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  • Swaine BR, Tremblay C, Platt R, Grimard G, Zhang X, Pless IB. Previous head injury is a risk factor for subsequent head injury in children: Longitudinal cohort study. Pediatrics, 2007;119(4):749-758 <GO>

  • Keays G, Swaine B, Feldman D. Influence of injury severity on risk of subsequent injury in children and adolescents. Archives of Pediatrics & Adolescent Medicine; 2006;160:812-816 <GO>

  • Auger C, Demers L, Swaine B. Making sense of pragmatic criteria for the selection of geriatric rehabilitation measurement tools. Archives of Gerontology and Geriatrics, 2006;43:65-83 <GO>

  • Kostylova A, Swaine B, Feldman D. Concordance between childhood injury diagnoses from two sources: an injury surveillance system and a physician billing claims database Injury Prevention, 2005;11:186-190 <GO>

  • Swaine BR, Desrosier J, Bourbonnais D, Larochelle J-L Norms for 15 to 34 year olds for different versions of the Finger-to-Nose Test. Archives of Physical Medicine and Rehabilitation, 2005,86:1665-1669 <GO>

  • Bonnie R Swaine, Élisabeth Dutil, Louise Demers and Marie Gervais. Evaluating clients’ perceptions of the quality of head injury rehabilitation services: development and validation of a questionnaire. Brain Injury, 2003;17(7):575–587 <GO>

Previous Head Injury Is a Risk Factor for Subsequent
Head Injury in Children: A Longitudinal Cohort Study

Bonnie R. Swaine, PhD, Camille Tremblay, MSc, Robert W. Platt, PhD,
Guy Grimard, MD, Xun Zhang, PhD & I. Barry Pless, MD (2007)

  • Résumé
    • PEDIATRICS Vol. 119 No. 4 April 2007, pp. 749-758

      Objectives: The objective of this study was to determine whether children who sought care for a head injury were at greater risk of having a subsequent head injury within the following 6 and 12 months compared with children who sought care for an injury other than to the head.

      Design/Setting: This was a longitudinal cohort study conducted in the emergency departments of 2 Montreal (Quebec, Canada) pediatric hospitals.

      Participants: The parents of 11867 injured children aged 1 to 18 years were interviewed by telephone at 6 (n = 10315) and 12 (n = 9486) months after their child 's injury to ascertain outcome (ie, subsequent head injury) and to provide information on potential risk factors (age, gender, chronic medical condition, activity level, and socioeconomic status).

      Main Outcome Measure: The outcome of interest was a head injury requiring medical attention within the following year ascertained by parental recall or physician claims data.

      Results: A total of 245 and 386 previously head-injured children sustained a subsequent head injury within 6 and 12 months, respectively. Children who sought care for an initial head injury (n = 3599) were at higher risk of having a subsequent head injury within 6 months than children who sought care for an injury not to the head (n = 6716). The adjusted odds ratio suggested weak confounding by age, gender, and history of previous head injury. Results were consistent on the basis of physician claims data and 12-month follow-up interview data.

      Conclusions: These results provide evidence that having a head injury increases a child 's risk of having a subsequent head injury. Although age, gender, and history of previous head injury confound the relationship, the effect remains substantial.

      Key Words: children • recurrence • injury • head trauma • rehabilitation


Glenn Keays, MS; Bonnie Swaine, PhD; Debbie Ehrmann-Feldman, PhD

  • Résumé
    • Arch Pediatr Adolesc Med. 2006;160:812-816

      Objectives: To describe the frequency of subsequent injuries in children who were seen at an emergency department (ED) for a musculoskeletal injury and to explore factors associated with sustaining a subsequent injury within a year.

      Design: This was a prospective cohort study of children aged 1 through 17 years who sought care at an ED for an injury. Subsequent injuries were assessed through telephone interviews.

      Setting: Subjects were recruited from a national database of childhood injury after they presented to a hospital ED at 1 of the 2 pediatric trauma centers in Montreal, Quebec.

      Patients/Participants: A consecutive sample of 7640 children aged 1 through 17 years who sought care for a fracture or a soft-tissue injury to an arm or a leg; 6182 completed both telephone interviews (80.9% response rate).

      Main Exposure: Having a more severe injury was defined in 2 ways: (1) fracture of a limb or (2) injury that required follow-up or admission.

      Main Outcome: Measure Having a subsequent injury during 12-month follow-up.

      Results: Subjects with an index fracture were at lower risk of subsequent injury than were those with a soft-tissue injury (13.5% compared with 17.7%; adjusted odds ratio, 0.74; 95% confidence interval, 0.63-0.87). Subjects whose injury needed a follow-up were also at lower risk of subsequent injury than those whose injury was treated only in the ED (17.7% compared with 14.3%; adjusted odds ratio, 0.79; 95% confidence interval, 0.67-0.93) as were those who were admitted (17.7% compared with 8.7%; adjusted odds ratio, 0.51; 95% confidence interval, 0.26-0.99).

      Conclusions: Having had a severe musculoskeletal injury may be associated with a decreased risk of subsequent injury in children and adolescents. A possible explanation could be reduced exposure to risk.


