300, Toronto, ON, M4P 1E8, Canada.
| | | | - Shannon Piedt
- British Columbia Injury Research and Prevention Unit, F508-4480 Oak Street, Vancouver, BC, V6H 3 V4, Canada.
| | - Ian Pike
- Department of Pediatrics, University of British Columbia, F508-4480 Oak Street, Vancouver, BC, V6H 3 V4, Canada.
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Al-Dajani M, Quiñonez C, Macpherson AK, Clokie C, Azarpazhooh A. Epidemiology of Maxillofacial Injuries in Ontario, Canada. J Oral Maxillofac Surg 2015; 73:693.e1-9. [DOI: 10.1016/j.joms.2014.12.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2014] [Revised: 12/01/2014] [Accepted: 12/02/2014] [Indexed: 11/27/2022]
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Pike I, McDonald RJ, Piedt S, Macpherson AK. Developing injury indicators for First Nations and Inuit children and youth in Canada: a modified Delphi approach. ACTA ACUST UNITED AC 2014. [DOI: 10.24095/hpcdp.34.4.03] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Introduction
The purpose of this research was to take the initial step in developing valid indicators that reflect the injury issues facing First Nations and Inuit children and youth in Canada.
Methods
Using a modified-Delphi process, relevant expert and community stakeholders rated each indicator on its perceived usefulness and ability to prompt action to reduce injury among children and youth in indigenous communities. The Delphi process included 5 phases and resulted in a refined set of 27 indicators.
Results
Indicators related to motorized vehicle collisions, mortality and hospitalization rates were rated the most useful and most likely to prompt action. These were followed by indicators for community injury prevention training and response systems, violent and inflicted injury, burns and falls, and suicide.
Conclusion
The results suggest that a broad-based modified-Delphi process is a practical and appropriate method, within the OCAP™ (Ownership, Control, Access and Possession) principles, for developing a proposed set of indicators for injury prevention activity focused on First Nations and Inuit children and youth. Following additional work to validate and populate the indicators, it is anticipated that communities will utilize them to monitor injury and prompt decisions and action to reduce injuries among children and youth.
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Affiliation(s)
- I Pike
- Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- B.C. Injury Research and Prevention Unit, Child and Family Research Institute, B.C. Children's Hospital, Vancouver, British Columbia, Canada
- First Nations and Inuit Children and Youth Injury Indicators Working Group
| | - RJ McDonald
- First Nations and Inuit Children and Youth Injury Indicators Working Group
- Katenies Research and Management Services, Akwesasne Mohawk Territory, Cornwall, Ontario, Canada
| | - S Piedt
- B.C. Injury Research and Prevention Unit, Child and Family Research Institute, B.C. Children's Hospital, Vancouver, British Columbia, Canada
- First Nations and Inuit Children and Youth Injury Indicators Working Group
| | - AK Macpherson
- First Nations and Inuit Children and Youth Injury Indicators Working Group
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, Ontario, Canada
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Pike I, McDonald RJ, Piedt S, Macpherson AK. Developing injury indicators for First Nations and Inuit children and youth in Canada: a modified Delphi approach. Chronic Dis Inj Can 2014; 34:203-209. [PMID: 25408179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
INTRODUCTION The purpose of this research was to take the initial step in developing valid indicators that reflect the injury issues facing First Nations and Inuit children and youth in Canada. METHODS Using a modified-Delphi process, relevant expert and community stakeholders rated each indicator on its perceived usefulness and ability to prompt action to reduce injury among children and youth in indigenous communities. The Delphi process included 5 phases and resulted in a refined set of 27 indicators. RESULTS Indicators related to motorized vehicle collisions, mortality and hospitalization rates were rated the most useful and most likely to prompt action. These were followed by indicators for community injury prevention training and response systems, violent and inflicted injury, burns and falls, and suicide. CONCLUSION The results suggest that a broad-based modified-Delphi process is a practical and appropriate method, within the OCAP™ (Ownership, Control, Access and Possession) principles, for developing a proposed set of indicators for injury prevention activity focused on First Nations and Inuit children and youth. Following additional work to validate and populate the indicators, it is anticipated that communities will utilize them to monitor injury and prompt decisions and action to reduce injuries among children and youth.
