Browsing by Author "Nettel-Aguirre, Alberto"
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- ItemOpen AccessA comparative study of dementia-related service provision and configuration in Canada(2013-09-20) Tam-Tham, Helen; Drummond, Neil; Nettel-Aguirre, AlbertoThe purpose of this study was to describe and compare the provision of dementia-related services throughout the disease trajectory. Previously collected interview data from family physicians, geriatric specialists, and case managers in Calgary, Edmonton, and Ottawa (n=34) using a standardized interview schedule were quantified and thematically categorized. The proportions of participants that identified specific services were analyzed at each stage and cumulatively using chi-square tests; proportions of identifiers were also examined through time using time-to-event analysis. Further, relationships between participants and services were described using social network analysis. The following services were analyzed: neuroimaging, depression-related, delirium-related, future planning, informal support, Alzheimer Society and related, in-home support, and day program services. Overall, the findings indicated variation in service delivery among professionals and locations; family physicians and Ottawa clinicians, particularly, may not be providing services at frequencies and times recommended in national guidelines.
- ItemOpen AccessA Multidisciplinary Clinic for Children with Problematic Severe Asthma: Assessment of Clinical Outcomes, Healthcare Utilization and Costs(2014-12-24) Kam, Karen; Currie, Gillian; Nettel-Aguirre, AlbertoBackground: The Intensive Management of Asthma Clinic (IMAC) at the Alberta Children’s Hospital is a novel multidisciplinary clinic for children with severe problematic asthma. Whether consolidating resources in this clinic is effective, compared to the regular asthma clinic, has not been studied. Methods: This quasi-experimental retrospective study compared the IMAC and regular asthma clinic. Data was collected in three categories: clinical outcomes, healthcare utilization, and costs (healthcare utilization, patient-borne). Primary analyses used linear mixed effects modeling, paired t-tests, and ANOVA. Results: Lung function improved more for IMAC patients. Quality of life scores, measured only in the IMAC, improved. Scheduled clinic visits increased, while ED visits decreased. The increased cost of the IMAC was greater than the total costs saved by subsequent decreased healthcare utilization; overall the IMAC was more expensive. Conclusion: The IMAC is effective in improving clinical outcomes and decreasing healthcare utilization; however, these benefits come at extra cost.
- 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 AccessAssociation of prenatal medical risk with breastfeeding outcomes up to 12 months in the All Our Families community-based birth cohort(2021-09-15) Scime, Natalie V.; Metcalfe, Amy; Nettel-Aguirre, Alberto; Tough, Suzanne C.; Chaput, Kathleen H.Abstract Background Prenatal medical risk describes physical health issues or biological factors that predate or arise during pregnancy which heighten the risk of adverse outcomes, and often warrant specialized obstetric care. The influence of the nature and magnitude of prenatal risk on breastfeeding outcomes remains poorly understood. The objective of this study was to determine the association between prenatal medical risk and breastfeeding initiation and duration up to 1 year postpartum. Methods We analysed a subset of data from the All Our Families longitudinal cohort (n = 2706) of women in Calgary, Canada who delivered a liveborn infant between 2008 and 2010. Data were collected from self-report questionnaires and medical records. Women with complete data on prenatal medical risk factors and breastfeeding outcomes were included in this analysis. Prenatal medical risk was operationalized as one integer score of risk severity and four binary risk types capturing pre-pregnancy characteristics, past obstetric problems, current obstetric problems, and substance use. Outcomes were breastfeeding initiation defined as the infant ever receiving breast milk, and duration operationalized as still breastfeeding at 4 months, at 12 months, and time to breastfeeding cessation in weeks. We used logistic regression and Cox regression with right censoring at 52 weeks or attrition to calculate odds ratios (OR) and hazard ratios (HR), respectively, adjusting for sociodemographic vulnerability, parity, mode of delivery, and gestational age. Results Prenatal medical risk severity and type were not significantly associated with breastfeeding initiation, with the exception of pre-pregnancy risk type (OR 0.45; 95% CI 0.26, 0.77). Risk severity was associated with lower odds of breastfeeding to 4 months (OR 0.94; 95% CI 0.90, 0.99), 12 months (OR 0.93; 95% CI 0.87, 0.98), and earlier breastfeeding cessation (HR 1.05; 95% CI 1.02, 1.08). Associations with shorter breastfeeding length across the first postpartum year were observed for pre-pregnancy, current obstetric, and substance use risk types, but not past obstetric problems. Conclusion Prenatal medical risk is associated with shortened duration of breastfeeding. Women with prenatal medical risk may benefit from the proactive arrangement of lactation support before and following delivery to promote continued breastfeeding.
