Douglas R. Wilson

Socio-economic status and types of childhood injury in Alberta: a population based study

BackgroundChildhood injury is the leading cause of mortality, morbidity and permanent disability in children in the developed world. This research examines relationships between socio-economic status (SES), demographics, and types of childhood injury in the province of Alberta, Canada.MethodsSecondary analysis was performed using administrative health care data provided by Alberta Health and Wellness on all children, aged 0 to 17 years, who had injuries treated by a physician, either in a physicians office, outpatient department, emergency room and/or as a hospital inpatient, between April 1st. 1995 to March 31st. 1996. Thirteen types of childhood injury were assessed with respect to age, gender and urban/rural location using ICD9 codes, and were related to SES as determined by an individual level SES indicator, the payment status of the Alberta provincial health insurance plan. The relationships between gender, SES, rural/urban status and injury type were determined using logistic regression.ResultsTwenty-four percent of Alberta children had an injury treated by physician during the one year period. Peak injury rates occurred about ages 2 and 13–17 years. All injury types except poisoning were more common in males. Injuries were more frequent in urban Alberta and in urban children with lower SES (receiving health care premium assistance). Among the four most common types of injury (78.6% of the total), superficial wounds and open wounds were more common among children with lower SES, while fractures and dislocations/sprains/strains were more common among children receiving no premium assistance.ConclusionThese results show that childhood injury in Alberta is a major health concern especially among males, children living in urban centres, and those living on welfare or have Treaty status. Most types of injury were more frequent in children of lower SES. Analysis of the three types of the healthcare premium subsidy allowed a more comprehensive picture of childhood injury with children whose families are on welfare and those of Treaty status presenting more frequently for an injury-related physicians consultation than other children. This report also demonstrates that administrative health care data can be usefully employed to describe injury patterns in children.

Internet Users' Prior Psychological and Social Difficulties

This study addressed the hypothesis that frequent Internet use produces social and psychological difficulties. An Internet-administered survey was given to a sample of Internet users. Comparisons were made between this sample and general population norms on a selection of social and psychological variables. Internet users showed a more detrimental mean rating on 11 of 13 of the variables (two measures of social contact were more positive among the user sample). However, for those variables for which time of onset was available (n = 7), the disorder had begun 5-22 years before Internet use. These findings are not in accord with the theory that Internet use causes disorder or social difficulty, and suggest the possibility that the Internet may provide a particular benefit for certain individuals who have already displayed these personal and social difficulties.

Comparison of Student Experiences with Different Online Graduate Courses in Health Promotion

The purpose of this study was to understand the experience of students as they progressed through three specific online graduate courses in health promotion studies delivered primarily by asynchronous computer conferencing. Focused teleconference discussions were conducted with approximately 45 students from the different courses and the transcripts subjected to qualitative analysis. Themes that emerged included what new students appreciated most when adapting to learning online, factors that contributed to learner satisfaction, and the difficulties encountered by students taking a course when the content was not as well suited to the instructional method. The findings are discussed in relation to the three components of Garrison, Anderson and Archer’s (2000) Community of Inquiry model of learning: cognitive, social and teacher presence. Implications are presented for assisting students with the process of adapting to online learning and enhancing the ‘fit’ between course content and online instructional methods.

Development and testing of a framework for assessing the effectiveness of health promotion

SummaryObjectives: The purpose was to develop and test a framework for assessing the overall effectiveness of health promotion in one Canadian province. Methods: The project relied on expert opinion and consensus. A multidisciplinary team developed a Project Description Framework and a Health Promotion Evaluation Framework. Two sets of inclusion criteria were developed for selecting projects to be assessed using the Framework. The sampling frame was all health promotion projects starting in Alberta in January 1993 or later for which a written program evaluation could be obtained. Of 180 project reports, 91 met the first set and 35 met the remaining inclusion criteria. Two research associates independently used the Project Description Framework. Three associates independently applied the inclusion criteria. Consensus was reached in all cases. Research team members used the Health Promotion Evaluation Framework to assess the 35 projects and to comment on its utility and any gaps identified. Results: A framework for assessing the effectiveness of health promotion was developed and tested. Conclusion: This framework is a useful tool as evidenced by the review that was obtained and subsequent applications.

A 4-Year Sequential Assessment of the Families First Edmonton Partnership: Challenges to Synergy in the Implementation Stage

This article assesses the partnership functioning of Families First Edmonton, a multisectored collaborative effort formed to determine the best health and recreation service delivery model for families with low income. Partners’ evaluations of the collaborative process are examined across the formation, implementation, and maintenance stages of development. Statistical analyses of questionnaire data reveal a significant decrease in the partnership’s capacity to maximize synergy—a main indicator of a successful collaborative process—in the implementation stage of the partnership. Implications for partnership practice are addressed.

Maternal cell contamination of amniotic fluid samples obtained by open-needle versus trocar technique of amniocentesis

Abstract Objective: Maternal cell contamination (MCC) is rare in cultured amniotic fluid samples, but it poses a serious potential source of prenatal misdiagnosis. Our goal was to determine whether the amniocentesis sampling technique influences the incidence of maternal cell contamination. Study design: A retrospective study was performed on 2,498 amniocentesis results in two tertiary care centers in Canada. The University of Alberta used the open-needle technique, and the University of British Columbia used a technique with the trocar in place. We reviewed midtrimester amniocenteses performed by perinatologists on singleton male fetuses. We excluded all transplacental insertions. Data were gathered regarding the nature of the amniotic fluid, number of needle passes, amniocentesis results, and the occurrence of maternal cell contamination. Results: The incidence of MCC was similar at the two study centers: 1.16% and 0.78% at the University of Alberta and the University of British Columbia, respectively. The odds ratio for MCC with the open versus the trocar-in-place technique with use of logistic regression was 1.48 (95% CI, 0.3–3.3) with a P value less than 0.315, which is not significant. Bloody fluid taps and the number of needle insertions were both controlled for in the statistical analysis. Conclusion: The data indicate that there is no significant increase in maternal cell contamination with the open-needle technique of amniocentesis. We believe that open-needle amniocentesis has advantages for the patient and the physician and that it is a safe and reliable technique for amniocentesis.