Background: There has been increasing scrutiny of opioid prescribing following injury because of ... more Background: There has been increasing scrutiny of opioid prescribing following injury because of concerns that prescribed opioids may contribute to addiction and overdose. This study aimed to better understand the relationship between injury, opioids prescribed before and after injury, and non-medical drug poisoning. Data and methods: Working age (15 to 65 years old) residents of British Columbia's Fraser Health region with an injury that involved an emergency department visit were included. Factors examined included the prescription of opioid and opioid agonist therapy (OAT) medications before and after injury, age, sex, work-related injuries, and socioeconomic status, as well as how they were associated with non-medical drug poisoning risk and post-injury prescriptions. Results: Opioid-naive individuals (those without an opioid prescription captured before their injury) who were prescribed OAT medication-a marker of opioid use disorder-following their injury had a higher risk of subsequent non-medical drug poisoning (Hazard ratio (HR): 21.4 to 22.4 compared with opioid-naive individuals without an opioid or OAT prescription). Post-injury opioid prescription in these individuals increased poisoning risk (HR: 1.27 compared with those without a prescription). Being of male sex (HR: 1.80), being younger (HR: 0.76 for every 10-year increase in age) and living in the lowest-income neighbourhoods (HR: 1.44 compared with the middle quintile) increased poisoning risk. Compared with injuries sustained outside of work, work-related injuries reduced risk (HR: 0.62). Interpretation: Among a cohort of British Columbians visiting emergency departments following an injury, opioid prescribing in patients who were opioid-naive appears to be a minor contributor to non-medical drug poisoning, particularly when compared with other patient factors, such as being male, being younger and having a low socioeconomic status.
Cochrane Database of Systematic Reviews, Mar 16, 2011
Demographic data in North America, Europe, Asia, Australia and New Zealand suggest a rapid growth... more Demographic data in North America, Europe, Asia, Australia and New Zealand suggest a rapid growth in the number of persons over the age of 65 years as the baby boomer generation passes retirement age. As older adults make up an increasing proportion of the population, they are an important consideration when designing future evidence-based traffic safety policies, particularly those that lead to restrictions or cessation of driving. Research has shown that cessation of driving among older drivers can lead to negative emotional consequences such as loss of independence and depression. Those older adults who continue to drive tend to do so less frequently than other demographic groups and are more likely to be involved in a road traffic crash, probably due to what is termed the 'low mileage bias'. There is universal agreement among researchers that vision plays a significant role in driving performance, and that there are age-related visual changes. Vision testing of all drivers, and in particular of older drivers, is therefore an important road safety issue. The components of visual function essential for driving are acuity, field, depth perception and contrast sensitivity, which are currently not fully measured by licensing agencies. Furthermore, it is not known how effective vision screening tools are, and current vision screening regulations and cut-off values required to pass a licensing test vary from country to country. There is, therefore, a need to develop evidence-based tools for vision screening for driving, thereby increasing road safety. To assess the effects of vision screening interventions for older drivers to prevent road traffic injuries and fatalities. We searched the Cochrane Injuries Group Specialized Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2006, issue 3), MEDLINE, EMBASE, TRANSPORT, AgeInfo, AgeLine, the National Research Register, the Science (and Social Science) Citation Index, IBSS (International Bibliography of Social Sciences), PsycINFO, and Zetoc. We also searched the Internet and checked the reference lists of relevant papers to identify any further studies. The searches were conducted up to September 2006. Randomized controlled trials (RCTs) and controlled before and after studies comparing vision screening to non-screening of drivers aged 55 years and older, and which assessed the effect on road traffic crashes, injuries, fatalities and any involvement in traffic law violations, were included. Two authors independently screened the reference lists for eligible articles and independently assessed the articles for inclusion against the criteria. Two authors independently extracted data using a standardized extraction form. No studies were found which met the inclusion criteria for this review. Most countries require a vision screening test for the renewal of an individual's driver's license. There is, however, insufficient evidence to assess the effect of vision screening tests on subsequent motor vehicle crash reduction. There is a need to develop valid and reliable tools of vision screening that can predict driving performance.