- ItemOpen AccessAssociations between Aspects of Friendship Networks, Physical Activity, and Sedentary Behaviour among Adolescents(2014-09-24) Sawka, Keri Jo; McCormack, Gavin R.; Nettel-Aguirre, Alberto; Blackstaffe, Anita; Perry, Rosemary; Hawe, PenelopeBackground. Adolescent friendships have been linked to physical activity levels; however, network characteristics have not been broadly examined. Method. In a cross-sectional analysis of 1061 adolescents (11–15 years), achieving 60 minutes/day of moderate-to-vigorous physical activity (MVPA) and participating in over 2 hours/day of sedentary behaviour were determined based on friendship network characteristics (density; proportion of active/sedentary friends; betweenness centrality; popularity; clique membership) and perceived social support. Results. Adolescents with no friendship nominations participated in less MVPA. For boys and girls, a ten percent point increase in active friends was positively associated with achievement of 60 minutes/day of MVPA (OR 1.11; 95% CI 1.02–1.21, OR 1.14; 95% CI 1.02–1.27, resp.). For boys, higher social support from friends was negatively associated with achieving 60 minutes/day of MVPA (OR 0.63; 95% CI 0.42–0.96). Compared with low density networks, boys in higher density networks were more likely to participate in over 2 hours/day of sedentary behaviour (OR 2.93; 95% CI 1.32–6.49). Social support from friends also modified associations between network characteristics and MVPA and sedentary behaviour. Conclusion. Different network characteristics appeared to have different consequences. The proportion of active close friends was associated with MVPA, while network density was associated with sedentary behaviour. This poses challenges for intervention design.
- ItemOpen AccessAssociations between the Neighbourhood Built Environment and Walking(2018-07-11) Farkas, Brenlea Jenelle Marie; McCormack, Gavin Robert; Friedenreich, Christine Marthe; Nettel-Aguirre, AlbertoPhysical inactivity is a risk factor for overweight and obesity, type II diabetes, cardiovascular disease, depression, and breast/colon cancer. Despite the known benefits of physical activity, many Canadian adults do not achieve the recommended levels of physical activity necessary to obtain optimal health. Evidence suggests that built characteristics within neighbourhoods are associated with physical activity, and in particular walking. There is growing policy interest in neighbourhood interventions to increase physical activity, specifically walking, suggesting the need for a synthesis of Canadian evidence to better inform local urban planning. There were two main aims of this thesis. The first was to provide a better understanding of how the built environment influences walking behaviour in Canadian adults. The second was to contribute to this body of evidence by studying the associations between individual characteristics of the neighbourhood environment and walking outcomes. A systematized review of Canadian evidence supported findings from other reviews, suggesting that overall walkability, land-use mix, and proximity to destinations are important features of the built environment for promoting transportation walking. Built environment associations with recreation walking are less clear. The systematized review also identified gaps in the current body of research, some of which were addressed in the analytic component of this thesis. A quantitative data analysis for a sample of Canadian adults living in 12 neighbourhoods of varying urban form and socioeconomic status in Calgary, Canada did not find any statistically significant associations between individual characteristics of the neighbourhood built environment and recreation walking or transportation walking, after adjusting for residential self-selection, sociodemographic characteristics, and neighbourhood socioeconomic status. Further research is needed to better understand how individual characteristics of the neighbourhood built environment facilitate or inhibit walking in order to better inform urban planning and public health policy.