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Affiliation(s)
- I Pike
- Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; B.C. Injury Research and Prevention Unit, Child and Family Research Institute, B.C. Children's Hospital, Vancouver, British Columbia, Canada; First Nations and Inuit Children and Youth Injury Indicators Working Group
| | - R J McDonald
- First Nations and Inuit Children and Youth Injury Indicators Working Group; Katenies Research and Management Services, Akwesasne Mohawk Territory, Cornwall, Ontario, Canada
| | - S Piedt
- B.C. Injury Research and Prevention Unit, Child and Family Research Institute, B.C. Children's Hospital, Vancouver, British Columbia, Canada; First Nations and Inuit Children and Youth Injury Indicators Working Group
| | - A K Macpherson
- First Nations and Inuit Children and Youth Injury Indicators Working Group; School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, Ontario, Canada
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Brown RE, Riddell MC, Macpherson AK, Canning KL, Kuk JL. All-cause and cardiovascular mortality risk in U.S. adults with and without type 2 diabetes: Influence of physical activity, pharmacological treatment and glycemic control. J Diabetes Complications 2014; 28:311-5. [PMID: 23886620 DOI: 10.1016/j.jdiacomp.2013.06.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Revised: 06/17/2013] [Accepted: 06/17/2013] [Indexed: 11/18/2022]
Abstract
AIMS This study determined the joint association between physical activity, pharmacotherapy, and HbA1c control on all-cause and cardiovascular disease (CVD) mortality risk in adults with and without type 2 diabetes (T2D). METHODS 12,060 adults from NHANES III and NHANES continuous (1999-2002) surveys were used. Cox proportional hazards analyses were included to estimate mortality risk according to physical activity, pharmacotherapy, and glycemic control (HbA1c <7.0%) status, with physically active, treated and controlled (goal situation) as the referent. RESULTS Compared to the referent, adults with T2D who were uncontrolled, or controlled but physically inactive had a higher all-cause mortality risk (p<0.05). Compared to the referent, only adults with T2D who were physically inactive had a higher CVD mortality risk, regardless of treatment or control status (p<0.05). Normoglycemic adults had a similar all-cause and CVD mortality risk as the referent (p>0.05). CONCLUSIONS Physical activity and glycemic control are both associated with lower all-cause and CVD mortality risk in adults with T2D. Adults with T2D who are physically active, pharmacologically treated, and obtain glycemic control may attain similar mortality risk as normoglycemic adults.
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Affiliation(s)
- Ruth E Brown
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada M3J 1P3
| | - Michael C Riddell
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada M3J 1P3
| | - Alison K Macpherson
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada M3J 1P3
| | - Karissa L Canning
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada M3J 1P3
| | - Jennifer L Kuk
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada M3J 1P3.
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Poulos CCN, Gallucci J, Gage WH, Baker J, Buitrago S, Macpherson AK. The perceptions of professional soccer players on the risk of injury from competition and training on natural grass and 3rd generation artificial turf. BMC Sports Sci Med Rehabil 2014; 6:11. [PMID: 24581229 PMCID: PMC4108054 DOI: 10.1186/2052-1847-6-11] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Accepted: 02/14/2014] [Indexed: 01/13/2023]
Abstract
BACKGROUND The purpose of this study was to describe professional soccer players' perceptions towards injuries, physical recovery and the effect of surface related factors on injury resulting from soccer participation on 3rd generation artificial turf (FT) compared to natural grass (NG). METHODS Information was collected through a questionnaire that was completed by 99 professional soccer players from 6 teams competing in Major League Soccer (MLS) during the 2011 season. RESULTS The majority (93% and 95%) of the players reported that playing surface type and quality influenced the risk of sustaining an injury. Players believed that playing and training on FT increased the risk of sustaining a non-contact injury as opposed to a contact injury. The players identified three surface related risk factors on FT, which they related to injuries and greater recovery times: 1) Greater surface stiffness 2) Greater surface friction 3) Larger metabolic cost to playing on artificial grounds. Overall, 94% of the players chose FT as the surface most likely to increase the risk of sustaining an injury. CONCLUSIONS Players believe that the risk of injury differs according to surface type, and that FT is associated with an increased risk of non-contact injury. Future studies should be designed prospectively to systematically track the perceptions of groups of professional players training and competing on FT and NG.
