Browsing by Author "Hagel, Brent Edward"

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    Determining 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.
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    Emergency Medical Services Response Time and Mortality in Paediatric Trauma Patients in the Urban Setting: A Cohort Study
    (2015-09-29) Couperthwaite, Amy Bonnie Gale; Hagel, Brent Edward
    Introduction: The standard for Emergency Medical Services (EMS) response times has been set at eight minutes or less in many places in the world. We examined the relationship between trauma related mortality and morbidity and EMS response time. Methods: Retrospective cohort study of paediatric patients under the age of 18 who suffered a traumatic injury and were attended to by EMS in Calgary and Edmonton, Alberta between April 2010 and September 2013 Results: The adjusted risk ratio of mortality given a response time of ≥8 minutes is 0.635 times that of a response time <8 minutes (95% CI: 0.346-1.166; p=0.143). The adjusted risk ratio of admission to hospital given a response time of >8 minutes is 1.165 times that of a response time <8 minutes (95% CI: 0.985-1.379; p=0.075). Conclusions: The eight minute response time was not associated with a difference in all cause mortality or admission to hospital.
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    Helmet Use Among Skiers and Snowboarders in Southern Alberta
    (2019-11) Pfister, Ken; Hagel, Brent Edward; Nettel-Aguirre, Alberto; Emery, Carolyn A.
    Skiing and snowboarding are among the most popular winter activities in Canada. Unfortunately, many injuries occur in these activities, including severe injuries often involving the head, which can result in death. These injuries, particularly severe head or brain injuries, are an important burden on the health care system, and may be prevented by encouraging helmet use. Helmet effectiveness is well established, but there are little recent data on ski and snowboard helmet prevalence at ski areas in southern Alberta, with no published reports on correct helmet fit. This study determined the prevalence of helmet use and correct helmet use at a single ski area in Southern Alberta and examined the factors associated with helmet use and correct fit. Information on helmet use and correct use, as well as environmental and behavioural characteristics was collected at the base of the ski hill by both interviewing and observing participants. Age (<18 years old), skiing/snowboarding with companions, and skiing/snowboarding with companions also wearing helmets increased the likelihood of each wearing a helmet and wearing a helmet correctly. The protective effect of helmets in skiers and snowboarders has been demonstrated convincingly. The education and promotion of helmet use and correct helmet use is paramount in reducing the risk of head injuries among skiers and snowboarders. Our findings will inform participants, parents, members of the ski-snowboard industry, and the stakeholders that seek to influence them to improve the safety of skiers and snowboarders of all ages.
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    Injuries in Canadian female high school rugby and coach perceptions of injury prevention: Informing an injury prevention implementation strategy
    (2021-01-06) Shill, Isla Jordan; Emery, Carolyn A.; Hagel, Brent Edward; Black, Amanda M.; Pasanen, Kati
    This MSc thesis contains two projects focused on Canadian high school rugby. The first project is an evaluation of the epidemiology of female high school rugby in a Canadian context. Objective: To describe injury rates in female high school rugby and evaluate the association between baseline risk factors and injury outcomes. Methods: Injury surveillance was completed during a two-year prospective cohort study in the Calgary female high school rugby league. Results: Injury and concussion incidence rates were 93.7 injuries/ 1000 match-hours and 37.5 concussions/ 1000 match-hours, respectively. Injury within the past twelve months was associated with higher match injury rates. Higher team playing division was associated with higher training injury rates. The second project is an evaluation of the Canadian high school rugby coaching context. Objective: To describe the Canadian high school rugby coach context and evaluate intention to use a rugby-specific neuromuscular training warm-up. Methods: High school rugby coaches participated in a 2-hour “Train-the-Coach” neuromuscular training warm-up workshop. Pre- and post-workshop questionnaires were administered. Results: Pre-workshop, 92% of coaches agreed or strongly agreed they would ‘complete a rugby-specific warm-up program prior to every game and training session this season’. Post-workshop, 85% of coaches partly or strongly agreed that they “would conduct the SHRed Injuries program in every session with their students/athletes/client”. Conclusions: Injury and concussion rates in Canadian female high school rugby are high and intention to use a rugby-specific neuromuscular training warm-up was high before and after the workshop.
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    Optimally Linking Prehospital and Health System Data: The Association between Emergency Medical Services Offload Time, Response Time and Mortality
    (2020-01-14) Blanchard, Ian; Doig, Christopher James; Lang, Eddy S.; Dean, Stafford R.; Hagel, Brent Edward; Niven, Daniel J.; Williamson, Tyler S.
    INTRODUCTION: Delays in offloading Emergency Medical Services (EMS) patients in the hospital may impact timely response to emergencies, but no published studies are available. Little research has been conducted on the potential for bias when EMS data are linked to health system outcome and on the optimal EMS response time for survival of critically injured or ill patients. METHODS: Three years of EMS data from a large urban system were used to create hourly estimates of median hospital time and response time, and linked to health system outcome. Multivariable modelling and descriptive statistics were used to: 1. Explore the association between paramedic hospital time and response time while controlling for the effects of system volume, time of day, and season; 2. Describe the linkage rate between the standard strategy and one designed to optimize linkage; and 3. Explore the association between response time and mortality in critically injured or ill patients who did not experience an out-of-hospital cardiac arrest while controlling for age and sex. RESULTS: Depending on the time of day, there was between a one and three minute increase in predicted median response time when the system was experiencing a median hospital time of 90 minutes, during the winter in heavy system volume, compared to a 30 minute median hospital time, during the summer in light system volume. The optimized strategy increased the linkage rate from 88% to 97.1%, and reduced linkage failure in key clinical sub-groups. There was no significant association between response time and mortality except in one secondary analysis subgroup, which suggested longer response decreased mortality. CONCLUSIONS: There is an association between EMS hospital time and response time, but the relationship is complex and influenced by system level factors such as time of day, volume and season. An optimized strategy for linking EMS data to health system outcome improved the linkage rate and reduced the potential for bias. No consistent association between response time and mortality could be demonstrated. These analyses underscore the importance of research quality linked EMS data in the development of knowledge for EMS and paramedic practice.
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    Trajectories of Kidney Function in Children with Reduced Kidney Function
    (2018-05-18) Kahlon, Bhavneet Kaur; Samuel, Susan M.; James, Matthew T.; Pacaud, Danièle Le; Ronksley, Paul Everett; Hagel, Brent Edward
    Little is known about the progression of chronic kidney disease (CKD) during the emerging adulthood period in patients with pediatric onset CKD cared for in primary care. We performed a retrospective cohort study using administrative data from The Health Improvement Network Database to determine the natural history of CKD, the impact of the emerging adulthood period, and the effects of comorbidities including mental health disorders, substance use, and pregnancy on CKD progression. We identified 15,679 patients who met cohort inclusion criteria. We found that kidney function measured using the estimated glomerular filtration rate (eGFR) increased with increasing age. Emerging adulthood was associated with an attenuation in this increase in eGFR. Finally, the presence of mental health disorders, substance use, and pregnancy modified the relationship between age and eGFR resulting in a small, but statistically significant acceleration in the eGFR increase over age, but were associated with lower baseline eGFR.