- ItemOpen AccessBreastfeeding difficulties in the first 6 weeks postpartum among mothers with chronic conditions: a latent class analysis(2023-02-02) Scime, Natalie V.; Metcalfe, Amy; Nettel-Aguirre, Alberto; Nerenberg, Kara; Seow, Cynthia H.; Tough, Suzanne C.; Chaput, Kathleen H.Abstract Background Breastfeeding difficulties frequently exacerbate one another and are common reasons for curtailed breastfeeding. Women with chronic conditions are at high risk of early breastfeeding cessation, yet limited evidence exists on the breastfeeding difficulties that co-occur in these mothers. The objective of this study was to explore clusters of breastfeeding difficulties experienced up to 6 weeks postpartum among mothers with chronic conditions and to examine associations between chronic condition types and breastfeeding difficulty clusters. Methods We analyzed 348 mothers with chronic conditions enrolled in a prospective, community-based pregnancy cohort study from Alberta, Canada. Data were collected through self-report questionnaires. We used latent class analysis to identify clusters of early breastfeeding difficulties and multinomial logistic regression to examine whether types of chronic conditions were associated with these clusters, adjusting for maternal and obstetric factors. Results We identified three clusters of breastfeeding difficulties. The “physiologically expected” cluster (51.1% of women) was characterized by leaking breasts and engorgement (reference outcome group); the “low milk production” cluster (15.4%) was discerned by low milk supply and infant weight concerns; and the “ineffective latch” cluster (33.5%) involved latch problems, sore nipples, and difficulty with positioning. Endocrine (adjusted relative risk ratio [RRR] 2.34, 95% CI 1.10–5.00), cardiovascular (adjusted RRR 2.75, 95% CI 1.01–7.81), and gastrointestinal (adjusted RRR 2.51, 95% CI 1.11–5.69) conditions were associated with the low milk production cluster, and gastrointestinal (adjusted RRR 2.44, 95% CI 1.25–4.77) conditions were additionally associated with the ineffective latch cluster. Conclusion Half of women with chronic conditions experienced clusters of breastfeeding difficulties corresponding either to low milk production or to ineffective latch in the first 6 weeks postpartum. Associations with chronic condition types suggest that connections between lactation physiology and disease pathophysiology should be considered when providing breastfeeding support.
- ItemEmbargoBreastfeeding intentions, difficulties, and outcomes in mothers with chronic physical health conditions: the Motherhood and Chronic Illness (MaCI) prospective cohort study(2022-07-11) Scime, Natalie V.; Chaput, Kathleen H; Tough, Suzanne C; Metcalfe, Amy; Nettel-Aguirre, AlbertoBreastfeeding from birth to 6 months has numerous benefits for maternal and child health. Mothers with chronic conditions are at risk for suboptimal breastfeeding outcomes, yet the underlying reasons for this are poorly understood. This thesis research investigated the factors associated with breastfeeding intentions, difficulties, and outcomes in mothers with chronic conditions. We conducted a prospective, community-based pregnancy cohort study called the Motherhood and Chronic Illness (MaCI) Study following 405 women from Alberta who reported living with a long-term physical health condition, carrying a singleton pregnancy, and intending to try breastfeeding. Women completed questionnaires at 32 weeks gestation, 6 weeks postpartum, and 6 months postpartum (overall response rate, 86.7%). In the prenatal period, we found that women who perceived their chronic condition to worsen during pregnancy were less likely to plan to exclusively breastfeed to 6 months per the global recommendation (adjusted odds ratio [OR] 0.50, 95% CI 0.30–0.82). From birth to 6 weeks postpartum, we identified three clusters of breastfeeding difficulties corresponding to physiologically expected lactation changes (51.1% of women), low milk production (15.4%), and ineffective latch (33.5%). Mothers with endocrine (adjusted relative risk ratio [RRR] 2.41, 95% CI 1.13–5.13), cardiovascular (adjusted RRR 2.87, 95% CI 1.02–8.09), and gastrointestinal (adjusted RRR 2.57, 95% CI 1.13–5.82) conditions were more likely to belong to the low milk production cluster and mothers with gastrointestinal (adjusted RRR 2.47, 95% CI 1.27–4.81) conditions were more likely to belong to the ineffective latch cluster, relative to the physiologically expected cluster. By 6 months postpartum, we found that one third (31.2%) of mothers had stopped breastfeeding, nearly all of whom did so earlier than planned. Compared to mothers who adhered to their pre-existing medications, mothers who did not adhere to pre-existing medications had shorter breastfeeding duration (adjusted hazard ratio [HR] 1.69, 95% CI 1.04–2.74) and greater odds of earlier than planned breastfeeding cessation (adjusted OR 1.85, 1.01–3.41). The MaCI Study highlighted three unique determinants of breastfeeding in mothers with chronic conditions, which can be addressed through person-centred support that jointly considers the ways in which breastfeeding patterns influence, and are influenced by, chronic condition status and management.