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Affiliation(s)
- Constantine CN Poulos
- School of Kinesiology and Health Science, York University, 4700 Keele St, M3J 1P3 Toronto, Canada
| | - John Gallucci
- JAG Physical Therapy, New Jersey, USA
- Major League Soccer, New York City, USA
| | - William H Gage
- School of Kinesiology and Health Science, York University, 4700 Keele St, M3J 1P3 Toronto, Canada
| | - Joseph Baker
- School of Kinesiology and Health Science, York University, 4700 Keele St, M3J 1P3 Toronto, Canada
| | - Sebastian Buitrago
- School of Kinesiology and Health Science, York University, 4700 Keele St, M3J 1P3 Toronto, Canada
| | - Alison K Macpherson
- School of Kinesiology and Health Science, York University, 4700 Keele St, M3J 1P3 Toronto, Canada
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Fridman L, Fraser-Thomas JL, McFaull SR, Macpherson AK. Epidemiology of sports-related injuries in children and youth presenting to Canadian emergency departments from 2007-2010. Sports Med Arthrosc Rehabil Ther Technol 2013; 5:30. [PMID: 24364875 PMCID: PMC3878023 DOI: 10.1186/2052-1847-5-30] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Accepted: 12/17/2013] [Indexed: 02/08/2023]
Abstract
Background Although injuries related to sports and recreation represent a significant burden to children and youth, few studies have examined the descriptive epidemiology of sports-related injury since 2005, and some sports such as ringette have not been evaluated to date. The primary purpose of this study was to provide the descriptive epidemiology of sports-related injuries treated in emergency departments for children and youth aged 5 – 19. Methods A retrospective data analysis was performed using data from the Canadian Hospitals Injury Reporting and Prevention Program [CHIRPP] from fiscal years (April – March) 2007/08 to 2009/10. CHIRPP is a computerized information system designed by the Public Health Agency of Canada that collects information about injuries to people evaluated in emergency departments across 11 pediatric hospitals and 5 general hospitals in Canada. Thirteen sports or activities were analyzed (baseball, basketball, cycling, football, ice hockey, lacrosse, ringette, rugby, skiing, sledding, snowboarding, soccer, and volleyball). Descriptive statistics, including frequency by sport, age and sex, as well as the percent of concussions within each sport were calculated. Results Out of a total of 56, 691 reported sports and recreational injuries, soccer accounted for the largest proportion of injuries with 11,941 reported cases over the 3 year time period. Of these, approximately 30% were fractures. The 10 – 14 year age group reported the greatest proportion of injuries in 10 out of the 13 sports analyzed. In addition, males reported a greater number of overall injuries than females in 11 out of the 13 sports analyzed. The largest percentage of concussions was reported in ringette; these injuries accounted for 17.1% of overall injuries within this sport. Conclusions Injury prevention programs in Canada should focus on improving evidence-based programs to reduce the burden of injuries in all sports.
