Jennifer Crain

Measurement of emotional/psychological child maltreatment: A review

BACKGROUND Emotional/psychological child maltreatment (ECM) is a major public health problem with serious consequences including emotional and behavioral problems. Nevertheless, ECM is an understudied area. OBJECTIVES The aims of this review are to identify measures of ECM and to evaluate their psychometric properties and utilities. We provide a summary of ECM measures that have been tested for their reliability and validity, evaluate the quality of these assessments and suggest directions for future research. METHODS We searched PsycINFO and Medline databases from 2000 to 2010 in addition to a hand search of retrieved references; 2344 were identified and the abstracts reviewed independently by two authors to identify relevant articles. Using pre-established criteria, 144 of those articles were selected and reviewed in full to assess whether the instruments included a separate measure of ECM and its psychometric properties. RESULTS Forty-five articles examining 33 measures met the inclusion criteria and were selected for further review. The majority of measures demonstrated acceptable reliability; fewer measures had evaluated one or more types of validity. CONCLUSION Both reliability and validity testing are required in order to establish more accurate measures of ECM. PRACTICE IMPLICATIONS Reliable and valid measures are necessary to enhance our limited knowledge about the distribution, determinants and consequences of ECM.

Injuries related to off-road vehicles in Canada

Off-road vehicles (ORVs; this includes snowmobiles, all-terrain vehicles or ATVs and dirt bikes) were once used primarily for work and travel. Such use remains common in Canada, although their recreational use has also gained popularity in recent years. An epidemiological injury profile of ORV users is important for better understanding injuries and their risk factors to help inform injury prevention initiatives. The Traffic Injury Research Foundation (TIRF) partnered with the Public Health Agency of Canada (PHAC) to analyze the epidemiology of ORV-related injuries. The primary aim was to assess crashes and injuries in Canada, including the extent of alcohol involvement. Secondly, the burden of injury among children and teen ORV drivers in Canada, as well as passengers, was investigated. Descriptive and inferential epidemiological statistics were generated using the following data sources: first, TIRFs National Fatality Database, which is a comprehensive, pan-Canadian, set of core data on all fatal motor vehicle crashes; second, TIRFs Serious Injury Database, which contains information on persons seriously injured in crashes; and, third, PHACs Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP), a surveillance system currently operating in the emergency departments of some pediatric and general hospitals across Canada. Exposure data have been used in the analyzes where available. Between 1990 and 2010, fatality rates increased among ATV and dirt bike operators. The fatality rate among snowmobilers declined during this period. Of particular concern, among fatally injured female ATV users, children aged 0-15 years comprised the highest proportion of any age group at 33.8%. Regarding alcohol use, among fatally injured snowmobile and ATV/dirt bike operators tested for alcohol, 66% and 55% tested positive, respectively. Alcohol involvement in adult ORV crashes remains an important factor. In light of the growing popularity of ORVs, prevention and mitigation measures are required to address this issue.

Fatal and serious injuries related to vulnerable road users in Canada

INTRODUCTION The goals of this study were to analyze possible trends of fatal and serious injuries related to vulnerable road users in Canada (pedestrians, cyclists and motorcyclists) from 1990 to 2012 and the role of alcohol and drugs in these cases. Drugs have rarely been documented with respect to vulnerable road users. METHOD The Traffic Injury Research Foundations National Fatality and Serious Injury Databases and the Public Health Agency of Canadas Canadian Hospitals Injury Reporting and Prevention Program databases were used. Numbers and rates of fatalities and serious injuries among vulnerable road users were analyzed and regression models were used to assess changes over time. RESULTS The analyses show that while the absolute number of fatalities and the rate per 100,000 population among vulnerable road users may be decreasing, no such trends are apparent when looking at the proportions of these road user fatalities out of all motor-vehicle fatalities. The trend for the proportion of motorcyclist fatalities is significantly increasing (coef.=0.16, p<0.001). The elderly (76years or older) are overrepresented among pedestrian fatalities, and serious injuries (they represent 18.5% of all pedestrian fatalities but only 5.8% of the population), while those 15years or younger are overrepresented among cyclists (they represent 23.3% of cyclist fatalities but 19.5% of the population), and those 16 to 25years old are overrepresented among motorcyclists (27.2% of motorcyclists fatalities and 13.6% of population). Alcohol and drug use among fatally injured vulnerable road users were significant problems, especially among pedestrians. Among fatally injured pedestrians tested for alcohol and drugs, 39.7% and 43.4% tested positive, respectively. CONCLUSIONS With the promotion of walking and cycling as forms of exercise and the popularity of motorcycling, the safety of vulnerable road users is an important issue. The results corroborate previous research and extend our understanding about the influence of alcohol and drugs in vulnerable road user injuries. PRACTICAL APPLICATIONS These findings can help better inform prevention and mitigation initiatives for vulnerable road users.