- ItemOpen AccessThe Canadian Childhood Nephrotic Syndrome (CHILDNEPH) Project: overview of design and methods(BioMed Central, 2014-07-22) Samuel, Susan M.; Scott, Shannon; Morgan, Catherine; Dart, Allison; Mammen, Cherry; Parekh, Rulan; Nettel-Aguirre, Alberto; Eddy, Allison; Flynn, Rachel; Pinsk, Maury; Wade, Andrew; Arora, Steven; Benoit, Geneviève; Bitzan, Martin; Erickson, Robin; Feber, Janusz; Filler, Guido; Geier, Pavel; Girardin, Colette; Grisaru, Silviu; Tee, James; Kemp, Kyle; Zappitelli, Michael
- ItemOpen AccessChanges in Peer Friendships and Physical Activity among Children across School-Grade Transition(2016) Swanson, Kenda Charlotte; McCormack, Gavin Robert; Nettel-Aguirre, Alberto; Hawe, Penny; Johnston, Jennifer CyneChildren’s physical activity (PA) may be affected by transitioning school grade; however, limited evidence exists on the associations between aspects of children’s peer friendships and their PA over the transition to a new school year. This thesis addressed this gap by examining whether or not associations between children’s peer friendships; including, popularity, number of sent friendship nominations, and friend’s average PA were associated with individual PA pre-, post- and over the transition to a higher school grade. We found that sent friendships and friends’ average PA were positively associated with an individual’s PA pre- and post-transition, and that changes in friendships did not directly correspond with PA changes over the transition. We did not identify differences according to sex. Future studies should employ social network analysis and longitudinal study designs to further examine these relationships. School-based interventions that promote friendly interactions among peers while simultaneously increasing PA are recommended.
- ItemOpen AccessChild and adolescent bicycling injuries involving motor vehicle collisions(2019-03-04) Pitt, Tona M; Nettel-Aguirre, Alberto; McCormack, Gavin R; Howard, Andrew W; Piatkowski, Camilla; Rowe, Brian H; Hagel, Brent EAbstract Background Bicycle-related injuries are among the most common recreational injuries for children in Canada; moreover, bicycle-motor vehicle collisions often result in serious injuries. This study seeks to examine environmental, motorist, and bicyclist characteristics of bicycle-motor vehicle collisions that resulted in police reported severe injuries in youth (< 18 years old) bicyclists, in Alberta, Canada. Findings Using Calgary and Edmonton police collision reports, 423 youth bicycle-motor vehicle collisions were identified from 2010 to 2014. Forty-three (10.2%) of these collisions resulted in major/fatal (severe) injuries. These severe injury cases were compared with the 380 youth bicycle-motor vehicle collisions resulting in minor or no injury (controls) using classification tree and logistic regression analyses. There were no driver or bicyclist characteristics with a significant effect on the odds of severe injury to youth bicyclists; however, lower odds were found on each of: divided roads with no barrier (aOR = 0.36; 95% CI: 0.13–0.97) or during peak traffic time (aOR = 0.44; 95% CI: 0.16–0.99). Conclusion Personal and environment characteristics should be considered in future research and interventions focused on reducing severe youth bicycle-motor vehicle collision injuries.
- ItemOpen AccessClassification Models for Multivariate Non-normal Repeated Measures Data(2021-01-08) Brobbey, Anita; Sajobi, Tolulope T.; Wiebe, Samuel; Williamson, Tyler S.; Nettel-Aguirre, AlbertoMultivariate repeated measures data, in which multiple outcomes are repeatedly measured at two or more occasions, are commonly collected in several disciplines (e.g., medicine, ecology, environmental sciences), where investigators seek to discriminate between population groups or make predictions based on changes in multiple correlated outcomes over time. Repeated measures discriminant analysis have been developed and applied to address these research questions. These classification models, which have been mostly developed based on growth curve models, covariance pattern models, and mixed-effects models, are advantageous in that they can account for complex correlation structures in multivariate repeated measures data (e.g., within-outcome and between-outcome correlations) to improve their predictive accuracy. However, they largely rely on the assumption of multivariate normality, which is rarely satisfied in multivariate repeated measures data. To our knowledge, there has been limited investigation of the behavior of these existing models in multivariate non-normal repeated measures data. The overarching goal of this research was to develop robust repeated measures discriminant analysis classifiers for multivariate non-normal repeated measures data. Specifically, we developed repeated measures discriminant analysis based on maximum trimmed likelihood estimators (MTLE) and generalized estimating equations (GEE) estimators and examine their accuracy in comparison to classifiers based on maximum likelihood estimation (MLE) using Monte Carlo methods. The simulation conditions examined, included population distribution, sample size, covariance structure (between-outcomes and within-outcome), covariance heterogeneity, repeated number of occasions, and number of outcome variables. The Monte Carlo study results indicated that the proposed methods increased overall mean classification accuracy by 2% - 15% in multivariate non-normal repeated measures data compared to repeated measures discriminant analysis based on MLE under most scenarios. Data from two cohort studies were used to illustrate the implementation of the proposed repeated measures discriminant analysis methods. The outcomes of this research includes novel multivariate classifiers for predicting group membership in multivariate normal and non-normal repeated measures data. This research contributes to the advancement of statistical science on methods for analyzing multivariate repeated measures data.