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Affiliation(s)
- Liraz Fridman
- School of Kinesiology and Health Science, York University, 4700 Keele Street, Toronto, Ontario M3J 1P3 Canada
| | - Jessica L Fraser-Thomas
- School of Kinesiology and Health Science, York University, 4700 Keele Street, Toronto, Ontario M3J 1P3 Canada
| | - Steven R McFaull
- Injury and Child Maltreatment Section, Health Surveillance and Epidemiology Division, Centre for Chronic Disease Prevention and Control, Public Health Agency of Canada, Building # 19, Tunney's Pasture, AL 1910C Ottawa, Ontario K1A 0 K9 Canada
| | - Alison K Macpherson
- School of Kinesiology and Health Science, York University, 4700 Keele Street, Toronto, Ontario M3J 1P3 Canada
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Brown RE, Riddell MC, Macpherson AK, Canning KL, Kuk JL. The joint association of physical activity, blood-pressure control, and pharmacologic treatment of hypertension for all-cause mortality risk. Am J Hypertens 2013; 26:1005-10. [PMID: 23690165 DOI: 10.1093/ajh/hpt063] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND We conducted a study to determine the joint association of physical activity, pharmacologic treatment for hypertension, and the control of blood pressure (BP) on all-cause mortality risk. METHODS The study subjects were 10,665 adults from the Third National Health and Nutrition Examination Survey (NHANES III) and the Continuous NHANES survey (1999-2000 and 2000-2001). Cox proportional hazards analyses were used to estimate differences in mortality risk according to physical activity, pharmacologic treatment for hypertension, and BP control, with physically active, treated, and controlled as the referent category. RESULTS The average follow-up time in the study was 8.6±4.8 years. The main effect of physical activity was significant independently of pharmacologic treatment and BP control (P < 0.001). Physically inactive adults with hypertension had a higher risk of mortality than did physically active adults with treated and controlled hypertension (inactive, treated and controlled hypertension: HR, 1.42; 95% CI, 1.17-1.72; P < 0.01; inactive, treated, and uncontrolled hypertension: HR, 1.55; 95% CI, 1.30-1.84; P < 0.01; inactive, untreated, and uncontrolled hypertension: HR, 1.27; 95% CI, 1.07-1.52, P < 0.01). However, the risk of mortality for physically active adults with hypertension did not differ significantly with or without treatment for hypertension if their hypertension remained uncontrolled (active, treated and uncontrolled hypertension: HR, 1.17; 95% CI 0.98-1.40; P = 0.08; active, untreated and uncontrolled hypertension: HR, 0.90; 95% CI, 0.76-1.08; P = 0.25). Physically active, normotensive individuals had a lower all-cause mortality risk than did the referent group of physically active individuals being treated with antihypertensive medication and who had controlled hypertension (HR, 0.72; 95% CI, 0.60-0.86; P < 0.01), whereas physically inactive, normotensive individuals had a risk of mortality similar to that of the referent group (HR, 1.08; 95% CI, 0.90-1.30; P = 0.42). CONCLUSION Physical activity may be as or even more important than pharmacotherapy for reducing the risk of mortality in adults with hypertension. However, the risk of mortality remained higher for physically active adults with treated and controlled hypertension than did the risk of mortality for physically active normotensive populations. Prevention of hypertension is therefore imperative for reducing the all-cause risk of premature mortality in adults.
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Affiliation(s)
- Ruth E Brown
- School of Kinesiology and Health Science, York University, 4700 Keele Street, Toronto, ON, Canada, M3J 1P3
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Brown RE, Riddell MC, Macpherson AK, Canning KL, Kuk JL. The Association Between Frequency of Physical Activity and Mortality Risk Across the Adult Age Span. J Aging Health 2013; 25:803-14. [DOI: 10.1177/0898264313492823] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives: To determine if the association between frequency of leisure-time physical activity and mortality risk differs across adulthood. Method: 9,249 adults from the NHANES III (1988-1994) were categorized as middle-aged (40-64 years), old (65-79 years) or very old (≥80 years), and as inactive (0 bouts of physical activity/week), lightly active (1-2 bouts/week), moderately active (3-4 bouts/week) or very active (5+ bouts/week). Results: In all age categories, lightly, moderately, and very active adults had a lower mortality risk compared to inactive adults ( p < .001). In very old adults only, being very active was associated with a lower mortality risk compared to being lightly active (HR 0.80, 95% CI 0.64-0.98; p = .03) and moderately active (HR 0.80, 95% CI 0.65-0.98; ( p = .03). Discussion: The association between physical activity frequency and mortality risk is strongest in very old adults. All adults and particularly very old adults may benefit from participating in physical activity five or more times a week.
