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Laing A.C.,University of Waterloo | Feldman F.,Fraser Health Authority | Jalili M.,Simon Fraser University | Tsai C.M.,Simon Fraser University | Robinovitch S.N.,Simon Fraser University
Journal of Biomechanics | Year: 2011

Wearable hip protectors (padded garments) represent a promising strategy to decrease impact force and hip fracture risk during falls, and a wide range of products are currently marketed. However, little is known about how design features of hip protectors influence biomechanical effectiveness. We used a mechanical test system (simulating sideways falls) to measure the attenuation in femoral neck force provided by 26 commercially available hip protectors at three impact velocities (2, 3, and 4. m/s). We also used a materials testing machine to characterize the force-deflection properties of each device. Regression analyses were performed to determine which geometric (e.g., height, width, thickness, volume) and force-deflection properties were associated with force attenuation. At an impact velocity of 3. m/s, the force attenuation provided by the various hip protectors ranged between 2.5% and 40%. Hip protectors with lower stiffness (measured at 500. N) provided greater force attenuation at all velocities. Protectors that absorbed more energy demonstrated greater force attenuation at the higher impact velocities (3 and 4. m/s conditions), while protectors that did not directly contact (but instead bridged) the skin overlying the greater trochanter attenuated more force at velocities of 2 and 3. m/s. At these lower velocities, the force attenuation provided by protectors that contacted the skin overlying the greater trochanter increased with increasing pad width, thickness, and energy dissipation. By providing a comparison of the protective value of a large range of existing hip protectors, these results can help to guide consumers and researchers in selecting hip protectors, and in interpreting the results of previous clinical trials. Furthermore, by determining geometric and material parameters that influence biomechanical performance, our results should assist manufacturers in designing devices that offer improved performance and clinical effectiveness. © 2011 Elsevier Ltd. Source

Tsang R.S.W.,Public Health Agency of Canada | Bruce M.G.,Centers for Disease Control and Prevention | Lem M.,Fraser Health Authority | Barreto L.,National Research Council Canada
Epidemiology and Infection | Year: 2014

Historically, the highest incidence rates of invasive Haemophilus influenzae disease in the world were found in North American and Australian Indigenous children. Although immunization against H. influenzae type b (Hib) led to a marked decrease in invasive Hib disease in countries where it was implemented, this disease has not been eliminated and its rates in Indigenous communities remain higher than in the general North American population. In this literature review, we examined the epidemiology of invasive H. influenzae disease in the pre-Hib vaccine era, effect of carriage on disease epidemiology, immune response to H. influenzae infection and Hib vaccination in Indigenous and Caucasian children, and the changing epidemiology after Hib conjugate vaccine has been in use for more than two decades in North America. We also explored reasons behind the continued high rates of invasive H. influenzae disease in Indigenous populations in North America. H. influenzae type a (Hia) has emerged as a significant cause of severe disease in North American Indigenous communities. More research is needed to define the genotypic diversity of Hia and the disease burden that it causes in order to determine if a Hia vaccine is required to protect the vulnerable populations. Copyright © Cambridge University Press 2014. Source

Marra F.,University of British Columbia | Marra F.,Center for Disease Control | Young F.,Fraser Health Authority | Richardson K.,University of British Columbia | Marra C.A.,University of British Columbia
Influenza and other Respiratory Viruses | Year: 2013

Objective To determine immunogenicity and safety of intradermal (ID) influenza vaccines compared with intramuscular (IM) administration and effect of dose and age. Design Meta-anlysis. Setting Systematic review and meta-analysis of randomized controlled trials on influenza vaccines. Sample Randomized, controlled trials comparing ID seasonal split-virus influenza vaccines with 15μg IM control in subjects 18years of age or older and assessed antibody response at 21-28days post-vaccination were considered for inclusion. Results A total of 13 trials were included. The pooled immunogenicity outcomes did not differ significantly between the IM and ID vaccine groups for the H1N1 (ratio of GMTR: 0·92, 95% confidence interval 0·77-1·09; seroconversion: 0·94, 0·86-1·02; seroprotection: 0·97, 0·94-1·00) and B strains (GMTR: 0·93, 0·80-1·08; seroconversion: 0·91, 0·80-1·04; seroprotection: 0·97, 0·91-1·03). For the H3N2 strain, there was no significant difference in GMTR (0·97, 0·80-1·18); however, there was a lower pooled seroconversion (0·89, 0·80-0·99) and seroprotection rate (0·98, 0·96-0·99) for ID recipients. There was a statistically significant association between increasing doses of the ID vaccination with increasing immunogenicity response (P=0·01). There were no differences in adverse event rates within 3days post-vaccination for ID versus IM. But for adverse events occurring 7days post-vaccination, ID vaccination was associated with a greater incidence of local events but not systemic events. Conclusions There was no significant difference in immunologic response when comparing ID with IM administration of the influenza vaccination in the overall population, but higher doses of ID vaccine in the older adult population produced a better response. © 2012 John Wiley & Sons Ltd. Source

News Article | December 15, 2015
Site: http://www.fastcompany.com

Our health is determined not only by what we eat and how much we exercise, but also by our environment. For example, does your neighborhood encourage walking or cycling to restaurants or stores? Does it make you want to take a stroll after dinner in the evening? A new study finds a strong correlation between walkability and health outcomes. It shows that adults in walkable cities are 31% less likely to be overweight or obese than people living in car-dependent areas. Researchers at the Fraser Health Authority, Vancouver Coastal Health, and the University of British Columbia surveyed 28,000 people in the metro area, mostly online. Then they cross-referenced what respondents said about their weight and health with data from Walk Score. People in the second most walkable places ("very walkable") were 11% less likely to be fat than those in car dependent areas. (Of course, it could be that people who are already more active or health-minded are attracted to the most walkable neighborhoods). For reference, Walk Score rates Philadelphia, Miami, and Chicago as "very walkable" and Nashville and Jacksonville, Florida, as "car dependent." But of course that doesn't apply to every part of each city, and there's no way of knowing if Vancouver's patterns would translate elsewhere. Cities can improve walkability by adding sidewalks, lighting, and safety features, by zoning for cafes and restaurants, and by improving overall ambience. The paper says health should be another consideration when cities get redesigned. "Walkable neighborhoods may play an important role in prevention of obesity and type 2 diabetes by encouraging active lifestyles and increasing accessibility to services and amenities which promote healthy living," the authors say. "Planners should view access to walkable neighborhoods not only for community connectedness but as physical activity resources for the community."

Kelly R.,Fraser Health Authority | Puurveen G.,University of British Columbia | Gill R.,Fraser Health Authority
Journal of Applied Gerontology | Year: 2016

Delays to institutionalization were compared between elderly individuals who differed in the amounts ("dosages") of adult day services (ADS) they attended. A Kaplan-Meier survival analysis revealed higher dosages of ADS to be associated with greater delays to institutionalization. Retrospective data from financial and service utilization systems and from the Resident Assessment Instrument for Home Care (RAI-HC) were then used to fit a Cox regression model that was adjusted for potential selection biases. This model also found systematically lower hazards for institutionalization at higher ADS dosages. The ADS effect did not appear to be an artifact of increased utilization of additional home health services. Results suggest a beneficial effect of ADS on delay to institutionalization that cannot be attributed to home support, respite, or case management services. © Southern Gerontological Society. Source

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