- ItemOpen AccessDetermining the cause of motor-vehicle related paediatric bicycling injuries(2018-07-18) Pitt, Tona Michael Chase; Hagel, Brent Edward; McCormack, Gavin R.; Nettel-Aguirre, Alberto; Howard, Andrew W.; Ronsky, Janet L.Despite health benefits, bicycling as a form of active transportation has declined. Bicycle-motor vehicle collisions (BMVCs) pose a risk for severe injury to youth and are a leading deterrent to youth bicycling. This thesis aims to identify characteristics of BMVCs. Divided roads with no barrier, signage presence and peak traffic times had lower odds of severe injury in youth after BMVC. We adapted a culpability tool to Alberta police collision report data and used this tool to define a control group of drivers from collisions involving only motor vehicles. These controls were compared with drivers in BMVCs. Drivers older than 54 years had higher odds of youth BMVC, light trucks/vans had lower odds and driving between18:01hrs-24:00hrs had the highest odds of BMVC. It is possible to adapt culpability tools to other jurisdictions and can be used to address the often-neglected role of the driver in youth BMVCs.
- ItemOpen AccessDevelopment and Assessment of a Neighbourhood International Physical Activity Questionnaire (N-IPAQ)(2018-06-08) Frehlich, Levi Colt; McCormack, Gavin Robert; Nettel-Aguirre, Alberto; Friedenreich, Christine MarthePhysical activity is a cornerstone for health, moreover, physical inactivity is independently associated with poor health outcomes. The neighbourhood built environment provides a unique opportunity to address both physical activity and inactivity. Higher walkable neighbourhoods have consistently shown increases in active transportation; however, many of these outcomes have been supported using non-context specific tools (i.e., measures of general physical activity). This project addresses this research gap by developing and testing a neighbourhood specific physical activity questionnaire (N-IPAQ). The N-IPAQ demonstrated reliability through self-administered paper and online formats. Moreover, the N-IPAQ demonstrated construct and concurrent validity using objective measures of neighborhood and physical activity. The N-IPAQ was also able to distinguish physical activity differences between high and low walkable neighborhoods. The use of the N-IPAQ in larger population based research could therefore better elucidate the specific built environment characteristics that foster or hinder physical activity.
- ItemOpen AccessThe effect of a ski-snowboard injury prevention video on safety knowledge and behaviours in school programs(2018-01-11) Mitra, Tatum; Hagel, Brent; Emery, Carolyn; Nettel-Aguirre, Alberto; Caird, Jeff; Russell, KellyPurpose: To implement and evaluate the effects of a skiing and snowboarding injury prevention video on child and adolescent safety knowledge and behaviours. Study Design: Cluster-randomized controlled trial. Background: Skiing and snowboarding are two popular winter activities; however, these sports can lead to injury. Previous studies have found that injuries in snow sports can be prevented and may be associated with poor decisions, actions and human error. Currently, there is no comprehensive injury prevention program found in skiing and snowboarding. Methods: The participants were students in grades 2 through 9 who were a part of the ski and snowboard school programs at a ski area in Southern Alberta. The participants were randomized into either the control or intervention group, based on the school they attended. The control group followed the current standard protocol for the ski and snowboard school programs, including an orientation video, while the intervention group received a video that focuses on safety knowledge and injury prevention. The outcomes were measured through the use of pre- and post-tests (safety knowledge uptake) and the observations of risky behaviours on the ski hill. Results: There was a significant increase in safety knowledge scores for those in the intervention group immediately following exposure to the video intervention (mean change: +1.91 points/15 points) compared with the control group after exposure to the control video (mean change: +0.10 points/15 points). There were 23.31 risky behaviours/100 runs (95% CI: 16.75-29.87) for those in the control group, and 22.95 risky behaviours/100 runs (95% CI: 17.63-28.26) for those in the intervention group. Conclusion: This project demonstrates that a skiing and snowboarding injury prevention video can improve knowledge scores within a school-aged population. The video intervention, however, was not associated with the overall incidence of risky behaviours in this population. Future injury prevention research should investigate how to better translate knowledge to induce behavioural changes and limit risky behaviours in child and adolescent skiers and snowboarders.