Claudine Auger, Louise Demers and Bonnie Swaine

  • Résumé
    • Archives of Gerontology and Geriatrics, 2006;43:65-83.

      In geriatric rehabilitation, the selection of the most appropriate measurement tools involves pragmatic as well as psychometric considerations. However, there is no consensus about the conceptual and operational definitions of the pragmatic criteria involved in this selection. The objective of this research was to identify such operational criteria through a literature search between 1995 and 2004. Results identified operational criteria that were grouped under four categories using a conceptual mapping methodology: respondent burden, examiner burden, score distribution and format compatibility. We recommend the umbrella term applicability to refer to this grouping of pragmatic qualities of a measurement tool. Examining the applicability of measurement tools should assist clinicians and researchers in selecting the most appropriate for use in geriatric rehabilitation.

      Keywords: Applicability; Acceptability; Assessment; Feasibility; Geriatric rehabilitation


  • Résumé
    • Inj Prev 2005;11:186-190

      Objectives: (1) To determine the concordance between injury diagnoses (head injury (HI), probable HI, or orthopedic injury) for children visiting an emergency department for an injury using two data sources: an injury surveillance system (Canadian Hospitals Injury Research and Prevention Program, CHIRPP) and a physician billing claims database (Régie de l’assurance maladie de Québec, RAMQ), and (2) to determine the sensitivity and specificity of diagnostic and procedure codes in billing claims for identifying HI and orthopedic injury among children.

      Design: In this cross sectional cohort, data for 3049 children who sought care for an injury (2000–01) were obtained from both sources and linked using the child’s personal health insurance number.

      Methods: The physician recorded diagnostic codes from CHIRPP were used to categorize the children into three groups (HI, probable HI, and orthopedic), while an algorithm, using ICD-9-CM diagnostic and procedures codes from the RAMQ, was used to classify children into the same three groups.

      Results: Concordance between the data sources was "substantial " (weighted Kappa 0.66; 95% CI 0.63 to 0.69). The sensitivity of diagnostic and procedure codes in the RAMQ database for identifying HI and for orthopedic injury were 0.61 (95% CI 0.57 to 0.64) and 0.97 (95% CI 0.96 to 0.98), respectively. The specificity for identifying HI and for orthopedic injury were 0.97 (95% CI 0.96 to 0.98) and 0.58 (95% CI 0.56 to 0.63), respectively.

      Conclusion: Combining diagnostic and procedures codes in a physician billing claims database (the RAMQ database) may be a valid method of estimating injury occurrence among children.

      Abbreviations: CHIRPP, Canadian Hospitals Injury Research and Prevention Program; HI, head injury; RAMQ, Régie de l’assurance maladie de Québec.

      Keywords: injury surveillance; head injury; validity; medical service claims


Norms for 15- to 34-Year-Olds
for Different Versions of the Finger-to-Nose Test

Swaine BR, Desrosiers J, Bourbonnais D, Larochelle J-L

  • Résumé
    • Archives of Physical Medicine and Rehabilitation, 2005,86(8):1665-1669

      Objectives: To develop norms for the time to execute different versions of the finger-to-nose test (FNT) and to determine the effects of different testing procedures on performance in people aged 15 to 34 years.

      Design: Cross-sectional.

      Setting: Research center.

      Participants: Healthy subjects (149 men, 148 women; age range, 15–34y) participated, and 36 men and 36 women were included in each of the 4 age categories studied (15–19y, 20–24y, 25–29y, 30–34y). Participants performed, in random order, 5 forms of the test in 2 positions (sitting, supine) with the right and left upper limbs (ULs).

      Interventions: Not applicable.

      Main Outcome: Measure Time (in seconds) to complete 5 cycles of movement.

      Results: Test version and side of UL were found to affect performances; right-sided performances were faster than left-sided. Performances did not vary significantly (P>.001) with sex or among age categories; therefore, the results are presented for the group. Mean performances varied from 3.44 to 4.29 seconds. Subsequent analysis of variance (with data for each UL) showed main effects for testing position (sitting > lying) and eye condition (eyes open > eyes closed). Versions were strongly interrelated (.85<.98).

      Conclusions: Norms for the time to execute different FNT versions were developed for both ULs for healthy people ages 15 to 34 years.


  • Résumé
    • Brain Injury, Vol. 17, No. 7 (July 2003), 575–587)

      Objective: The objective of this research was to develop a tool to assess clients’ perception of the quality of head injury rehabilitation services.

      Methods and results: A questionnaire PQRS-Montreal 1.0 was developed in Montreal, Quebec using a standardized methodology that incorporated a new technique to reach consensus regarding the tool’s contents. Five dimensions of care (i.e. ecological approach, client-centred approach, accessibility, quality of the service providers and continuity) and their corresponding standards were identified as pertinent to include in the tool and were subsequently validated by experts. A phase of item generation followed that led to the development of an 87-item prototype of the questionnaire. The questionnaire is to be administered during an interview and employs a 5-point rating scale.

      Discussion and conclusion: The implications for the use of PQRS-Montreal 1.0 in the accreditation process of head injury rehabilitation services are discussed, as well as plans for future quantitative research in the development of the tool.


Date de création : 2014.01.27 @ 21:49
Dernière modification : 2014.01.27 @ 21:49
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