Browsing by Author "Hagel, Brent E."
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- ItemOpen AccessAssessing inter-rater agreement of environmental audit data in a matched case-control study on bicycling injuries(BMJ Publishing Group, 2013-01-30) Romanow, Nicole T.R.; Couperthwaite, Amy B.; McCormack, Gavin R.; Nettel-Aguirre, Alberto; Rowe, Brian H.; Hagel, Brent E.BACKGROUND: Environmental audit tools must be reliable in order to accurately estimate the association between built environmental characteristics and bicycling injury risk. OBJECTIVE: To examine the inter-rater agreement of a built environment audit tool within a case-control study on the environmental determinants of bicycling injuries. METHODS: Auditor pairs visited locations where bicycling injuries occurred and independently recorded location characteristics using the Systematic Pedestrian and Cyclist Environmental Scan (SPACES). Two case groups were defined: (1) where a bicyclist was struck by a motor-vehicle (MV) and (2) where the bicyclist's injuries required hospitalisation. The two corresponding control groups were (1) where non-MV bicycle-related injuries occurred and (2) where minor bicycle-related injuries occurred. Inter-rater reliability of each item on the tool was assessed using observed agreement and κ with 95% CI. RESULTS: Ninety-seven locations were audited. Inter-observer agreement was generally high (≥95%); most items had a 1-2% difference in responses. Items with ≥5% differences between raters included path condition, slope and obstructions. For land use, path and roadway characteristics, κ ranged from 0.3 for presence of offices and cleanliness to 0.9 for schools and number of lanes; overall, 78% of items had at least substantial agreement (κ≥0.61). For bicyclists struck by a MV the proportion of items with substantial agreement was 60%, compared with 73% for non-MV related injuries. For hospitalisations and minor bicycle-related injuries, 76% of items had substantial agreement. CONCLUSIONS: Agreement was substantial for most, but not all SPACES items. The SPACES provides reliable quantitative descriptions of built environmental characteristics at bicycling injury locations.
- ItemOpen AccessDevelopment of the quality of teen trauma acute care patient and parent-reported experience measure(2022-09-23) Yeung, Matthew; Hagel, Brent E.; Bobrovitz, Niklas; Stelfox, Thomas H.; Yanchar, Natalie L.Abstract Objective Patient-Reported Experience Measures (PREMs) provide valuable patient feedback on quality of care and have been associated with clinical outcomes. We aimed to test the reliability of a modified adult trauma care PREM instrument delivered to adolescents admitted to hospital for traumatic injuries, and their parents. Modifications included addition of questions reflecting teen-focused constructs on education supports, social network maintenance and family accommodation. Results Forty adolescent patients and 40 parents participated. Test-retest reliability was assessed using Cohen’s kappa, weighted kappa, and percent agreement between responses. Directionality of changed responses was noted. Most of the study ran during the COVID-19 pandemic. We established good reliability of questions related to in-hospital and post-discharge communication, clinical and ancillary care and family accommodation. We identified poorer reliability among constructs reflecting experiences that varied from the norm during the pandemic, which included “maintenance of social networks”, “education supports”, “scheduling clinical follow-ups” and “post-discharge supports”. Parents, but not patients, demonstrated more directionality of change of responses by responding with more negative in-hospital and more positive post-discharge experiences over time between the test and retest periods, suggesting risk of recall bias. Situational factors due to the COVID-19 pandemic and potential risks of recall bias may have limited the reliability of some parts of the survey.
- ItemOpen AccessDistribution of Injuries in Men's Canada West University Football(Sage Publications, 2000) Meeuwisse, Willem H.; Hagel, Brent E.; Mohtadi, Nicholas G. H.; Butterwick, Dale J.; Fick, Gordon H.
