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Context: Athletic therapy students learn emergency skills through a variety of modes, including students portraying injured athletes and cardiopulmonary resuscitation manikins. Although acceptable and satisfactory forms of teaching, these methods are limited in their ability to create realistic physiological symptoms of injury. Objective: To assess how athletic therapy students perceive their learning needs (LNs) relative to the use of high-fidelity manikin simulation (HFMS) compared with student simulation (SS) in the laboratory setting. Design: Pretest-posttest study design. Setting: Nursing Simulation Centre, Sheridan College, Brampton, Ontario, Canada. Patients or Other Participants: Thirty students from the Bachelor of Applied Health Science (Athletic Therapy) program at Sheridan College in years 2 and 4. Intervention(s): Perceived LNs related to the use of the Laerdal Medical SimMan3G HFMS contrasted with the use of SS for learning to respond to a prescribed emergency scenario. Main Outcome Measure(s): Participants completed questionnaires for both the SS and HFMS environments that consisted of 16 specific LNs spanning the cognitive, psychomotor, and affective domains of learning. Paired t tests and a 2-way analysis of variance were used to analyze the questionnaire data. Results: Participants reported all LNs as being equally important in both environments, but HFMS was identified as a better environment for achieving 13 of the 16 LNs. The mean change from pretesting to posttesting of all LNs in the affective domain improved significantly (P < 0.05) in the HFMS environment. Year 4 participants deemed HFMS to be a more effective means of learning in the cognitive and psychomotor domains (P < 0.05). Conclusions: The HFMS experience enhanced athletic therapy students' perceptions of their confidence, base of knowledge, decision-making skills, and overall acute management of critical lifesaving situations. The HMFS environment is a more effective tool for addressing the LNs in the affective domain, which includes skills related to confidence, attitudes, values, and appreciations.

The impact of age, sex and body mass index on interstitial glucose levels as measured via continuous glucose monitoring (CGM) during exercise in the healthy population is largely unexplored. We conducted a multivariable generalized estimating equation (GEE) analysis on CGM data (Dexcom G6, 10 days) collected from 119 healthy exercising individuals using CGM with the following specified covariates: age; sex; BMI; exercise type and duration. Females had lower postexercise glycemia as compared with males (92 ± 18 vs. 100 ± 20 mg/dL, p = 0.04) and a greater change in glycemia during exercise from pre- to postexercise (p = 0.001) or from pre-exercise to glucose nadir during exercise (p = 0.009). Younger individuals (i.e., <20 yrs) had higher glucose during exercise as compared with all other age groups (all p < 0.05) and less CGM data in the hypoglycemic range (<70 mg/dL) as compared with those aged 20–39 yrs (p < 0.05). Those who were underweight, based on body mass index (BMI: <18.5 kg/m2), had higher pre-exercise glycemia than the healthy BMI group (104 ± 20 vs. 97 ± 17 mg/dL, p = 0.02) but similar glucose levels after exercise. Resistance exercise was associated with less of a drop in glycemia as compared with aerobic or mixed forms of exercise (p = 0.008) and resulted in a lower percent of time in the hypoglycemic (p = 0.04) or hyperglycemic (glucose > 140 mg/dL) (p = 0.03) ranges. In summary, various factors such as age, sex and exercise type appear to have subtle but potentially important influence on CGM measurements during exercise in healthy individuals. [ABSTRACT FROM AUTHOR]

The objective of this study was to describe deliberate self-harming (DSH) characteristics in a child-welfare population identified as having threatened or completed self-harm. Secondary data from 621 serious occurrence reports (SOR) that documented 2004-2007 DSH incidents and DSH threats with 252 Canadian youth in care (Y-INC) of the Children's Aid Society of Toronto (CAS-T) was analyzed. In addition to descriptive analysis, a clustered design binary logistic regression was employed to determine factors associated with DSH characteristics such as repetition, reported behaviour, and severity. Y-INC males (n = 140) made up a slight majority in both DSH categories: single incident of self-harm (sDSH) vs. repeat incidents (rDSH) (55.4% and 56.0% respectively); the female Y-INC sample (n = 112) was responsible for the majority of rDSH incidents (69.1%). Most DSH incidents took place between 6 pm to 12 am, Monday to Friday. Factors found to be associated with DSH in an in-care population of DSH youth were: "non-permanent status" (non-Crown wards were more likely to self-harm vs. threaten self-harm compared to permanent/Crown wards(OR 2.46, CI 1.26-4.80); "older Y-INC" (age 14-21) were more likely to receive medical attention due to a DSH incident vs. 6-13 year olds (OR 4.26, CI 2.51-7.21); and "female Y-INC" were found more likely to have repeat DSH incidents (OR 2.55, CI 1.08-6.02). In addition to heightened supervision and resources for Y-INC that are at-risk for or engage in DSH, greater research attention to this issue is warranted.