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Affiliation(s)
- Ruth E. Brown
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
| | - Michael C. Riddell
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
| | | | - Karissa L. Canning
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
| | - Jennifer L. Kuk
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
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Abstract
BACKGROUND Motor vehicle collisions (MVCs) that result in one or more fatalities on the 400-series Highways represent a serious public health problem in Ontario, and were estimated to have cost $11 billion in 2004. To date, no studies have examined risk factors for fatal MVCs on Ontario's 400 series highways.The investigate how demographic and environmental risk factors are associated with fatal MVCs on Ontario's 400-Series Highways. METHODS Data were provided from the Ontario Ministry of Transport database, and included driver demographics, vehicle information, environmental descriptors, structural descriptors, as well as collision information (date and time), and severity of the collision. Multivariate analysis was used to identify factors significantly associated with the odds of dying in a collision. RESULTS There were 53,526 vehicles involved in collisions from 2001 to 2006 included in our analysis. Results from the multivariate analysis suggest that collisions with older age and male drivers were associated with an increased risk of involving a fatality. Highway 405 and an undivided 2-way design proved to be the most fatal structural configurations. Collisions in the summer, Fridays, between 12 am-4 am, and in drifting snow conditions during the wintertime were also shown to have a significantly increased risk of fatality. CONCLUSION Our results suggest that interventions to reduce deaths as a result of MVCs should focus on both driver-related and road-related modifications.
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Affiliation(s)
- Damian Rzeznikiewiz
- School of Kinesiology and Health Science, York University, 4700 Keele Street, Toronto, M3J 1P3, Canada
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Harrington AM, Yanchar N, Pike I, Macpherson AK. Who goes where? determining factors that influence where severely injured Canadian children are treated. Inj Prev 2012. [DOI: 10.1136/injuryprev-2012-040590b.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Abstract
Excess weight afflicts the majority of the US adult population. Research suggests that the role of primary care physicians in reducing overweight and obesity is essential; moreover, little is known about self-care of obesity. This report assessed the secular trends in the care of overweight and investigated the secular association between obesity with care of overweight in primary care and self-care of overweight. Cross-sectional evaluation of the National Health and Nutrition Examination Survey (NHANES) III (1988-1994) and the Continuous NHANES (1999-2008) was employed; the total sample comprised 31,039 nonpregnant adults aged 20-90 years. The relationship between diagnosed overweight, and directed weight loss with time and obesity was assessed. Despite the combined secular increase in the prevalence of overweight and obesity (BMI >25.0 kg/m(2)) between 1994 and 2008 (56.1-69.1%), there was no secular change in the odds of being diagnosed overweight by a physician when adjusted for covariates; however, overweight and obese individuals were 40 and 42% less likely to self-diagnose as overweight, and 34 and 41% less likely to self-direct weight loss in 2008 compared to 1994, respectively. Physicians were also significantly less likely to direct weight loss for overweight and obese adults with weight-related comorbidities across time (P < 0.05). Thus, the surveillance of secular trends reveals that the likelihood of physician- and self-care of overweight decreased between 1994 and 2008 and further highlights the deficiencies in the management of excess weight.
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Affiliation(s)
- Erika A Yates
- Faculty of Health, School of Kinesiology & Health Science, York University, Toronto, Ontario, Canada
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