Objective: Concussion is a public health concern across all ages, yet there is little research on... more Objective: Concussion is a public health concern across all ages, yet there is little research on providing concussion education and training within the educational context. The Concussion Awareness Training Tool for School Professionals (CATT SP) was developed to provide the necessary concussion education and resources for school professionals to support a student with concussion while integrating back to school. Methods: The CATT SP module underwent a 2016 pre/post-intervention evaluation to determine if knowledge and attitudes significantly improved among educators and administrators following completion of the CATT SP, as well as a 2018-19 pilot study within a school district in British Columbia with an accompanying Quality Assurance/ Quality Improvement assessment. Results: A statistically significant positive change in knowledge (p = .027) was found among those who indicated that they had accessed CATT SP. Results of the pilot study and QA/QI assessment found support of the use of CATT within the school district. Conclusions: Evidence-based concussion training and resources are key components for school professionals who are collaboratively supporting a student’s individualized return to school and learning following a concussion, and when developing and implementing a concussion policy within districts and school.
We evaluated evidence of community interventions to improve Aboriginal child passenger safety (CP... more We evaluated evidence of community interventions to improve Aboriginal child passenger safety (CPS) in terms of its scientific merit and cultural relevance.We included studies if they reported interventions to improve CPS in Aboriginal communities, compared at least pre- and postintervention conditions, and evaluated rates and severity of child passenger injuries, child restraint use, or knowledge of CPS. We also appraised quality and cultural relevance of studies.Study quality was associated with community participation and cultural relevance. Strong evidence showed that multicomponent interventions tailored to each community improves CPS. Interventions in Aboriginal communities should incorporate Aboriginal views of health, involve the community, and be multicomponent and tailored to the community’s circumstances and culture.
The purpose of this evaluation for CATT was to determine if attitudes and knowledge were signific... more The purpose of this evaluation for CATT was to determine if attitudes and knowledge were significantly improved among parents with a child registered in an organized sport following completion of CATT. Parents were recruited to complete pre and postintervention surveys designed to measure changes in attitudes and knowledge around concussion recognition and management. The survey was administered using FluidSurveys (www. fluidsurveys.com), a secure Canadian online survey company. Participants completed the survey before the intervention (before completing CATT) and subsequently completed the same survey again 3 to 4 months post intervention. A total of 35 parents completed the study. The recruitment period for this study was extended due to low response rates.
The purpose of this report is to provide details on the burden of concussion hospitalizations amo... more The purpose of this report is to provide details on the burden of concussion hospitalizations among children and youth in British Columbia (BC).
IntroductionThis study aimed to quantify the total cost of violent firearm-related offenses in Br... more IntroductionThis study aimed to quantify the total cost of violent firearm-related offenses in British Columbia in 2016 Canadian dollars over a five-year period, 2012 to 2016. The purposes of this study were to estimate the direct costs to the health care system and indirect costs to society for violent firearm injuries and deaths; and to estimate criminal justice system costs pertaining to firearm incidents.MethodsHuman and economic costs to the health care system and productivity losses were calculated using health administrative datasets such as B.C. Vital Statistics and Discharge Database. Criminal justice system costs pertaining to firearm incidents were estimated by applying weighted average costs to aggregate expenditures using methodology consistent with that used by Statistics Canada.ResultsThere was a total of 108 deaths and 245 hospitalizations resulting from violent firearm injuries. The total estimated cost of all violent firearm crime averaged $294,378,985 per year; hu...
The purpose of this report is to provide details on the burden of concussion hospitalizations amo... more The purpose of this report is to provide details on the burden of concussion hospitalizations among children and youth in Island Health Authority.
This report encompasses of the development and evaluation of Active & Safe Central: Describing th... more This report encompasses of the development and evaluation of Active & Safe Central: Describing the methods used to develop the Active & Safe Central online platform; Summarizing the results from the post-launch promotion and evaluation.