Background: Injuries are the leading cause of death among Canadian children and are responsible for a substantial proportion of hospitalizations and emergency department visits. This investigation sought to identify the factors associated with the likelihood of sustaining an injury at school among Ottawa-area children. Methods: Children presenting to Ottawa-area hospitals and urgent care clinics from January to December 2002 (n = 24,074) were included for analysis. The frequency of school injuries by sex, age group, type of injury, and hospitalization was analyzed. Multivariate logistic regression was used to assess the factors associated with sustaining an injury at school. The school activities most associated with injury and the most frequent types of school injuries were assessed. Results: A total of 4287 Ottawa-area children were injured at school in 2002, representing 18% of all injuries. Children aged 5-9 years and 10-14 years were more likely to have school injuries than older children (aged 15-19 years) (OR = 3.07, 95% CI = 2.77-3.40 and OR = 3.10, 95% CI = 2.83-3.37, respectively). The most frequently encountered school injuries were fractures (n = 1132) and musculoskeletal injury (n = 907). The most frequent mechanisms of school injuries were "playing" (n = 1004) and "informal sports" (n = 1503). Conclusions: Many children get hurt at school, particularly during informal recreation activities. Environmental modification and increased supervision are strategies that may reduce school injuries. (Contains 2 tables and 2 figures.)

Fifteen percent of individuals who sustain a concussion develop persistent concussion symptoms (PCS). Recent literature has demonstrated atrophy of the frontal, parietal, and cerebellar regions following acute concussive injury. The frontoparietal-cerebellar network is essential for the performance of visuomotor transformation tasks requiring cognitive-motor integration (CMI), important for daily function. We investigated cortical and subcortical structural differences and how these differences are associated with CMI performance in those with PCS versus healthy controls. Twenty-six age-matched female participants (13 PCS, 13 healthy) completed four visuomotor tasks. Additionally, MR-images were analyzed for cortical thickness and volume, and cerebellar lobule volume. No statistically significant group differences were found in CMI performance. However, those with PCS demonstrated a significantly thicker and larger precuneus, and significantly smaller cerebellar lobules (VIIIa, VIIIb, X) compared to controls. When groups were combined, volumes of both the cerebellar lobules and cortical regions were associated with CMI task performance. The lack of behavioral differences combined with the structural differences may reflect a compensatory mechanism for those with PCS. In addition, this study highlights the effectiveness of CMI tasks in estimating the structural integrity of the frontoparietal-cerebellar network and is among the first to demonstrate structural correlates of PCS. [ABSTRACT FROM AUTHOR]

Purpose: To compare on-ice external and internal training loads in world-class women's ice hockey during training and competition. Methods: On-ice training loads were collected during 1 season from 25 world-class ice hockey players via wearable technology. A total of 105 on-ice sessions were recorded, which consisted of 61 training sessions and 44 matches. Paired and unpaired t tests compared training and competition data between and across playing positions. Results: For training data, there was a difference between positions for PlayerLoad (P <.001, effect size [ES]=0.32), PlayerLoad·minute-1 (P < .001, ES = 0.55), explosive efforts (P c .001, ES = 0.63), and training impulse (P < .001, ES = 0.48). For the competition data, there were also differences between positions for PlayerLoad (P < .001, ES = 0.26), PlayerLoad ·minute-1 (P < .001, ES = 0.38), explosive efforts (P < .001, ES = 0.64), and training impulse (P < .001, ES = 1.47). Similar results were found when positions were viewed independently; competition had greater load and intensity across both positions for PlayerLoad, training impulse, and explosive efforts (P < .001, ES = 1.59-2.98) and with PlayerLoad ·minute-1 (P = .016, ES = 0.25) for the defense. Conclusions: There are clear differences in the volume and intensity of external and internal workloads between training and competition sessions. These differences were also evident when comparing the playing positions, with defense having lower outputs than forwards. These initial results can be used to design position-specific drills that replicate match demands for ice hockey athletes. [ABSTRACT FROM AUTHOR]

Abstract Background Motor vehicle collisions (MVCs) that result in one or more fatalities on the 400-series Highways represent a serious public health problem in Ontario, and were estimated to have cost $11 billion in 2004. To date, no studies have examined risk factors for fatal MVCs on Ontario’s 400 series highways. The investigate how demographic and environmental risk factors are associated with fatal MVCs on Ontario’s 400-Series Highways. Methods Data were provided from the Ontario Ministry of Transport database, and included driver demographics, vehicle information, environmental descriptors, structural descriptors, as well as collision information (date and time), and severity of the collision. Multivariate analysis was used to identify factors significantly associated with the odds of dying in a collision. Results There were 53,526 vehicles involved in collisions from 2001 to 2006 included in our analysis. Results from the multivariate analysis suggest that collisions with older age and male drivers were associated with an increased risk of involving a fatality. Highway 405 and an undivided 2-way design proved to be the most fatal structural configurations. Collisions in the summer, Fridays, between 12 am-4 am, and in drifting snow conditions during the wintertime were also shown to have a significantly increased risk of fatality. Conclusion Our results suggest that interventions to reduce deaths as a result of MVCs should focus on both driver-related and road-related modifications.