- ItemOpen AccessEnvironmental Determinants of Bicycling Injuries in Alberta, Canada(2012-11-28) Romanow, Nicole T. R.; Couperthwaite, Amy B.; McCormack, Gavin R.; Nettel-Aguirre, Alberto; Rowe, Brian H.; Hagel, Brent E.This study examined environmental risk factors for bicycling injuries, by combining data on bicyclist injuries collected by interviews in the emergency department (ED) with street-level environmental audits of injury locations, capturing path, roadway, safety, land use, and aesthetic characteristics. Cases were bicyclists struck by a motor vehicle (MV) or with severe injuries (hospitalized). Controls were bicyclists who were not hit by a car or those seen and discharged from the ED, matched on time and day of injury. Logistic regression odds ratios (ORs) adjusted for age, sex, peak time, and bicyclist speed with 95% confidence intervals (CIs) were estimated to relate injury risk to environmental characteristics. Factors contributing to MV events included greater traffic volume (OR 5.13; 95% CI [1.44, 18.27]), intersections (OR 6.89; 95% CI [1.48, 32.14]), retail establishments (OR 5.56; 95% CI [1.72, 17.98]), and path obstructions (OR 3.83; 95% CI [1.03, 14.25]). Locations where the road was in good condition (OR 0.25; 95% CI [0.07, 0.96]) and where there was high surveillance from surrounding buildings (OR 0.32; 95% CI [0.13, 0.82]) were associated with less severe injuries. These findings could be used by bicyclists and transportation planners to improve safety.
- ItemOpen AccessHeads Above the Rest: Examining Head impacts in Canadian High School Football(2021-04-16) Pankow, Mark Patrick; Emery, Carolyn A.; Dennison, Christopher R.; Hagel, Brent E.; Mrazik, MartinThis thesis contains three projects focused on concussion and head impacts in tackle football. First, is a systematic review and meta-analysis. Objective: To examine youth football concussion and head impact rates, modifiable risk factors, and football-specific prevention strategies. Methods: Nine databases were searched. Two authors (with a third to resolve disagreements) completed study screening and assessment of bias. Results: Concussion rates for high school (ages 13-19) and minor football (ages 5-15) were 0.78/1000 athlete exposures and 1.15/1000 athlete exposures. Of prevention strategies, contact training and contact restrictions had the strongest evidence supporting their effectiveness. Conclusions: The high rates of concussion and head impacts affirm the need for prevention strategies in youth football. The second manuscript investigated head impact rates in Canadian high school football. Objective: To describe head impact rates in Canadian high school football. Methods: Games (n=14) involving two teams were recorded during the 2019 season and analyzed to identify head impacts. Results: The offense experienced head impacts at a higher rate than the kicking and receiving units, but not the defense. Conclusion: To help reduce the head impact rates in this cohort, contact training emphasizing the removal of the head from contact may be beneficial. The third manuscript evaluated a score-based running time rule. Objective: To describe the effect of the score-based running time rule on the rates of head impacts in Canadian high school football. Methods: Video analysis was used to identify head impacts in games (n=14) involving two teams that were followed during the 2019 football season. Results: The rates of head impacts in games where running time came into effect were lower for the offense and defense, but not special team units (kicking team and receiving team). Conclusions: The score-based running time rule was associated with lower head impact rates for two of four team units.
- ItemOpen AccessMountain bike terrain park-related injuries: an emerging cause of morbidity(Taylor & Francis Online, 2012-12-18) Romanow, Nicole T.R.; Hagel, Brent E.; Nguyen, Michelle; Embree, Tania; Rowe, Brian H.This case–control study describes the profile of bicyclists injured in mountain bike terrain parks (MBTPs) and examines risk factors for severe injury among MBTP riders. Cases were hospitalised bicyclists injured in MBTPs. Controls were bicyclists injured in MBTPs who were discharged from the emergency department. No significant differences were observed in the distribution of age and sex between cases and controls. A higher proportion of cases compared with controls suffered a head injury (22%), fracture (41%) or internal organ injury (32%). Controls suffered a higher proportion of superficial injuries (26%), sprains (10%) or wounds (16%). Upper extremity protective equipment (e.g. elbow or shoulder pads) was used more by cases than controls (23% vs. 11%, p = 0.03). Riders who self-reported cycling faster than usual had significantly higher risk of severe injury compared with others. The risk of severe injury may be reduced by encouraging bicyclists to control their speed or by modifying MBTP design to limit the opportunity to gain speed.
- ItemOpen AccessRisk factor analysis of skiing and snowboarding injuries in southern Alberta youth(1998) Hagel, Brent E.; Meeuwisse, Willem H.
- ItemOpen AccessThe relationship between injuries and terrain park feature use among pediatric and adult snowboarders in Alberta(2011) Kelly, Russell; Hagel, Brent E.; Meeuwisse, Willem H.