- ItemOpen AccessEffect of Increased 25(OH)D on Bone Health, a High Resolution Peripheral Computed Tomography Study(2016) Hildebrandt, Erin Marie; Boyd, Steven Kyle; Hanley, David Arthur; Bertram, John Edward Arthur; Nettel-Aguirre, Alberto; Kothandaraman, Maitreyi; Edwards, William BrentVitamin D is important for normal bone health, however, there is still debate over the intake for optimal bone health. The objective of this study is to assess the relationship between large changes in 25(OH)D to bone health, and the safety of taking up to 10,000 IU/day of vitamin D over one-year using a pilot cohort of a three-year ongoing randomized control trial. The results suggest that with increased 25(OH)D there was an improvement in trabecular and cortical BMD, as well as a decrease in cortical area and thickness, while maintaining bone strength. Based on biomarker data, taking doses of vitamin D up to 10,000 IU/day for one year was found to be safe within the population studied. This study has provided new insight into the understanding of large changes in 25(OH)D on bone health and demonstrates the importance of 25(OH)D for maintaining bone health in a healthy adult population.
- 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 AccessExamining Measures of Weight as Risk Factors for Sport-Related Injury in Adolescents(2016-07-20) Richmond, Sarah A.; Nettel-Aguirre, Alberto; Doyle-Baker, Patricia K.; Macpherson, Alison; Emery, Carolyn A.Objectives. To examine body mass index (BMI) and waist circumference (WC) as risk factors for sport injury in adolescents. Design. A secondary analysis of prospectively collected data from a pilot cluster randomized controlled trial. Methods. Adolescents () at the ages of 11–15 years from two Calgary junior high schools were included. BMI (kg/m2) and WC (cm) were measured from direct measures at baseline assessment. Categories (overweight/obese) were created using validated international (BMI) and national (WC) cut-off points. A Poisson regression analysis controlling for relevant covariates (sex, previous injury, sport participation, intervention group, and aerobic fitness level) estimated the risk of sport injury [incidence rate ratios (IRR) with 95% confidence intervals (CI)]. Results. There was an increased risk of time loss injury (IRR = 2.82, 95% CI: 1.01–8.04) and knee injury (IRR = 2.07, 95% CI: 1.00–6.94) in adolescents that were overweight/obese; however, increases in injury risk for all injury and lower extremity injury were not statistically significant. Estimates suggested a greater risk of time loss injury [IRR = 1.63 (95% CI: 0.93–2.47)] in adolescents with high measures of WC. Conclusions. There is an increased risk of time loss injury and knee injury in overweight/obese adolescents. Sport injury prevention training programs should include strategies that target all known risk factors for injury.
- ItemOpen AccessFactors Influencing Fine and Gross Motor Development among Children 24 Months of Age: Results from the All Our Families Study(2017) Dodd, Shawn X.; Tough, Suzanne; Hagel, Brent; Cabaj, Jason; Nettel-Aguirre, AlbertoObjective: The objective of this study was to identify factors influencing fine and gross motor development of Albertan children at 24 months of age. Methods: This is a secondary analysis of data from the All Our Families study, a prospective pregnancy cohort. Multivariable logistic regression was performed to identify factors influencing motor development. Results: Early developmental delays, maternal abuse and maternal postpartum drug use were associated with an increased odds of suboptimal gross motor development at 24 months of age. Pregnancy complications were associated with a reduction in risk for gross motor delays. Early developmental delays, NICU admission and maternal postpartum alcohol consumption were associated with an increased risk for delays in fine motor development at 24 months of age. Conclusion: Delayed motor development at 24 months of age may be mitigated through detection and intervention of early cognitive, social and motor developmental delays.