The lows of getting high: sentinel surveillance of injuries associated with cannabis and other substance use

ObjectivesCannabis is a widely used illicit substance that has been associated with acute injuries. This study seeks to provide near real-time injury estimates related to cannabis and other substance use from the electronic Canadian Hospitals Injury Reporting and Prevention Program (eCHIRPP) database.MethodsData from the eCHIRPP database, years 2011 to 2016, were analyzed via data mining, descriptive, logistic regression, and sensitivity analyses. Drug use trends over time for cannabis and/or other substances (alcohol, illicit drugs, and medications) were assessed. Descriptive statistics (intent, external cause, and nature of injury) and proportionate injury ratios (PIR) associated with cannabis use are presented.ResultsCannabis use was observed in 184 cases/100,000 eCHIRPP cases, and related injuries were mostly identified as unintentional (66.8%). Poisoning (68.5%) and intoxication (69.4%) were the external cause and nature of injury most associated with these events, and hospitalization was recorded for 14.3% of cases. Per 100,000 eCHIRPP cases, cannabis was used alone in 72.4 cases, and in combination with alcohol, illicit drugs, or medications in 74.6 cases, 11.3 cases, and 7.9 cases, respectively. Relative to non-use, the PIR of hospitalization was not significant for cannabis-only users of either sex (males: PIR 1.0, 95% CI 0.6–1.7, females: PIR 0.9, 95% CI: 0.5–1.7).ConclusionCannabis use injuries are rare, but can occur when cannabis is used with or without other substances. As Canada considers legislative changes, our finding of cases related to unintentional injury, poisoning, and intoxication suggests areas that might benefit from health literacy efforts.RésuméObjectifsLe cannabis, une substance illicite largement consommée, est associé à des blessures aiguës. Notre étude vise à présenter en quasi temps réel les blessures estimatives liées à la consommation de cannabis et d’autres substances d’après la base de données de la plateforme électronique du Système canadien hospitalier d’information et de recherche en prévention des traumatismes (eSCHIRPT).MéthodeNous avons analysé les données de la base eSCHIRPT pour les années 2011 à 2016 au moyen de techniques de forage de données et d’analyses descriptives, de sensibilité et de régression logistique. Nous avons estimé les tendances de la consommation de cannabis avec ou sans autres substances (alcool, drogues et médicaments) au fil du temps. Nous présentons les statistiques descriptives (intention, cause externe et nature de la blessure) et les rapports proportionnels de blessures (RPB) associés à la consommation de cannabis.RésultatsLa consommation de cannabis a été observée dans 184 pour 100,000 cas dans eSCHIRPT, et les blessures associées étaient principalement non intentionnelles (66,8%). L’empoisonnement (68,5%) et l’intoxication (69,4%) étaient la cause externe et la nature de la blessure les plus souvent associées à ces épisodes, et une hospitalization a été enregistrée dans 14,3% des cas. Pour 100,000 cas dans eSCHIRPT, le cannabis avait été consommé seul dans 72,4 cas, et en combinaison avec de l’alcool, de la drogue ou des médicaments dans 74,6, 11,3 et 7,9 cas, respectivement. Par rapport à la non-consommation, les RPB de l’hospitalization n’étaient pas significatifs pour les consommateurs et consommatrices de cannabis seul (hommes: RPB 1,0, IC de 95%: 0,6–1,7; femmes: RPB 0,9, IC de 95%: 0,5–1,7).ConclusionLes blessures dues à la consommation de cannabis sont rares, mais elles peuvent se produire, que le cannabis soit consommé seul ou avec d’autres substances. Étant donné les modifications législatives envisagées au Canada, nos constatations sur les cas de blessures, d’empoisonnements et d’intoxications involontaires indiquent que des efforts pour renforcer l’information en matière de santé sur ces aspects pourraient être bénéfiques.

At-a-glance - Sentinel surveillance of emergency department presentations for barbecue brush-related injuries: the electronic Canadian Hospitals Injury Reporting and Prevention Program, 2011 to 2017

A barbecue (BBQ) brush is a common household item designed for cleaning grills used for barbecuing. Data from the electronic Canadian Hospitals Injury Reporting and Prevention Program database were analysed to estimate the frequency of injuries related to BBQ brushes as a proportion of all injuries, as well as to describe characteristics associated with such injury events. Between April 1, 2011 and July 17, 2017, BBQ brush injuries were observed at a frequency of 1.5 cases per 100 000 eCHIRPP cases (N = 12). Findings suggest that in addition to risks associated with the ingestion of loose BBQ brush bristles attached to foods, loose bristles could also result in injury via other mechanisms.

Aperçu – Blessures associées aux planches gyroscopiques traitées dans les services d’urgence au Canada : plate-forme électronique du Système canadien hospitalier d’information et de recherche en prévention des traumatismes, 2015-2016

Le Système canadien hospitalier d’information et de recherche en prévention des traumatismes (SCHIRPT)1 est un système de surveillance des blessures et des intoxications qui a été mis en place en 1990 pour améliorer la disponibilité en données récentes de surveillance au Canada. Le SCHIRPT, financé et administré par l’Agence de la santé publique du Canada, est actuellement utilisé dans 11 hôpitaux pédiatriques et 6 hôpitaux généraux à l’échelle du Canada. Ce compte rendu vise à donner un aperçu des blessures associées aux planches gyroscopiques déclarées au moyen de la plate-forme électronique du SCHIRPT (eSCHIRPT) au 7 juillet 2016.