Alison Macpherson’s research while affiliated with York University and other places

Aims Previous studies have consistently shown a decline in cognitive-motor integration (CMI) performance in those either with a history of concussion, less sport experience or of older age. The present study sought to characterize CMI performance of individuals as a function of these factors combined. Hypothesis: relative to those with one concussion, those with multiple concussions would experience significantly greater neuropathological effects on the brain networks required for standard and rule-based visuomotor performance, resulting in impaired motor performance. Study design: Individual cross-sectional study. Level of evidence: Level 3. Materials & Methods Two hundred and twenty-three asymptomatic individuals with a concussion history participated in this study. They performed two touchscreen-based eye–hand coordination tasks, including a standard direct interaction task and one which involved CMI; target location and motor action were dissociated in the CMI task. Results A significant percentage of standard and CMI variance was explained only by age and sport experience in our sample of younger, mainly select-level athletes. Conclusion These findings may suggest that motor developmental stage, which corresponds to age, and sport experience provide brain network resilience that can compensate for concussion-related performance declines. Clinical relevance: These data provide evidence around the importance of accounting for sport experience and developmental age when evaluating return to play metrics in youth and young adults.

Background Over decades, governments have enacted policies and legislation mandating strategies to reduce the incidence and severity of all-terrain vehicle (ATV)-related injuries. We performed a systematic review to determine the efficacy of laws and policies in reducing these injuries. Methods Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, 20 articles from the peer-reviewed literature were systematically selected. Associations between legislation/policy and changes or differences in injury numbers, rates or severity were queried. Results Data were available to examine age restrictions or child/youth-directed safety measures, use of helmets and vehicle-specific/engineering policies. Legislating age restrictions was associated with limited paediatric injury reduction in five of nine studies; sustained efficacy may require concurrent socialisation through media or regulated riding environments. Mandated helmet use was associated with reduced ATV-related mortality in five of six studies. However, the concurrent presence of other safety legislation precludes concluding the efficacy of helmet laws, alone. Legislation targeting vehicle design/engineering is limited, as are studies of their efficacy. A US federal decree for large-scale vehicle-related and industry-related changes was associated with a brief but dramatic decrease in ATV-related deaths; this reversed once the decree was lifted. Conclusions With the possible exception of helmet legislation, many laws aimed at reducing ATV-related injuries demonstrate little association with actual injury reduction. Most target changing individual behaviours and may be unsuccessful due to personal perceptions of low risk of injury. Enacting policies directed to industry, to address design and engineering interventions that can reduce risk during operation of these products, is more likely to result in substantive and sustained change.

The objective of the study is to explore differences in weight loss (WL) and treatment time with having health, mobility, and/or aesthetics motivations for attempting WL. Data from 7540 adults with overweight or obesity who participated in a publicly funded weight management programme at the Wharton Medical Clinic were analysed. Patients' WL motivations were categorised into six groups: Health only; Health and Aesthetics; Health and Mobility; Health, Mobility and Aesthetics; No Health; and None. Women with Health, Mobility and Aesthetics or No Health motivations had marginally higher WL goals compared to other groups, with no differences in men. Men with Health and Aesthetics or Health and Mobility motivations showed marginally higher 6‐month attendance rates. Men who discontinued after one visit were 40% less likely to have a Health and Aesthetics motivation as opposed to Health only, compared to those who continued. No differences were observed in WL between motivation groups in either sex. No correlation was found between WL goals and WL attained. Only weak correlations between treatment time and WL were observed across most motivation groups. Despite small differences in treatment time and WL goals, motivations for attempting WL were not significantly associated with differences in the WL achieved.