Background: There has been increasing scrutiny of opioid prescribing following injury because of ... more Background: There has been increasing scrutiny of opioid prescribing following injury because of concerns that prescribed opioids may contribute to addiction and overdose. This study aimed to better understand the relationship between injury, opioids prescribed before and after injury, and non-medical drug poisoning. Data and methods: Working age (15 to 65 years old) residents of British Columbia's Fraser Health region with an injury that involved an emergency department visit were included. Factors examined included the prescription of opioid and opioid agonist therapy (OAT) medications before and after injury, age, sex, work-related injuries, and socioeconomic status, as well as how they were associated with non-medical drug poisoning risk and post-injury prescriptions. Results: Opioid-naive individuals (those without an opioid prescription captured before their injury) who were prescribed OAT medication-a marker of opioid use disorder-following their injury had a higher risk of subsequent non-medical drug poisoning (Hazard ratio (HR): 21.4 to 22.4 compared with opioid-naive individuals without an opioid or OAT prescription). Post-injury opioid prescription in these individuals increased poisoning risk (HR: 1.27 compared with those without a prescription). Being of male sex (HR: 1.80), being younger (HR: 0.76 for every 10-year increase in age) and living in the lowest-income neighbourhoods (HR: 1.44 compared with the middle quintile) increased poisoning risk. Compared with injuries sustained outside of work, work-related injuries reduced risk (HR: 0.62). Interpretation: Among a cohort of British Columbians visiting emergency departments following an injury, opioid prescribing in patients who were opioid-naive appears to be a minor contributor to non-medical drug poisoning, particularly when compared with other patient factors, such as being male, being younger and having a low socioeconomic status.
Cochrane Database of Systematic Reviews, Mar 16, 2011
Demographic data in North America, Europe, Asia, Australia and New Zealand suggest a rapid growth... more Demographic data in North America, Europe, Asia, Australia and New Zealand suggest a rapid growth in the number of persons over the age of 65 years as the baby boomer generation passes retirement age. As older adults make up an increasing proportion of the population, they are an important consideration when designing future evidence-based traffic safety policies, particularly those that lead to restrictions or cessation of driving. Research has shown that cessation of driving among older drivers can lead to negative emotional consequences such as loss of independence and depression. Those older adults who continue to drive tend to do so less frequently than other demographic groups and are more likely to be involved in a road traffic crash, probably due to what is termed the 'low mileage bias'. There is universal agreement among researchers that vision plays a significant role in driving performance, and that there are age-related visual changes. Vision testing of all drivers, and in particular of older drivers, is therefore an important road safety issue. The components of visual function essential for driving are acuity, field, depth perception and contrast sensitivity, which are currently not fully measured by licensing agencies. Furthermore, it is not known how effective vision screening tools are, and current vision screening regulations and cut-off values required to pass a licensing test vary from country to country. There is, therefore, a need to develop evidence-based tools for vision screening for driving, thereby increasing road safety. To assess the effects of vision screening interventions for older drivers to prevent road traffic injuries and fatalities. We searched the Cochrane Injuries Group Specialized Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2006, issue 3), MEDLINE, EMBASE, TRANSPORT, AgeInfo, AgeLine, the National Research Register, the Science (and Social Science) Citation Index, IBSS (International Bibliography of Social Sciences), PsycINFO, and Zetoc. We also searched the Internet and checked the reference lists of relevant papers to identify any further studies. The searches were conducted up to September 2006. Randomized controlled trials (RCTs) and controlled before and after studies comparing vision screening to non-screening of drivers aged 55 years and older, and which assessed the effect on road traffic crashes, injuries, fatalities and any involvement in traffic law violations, were included. Two authors independently screened the reference lists for eligible articles and independently assessed the articles for inclusion against the criteria. Two authors independently extracted data using a standardized extraction form. No studies were found which met the inclusion criteria for this review. Most countries require a vision screening test for the renewal of an individual's driver's license. There is, however, insufficient evidence to assess the effect of vision screening tests on subsequent motor vehicle crash reduction. There is a need to develop valid and reliable tools of vision screening that can predict driving performance.
Objective: Concussion is a public health concern across all ages, yet there is little research on... more Objective: Concussion is a public health concern across all ages, yet there is little research on providing concussion education and training within the educational context. The Concussion Awareness Training Tool for School Professionals (CATT SP) was developed to provide the necessary concussion education and resources for school professionals to support a student with concussion while integrating back to school. Methods: The CATT SP module underwent a 2016 pre/post-intervention evaluation to determine if knowledge and attitudes significantly improved among educators and administrators following completion of the CATT SP, as well as a 2018-19 pilot study within a school district in British Columbia with an accompanying Quality Assurance/ Quality Improvement assessment. Results: A statistically significant positive change in knowledge (p = .027) was found among those who indicated that they had accessed CATT SP. Results of the pilot study and QA/QI assessment found support of the use of CATT within the school district. Conclusions: Evidence-based concussion training and resources are key components for school professionals who are collaboratively supporting a student’s individualized return to school and learning following a concussion, and when developing and implementing a concussion policy within districts and school.
We evaluated evidence of community interventions to improve Aboriginal child passenger safety (CP... more We evaluated evidence of community interventions to improve Aboriginal child passenger safety (CPS) in terms of its scientific merit and cultural relevance.We included studies if they reported interventions to improve CPS in Aboriginal communities, compared at least pre- and postintervention conditions, and evaluated rates and severity of child passenger injuries, child restraint use, or knowledge of CPS. We also appraised quality and cultural relevance of studies.Study quality was associated with community participation and cultural relevance. Strong evidence showed that multicomponent interventions tailored to each community improves CPS. Interventions in Aboriginal communities should incorporate Aboriginal views of health, involve the community, and be multicomponent and tailored to the community’s circumstances and culture.
The purpose of this evaluation for CATT was to determine if attitudes and knowledge were signific... more The purpose of this evaluation for CATT was to determine if attitudes and knowledge were significantly improved among parents with a child registered in an organized sport following completion of CATT. Parents were recruited to complete pre and postintervention surveys designed to measure changes in attitudes and knowledge around concussion recognition and management. The survey was administered using FluidSurveys (www. fluidsurveys.com), a secure Canadian online survey company. Participants completed the survey before the intervention (before completing CATT) and subsequently completed the same survey again 3 to 4 months post intervention. A total of 35 parents completed the study. The recruitment period for this study was extended due to low response rates.
The purpose of this report is to provide details on the burden of concussion hospitalizations amo... more The purpose of this report is to provide details on the burden of concussion hospitalizations among children and youth in British Columbia (BC).
IntroductionThis study aimed to quantify the total cost of violent firearm-related offenses in Br... more IntroductionThis study aimed to quantify the total cost of violent firearm-related offenses in British Columbia in 2016 Canadian dollars over a five-year period, 2012 to 2016. The purposes of this study were to estimate the direct costs to the health care system and indirect costs to society for violent firearm injuries and deaths; and to estimate criminal justice system costs pertaining to firearm incidents.MethodsHuman and economic costs to the health care system and productivity losses were calculated using health administrative datasets such as B.C. Vital Statistics and Discharge Database. Criminal justice system costs pertaining to firearm incidents were estimated by applying weighted average costs to aggregate expenditures using methodology consistent with that used by Statistics Canada.ResultsThere was a total of 108 deaths and 245 hospitalizations resulting from violent firearm injuries. The total estimated cost of all violent firearm crime averaged $294,378,985 per year; hu...
The purpose of this report is to provide details on the burden of concussion hospitalizations amo... more The purpose of this report is to provide details on the burden of concussion hospitalizations among children and youth in Island Health Authority.
This report encompasses of the development and evaluation of Active & Safe Central: Describing th... more This report encompasses of the development and evaluation of Active & Safe Central: Describing the methods used to develop the Active & Safe Central online platform; Summarizing the results from the post-launch promotion and evaluation.
The objective of this review was to assess the risk of obesity in injuries and fatalities resulti... more The objective of this review was to assess the risk of obesity in injuries and fatalities resulting from motor vehicle crash (MVC), as compared with individuals with a normal-range body mass index. A systematic review of the literature was conducted yielding 824 potential studies. Nine of these studies met our inclusion criteria. Meta-analyses examining obesity as a risk factor for various injury types and risk of fatality were conducted using data from these studies. Obesity was associated with higher fatality risk (odds ratio [OR] = 1.89, 95% confidence interval [CI] = 1.51-2.37, P = .0001; pooled estimate from 6 studies), and increased risk of lower extremity fractures (OR = 1.39, 95% CI = 1.18-1.65, P = .0001; pooled estimate from 2 studies). No significant differences were observed when considering abdominal injuries or pelvic fractures. Interestingly, for head injuries obesity was a protective factor (OR = 0.67, 95% CI = 0.46-0.97, P = .0001; pooled data from 3 studies). Evidence strongly supports the association of obesity with higher fatality and fractures of the lower extremities in MVCs. Contrary to our hypothesis, 3 studies showed that obesity was a protective factor in reducing head injuries. Furthermore, the review shows that obesity was not a risk factor of MVC-related pelvic fractures and abdominal injuries.
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Papers by Kate Turcotte