Objective The COVID-19 pandemic affected burn injury patterns in many countries, but literature on this topic in Canada is limited. The objective of this study is to investigate the changes in the epidemiology of burn injuries in a Canadian population during the COVID-19 pandemic. Methods Data from the Canadian Institute for Health Information were used to evaluate differences in emergency department visits before and during the COVID-19 pandemic. Logistic regression models estimated the odds of a severe burn occurrence. Results During the pandemic, there were significant decreases in emergency department visits for burns. Distributions of factors associated with burns showed little to no change. The pandemic period, age, sex, income, month and time of day were significantly associated with severe burns during the study time period. Conclusions The study found large reductions in the number of emergency department visits during the pandemic, but no evidence of changes in the epidemiology of burns or patterns in the patient populations. Demographic factors associated with severe burns were identified. These factors should be studied to deepen the understanding of the relationship between burn injuries and patient populations.

Background Social determinants of health (SDH), including “the conditions in which individuals are born, grow, work, live and age” affect child health and well-being. Several studies have synthesized evidence about the influence of SDH on childhood injury risks and outcomes. However, there is no systematic evidence about the impact of SDH on accessing care and quality of care once a child has suffered an injury. We aim to evaluate the extent to which access to care and quality of care after injury are affected by children and adolescents’ SDH. Methods Using Cochrane methodology, we will conduct a systematic review including observational and experimental studies evaluating the association between social/material elements contributing to health disparities, using the PROGRESS-Plus framework: place of residence, race/ethnicity/culture/language, occupation, gender/sex, religion, education, socioeconomic status, and social capital and care received by children and adolescents (≤ 19 years of age) after injury. We will consult published literature using PubMed, EMBASE, CINAHL, PsycINFO, Web of Science, and Academic Search Premier and grey literature using Google Scholar from their inception to a maximum of 6 months prior to submission for publication. Two reviewers will independently perform study selection, data extraction, and risk of bias assessment for included studies. The risk of bias will be assessed using the ROBINS-E and ROB-2 tools respectively for observational and experimental study designs. We will analyze data to perform narrative syntheses, and if enough studies are identified, we will conduct a meta-analysis using random effects models. Discussion This systematic review will provide a synthesis of evidence on the association between SDH and pediatric trauma care (access to care and quality of care) that clinicians and policymakers can use to better tailor care systems and promote equitable access and quality of care for all children. We will share our findings through clinical rounds, conferences, and publication in a peer-reviewed journal. Systematic review registration PROSPERO CRD42023408467

Objective To detect differences in cervical arteries that contribute to cerebral blood flow (Common Carotid Artery; CCA, Internal Carotid Artery; ICA and Vertebral artery; VA) between athletes with a concussion history (Hx) and athletes without concussion history (no Hx). We hypothesized that athletes with Hx would have reduced blood flow volume compared to athletes with no Hx. Design Prospective study. Setting Canadian University. Participants Eighty-two asymptomatic university athletes during pre-season baseline testing from 6 teams (42 females, 40 males); 36 athletes (18 females, 18 males) reported having Hx and 46 athletes (24 females, 22 males) had none. Interventions (or Assessment of Risk Factors) Doppler ultrasound measured blood flow volume in CCA, ICA, and VA bilaterally. Outcome Measures Blood flow volume differences in 6 cervical arteries that contribute to cerebral blood flow. Main Results Females with no Hx had significantly lower blood flow volume (BFV) compared to males with no Hx in right CCA (β=-83.78; p=0.009); left CCA (β=-72.40; p=0.027); and right ICA (β=-74.84 ; p=0.010). Females with Hx had significantly lower BFV in right CCA (β=-140.79; p <0.001); left CCA (β=-126.895; p <0.001); and right ICA (β=-101.47; p=0.001). All beta-coefficients were adjusted. There were no significant differences between males and females, regardless of Hx in the vertebral arteries bilaterally. Conclusions This preliminary data demonstrates sex-related differences, particularly in the anterior cervical vessels contributing to cerebral blood flow in athletes with Hx. This suggests soft tissue in the neck may be a mechanism influencing blood flow to the brain post-concussion injury.

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.